Search results for: service improvement

Authors: Manar Aslan, Ayse Yildiz

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The study was conducted descriptively to assess their hospital institutionalization of upper and mid-level managers of 18 hospitals affiliated to Public Hospitals Association. In its simplest form institutionalization is whatever the subject matter, is dominated by the rules of articulated and determined behavior in all kinds of business, interaction, and communication. Hospital service is a type of service carried out chained together. It should not be forgotten that this kind of services is carried out without barrier, and who and what to do with definite lines, hospital management is a process, and this process can be achieved through institutionalization. With the establishment of the Public Hospitals Unions in Turkey, all the state hospitals in the provinces have been gathered under this roof. One of the goals is to establish control mechanisms to ensure that hospitals reach pre-determined financial, medical, and administrative standards. In this way, the preparations for the institutionalization of units and hospital enterprises will be completed. The data of the study were collected by institutionalization management attitude scale (cronbach alpha: 0.98) of composed of 5 sub-dimensions and 52 questions in 18 hospitals’ managers (N=310) in the largest province in Turkey. The results of the study revealed that the total score taken by managers at the institutionalization scale was 200.80, and this was close to the maximum score. In addition, it was determined that the difference between the mean score of the scale and its sub-dimensions with the gender, the hospitals, and the management position.

Keywords: institutionalization, hospital, manager, evaluation

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Authors: Tahira Iram, Ahmad Raza Bilal

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In 2016, the Kingdom of Saudi Arabia (KSA) initiated Saudi Vision 2030, an ambitious plan to lessen the country's dependency on fossil fuels and increase economic diversification. The Vision 2030 framework strives to establish a thriving economy, a vibrant society, and an ambitious nation. This study aims to investigate the role of green service innovation (SI) and green work engagement (WE) in mediating the nexus between green HRM and green creativity (GC) under the conditional role of spiritual leadership (SL). A survey was done of 300 female intrepreneurs working in the organization within Saudi Arabia. This study has collected data via a stratified random sampling technique. The framework was tested using PLS-SEM software. The findings reveal that WE fully intervenes in the nexus between green HRM and GC. Moreover, SL positively moderates the nexus between green HRM and SI. Thus based on findings, it is recommended that female intrapreneurs prioritize environmentally responsible operations to gain and sustain a competitive edge over rivals in the Saudi competitive market.

Keywords: green HRM, spiritual leadership, Vision 2030, women intrapreneurs, green service innovation behavior, green creativity

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Authors: Saleem Rao, Mohammed Al-Ghadeer, Archan Banerjee, Hossein Fariborzi

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Materials imperfection, particularly two-level-system (TLS) defects in planer superconducting quantum circuits, contributes significantly to decoherence, ultimately limiting the performance of quantum computation and sensing. Oxides at air interfaces are among the host of TLS, and different material has been used to reduce TLS losses. Passivation with an inorganic layer is not an option to reduce these interface oxides; however, they can be etched away, but their regrowth remains a problem. Here, we report the chemisorption of molecular self-assembled monolayers (SAMs) at air interfaces of superconducting co-planer waveguide (CPW) resonators that suppress the regrowth of oxides and also modify the dielectric constant of the interface. With SAMs, we observed sustained order of magnitude improvement in quality factor -better than oxide etched interfaces. Quality factor measurements at millikelvin temperature and at single photon, XPS data, and TEM images of SAM passivated air interface sustenance our claim. Compatibility of SAM with micro-/nano-fabrication processes opens new ways to improve the coherence time in cQED.

Keywords: superconducting circuits, quality-factor, self-assembled monolayer, coherence

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Authors: Ana Maria Girotti Sperandio, Jussara Conceição Guarnieri, Lauro Luiz Francisco Filho, Ana Claudia Martins Alves, Adriana Aparecida Carneiro Rosa

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The urban planning of a city should contemplate the construction of healthy spaces to provide quality of life for people. In a Brazilian municipality located 180 km from the capital of São Paulo with around 27,000 thousand inhabitants, the federal government made possible a program that allows the improvement of the quality of life of the inhabitants through the practice of physical activity. To describe health promotion strategies in the city that collaborate in the reduction of chronic non-communicable diseases (CDNT) and the improvement the quality of its residents. Considering the CDNT as a fundamental public health concern in different countries, the methodology of this work considered the different actions of health promotion that occurred in the city for the implementation of the Polo Health Academy with the objective of increasing the population's access to places that could develop targeted physical activities. As an instrument, it used records of participants of this academy such as: assessment sheets, evolution, photos, filming and daily reports of physical activities. Results: The implantation and implementation process of the Polo Health Academy in the city of Conchal / SP / Brazil was in accordance with the principles and values of the National Health Promotion Policy (PNaPS) in Brazil and with the city statute, that provides improvement in the quality of life of the Brazilian population. An increase was observed in the number of participants in different hours practicing physical activities in the territory linked to one of the five Health Units, showing the program provides that happiness and well-being to the students. The Brazilian health promotion policy, combined with the city’s development policy, provides the population with access to programs that stimulate the reduction of CDNTs, confirming the urban planning of a healthy city.

