Search results for: top management support

Authors: Md. Rezaul Karim, Andreas Thiel

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Bangladesh is known as one of the most climate vulnerable countries in the world. Innovative technologies are always the key responses to the management of climate impacts. The objectives of this study are to determine the farmer’s perception of climate variability, to compare farmers’ perceptions with metrological data, and to explore the determinants that affect the likelihood of adoption of the selected Climate Smart Agricultural (CSA) technologies. Data regarding climate change perception, determinants and adoption were collected based on the household survey from stratified and randomly selected 365 farmers of the Biral sub-district under Dinajpur district in drought-prone northern Bangladesh. The likelihood of adoption of CSA technologies was analyzed following a multivariate probit model. The findings show that about 82.5% of the farmers perceived increasing temperature, and 75.1 % of farmers perceived decreasing dry season rainfall over the years, which is similarly relevant to metrological data. About 76.4.7% and 80.85% of farmers were aware of the drought tolerance crops and vermicompost, respectively; more than half of the farmers adopted these practices. Around 70.7% of farmers were aware of perching for insect control, but 46.3% of farmers adopted this practice. Although two-thirds of farmers were aware of crop diversification and pheromone trap, adoption was lower compared to the other three CSAs. Results also indicate that the likelihood of adoption of the selected CSAs is significantly influenced by different factors such as socio-economic characteristics, institutional factors and perceived technological or innovation attributes. The likelihood of adopting drought tolerance crops is affected by 11, while crop diversification and perching method by 7, pheromone trap by 9 and vermicompost by 8 determining factors. Lack of information and unavailability of input appear to be major obstacles to the non-adoption of CSA technologies. This study suggests that policy implications are necessary to promote extension services and overcome the obstacles to the non-adoption of individual CSA technologies. It further recommends that the research study should be conducted in a diverse context, nationally or globally.

Keywords: determinants, adoption, climate smart agriculture, northern Bangladesh

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Authors: Abanda Wilfred Chick

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Background: According to World Health Organization (WHO), the role of Information and Communication Technologies (ICT) in health sectors of developing nations has been demonstrated to have had a great improvement of fifty percent reduction in mortality and or twenty-five-fifty percent increase in productivity. The objective of this study was to assess the use of information and communication technologies in enhancing health care delivery for Human Immunodeficiency Virus (HIV) patients in Bamenda Health District. Methods: This was a descriptive-analytical cross-sectional study in which 388 participants were consecutively selected amongst health personnel and HIV patients from public and private health institutions involved in Human Immunodeficiency Virus management. Data on socio-demographic variables, the use of information and communication technologies tools, and associated challenges were collected using structured questionnaires. Descriptive statistics with a ninety-five percent confidence interval were used to summarize findings, while Cramer’s V test, logistic regression, and Chi-square test were used to measure the association between variables, Epi info version7.2, MS Excel, and SPSS version 25.0 were utilized for data entry and statistical analysis respectively. Results: Of the participants, one-quarter were health personnel, and three-quarters were HIV patients. For both groups of participants, there was a significant relationship between the use of ICT and demographic information such as level of education, marital status, and age (p<0.05). For the impediments to using ICT tools, a greater proportion identified the high cost of airtime or internet bundles, followed by an average proportion that indicated inadequate training on ICT tools; for health personnel, the majority said inadequate training on ICT tools/applications and half said unavailability of electricity. Conclusion: Not up to half of the HIV patients effectively make use of ICT tools/applications to receive health care. Of health personnel, three quarters use ICTs, and only one quarter effectively use mobile phones and one-third of computers, respectively, to render care to HIV patients.

Keywords: ICT tools, HIV patients, health personnel, health care delivery

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Authors: Selin Tosun

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The improvements in technology have started to transform the way we live, work, play, and commute in our cities. The emerging smart city understanding has been paving the way for more efficient, more useful, and more profitable cities. Smart sensors, smart lighting, smart waste, water and electricity management, smart transportation and communication systems are introduced to cities at a rapid pace. In today's world, innovation is often correlated with start-up companies and technological pioneers seeking broader economic objectives such as production and competitiveness. The government's position is primarily that of an enabler, with creativity mostly coming from the private sector. The paper argues that to achieve sustainable development, the ways in which smart and sustainable city approaches are being applied to cities need to be redefined. The research aims to address common discussions in the discourse of smart and sustainable cities criticizing the priority of lifestyle sterilization over human-centered sustainable interventions and social innovation strategies. The dichotomy between the fact that smart cities are mostly motivated by the competitive global market and the fact that the delocalization is, in fact, their biggest problem in the way of becoming authentic, sustainable cities is the main challenge that we face today. In other words, the key actors in smart cities have different and somewhat conflicting interests and demands. By reviewing the roles of the public and private actors in smart city making, the paper aspires to reconceptualize the understanding of “smartness” in achieving sustainable development in which the “smartness” is understood as a multi-layered complex phenomenon that can be channeled through different dynamics. The case cities around the world are explored and compared in terms of their technological innovations, governance and policy innovations, public-private stakeholder relationships, and the understanding of the public realm. The study aims to understand the current trends and general dynamics in the field, key issues that are being addressed, the scale that is preferred to reflect upon and the projects that are designed for the particular issues.

Keywords: smart city, sustainable development, technological innovation, social innovation

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Authors: Anh Nguyen, Jane Fisher, Thach Tran, Anh T. T. Tran

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Trait Emotional Intelligence is the knowledge, beliefs, and attitudes an individual has about their own and other people’s emotions. It is believed that trait emotional intelligence is a component of personality. Petrides’ Trait Emotional Intelligence Questionnaire (TEIQue) is well regarded and well-established, with validation data about its functioning among adults from many countries. However, there is little data yet about its use among Asian populations, including adolescents. The aims were to translate and culturally verify the Trait Emotional Intelligence Adolescent Short Form (TEIQue-ASF) and investigate content validity, construct validity, and reliability among adolescents attending high schools in Vietnam. Content of the TEIQue-ASF was translated (English to Vietnamese) and back-translated (Vietnamese to English) in consultation with bilingual and bicultural health researchers and pilot tested among 51 potential respondents. Phraseology and wording were then adjusted and the final version is named the VN-TEIQue-ASF. The VN-TEIQue-ASF’s properties were investigated in a cross-sectional elf-report survey among high school students in Central Vietnam. In total 1,546 / 1,573 (98.3%) eligible students from nine high schools in rural, urban, and coastline areas completed the survey. Explanatory Factor Analysis yielded a four-factor solution, including some with facets that loaded differently compared to the original version: Well-being, Emotion in Relationships, Emotion Self-management, and Emotion Sensitivity. The Cronbach’s alpha of the global score for the VN-TEIQue-ASF was .77. The VN-TEIQue-ASF is comprehensible and has good content and construct validity and reliability among adolescents in Vietnam. The factor structure is only partly replicated the original version. The VN-TEIQue-ASF is recommended for use in school or community surveys and professional study in education, psychology, and public health to investigate the trait emotional intelligence of adolescents in Vietnam.