Keywords: health city, health promotion, physical activity, urban planning

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Authors: Masashi Kanazawa, Takaaki Nakano, Masaaki Takemoto, Tomonori Imamura, Mamiko Sugimura, Toshitaka Ito

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Introduction: We experienced a massive disaster due to inhalation of water-soluble paint. Sixteen patients were brought to our emergency room, and pulmonary edema was revealed on the CT images of 12 cases. Purpose: Transition of chest CT-scan findings in cases with pulmonary edema was examined. Method: CT-scans were performed on the 1st, 2nd, 5th, and 19th days after the inhalation event. Patients whose pulmonary edema showed amelioration or exacerbation were classified into the improvement or the exacerbation group, respectively. Those with lung edema findings appearing at different sites after the second day were classified into the changing group. Results: Eight, one and three patients were in the improvement, exacerbation and changing groups, respectively. In all cases, the pulmonary edema had disappeared from CT images on the 19th day after the inhalation event. Conclusion: Inhalation of water-soluble paints is considered to be relatively safe. However, our observations in these emergency cases suggest that, even if pulmonary edema is not severe immediately after the exposure, new lesions may appear later and existing lesions may worsen. Follow-up imaging is thus necessary for about two weeks.

Keywords: CT scan, intoxication, pulmonary edema, water-soluble paint

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Authors: Tarek M. Ahmed, Ahmed S. El Mesalamy, Amro M. Youssef, Tawfik T. El Midany

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Abrasive waterjet (AWJ) machining is considered as one of the most powerful cutting processes. It can be used for cutting heat sensitive, hard and reflective materials. Aluminum 2024 is a high-strength alloy which is widely used in aerospace and aviation industries. This paper aims to improve aluminum alloy and to investigate the effect of AWJ control parameters on surface geometry quality. Design of experiments (DoE) is used for establishing an experimental matrix. Statistical modeling is used to present a relation between the cutting parameters (pressure, speed, and distance between the nozzle and cut surface) and responses (taper angle and surface roughness). The results revealed a tangible improvement in productivity by using AWJ processing. The taper kerf angle can be improved by decreasing standoff distance and speed and increasing water pressure. While decreasing (cutting speed, pressure and distance between the nozzle and cut surface) improve the surface roughness in the operating window of cutting parameters.

Keywords: abrasive waterjet machining, machining of aluminum alloy, non-traditional cutting, statistical modeling

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Authors: Muhammad Yusuf, Abdul Latief Toleng, Djoni Prawira Rahardja, Ambo Ako, Sahiruddin Sahiruddin, Abdi Eriansyah

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The objective of this study was to know the reproductive performance of dairy cows at different parities. A total of 60 dairy Holstein-Friesian cows with parity one to three from five small farms raised by the farmers were used in the study. All cows were confined in tie stall barn with rubber on the concrete floor. The herds were visited twice for survey with the help of a questionnaire. Reproductive parameters used in the study were days open, calving interval, and service per conception (S/C). The results of this study showed that the mean (±SD) days open of the cows in parity 2 was slightly longer than those in parity 3 (228.2±121.5 vs. 205.5±144.5; P=0.061). None cows conceived within 85 days postpartum in parity 3 in comparison to 13.8% cows conceived in parity 2. However, total cows conceived within 150 days post partum in parity 2 and parity 3 were 30.1% and 36.4%, respectively. Likewise, after reaching 210 days after calving, number of cows conceived in parity 3 had higher than number of cows in parity 2 (72.8% vs. 44.8%; P<0.05). The mean (±SD) calving interval of the cows in parity 2 and parity 3 were 508.2±121.5 and 495.5±144.1, respectively. Number of cows with calving interval of 400 and 450 days in parity 3 was higher than those cows in parity 2 (23.1% vs. 17.2% and 53.9% vs. 31.0%). Cows in parity 1 had significantly (P<0.01) lower number of S/C in comparison to the cows with parity 2 and parity 3 (1.6±1.2 vs. 3.5±3.4 and 3.3±2.1). It can be concluded that reproductive performance of the cows is affected by different parities.

Keywords: dairy cows, parity, days open, calving interval, service per conception

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Authors: Harold Jideofor Nnachetam

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Maintenance management in Nigeria Polytechnic faced many issues due to poor service delivery, inadequate finance, and poor maintenance plan and maintenance backlogs. The purpose of this study is to improve the conventional method practices which tend to be ineffective in Nigeria Polytechnic. The case study was conducted with eight Polytechnics in Nigeria. The selected Polytechnic is based on conventional method practices and its major problems, attempt to implement computerized technology and the willingness of staff to share their experiences. All feedbacks from respondents through semi-structured interview were recorded using video camera and transcribed verbatim. The overall findings of this research indicated; poor service delivery, inadequate financial, poor maintenance planning and maintenance backlogs. There is also need to overcome less man power competencies of maintenance management practices which existed with all eight Polytechnics. In addition, the study also found that the Polytechnics still use conventional maintenance management processes in managing building facility condition. As a result, the maintenance management staff was not able to improve the maintenance management performance at the Polytechnics. The findings are intended to be used for maintenance management practices at Nigeria Polytechnics in order to provide high-quality of building facility with safe and healthy environments.