Keywords: adolescents, construct validity, content validity, factor analysis, questionnaire validity, trait emotional intelligence, Vietnam

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Authors: Theresa Belema Chris-Biriowu

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The change in trends in relation to gender representation in beer brand commercials was the thrust of the study. The study investigated how beer brand commercials reflect societal realities in their portrayals of gender roles within the span of a decade. The major objective of the study was to find out how gender was contextualized in selected beer brand commercials that both air on Nigerian television and stream on YouTube. The study was anchored on the muted group theory. The population of the study was in two streams: the total number of beer beverages that are produced by the eleven breweries in Nigeria and the registered advertising agencies in Lagos, Nigeria. The sample size was also two-pronged: the purposive selection of beer brands that have their commercials on television and YouTube and the purposive selection of an ad agency that has produced running commercials for beer brands within the period between 2010s and 2020s. They adopted visual framing analysis and narrative analysis research techniques. The study qualitatively analyzed the contents of beer brand commercials and conducted an interview with the management of the ad agency for data collection. The data was presented in images and words. The findings showed that females are underrepresented and misrepresented in the beer brand commercials and that the beer brands are not producing commercials that adequately reflect the realities of present times. It was also found that very little has changed in the ad industry between the periods studied, and commercial screenplays are not written with a specific aim to either target the female demographics or give them equal opportunities to thrive in the beer economy. The study concluded that the gender gap in beer commercials subsists and translates to gender discrimination, especially since it is established that females are also stakeholders in the beer economy. The study recommends that beer brands should produce commercials that appeal to their audience irrespective of gender, reflect contemporary realities, and give all genders equal opportunities to thrive in the increasingly competitive industry.

Keywords: beer brands, commercials, gender representation, visuals, television, YouTube

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Authors: M. R. Vijayakumar, Sanjay Kumar Singh, Lakshmi, Hithesh Dewangan, Sanjay Singh

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Trans resveratrol (RES) is a natural molecule proved for cancer preventive and therapeutic activities devoid of any potential side effects. However, the therapeutic application of RES in disease management is limited because of its rapid elimination from blood circulation thereby low biological half life in mammals. Therefore, the main objective of this study is to enhance the circulation as well as therapeutic efficacy using PEGylated liposomes. D-α-tocopheryl polyethylene glycol 1000 succinate (vitamin E TPGS) is applied as steric surface decorating agent to prepare RES liposomes by thin film hydration method. The prepared nanoparticles were evaluated by various state of the art techniques such as dynamic light scattering (DLS) technique for particle size and zeta potential, TEM for shape, differential scanning calorimetry (DSC) for interaction analysis and XRD for crystalline changes of drug. Encapsulation efficiency and invitro drug release were determined by dialysis bag method. Cancer cell viability studies were performed by MTT assay, respectively. Pharmacokinetic studies were performed in sprague dawley rats. The prepared liposomes were found to be spherical in shape. Particle size and zeta potential of prepared formulations varied from 64.5±3.16 to 262.3±7.45 nm and -2.1 to 1.76 mV, respectively. DSC study revealed absence of potential interaction. XRD study revealed presence of amorphous form in liposomes. Entrapment efficiency was found to be 87.45±2.14 % and the drug release was found to be controlled up to 24 hours. Minimized MEC in MTT assay and tremendous enhancement in circulation time of RES PEGylated liposomes than its pristine form revealed that the stearic stabilized PEGylated liposomes can be an alternative tool to commercialize this molecule for chemopreventive and therapeutic applications in cancer.

Keywords: trans resveratrol, cancer nanotechnology, long circulating liposomes, bioavailability enhancement, liposomes for cancer therapy, PEGylated liposomes

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Authors: Giang Ngo Tinh Nguyen

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Agriculture plays an important role in the economy of Vietnam and coffee is one of most crucial agricultural commodities for exporting but the current farming methods and processing infrastructure could not keep up with the development of the sector. There are many catastrophic impacts on the environment such as deforestation; soil degradation that leads to a decrease in the quality of coffee beans. Therefore, improving supply chain to develop the cultivation of sustainable coffee is one of the most important strategies to boost the coffee industry and create a competitive advantage for Vietnamese coffee in the worldwide market. If all stakeholders in the supply chain network unite together; the sustainable production of coffee will be scaled up and the future of coffee industry will be firmly secured. Buon Ma Thuot city, Dak Lak province is the principal growing region for Vietnamese coffee which accounted for a third of total coffee area in Vietnam. It plays a strategically crucial role in the development of sustainable Vietnamese coffee. Thus, the research is to improve the supply chain of sustainable Vietnamese coffee production in Buon Ma Thuot city, Dak Lak province, Vietnam for the purpose of increasing the yields and export availability as well as helping coffee farmers to be more flexible in an ever-changing market situation. It will help to affirm Vietnamese coffee brand when entering international market; improve the livelihood of farmers and conserve the environment of this area. Besides, after analyzing the data, a logistic regression model is established to explain the relationship between the dependent variable and independent variables to help sustainable coffee organizations forecast the probability of farmer will be having a sustainable certificate with their current situation and help them choose promising candidates to develop sustainable programs. It investigates opinions of local farmers through quantitative surveys. Qualitative interviews are also used to interview local collectors and staff of Trung Nguyen manufacturing company to have an overview of the situation.