Keywords: maintenance management, conventional method, maintenance management system, Nigeria polytechnic

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Authors: Fernando Araujo, Sandra Cardoso, Fátima Fonseca, Sandra Cavaca

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A debureaucratization strategy for the Portuguese Health Service was assumed by the Executive Board of the SNS, in deep articulation with the Shared Services of the Ministry of Health. Two of the main dimensions were focused on sick leaves (SL), that transform primary health care (PHC) in administrative institutions, limiting access to patients. The self-declaration of illness (SDI) project, through the National Health Service Contact Centre (SNS24), began on May 1, 2023, and has already resulted in the issuance of more than 300,000 SDI without the need to allocate resources from the National Health Service (NHS). This political decision allows each citizen, in a maximum 2 times/year, and 3 days each time, if ill, through their own responsibility, report their health condition in a dematerialized way, and by this way justified the absence to work, although by Portuguese law in these first three days, there is no payment of salary. Using a digital approach, it is now feasible without the need to go to the PHC and occupy the time of the PHC only to obtain an SL. Through this measure, bureaucracy has been reduced, and the system has been focused on users, improving the lives of citizens and reducing the administrative burden on PHC, which now has more consultation times for users who need it. The second initiative, which began on March 1, 2024, allows the SL to be issued in emergency departments (ED) of public hospitals and in the health institutions of the social and private sectors. This project is intended to allow the user who has suffered a situation of acute urgent illness and who has been observed in an ED of a public hospital or in a private or social entity no longer need to go to PHC only to apply for the respective SL. Since March 1, 54,453 SLs have been issued, 242 in private or social sector institutions and 6,918 in public hospitals, of which 134 were in ED and 47,292 in PHC. This approach has proven to be technically robust, allows immediate resolution of problems and differentiates the performance of doctors. However, it is important to continue to qualify the proper functioning of the ED, preventing non-urgent users from going there only to obtain SL. Thus, in order to make better use of existing resources, it was operationalizing this extension of its issuance in a balanced way, allowing SL to be issued in the ED of hospitals only to critically ill patients or patients referred by INEM, SNS24, or PHC. In both cases, an intense public campaign was implemented to explain the way it works and the benefits for patients. In satisfaction surveys, more than 95% of patients and doctors were satisfied with the solutions, asking for extensions to other areas. The administrative simplification agenda of the NHS continues its effective development. For the success of this debureaucratization agenda, the key factors are effective communication and the ability to reach patients and health professionals in order to increase health literacy and the correct use of NHS.

Keywords: debureaucratization strategy, self-declaration of illness, sick leaves, SNS24

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Authors: T. Suleiman, C. Mchugh, H. Ranu

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Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.

Keywords: asthma, nurse specialist, clinical audit, quality improvement

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Authors: Shyamlal Kumawat

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Cloud computing is shifting the approach IT capital are utilized. Cloud computing dynamically delivers convenient, on-demand access to shared pools of software resources, platform and hardware as a service through internet. The cloud computing model—made promising by sophisticated automation, provisioning and virtualization technologies. Users want the ability to access these services including infrastructure resources, how and when they choose. To accommodate this shift in the consumption model technology has to deal with the security, compatibility and trust issues associated with delivering that convenience to application business owners, developers and users. Absent of these issues, trust has attracted extensive attention in Cloud computing as a solution to enhance the security. This paper proposes a trusted computing technology through Standard Resource parameter Based Trust Model in Cloud Computing to select the appropriate cloud service providers. The direct trust of cloud entities is computed on basis of the interaction evidences in past and sustained on its present performances. Various SLA parameters between consumer and provider are considered in trust computation and compliance process. The simulations are performed using CloudSim framework and experimental results show that the proposed model is effective and extensible.

Keywords: cloud, Iaas, Saas, Paas

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Authors: Jagdeep Nayak, Biswajit Paul, Anup Gupta

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Characterization of coal refuses to fly ash, and steel slag from steel industries have been performed to develop a mixture of both these materials to enhance strength properties of their utilization in other sectors like mine fill, construction work, etc. A large amount of Linz-Donawitz (LD) slag and fly ash waste are generated from steel and thermal power industries respectively. Management of these wastes is problematic, and their reutilization may provide a sustainable waste management option. LD slag and fly ash mixed in different proportions were tested to analyse the micro structural improvement and hardening rate of the matrix. Mixing of activators such as sodium hydroxide and potassium silicate with silica-alumina of LD slag-fly ash mixture, geopolymeric structure were found to be developed. The effect of geo-polymerization behaviour and subsequent structural rearrangement has been studied using compressibility; shear strength and permeability tests followed by micro-graphical analysis. Densification in the mixture was observed along with an improvement of geotechnical properties due to the addition of LD slag. Due to suitable strength characteristics of these two waste materials as mixture, it can be used in the various construction field or may be used as a filling material in mine voids.