Keywords: supply chain management, sustainable agricultural development, sustainable coffee, Vietnamese coffee

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Authors: Ranjot Kaur, Om P. Katare, Anupama Sharma, Sarah R. Dennison, Kamalinder K. Singh, Bhupinder Singh

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Respiratory microbial infections being among the top leading cause of death worldwide are difficult to treat as the microbes reside deep inside the airways, where only a small fraction of drug can access after traditional oral or parenteral routes. As a result, high doses of drugs are required to maintain drug levels above minimum inhibitory concentrations (MIC) at the infection site, unfortunately leading to severe systemic side-effects. Therefore, delivering antimicrobials directly to the respiratory tract provides an attractive way out in such situations. In this context, current study embarks on the systematic development of lung lia pid-modified chitosan nanoparticles for inhalation of voriconazole. Following the principles of quality by design, the chitosan nanoparticles were prepared by ionic gelation method and further coated with major lung lipid by precipitation method. The factor screening studies were performed by fractional factorial design, followed by optimization of the nanoparticles by Box-Behnken Design. The optimized formulation has a particle size range of 170-180nm, PDI 0.3-0.4, zeta potential 14-17, entrapment efficiency 45-50% and drug loading of 3-5%. The presence of a lipid coating was confirmed by FESEM, FTIR, and X-RD. Furthermore, the nanoparticles were found to be safe upto 40µg/ml on A549 and Calu-3 cell lines. The quantitative and qualitative uptake studies also revealed the uptake of nanoparticles in lung epithelial cells. Moreover, the data from Spraytec and next-generation impactor studies confirmed the deposition of nanoparticles in lower airways. Also, the interaction of nanoparticles with DPPC monolayers signifies its biocompatibility with lungs. Overall, the study describes the methodology and potential of lipid-coated chitosan nanoparticles in futuristic inhalation nanomedicine for the management of pulmonary aspergillosis.

Keywords: dipalmitoylphosphatidylcholine, nebulization, DPPC monolayers, quality-by-design

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Authors: Marja A. Bernardo, Coreena A. Bueser, Cybele Lara R. Abad, Raul V. Destura

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Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection among people with HIV. Early consideration of PCP should be made even in patients whose HIV status is unknown as delay in treatment may be fatal. The use of absolute lymphocyte count (ALC) has been suggested as an alternative predictor of PCP especially in resource limited settings where PCR testing is costly or delayed. Objective: To determine whether the absolute lymphocyte count (ALC) can be used as a screening tool to predict Pneumocystis pneumonia in patients with unknown HIV status admitted at a private tertiary hospital. Methods: A retrospective cross-sectional study was conducted at a private tertiary medical center. Inpatient medical records of patients aged 18 years old and above from January 2012 to May 2014, in whom a clinical diagnosis of Pneumocystis jirovecii pneumonia was made were reviewed for inclusion. Demographic data, clinical features, hospital course, PCP PCR and HIV results were recorded. Independent t-test and chi-square analysis was used to determine any statistical difference between PCP-positive and PCP-negative groups. Mann-Whitney U-test was used for comparison of hospital stay. Results: There were no statistically significant differences in baseline characteristics between PCP positive and negative groups. While both the percent lymphocyte count (0.14 ± 0.13 vs 0.21 ± 0.16) and ALC (1160 ± 528.67 vs 1493.70 ± 988.61) were lower for the PCP-positive group, only the percent lymphocyte count reached a statistically significant difference (p= 0.067 vs p= 0.042). Conclusion: A quick determination of the ALC may be useful as an additional parameter to help screen for and diagnose pneumocystis pneumonia. In our study, the ALC of patients with PCP appear to be lower than in patients without PCP. A low ALC (e.g. below 1200) may help with the decision regarding empiric treatment. However, it should be used in conjunction with the patient’s clinical presentation, as well as other diagnostic tests. Larger, prospective studies incorporating the ALC with other clinical predictors are necessary to optimally predict those who would benefit from empiric or expedited management for potential PCP.

Keywords: Pneumocystis carinii pneumonia, Absolute Lymphocyte Count, infection, PCP

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Authors: María García-García, Esther Simancas-González, Said Balhadj, Carmen Silva-Robles, Driss Ferhane

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Cooperation between the territories on both sides of the Strait of Gibraltar is an urgent reality. the south of Spain and northern Morocco share a common historical past and belong to a very similar geographical and ecological area. Economic, social and cultural relations make cooperation between the two countries’ (Spain and Morocco) a priority for the EU and both countries governments. Likewise, deepened changes happened in production systems and consumption patterns had seriously damaged and weakened the craftwork sector. The promotion of local crafts, and its economic value, and the cooperation with the north of Morocco has been an important issue for the Andalusian government in recent years. The main aim of this work is to understand the strengths and weaknesses of the Tangier - Tetuan region craftworks sector in order to develop accurate communication and promotion plans. From the knowledge of the real identity, the sector could be repositioned. Promotion and communication could be a spur to traditional sectors, such as crafts. Competitiveness requires "the culture of communication, the cooperation between different companies to build powerful territory brands and maintain the establishment confidence and effectiveness relationships among agencies and organizations". The lack of previous literature addressing how Tangier craftwork promote and communicate its value to their stakeholders, has conducted the study to an exploratory approach with a double dimension: internal, Tangier craftwork sector image, and external, Andalusia image of the sector in Tangier. Different interviews were conducted with Andalusian partners involved in the artisanal sector (9 master craftsmen and 3 institutions) and focus groups with 9 Tangiers craftsmen were developed. The result of these interviews and expert groups are reflected in a SWOT analysis which reveals a handcraft industry with a worrying wide-spread and undifferentiated identity and reluctance to innovation and new technologies.

Keywords: communication management, image, Moroccan crafts, Spain-Morocco cooperation

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Authors: Sunantha Teyarachakul

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We consider the worker-learning Newsvendor Model, under the case of lost-sales for unmet demand, with the research objective of proposing the cost-minimization order policy and lot size, scheduled to arrive at the beginning of the selling-period. In general, the New Vendor Model is used to find the optimal order quantity for the perishable items such as fashionable products or those with seasonal demand or short-life cycles. Technically, it is used when the product demand is stochastic and available for the single selling-season, and when there is only a one time opportunity for the vendor to purchase, with possibly of long ordering lead-times. Our work differs from the classical Newsvendor Model in that we incorporate the human factor (specifically worker learning) and its influence over the costs of processing units into the model. We describe this by using the well-known Wright’s Learning Curve. Most of the assumptions of the classical New Vendor Model are still maintained in our work, such as the constant per-unit cost of leftover and shortage, the zero initial inventory, as well as the continuous time. Our problem is challenging in the way that the best order quantity in the classical model, which is balancing the over-stocking and under-stocking costs, is no longer optimal. Specifically, when adding the cost-saving from worker learning to such expected total cost, the convexity of the cost function will likely not be maintained. This has called for a new way in determining the optimal order policy. In response to such challenges, we found a number of characteristics related to the expected cost function and its derivatives, which we then used in formulating the optimal ordering policy. Examples of such characteristics are; the optimal order quantity exists and is unique if the demand follows a Uniform Distribution; if the demand follows the Beta Distribution with some specific properties of its parameters, the second derivative of the expected cost function has at most two roots; and there exists the specific level of lot size that satisfies the first order condition. Our research results could be helpful for analysis of supply chain coordination and of the periodic review system for similar problems.

Keywords: inventory management, Newsvendor model, order policy, worker learning

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Authors: Yinsheng Zhang

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Changes in the extent and amount of snow cover in Eurasia are of great interest because of their vital impacts on the global climate system and regional water resource management. This study investigated the spatial and temporal variability of the snow cover extent (SCE) and snow water equivalent (SWE) of continental Eurasia using the Northern Hemisphere Equal-Area Scalable Earth Grid (EASE-Grid) Weekly SCE data for 1972–2006 and the Global Monthly EASE-Grid SWE data for 1979–2004. The results indicated that, in general, the spatial extent of snow cover significantly decreased during spring and summer, but varied little during autumn and winter over Eurasia in the study period. The date at which snow cover began to disappear in spring has significantly advanced, whereas the timing of snow cover onset in autumn did not vary significantly during 1972–2006. The snow cover persistence period declined significantly in the western Tibetan Plateau as well as the partial area of Central Asia and northwestern Russia but varied little in other parts of Eurasia. ‘Snow-free breaks’ (SFBs) with intermittent snow cover in the cold season were mainly observed in the Tibetan Plateau and Central Asia, causing a low sensitivity of snow cover persistence period to the timings of snow cover onset and disappearance over the areas with shallow snow. The averaged SFBs were 1–14 weeks in the Tibetan Plateau during 1972–2006 and the maximum intermittence could reach 25 weeks in some extreme years. At a seasonal scale, the SWE usually peaked in February or March but fell gradually since April across Eurasia. Both annual mean and annual maximum SWE decreased significantly during 1979–2004 in most parts of Eurasia except for eastern Siberia as well as northwestern and northeastern China.

Keywords: Eurasia, snow cover extent, snow cover persistence period, snow-free breaks, onset and disappearance timings, snow water equivalent

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Authors: Dragan Zivotic, Mirjana Ilic, Aleksandra Perovic, Predrag Gavrilovic

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As with the provision of other services, the service quality perception is one of the key factors that the modern manager must pay attention to. Countries in which the state regulation is in transition also have specific features in providing fitness services. Identification of the dimensions in which the most significant different service quality perception between different types of fitness centers, enables managers to profile the offer according to the wishes and expectations of users. The aim of the paper was the comparison of the quality of services perception in the field of fitness in Serbia between three categories of fitness centers: the privately owned centers, the publicly owned centers, and the Public-private partnership centers. For this research 350 respondents of both genders (174 men and 176 women) were interviewed, aged between 18 and 68 years, being beneficiaries of fitness services for at least 1 year. Administered questionnaire with 100 items provided information about the 15 basic areas in which they expressed the service quality perception in the gym. The core sample was composed of 212 service users in private fitness centers, 69 service users in public fitness centers and 69 service users in the public-private partnership. Sub-samples were equal in representation of women and men, as well as by age and length of use of fitness services. The obtained results were subject of univariate analysis with the Kruskal-Wallis non-parametric analysis of variance. Significant differences between the analyzed sub-samples were not found solely in the areas of rapid response and quality outcomes. In the multivariate model, the results were processed by backward stepwise discriminant analysis that extracted 3 areas that maximize the differences between sub-samples: material and technical basis, secondary facilities and coaches. By applying the classification function 93.87% of private centers services users, 62.32% of public centers services users and 85.51% of the public-private partnership centers users of services were correctly classified (total 86.00%). These results allow optimizing the allocation of the necessary resources in profiling offers of a fitness center in order to optimally adjust it to the user’s needs and expectations.

Keywords: fitness, quality perception, management, public ownership, private ownership, public-private partnership, discriminative analysis

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Authors: Zeynep Aksoy

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Since global mobility of capital, information and people increase more and more, intercultural communication and management become a growing study field of investigating various aspects of the interaction between people from different cultural backgrounds. Human mobility, caused by several intentions from tourism to forced migration, often put people in facing communication barriers, issues or sometimes conflicts. This reality naturally enforces education institutions to develop international policies and programs for students in order to improve their intercultural experiences along with the educative objectives. Study-abroad programs, particularly the student exchanges in higher education provide an environment for participants to encounter with cultural differences. Therefore, international exchange programs (i.e. Erasmus Student Mobility, Global Exchange Program) are accepted to bring opportunities for intergroup contact, which may lead students to obtain new perspectives about the host culture, either in positive or negative ways, and new intercultural communication skills. This study aims to explore the role of short-term study abroad experience on intercultural communication competence with a qualitative approach. It attempts to reveal a comparative analysis, which is derived from two field studies conducted in Izmir (Turkey) and in Amsterdam (the Netherlands) in 2015 and 2016. They were both organized in two phases as pre-and-posttest to gain an insight into the changes (if any) in students’ attitudes and knowledge regarding the host culture, and their further motivations towards cross-cultural interactions. With this aim, focus group sessions and in-depth interviews have been taken place with participants at the beginning of their stay and at the end of the semester. The sample covers students mainly from Erasmus program (20 students in Izmir and 14 students in Amsterdam), and few from Global Exchange Program (5 students in Amsterdam). Data obtained from both studies were thematically analyzed and essential themes were identified within the framework of intercultural communication competence.