Keywords: LD slag, fly-ash, geopolymer, strength property, compressibility

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Authors: Muhamad Azani Yahya, Umi Nadiah Nor Ali, Mohammed Alias Yusof, Norazman Mohamad Nor, Vikneswaran Munikanan

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In construction, concrete is one of the materials that can commonly be used as for structural elements. Concrete consists of cement, sand, aggregate and water. Concrete can be added with admixture in the wet condition to suit the design purpose such as to prolong the setting time to improve workability. For strength improvement, concrete is being added with other hybrid materials to increase strength; this is because the tensile strength of concrete is very low in comparison to the compressive strength. This paper shows the usage of a waterproofing agent in concrete to enhance the tensile strength. High tensile concrete is expensive because the concrete mix needs fiber and also high cement content to be incorporated in the mix. High tensile concrete being used for structures that are being imposed by high impact dynamic load such as blast loading that hit the structure. High tensile concrete can be defined as a concrete mix design that achieved 30%-40% tensile strength compared to its compression strength. This research evaluates the usage of a waterproofing agent in a concrete mix as an element of reinforcement to enhance the tensile strength. According to the compression and tensile test, it shows that the concrete mix with a waterproofing agent enhanced the mechanical properties of the concrete. It is also show that the composite concrete with waterproofing is a high tensile concrete; this is because of the tensile is between 30% and 40% of the compression strength. This mix is economical because it can produce high tensile concrete with low cost.

Keywords: high tensile concrete, waterproofing agent, concrete, rheology

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Authors: Maureen Gibney

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The examination of narrative in psychology has a long tradition, starting with psychoanalytic theory and embracing over time cognitive, social, and personality psychology, among others. Narrative use has been richly detailed as well in medicine, nursing, and social service. One aspect of narrative that has ready utility in higher education and in clinical work is the exploration of suffering and its meaning. Because it is such a densely examined topic, suffering provides a window into identity, sense of purpose, and views of humanity and of the divine. Storytelling analysis permits an exploration of a host of specific manifestations of suffering such as pain and illness, moral injury, and the impact of prolonged suffering on love and relationships. This presentation will review the origins and current understandings of narrative theory in general, and will draw from psychology, medicine, ethics, nursing, and social service in exploring the topic of suffering in particular. It is suggested that the use of narrative themes such as meaning making, agency and communion, generativity, and loss and redemption allows for a finely grained analysis of common and more atypical sources of suffering, their resolution, and the acceptance of their continuation when resolution is not possible. Such analysis, used in professional work and in higher education, can enrich one’s empathy and one’s sense of both the fragility and strength of everyday life.

Keywords: meaning making, narrative theory, suffering, teaching

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Authors: Meltem Nur Erdöl, Feyzanur Bayrak, Elif Emanetçi, Faik Nüzhet Oktar, Cevriye Kalkandelen, Oğuzhan Gündüz

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Nowadays, the bioceramic graft applications are very important due to the fact that especially European population is getting much older. Consequently, healing approaches for some health problems become more important in the near future. For instance, osteoporosis is one of the reasons for serious hip fractures. Beside these, the traffic accidents playing role increasing of various hip fractures and other bone fractures. Naturally all these are leading the importance developing new bioceramic graft materials. Hydroxyapatite (HA) is one of the leading bioceramics on the market. Beside the high biocompatibility HA bioceramics unfortunately are weak materials for loaded areas. For improvement mechanical properties of HA material, some oxides and metallic powders can be added. In this study, some rare earth oxides like hafnium (IV) oxide (HfO₂) and samarium (III) oxide (Sm₂O₃) are added to HA for improvement of their material characteristics. Thus, compression, microhardness and theoretical density tests are performed. X-ray diffraction patterns are also investigated corresponding x-ray diffraction equipment. At the end, studies of scanning electron microscope (SEM) and energy-dispersive x-ray spectroscopy (EDX) are completed. All values were compared with past BHA and various composites.

Keywords: biocomposite, hafnium oxide, hydroxyapatite, nanotechnology, samarium oxide

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Authors: Harihara Prakash Ramanathan, Daksha Mishra, Ankita Dhaduk

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Relevance: This qualitative study will educate the clinician in putting into practice the advanced method of movement science in restoring the function. Purpose: The purpose of this study is to compare the effectiveness of Active Release Technique and myofascial release technique on range of motion, neck function and pain in patients with upper trapezius spasm. Methods/Analysis: The study was approved by the institutional Human Research and Ethics committee. This study included sixty patients of age group between 20 to 55 years with upper trapezius spasm. Patients were randomly divided into two groups receiving Active Release Technique (Group A) and Myofascial Release Technique (Group B). The patients were treated for 1 week and three outcome measures ROM, pain and functional level were measured using Goniometer, Visual analog scale(VAS), Neck disability Index Questionnaire(NDI) respectively. Paired Sample 't' test was used to compare the differences of pre and post intervention values of Cervical Range of motion, Neck disability Index, Visual analog scale of Group A and Group B. Independent't' test was used to compare the differences between two groups in terms of improvement in cervical range of motion, decrease in visual analogue scale(VAS), decrease in Neck disability index score. Results: Both the groups showed statistically significant improvements in cervical ROM, reduction in pain and in NDI scores. However, mean change in Cervical flexion, cervical extension, right side flexion, left side flexion, right side rotation, left side rotation, pain, neck disability level showed statistically significant improvement (P < 0. 05)) in the patients who received Active Release Technique as compared to Myofascial release technique. Discussion and conclusions: In present study, the average improvement immediately post intervention is significantly greater as compared to before treatment but there is even more improvement after seven sessions as compared to single session. Hence, this proves that several sessions of Manual techniques are necessary to produce clinically relevant results. Active release technique help to reduce the pain threshold by removing adhesion and promote normal tissue extensibility. The act of tensioning and compressing the affected tissue both with digital contact and through the active movement performed by the patient can be a plausible mechanism for tissue healing in this study. This study concluded that both Active Release Technique (ART) and Myofascial release technique (MFR) are equally effective in managing upper trapezius muscle spasm, but more improvement can be achieved by Active Release Technique (ART). Impact and Implications: Active Release Technique can be adopted as mainstay of treatment approach in treating trapezius spasm for faster relief and improving the functional status.