Keywords: Erasmus student mobility, intercultural communication competence, student exchange, short-term study abroad

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Authors: Jovana Petrovic, Biljana Pajin, Ivana Loncarevic, Aleksandar Fistes, Antun Jozinivic, Durdica Ackar, Drago Subaric

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Recovery of food wastes and their conversion to economically viable products will play a vital role for the management strategies in the years to come. Apple pomace may be considered as wastes, but they contain considerable amounts of high value reusable materials. Apple pomace, the by-product of apple juice and cider production, is a good source of fibre, particularly insoluble one. The remaining apple pulp contains 12% dry residue, which is half dietary fibre. Another remarkable aspect is its richness in polyphenols, components with antioxidant activity. Apple pomace could be an interesting alternative source for fibre and polyphenols in extruded corn meals. The extruded corn meals with the addition of finely ground apple pomace were prepared (the ratio of corn meal: apple pomace was 85:15 and 70:30). Characterization of the extrudates in terms of determining the chemical composition and colour was performed. The color of samples was measured by MINOLTA Chroma Meter CR-400 (Minolta Co., Ltd., Osaka, Japan) using D 65 lighting, a 2º standard observer angle and an 8-mm aperture in the measuring head. The following CIELab color coordinates were determined: L* – lightness, a* – redness to greenness and b* – yellowness to blueness. Protein content decreased significantly from 7.91% to 5.19% with increase in pomace from 0% to 30%, while total fibre content increase from 3.39% to 16.62%. The apple pomace addition produced extrudates with a significantly lower L* value and significantly higher a* value. This study has been fully supported by the Provincial Secretariat for High Education and Scientific Research of the Government of Autonomous Province of Vojvodina, Republic of Serbia, project 142-451-2483/2017 and the Ministry of Science and Technological Development of the Republic of Serbia (Project no. 31014).

Keywords: apple pomace, chemical composition, colour, extruded corn snack products, food waste recovery

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Authors: Djeddi Khaled, Houssou Hind, Miloudi Abdelatif, Rabah Siham

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Camels play a vital role as multipurpose animals, providing milk meat and serving as a means of transportation. They serve as a financial reserve for pastoralists and hold significant cultural and social value. Camel milk, known for its exceptional nutritional properties, is considered a valuable substitute for human milk. However, udder infections, particularly mastitis, pose significant challenges to camel farming. Clinical and subclinical mastitis can lead to substantial economic losses. Mastitis, especially the subclinical form, is a persistent and prevalent condition affecting milk hygiene and quality in dairy camels. This review offers insights into the prevalence and risk factors associated with subclinical mastitis in camels. The prevalence of subclinical mastitis in dairy camels was found to range from 9.28% to 87.78%. Major pathogens responsible for camel mastitis include Staphylococcus aureus, Coagulase-negative Staphylococcus, Streptococcus agalactiae, Streptococcus dysgalactiae, Escherichia coli, Micrococcus spp, Pasteurella haemolytica and Corynebacterium spp. The study outlines key risk factors contributing to camel mastitis, emphasizing factors such as severe tick infestation, age, stage of lactation, parity, body condition score, skin lesion on the teats or udders, anti-suckling devices, previous history of the udder, conformation of the udder, breed, unhygienic milking practices, production system, amongst others have been reported to be important in the prevalence of subclinical mastitis. This comprehensive overview provides valuable insights into the multifaceted aspects of camel mastitis, encompassing prevalent bacterial pathogens and diverse risk factors. The findings underscore the importance of holistic management practices, emphasizing hygiene, health monitoring, and targeted interventions to ensure the well-being and productivity of camels in various agro-pastoral contexts.

Keywords: bacterial pathogens, camel, mastitis, risk factors

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Authors: Kishor Chandra Kandpal, Amit Kumar

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The Indian Himalaya region harbours approximately 1748 plants of medicinal importance, and as per International Union for Conservation of Nature (IUCN), the 112 plant species among these are threatened and endangered. To ease the pressure on these plants, the government of India is encouraging its in-situ cultivation. The Saussurea costus, Valeriana jatamansi, and Picrorhiza kurroa have also been prioritized for large scale cultivation owing to their market demand, conservation value and medicinal properties. These species are found from 1000 m to 4000 m elevation ranges in the Indian Himalaya. Identification of these plants in the field requires taxonomic skills, which is one of the major bottleneck in the conservation and management of these plants. In recent years, Hyperspectral remote sensing techniques have been precisely used for the discrimination of plant species with the help of their unique spectral signatures. In this background, a spectral library of the above 03 medicinal plants was prepared by collecting the spectral data using a handheld spectroradiometer (325 to 1075 nm) from farmer’s fields of Himachal Pradesh and Uttarakhand states of Indian Himalaya. The Random forest (RF) model was implied on the spectral data for the classification of the medicinal plants. The 80:20 standard split ratio was followed for training and validation of the RF model, which resulted in training accuracy of 84.39 % (kappa coefficient = 0.72) and testing accuracy of 85.29 % (kappa coefficient = 0.77). This RF classifier has identified green (555 to 598 nm), red (605 nm), and near-infrared (725 to 840 nm) wavelength regions suitable for the discrimination of these species. The findings of this study have provided a technique for rapid and onsite identification of the above medicinal plants in the field. This will also be a key input for the classification of hyperspectral remote sensing images for mapping of these species in farmer’s field on a regional scale. This is a pioneer study in the Indian Himalaya region for medicinal plants in which the applicability of hyperspectral remote sensing has been explored.

Keywords: himalaya, hyperspectral remote sensing, machine learning; medicinal plants, random forests

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Authors: Maria Monica D. Espinosa

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This study aimed to identify and examine the characteristics of an effective leader in a Hospital institution from the perspectives of military nurse-managers. The researcher extracted the different facets of leadership from the stories of six nurse- managers from a military hospital. The stories which are in pre-reflective stage convey an unbiased perspective from which clinical leadership may be defined. Using Phenomenology as a method of Research, the lived experiences of the military nurse-managers served as empirical data which were reflected upon until the formulation of insights. The information from the co-researchers became gallows from which the characteristics of effective leadership in the clinical area were drawn. These insights were synthesized through layers of reflection that resulted to the knowledge about clinical leadership. The reflections are the following, (a) Clinical leaders develop their skills through experiences and hardwork; (b) Clinical leaders are devoted; (c) Clinical leaders are focused; (d) Clinical leaders are good in interpersonal relationship; (e) Clinical leaders are mentors; (f) Clinical leaders seek affirmation and recognition; and (g) Clinical leaders are responsible and dependable. The common themes that emerged from the nurse manager’s stories showed that clinical leadership maybe attained if leaders possessed the following traits, (a) The gift to establish a steadfast and firm management; (b) The proficiency to guide and encourage others towards the achievement of their goals and objectives; (c) The ability to instigate participative and collaborative work among his/her subordinates and (d) The aptitude and skill to address the institutional concerns in their unit. In the future, Clinical leaders should continually adapt an evaluation program on how they can relate socially with their subordinates, the result of which can be used as a basis in developing strategies on relationship enhancement. Moreover, they should empower the nurses by allowing them to voice out their opinions and concerns regarding assignments, role expectations, and workload issues to improve and strengthen the relationships among nurses. Lastly, they can incorporate a collaborative strategy to promote professional socialization attitudes of nurse managers who work with staff nurses to improve the quality of their proficiencies and enhance a positive clinical environment.

Keywords: clinical leadership, experiences, implications, military nurse - managers, phenomenology

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Authors: Majid Aldalbahi

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In 2009, over 3.4 billion people in the world resided in urban areas as a result of rapid urban growth. This figure is estimated to increase to 6.5 billion by 2050. This urban growth phenomenon has raised challenges for many countries in both the developing and developed worlds. Urban growth is a complicated process involving the spatiotemporal changes of all socio-economic and physical components at different scales. The socio-economic components of urban growth are related to urban population growth and economic growth, while physical components of urban growth and economic growth are related to spatial expansion, land cover change and land use change which are the focus of this research. The interactions between these components are complex and no-linear. Several factors and forces cause these complex interactions including transportation and communication, internal and international migrations, public policies, high natural growth rates of urban populations and public policies. Urban growth has positive and negative consequences. The positive effects relates to planned and orderly urban growth, while negative effects relate to unplanned and scattered growth, which is called sprawl. Although urban growth is considered as necessary for sustainable urbanization, uncontrolled and rapid growth cause various problems including consumption of precious rural land resources at urban fringe, landscape alteration, traffic congestion, infrastructure pressure, and neighborhood conflicts. Traditional urban planning approaches in fast growing cities cannot accommodate the negative consequences of rapid urban growth. Microsimulation programme, and modelling techniques are effective means to provide new urban development, management and planning methods and approaches. This paper aims to use these techniques to understand and analyse the complex interactions for the case study of Riyadh city, a fast growing city in Saudi Arabia.

Keywords: policy implications, urban planning, traffic congestion, urban growth, Suadi Arabia, Riyadh

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Authors: Pahirangan Sivapatham, Barbara Esser, Andreas Grimmel

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In times of limited public funds and, in particular, an increased social, environmental awareness, as well as the limited availability of construction materials, sustainable and resource-saving pavement management system, is becoming more and more important. Therefore, the knowledge about the condition of the structural substances, particularly bearing capacity and its consideration while planning the maintenance measures of the subordinate network, i.e., state and municipal roads unavoidable. According to the experience, the recommended ride speed of the Traffic Speed Deflectometer (TSD) shall be higher than 40 km/h. Holding of this speed on the intra-urban roads is nearly not possible because of intersections and traffic lights as well as the speed limit. A sufficient background of experience for the evaluation of bearing capacity measurements with TSD in the range of lower speeds is not available yet. The aim of this study is to determine the possible lowest ride speed of the TSD while the bearing capacity measurement on the intra-urban roads. The manufacturer of the TSD used in this study states that the measurements can be conducted at a ride speed of higher than 5 km/h. It is well known that with decreasing ride speed, the viscous fractions in the response of the asphalt pavement increase. This must be taken into account when evaluating the bearing capacity data. In the scope of this study, several measurements were carried out at different speeds between 10 km/h and 60 km/h on the selected intra-urban roads with Pavement-Scanner of the University of Wuppertal, which is equipped with TSD. Pavement-Scanner is able to continuously determine the deflections of asphalt roads in flowing traffic at speeds of up to 80 km/h. The raw data is then aggregated to 10 m mean values so that, as a rule, a bearing capacity characteristic value can be determined for each 10 m road section. By means of analysing of obtained test results, the quality and validity of the determined data rate subject to the riding speed of TSD have been determined. Moreover, the data and pictures of the additional measuring systems of Pavement-Scanners such as High-Speed Road Monitor, Ground Penetration Radar and front cameras can be used to determine and eliminate irregularities in the pavement, which could influence the bearing capacity.

Keywords: bearing capacity measurement, traffic speed deflectometer, inter-urban roads, Pavement-Scanner, structural substance

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Authors: A. A. Md. Ryhan Uddin, Swarup Das, Rajesh Barua, Joheb Hasan, Rashedul Islam

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Background: The herbicide has toxicological importance because some of them are associated with high mortality rates due to respiratory failure. Organophosphate poisoning (OPC) & Paraquat self-poisoning is a major clinical and public health problems in low and middle-income countries across much of South Asia. Paraquat was not used as a common suicidal agent previously in Bangladesh. We report a case of 15 years old female admitted to the ER with a history of nausea & vomiting after ingestion of an unknown substance in a suicidal attempt, later identified as mixed poisoning- OPC & Paraquat. She was initially asymptomatic but later developed renal shutdown & lung injuries as well as pneumothorax, referred to as Daisley Barton Syndrome. Objective: This case report aims to alert spontaneous pneumothorax in mixed poisoning on uncommon forms of presentation. Pneumothorax in a patient with paraquat poisoning is a less unusual but underdiagnosed finding. It has a high index of early mortality. Case history: The patient's attendant complained about nausea followed by vomiting, which was nonprojectile & contains undigested food materials first, then gastric juice later. After a few hours, she also complains of urinary retention. Her family members treated her with some home remedies for her initial symptoms, but all attempts failed. After admission, the patient was initially asymptomatic. Through repeated history taking, her attendant showed a bottle of OPC in liquid form, which they suspected that she may have ingested some of the liquid from that bottle accidentally or attempted Suicide. So, management started for OPC poisoning. She responded well initially, but on 4th day of admission, the patient's condition became deteriorating. After the workout with the family member, 2nd bottle of Pesticide was discovered, which was Paraquat. Conclusion: Physicians should be aware of the symptoms of mixed poisoning and the timely use of urine dithionate testing for early detection and treatment. Pneumothorax is an early predictor of mortality in patients with paraquat poisoning.