Keywords: trapezius spasm, myofascial release, active release technique, pain

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Authors: Zohreh Asadi-Shekari, Mehdi Moeinaddini, Muhammad Zaly Shah, Amran Hamzah

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Bicycle level of service (BLOS) is a measure for evaluating street conditions for cyclists. Currently, various methods are proposed for BLOS. These analytical methods however have some drawbacks: they usually assume cyclists as users that can share street facilities with motorized vehicles, it is not easy to link them to design process and they are not easy to follow. In addition, they only support a narrow range of cycling facilities and may not be applicable for all situations. Along this, the current paper introduces various effective design factors for bicycle-friendly streets. This study considers cyclists as users of streets who have special needs and facilities. Therefore, the key factors that influence BLOS based on different cycling facilities that are proposed by developed guidelines and literature are identified. The combination of these factors presents a complete set of effective design factors for bicycle-friendly streets. In addition, the weight of each factor in existing BLOS models is estimated and these effective factors are ranked based on these weights. These factors and their weights can be used in further studies to propose special bicycle-friendly street design model.

Keywords: bicycle level of service, bicycle-friendly streets, cycling facilities, rating system, urban streets

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Authors: Zhanara B. Suleimenova, Zhazira K. Saduyeva

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Filamentous fungi are major producers of enzymes that have important applications in the food and beverage industries. The overall objective of this research is a strain improvement technology for efficient industrial enzymes production. The new way of filamentous fungi cultivation method has been developed. Such technology prolong producers’ cultivation period up to 60 days and create the opportunity to obtain enzymes repeatedly in every 2-3 days of fungal cultivation. This method is based on immobilizing enzymes producers with solid support in submerged conditions of growth. Immobilizing has a range of advantages: Decreasing the price of the final product, absence of foreign substances, controlled process of enzyme-genesis, ability of various enzymes simultaneous production, etc. Design of proposed technology gives the opportunity to increase the activity of immobilized cells culture filtrate comparing to free cells, growing in periodic culture conditions. Thus, proposed research focuses on new, more versatile, microorganisms capable of squeezing more end-products as well as proposed cultivation technology led to increased enzymatic productivity by several times.

Keywords: filamentous fungi, immobilization, industrial enzymes production, strain improvement

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Authors: Levan Sabauri

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Audit is an independent inspection of the financial statement of the audited person and expresses the opinion of an auditor on the reliability of this statement. The auditor’s activity (auditor’s service) is realized by auditing organizations, individual auditors in connection to conduction of an audit and rendering of audit accompanying services. The profession of auditor means a high level of responsibility for rendered service. Results of decisions made by information users depend on the quality of the auditor’s conclusion. Owners, investors, creditors, and society rely on the opinion of the auditor under the condition that inspection was conducted with good quality. Therefore, the existence of the well-functioning audit quality control system for the administering of the audit is an important issue. An efficient audit quality control system is a substantial challenge that many countries face worldwide, especially those states where these systems are being formed within the respective reform program. The presented article reflects on the best practices of the leading countries, the assumptions and recommendations for the financial accounting, reporting and audit; current reforms in Georgia are made based on this comparative analysis.

Keywords: audit quality control, audit program, financial statement, perspective analysis

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Authors: Maria L. Ulloa, Ruth M. Crawford, Stephanie Kelly, Joey Domdom

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In recent decades health and social service delivery have become more collaborative and interdisciplinary. Emerging trends suggest the need for an integrative and interprofessional approach to meet the challenges faced by professionals navigating the complexities of health and social service practice environments. Terms such as multidisciplinary practice, interprofessional collaboration, interprofessional education and transprofessional practice have become the common language used across a range of social services and health providers in western democratic systems. In Aotearoa New Zealand, one example of an interprofessional collaborative approach to curriculum design and delivery in health and social service is the development of an innovative Masters of Professional Practice programme. This qualification is the result of a strategic partnership between two tertiary institutions – Whitireia New Zealand (NZ) and the Wellington Institute of Technology (Weltec) in Wellington. The Master of Professional Practice programme was designed and delivered from the perspective of a collaborative, interprofessional and relational approach. Teachers and students in the programme come from a diverse range of cultural, professional and personal backgrounds and are engaged in courses using a blended learning approach that incorporates the values and pedagogies of interprofessional education. Students are actively engaged in professional practice while undertaking the programme. This presentation describes the themes of exploratory qualitative formative observations of engagement in class and online, student assessments, student research projects, as well as qualitative interviews with the programme teaching staff. These formative findings reveal the development of critical practice skills around the common themes of the programme: research and evidence based practice, education, leadership, working with diversity and advancing critical reflection of professional identities and interprofessional practice. This presentation will provide evidence of enhanced learning experiences in higher education and learning in multi-disciplinary contexts.

Keywords: diversity, exploratory research, interprofessional education, professional identity

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Authors: Sabrina N. Jafralie, Arzina Zaver

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Responding to religious diversity and the need for social change, the Ethics and Religious Culture (ERC) Program was introduced as a mandatory subject for all students in Quebec, Canada. Now that the Quebec provincial government has announced the end of the ERC program, it time to discuss and assess both challenges and successes in it's implementation especially its impact on social change. Though many studies have been written around the wider concepts of religious education and religious literacy in the public system, few studies have included voices from educators. Jafralie and Zaver's qualitative research study examines the potentials and struggles of the ERC Program, and by doing so, raise important considerations around the effective teaching of.  The findings point to several consistent themes that teachers grapple with in regards to curriculum and pedagogy and highlights that in-service teachers are not thoroughly prepared to teach about ethics and religion, nor are teacher education programs effectively preparing pre-service teachers entering the field to deal with the complexities of teaching about religion or social change in their classrooms. The authors suggest avenues in which teacher education for teachers can look like in order for students and teachers to engage meaningfully with religious diversity and be agents of social change. 

Keywords: Pedagogy, Professional Development, Quebec, Teaching

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Authors: Muhammad Muhammad Suleiman

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Cloud Computing is a versatile concept that refers to a service that allows users to outsource their data without having to worry about local storage issues. However, the most pressing issues to be addressed are maintaining a secure and reliable data repository rather than relying on untrustworthy service providers. In this study, we look at how stenography approaches and collaboration with Digital Watermarking can greatly improve the system's effectiveness and data security when used for Cloud Computing. The main requirement of such frameworks, where data is transferred or exchanged between servers and users, is safe data management in cloud environments. Steganography is the cloud is among the most effective methods for safe communication. Steganography is a method of writing coded messages in such a way that only the sender and recipient can safely interpret and display the information hidden in the communication channel. This study presents a new text steganography method for hiding a loaded hidden English text file in a cover English text file to ensure data protection in cloud computing. Data protection, data hiding capability, and time were all improved using the proposed technique.

Keywords: cloud computing, steganography, information hiding, cloud storage, security

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Authors: Kouzi Katia

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This paper proposes a Direct Torque Control (DTC) algorithm of dual Stator Induction Motor (DSIM) drive using two approach intelligent techniques: Artificial Neural Network (ANN) approach replaces the switching table selector block of conventional DTC and Mamdani Fuzzy Logic controller (FLC) is used for stator resistance estimation. The fuzzy estimation method is based on an online stator resistance correction through the variations of stator current estimation error and its variation. The fuzzy logic controller gives the future stator resistance increment at the output. The main advantage of suggested algorithm control is to reduce the hardware complexity of conventional selectors, to avoid the drive instability that may occur in certain situation and ensure the tracking of the actual of the stator resistance. The effectiveness of the technique and the improvement of the whole system performance are proved by results.

Keywords: artificial neural network, direct torque control, dual stator induction motor, fuzzy logic estimator, switching table

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Authors: Siphesihle Hlongwane

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Background: Globally, alcohol consumption, smoking, and the use of illicit drugs kill more than 11.8 million people each year. In sub-Saharan Africa, substance abuse is responsible for more than 6.4% of all deaths recorded and about 4.7% of all Disability Adjusted Life Years (DALYs), with numbers still expected to grow if no drastic measures are taken to curb and address drug use. In a setting where substance use is rife, understanding contextual factors that influence an individual’s perceived eligibility to seek rehabilitation is paramount. Using the candidacy framework, we unpack how situational factors influence an individual’s perceived eligibility for healthcare uptake in adolescents and youth with substance use disorder (SUD). Methods: The candidacy framework is concerned with how people consider their eligibility for accessing a health service. The study collected and analyzed primary qualitative data to answer the research question. Data were collected between January and July 2022 on participants aged between 18 and 35 for drug users and 18 to 60 for family members. Participants include 20 previous and current drug users and 20 family members that experience the effects of addiction. A pre-drafted semi-structured interview guide was administered to a conveniently sampled population supplemented with a referral sampling method. Data were thematically analyzed using the NVivo 12pro software to manage the data. Findings: Our findings show that people with substance use disorders are aware of their drug use habits and acknowledge their candidacy for health services. Candidacy for health services is also acknowledged by those around them, such as family members and peers, and as such, information on the navigation of health services for drug users is shared by those who have attended health services, those affected by drug use, and this includes health service research by family members to identify accessible health services. While participants reported willingness to quit drug use if assistance is provided, the permeability of health care services is hindered by both individual determinations to quit drug use from long-time use and the availability of health services for drug users, such as rehabilitation centers. Our findings also show that drug users are conscious and can articulate their ailments; however, the hunt for the next dose of drugs and long waiting cues for health service acquisition overshadows their claim to health services. Participants reported a mixture of treatments prescribed, with some more gruesome than others prescribed, thus serving as both a facilitator and barrier for health service uptake. Despite some unorthodox forms of treatments prescribed in health care, the majority of those who enter treatment complete the process of treatment, although some are met with setbacks and sometimes relapse after treatment has finished. Conclusion: Drug users are able to ascertain their candidacy for health services; however, individual and environmental characteristics relating to drug use hinder the use of health services. Drug use interventions need to entice health service uptake as a way to improve candidacy for health use.