Keywords: pneumothorax, suicide, dithionate, OPC, herbicide

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Authors: César Coelho, Nikolai Wiegand

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The advancement of nanosatellite technology has opened new avenues for cost-effective and faster space missions. The NanoSat MO Framework (NMF) from the European Space Agency (ESA) provides a modular and simpler approach to the development of flight software and operations of small satellites. This paper presents a methodology using the NMF together with Docker for simulating constellations of satellites. By leveraging Docker containers, the software environment of individual satellites can be easily replicated within a simulated constellation. This containerized approach allows for rapid deployment, isolation, and management of satellite instances, facilitating comprehensive testing and development in a controlled setting. By integrating the NMF lightweight simulator in the container, a comprehensive simulation environment was achieved. A significant advantage of using Docker containers is their inherent scalability, enabling the simulation of hundreds or even thousands of satellites with minimal overhead. Docker's lightweight nature ensures efficient resource utilization, allowing for deployment on a single host or across a cluster of hosts. This capability is crucial for large-scale simulations, such as in the case of mega-constellations, where multiple traditional virtual machines would be impractical due to their higher resource demands. This ability for easy horizontal scaling based on the number of simulated satellites provides tremendous flexibility to different mission scenarios. Our results demonstrate that leveraging Docker containers with the NanoSat MO Framework provides a highly efficient and scalable solution for simulating satellite constellations, offering not only significant benefits in terms of resource utilization and operational flexibility but also enabling testing and validation of ground software for constellations. The findings underscore the importance of taking advantage of already existing technologies in computer science to create new solutions for future satellite constellations in space.

Keywords: containerization, docker containers, NanoSat MO framework, satellite constellation simulation, scalability, small satellites

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Authors: Natacha Jesus-Silva, Carla S. Pereira, Natercia Durao, Maria Das Dores Formosinho, Cristina Costa-Lobo

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Any assessment process, by its very nature, raises a wide range of doubts, uncertainties, and insecurities of all kinds. The evaluation process should be ethically irreproachable, treating each and every one of the evaluated according to a conduct that ensures that the process is fair, contributing to all recognize and feel well with the processes and results of the evaluation. This is a very important starting point and implies that positive and constructive conceptions and attitudes are developed regarding the evaluation of teaching performance, where students' responsibility is desired. It is not uncommon to find teachers feeling threatened at various levels, in particular as regards their autonomy and their professional dignity. Evaluation must be useful in that it should enable decisions to be taken to improve teacher performance, the quality of teaching or the learning climate of the school. This study is part of a research project whose main objective is to identify, select, evaluate and synthesize the available evidence on Quality Indicators in Higher Education. In this work, the 01 parameters resulting from pedagogical surveys in a Portuguese higher education institution in the north of the country will be presented, surveys for the 2015/2016 school year, presented to 1751 students, in a total of 11 degrees and 18 master's degrees. It has analyzed the evaluation made by students with respect to the performance of a group of 68 teachers working full time. This paper presents the lessons learned in the last three academic years, allowing for the identification of the effects on the following areas: teaching strategies and methodologies, capacity of systematization, learning climate, creation of conditions for active student participation. This paper describes the procedures resulting from the descriptive analysis (frequency analysis, descriptive measures and association measures) and inferential analysis (ANOVA one-way, MANOVA one-way, MANOVA two-way and correlation analysis).

Keywords: teaching performance, higher education, students responsibility, indicators of teaching management

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Authors: Devendra Gupta, S. P. Ambesh, P. K Singh

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Introduction: Minimally invasive coronary artery bypass grafting (MICABG) is a less invasive method of performing surgical revascularization. Minimally invasive direct coronary artery bypass (MIDCAB) provides many anesthetic challenges including one lung ventilation (OLV), managing myocardial ischemia, and pain. We present an early and midterm result of the use of this technique with OLV. Method: We enrolled 62 patients for analysis operated between 2008 and 2012. Patients were anesthetized and left endobronchial tube was placed. During the procedure left lung was isolated and one lung ventilation was maintained through right lung. Operation was performed utilizing off pump technique of coronary artery bypass grafting through a minimal invasive incision. Left internal mammary artery graft was done for single vessel disease and radial artery was utilized for other grafts if required. Postoperative ventilation was done with single lumen endotracheal tube. Median follow-up is 2.5 years (6 months to 4 years). Results: Median age was 58.5 years (41-77) and all were male. Single vessel disease was present in 36, double vessel in 24 and triple vessel disease in 2 patients. All the patients had normal left ventricular size and function. In 2 cases difficulty were encounter in placement of endobronchial tube. In 1 case cuff of endobronchial tube was ruptured during intubation. High airway pressure was developed on OLV in 1 case and surgery was accomplished with two lung anesthesia with low tidal volume. Mean postoperative ventilation time was 14.4 hour (11-22). There was no perioperative and 30 day mortality. Conversion to median sternotomy to complete the operation was done in 3.23% (2 out of 62 patients). One patient had acute myocardial infarction postoperatively and there were no deaths during follow-up. Conclusion: MICABG is a safe and effective method of revascularization with OLV in low risk candidates for coronary artery bypass grafting.

Keywords: MIDCABG, one lung ventilation, coronary artery bypass grafting, endobronchial tube

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Authors: Samuel Quick

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The purpose of this paper is to examine future urban street design in the context of developing technologies, evolving street typologies, and projected transportation trends. The goal was to envision a future urban street in the year 2060 that addresses the advent and implementation of autonomous vehicles, the promotion of new street typologies, and the projection of current transportation trends. Using a hierarchy of functional needs for urban streets, the future street was designed and evaluated based on the functions the street provides to the surrounding community. The site chosen for the future street design is an eight-block section of West North Avenue in the city of Baltimore, Maryland. Three different conceptual designs were initially completed and evaluated leading to a master plan for West North Avenue as well as street designs for connecting streets that represent different existing street types. Final designs were compared with the existing street design and evaluated with the adapted ‘Hierarchy of Needs’ theory. The review of the literature and the results from this paper indicate that urban streets will have to become increasingly multi-functional to meet the competing needs of the environment and community. Future streets will have to accommodate multimodal transit which will include mass transit, walking, and biking. Furthermore, a comprehensive implementation of green infrastructure within the urban street will provide access to nature for urban communities and essential stormwater management. With these developments, the future of an urban street will move closer to a greenway typology. Findings from this study indicate that urban street design will have to be policy-driven to promote and implement autonomous bus-rapid-transit in order to conserve street space for other functions. With this conservation of space, urban streets can then provide more functions to the surrounding community, taking a holistic approach to urban street design.