Keywords: substance use disorder, rehabilitation, drug use, relapse, South Africa, candidacy framework

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Authors: Jun-Ho Park, Kwang-Woo Nam, Seung-Mo Hong, Tae-Heon Moon, Sang-Ho Lee, Youn-Taik Leem

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The aim of this study was to build ‘Ubi-Net’, a decision-making support system for systematic establishment in U-City planning. We have experienced various urban problems caused by high-density development and population concentrations in established urban areas. To address these problems, a U-Service contributes to the alleviation of urban problems by providing real-time information to citizens through network connections and related information. However, technology, devices, and information for consumers are required for systematic U-Service planning in towns and cities where there are many difficulties in this regard, and a lack of reference systems. Thus, this study suggests methods to support the establishment of sustainable planning by providing comprehensive information including IT technology, devices, news, and social networking services(SNS) to U-City planners through intelligent searches. In this study, we targeted Smart U-Parking Planning to solve parking problems in an ‘old’ city. Through this study, we sought to contribute to supporting advances in U-Space and the alleviation of urban problems.

Keywords: desigin and decision support system, smart u-parking planning, social network analysis, urban engineering

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Authors: Sandra Cardoso, Gaspar Pais, Judite Neves, Sandra Cavaca, Fernando Araújo

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In 2021, Portugal has 63 emergency department (ED) visits per 100 people annually, the highest numbers in Europe. While EDs provide a critical service, high use is indicative of inappropriate and inefficient healthcare. In Portugal, all ED have the Manchester Triage System (MTS), a clinical risk management tool to enable that patients are seen in order of clinical priority. In 2023, more than 40% of the ED visits were of non-urgent conditions (blue and green), that could be better managed in primary health care (PHC), meaning wrong use of resources and lack of health literacy. From 2017, the country has a phone line, SNS24 (Contact Centre of the National Health Service), for triage, counseling, and referral service, 24 hours/7 days a week. The pilot project ‘Call before, save lives’ was implemented in the municipalities of Póvoa de Varzim and Vila do Conde (around 150.000 residents), in May 2023, by the executive board of the Portuguese Health Service, with the support of the Shared Services of the Ministry of Health, and local authorities. This geographical area has short travel times, 99% of the population a family doctor and the region is organized in a health local unit (HLU), integrating PHC and the local hospital. The purposes of this project included to increase awareness to contact SNS 24, before going to an ED, and non-urgent conditions oriented to a family doctor, reducing ED visits. The implementation of the project involved two phases, beginning with: i) development of campaigns using local influencers (fishmonger, model, fireman) through local institutions and media; ii) provision of telephone installed on site to contact SNS24; iii) establishment of open consultation in PHC; iv) promotion of the use of SNS24; v) creation of acute consultations at the hospital for complex chronic patients; and vi) direct referral for home hospitalization by PHC. The results of this project showed an excellent level of access to SNS24, an increase in the number of users referred to ED, with great satisfaction of users and professionals. The second phase, initiated in January 2024, for access to the ED, the need for prior referral was established as an admission rule, except for certain situations, as trauma patients. If the patient refuses, their registration in the ED and subsequent screening in accordance with the MTS must be ensured. When the patient is non-urgent, shall not be observed in the ED, provided that, according to his clinical condition, is guaranteed to be referred to PHC or to consultation/day hospital, through effective scheduling of an appointment for the same or the following day. In terms of results, 8 weeks after beginning of phase 2, we assist of a decrease in self-reported patients to ED from 59% to 15%, and a reduction of around 7% of ED visits. The key for this success was an effective public campaign that increases the knowledge of the right use of the health system, and capable of changing behaviors.

Keywords: contact centre of the national health service, emergency department visits, public campaign, health literacy, SNS24

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Authors: Md Asif Imrul, Maria Rafique, M. Habibur Rahman

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The study deals with an investigation into the impact of the relocation of tannery industry on water quality parameters of Buriganga. For this purpose, previous records have been collected from authentic data resources and for the attainment of present values, several samples were collected from three major locations of the Buriganga River during summer and winter seasons in 2018 to determine the distribution and variation of water quality parameters. Samples were collected six ft below the river water surface. Analysis indicates slightly acidic to slightly alkaline (6.8-7.49) in nature. Bio-Chemical Oxygen Demand, Total Dissolved Solids, Total Solids (TS) & Total Suspended Solids (TSS) have been found greater in summer. On the other hand, Dissolved Oxygen is found greater in rainy seasons. Relocation shows improvement in water quality parameters. Though the improvement related to relocation of tannery industry is not adequate to turn the water body to be an inhabitable place for aquatic lives.

Keywords: Buriganga river, river pollution, tannery industry, water quality parameters

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Authors: Chiyoung Kim, Jaegeol Yim

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Bus service is often either main or the only public transportation available in cities. In metropolitan areas, both subways and buses are available whereas in the medium sized cities buses are usually the only type of public transportation available. Bus Information Systems (BIS) provide current locations of running buses, efficient routes to travel from one place to another, points of interests around a given bus stop, a series of bus stops consisting of a given bus route, and so on to users. Thanks to BIS, people do not have to waste time at a bus stop waiting for a bus because BIS provides exact information on bus arrival times at a given bus stop. Therefore, BIS does a lot to promote the use of buses contributing to pollution reduction and saving natural resources. BIS implementation costs a huge amount of budget as it requires a lot of special equipment such as road side equipment, automatic vehicle identification and location systems, trunked radio systems, and so on. Consequently, medium and small sized cities with a low budget cannot afford to install BIS even though people in these cities need BIS service more desperately than people in metropolitan areas. It is possible to provide BIS service at virtually no cost under the assumption that everybody carries a smartphone and there is at least one person with a smartphone in a running bus who is willing to reveal his/her location details while he/she is sitting in a bus. This assumption is usually true in the real world. The smartphone penetration rate is greater than 100% in the developed countries and there is no reason for a bus driver to refuse to reveal his/her location details while driving. We have developed a mobile app that periodically reads values of sensors including GPS and sends GPS data to the server when the bus stops or when the elapsed time from the last send attempt is greater than a threshold. This app detects the bus stop state by investigating the sensor values. The server that receives GPS data from this app has also been developed. Under the assumption that the current locations of all running buses collected by the mobile app are recorded in a database, we have also developed a web site that provides all kinds of information that most BISs provide to users through the Internet. The development environment is: OS: Windows 7 64bit, IDE: Eclipse Luna 4.4.1, Spring IDE 3.7.0, Database: MySQL 5.1.7, Web Server: Apache Tomcat 7.0, Programming Language: Java 1.7.0_79. Given a start and a destination bus stop, it finds a shortest path from the start to the destination using the Dijkstra algorithm. Then, it finds a convenient route considering number of transits. For the user interface, we use the Google map. Template classes that are used by the Controller, DAO, Service and Utils classes include BUS, BusStop, BusListInfo, BusStopOrder, RouteResult, WalkingDist, Location, and so on. We are now integrating the mobile app system and the web app system.

Keywords: bus information system, GPS, mobile app, web site

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Authors: Attiq Ur Rahman Dogar, Sohaib Ishaq

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Pakistan had experienced rapid motorization in the last decade. Due to the soft leasing schemes of banks and increase in average household income, even the middle class can now afford cars. The public transit system is inadequate and sparse. Due to these reasons, traffic demand on urban arterials has increased manifold. Poor urban transit planning and aging transportation systems have resulted in traffic congestion. The focus of this study is to improve traffic flow on a section of N-5 passing through the Rawalpindi downtown. Present efforts aim to carry out the analysis of traffic conditions on this section and to investigate the impact of traffic signal co-ordination on travel time. In addition to signal co-ordination, we also examined the effect of different infrastructure improvements on the travel time. After the economic analysis of alternatives and discussions, the improvement plan for Rawalpindi downtown urban arterial section is proposed for implementation.

Keywords: signal coordination, infrastructure intervention, infrastructure improvement, cycle length, fuel consumption cost, travel time cost, economic analysis, travel time, Rawalpindi, Pakistan, traffic signals

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Authors: Debasish Chowdhury, Sunil Mekale, Sarvanamurthy Sakthivel, Sukhvinder Kaur, Rambabu Khambampati, Ashok Agarwal

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Introduction: The migrant intervention in India was initiated during the National AIDS Control Program (NACP) Phase-2 (2002-2007). HIV Sentinel surveillance Studies (HSS) conducted in 2012-13 indicated higher HIV prevalence among migrants (0.99%) compared to general populations (0.35%). Migrants continue to bear a heightened risk of HIV infection which results from the condition and structure of the migration process. USAID PHFI-PIPPSE project in collaboration with the National AIDS Control Organization (NACO) developed a unique system called Migrant Service Delivery System (MSDS) to capture migrants profile with respect to their risk profile and to provide tailor made services to them. Description: MSDS is a web-based system, designed and implemented to increase service uptake among migrants through evidence based planning. 110 destination migrants Targeted Intervention (TI) from 11 states were selected for study with varied target populations in terms of occupations; to understand occupation related risk behaviors among the migrants. Occupation wise registration data of high risk vulnerable migrants were analyzed through MSDS for the period April 2014–June 2016. Analysis was made on specific indicators among these occupational groups to understand the risk behavior and their vulnerability to HIV and STIs. Findings: Out of total HIV positive migrant’s workers (N= 847) enrolled in MSDS HIV rate is found to be highest among Auto-Rickshaw (18.66%) followed by Daily wage laborers (14.46%), Loom workers (10.73%), Industrial workers (10.04%) and Construction worker 7.93%. With 45.14% positivity, industrial workers are found to be most vulnerable to Sexually Transmitted Infections (STIs) (N=10057) among all occupational categories followed by loom workers (16.28%), Skilled worker (Furniture, Jeweler)-7.14%, daily wage laborers (5.45%). Conclusion: MSDS is an effective tool to assess migrants’ risk and their vulnerability to HIV for designing evidence informed program. This system calls for a replication across all destination TIs by NACO for differential strategies for different occupation groups to ensure better yield through scientific planning of intervention among high risk and high vulnerable migrants.

Keywords: migrants, migrant service delivery system, risk, vulnerability

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