Keywords: autonomous vehicle, greenway, green infrastructure, multi-modality, street typology

Procedia PDF Downloads 182

Authors: Farheen Tabassum, Shoab Ahmed Khan

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The brutality of attacks on networks and decisive infrastructures are on the climb over recent years and appears to continue to do so. Distributed Denial of service attack is the most prevalent and easy attack on the availability of a service due to the easy availability of large botnet computers at cheap price and the general lack of protection against these attacks. Application layer DDoS attack is DDoS attack that is targeted on wed server, application server or database server. These types of attacks are much more sophisticated and challenging as they get around most conventional network security devices because attack traffic often impersonate normal traffic and cannot be recognized by network layer anomalies. Conventional techniques of single-hosted security systems are becoming gradually less effective in the face of such complicated and synchronized multi-front attacks. In order to protect from such attacks and intrusion, corporation among all network devices is essential. To overcome this issue, a collaborative intrusion detection system (CIDS) is proposed in which multiple network devices share valuable information to identify attacks, as a single device might not be capable to sense any malevolent action on its own. So it helps us to take decision after analyzing the information collected from different sources. This novel attack detection technique helps to detect seemingly benign packets that target the availability of the critical infrastructure, and the proposed solution methodology shall enable the incident response teams to detect and react to DDoS attacks at the earliest stage to ensure that the uptime of the service remain unaffected. Experimental evaluation shows that the proposed collaborative detection approach is much more effective and efficient than the previous approaches.

Keywords: Distributed Denial-of-Service (DDoS), Collaborative Intrusion Detection System (CIDS), Slowloris, OSSIM (Open Source Security Information Management tool), OSSEC HIDS

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Authors: Rahul Paul, Peter Mctaggart, Luke Skinner

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Maintaining public safety and network reliability are the core objectives of all electricity distributors globally. For many electricity distributors, managing vegetation clearances from their above ground assets (poles and conductors) is the most important and costly risk mitigation control employed to meet these objectives. Light Detection And Ranging (LiDAR) is widely used by utilities as a cost-effective method to inspect their spatially-distributed assets at scale, often captured using high powered LiDAR scanners attached to fixed wing or rotary aircraft. The resulting 3D point cloud model is used by these utilities to perform engineering grade measurements that guide the prioritisation of vegetation cutting programs. Advances in computer vision and machine-learning approaches are increasingly applied to increase automation and reduce inspection costs and time; however, real-world LiDAR capture variables (e.g., aircraft speed and height) create complexity, noise, and missing data, reducing the effectiveness of these approaches. This paper proposes a method for identifying each conductor from LiDAR data via clustering methods that can precisely reconstruct conductors in complex real-world configurations in the presence of high levels of noise. It proposes 3D catenary models for individual clusters fitted to the captured LiDAR data points using a least square method. An iterative learning process is used to identify potential conductor models between pole pairs. The proposed method identifies the optimum parameters of the catenary function and then fits the LiDAR points to reconstruct the conductors.

Keywords: point cloud, LİDAR data, machine learning, computer vision, catenary curve, vegetation management, utility industry

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Authors: Claudio Clemente, Valentina Gargiulo, Alessio Occhicone, Giovanni Piero Pepe, Giovanni Ausanio, Michela Alfè

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Volatile organic compound (VOC) emissions represent a serious risk to human health and the integrity of the ecosystems, especially at high concentrations. For this reason, it is very important to continuously monitor environmental quality and develop fast and reliable portable sensors to allow analysis on site. Chemiresistors have become promising candidates for VOC sensing as their ease of fabrication, variety of suitable sensitive materials, and simple sensing data. A chemoresistive gas sensor is a transducer that allows to measure the concentration of an analyte in the gas phase because the changes in resistance are proportional to the amount of the analyte present. The selection of the sensitive material, which interacts with the target analyte, is very important for the sensor performance. The most used VOC detection materials are metal oxides (MOx) for their rapid recovery, high sensitivity to various gas molecules, easy fabrication. Their sensing performance can be improved in terms of operating temperature, selectivity, and detection limit. Metal-organic frameworks (MOFs) have attracted a lot of attention also in the field of gas sensing due to their high porosity, high surface area, tunable morphologies, structural variety. MOFs are generated by the self-assembly of multidentate organic ligands connecting with adjacent multivalent metal nodes via strong coordination interactions, producing stable and highly ordered crystalline porous materials with well-designed structures. However, most MOFs intrinsically exhibit low electrical conductivity. To improve this property, MOFs can be combined with organic and inorganic materials in a hybrid fashion to produce composite materials or can be transformed into more stable structures. MOFs, indeed, can be employed as the precursors of metal oxides with well-designed architectures via the calcination method. The MOF-derived MOx partially preserved the original structure with high surface area and intrinsic open pores, which act as trapping centers for gas molecules, and showed a higher electrical conductivity. Core-shell heterostructures, in which the surface of a metal oxide core is completely coated by a MOF shell, forming a junction at the core-shell heterointerface, can also be synthesized. Also, nanocomposite in which MOF structures are intercalated with graphene related materials can also be produced, and the conductivity increases thanks to the high mobility of electrons of carbon materials. As MOF structures, zinc-based MOFs belonging to the ZIF family were selected in this work. Several Zn-based materials based and/or derived from MOFs were produced, structurally characterized, and arranged in a chemo resistive architecture, also exploring the potentiality of different approaches of sensing layer deposition based on PLD (pulsed laser deposition) and, in case of thermally labile materials, MAPLE (Matrix Assisted Pulsed Laser Evaporation) to enhance the adhesion to the support. The sensors were tested in a controlled humidity chamber, allowing for the possibility of varying the concentration of ethanol, a typical analyte chosen among the VOCs for a first survey. The effect of heating the chemiresistor to improve sensing performances was also explored. Future research will focus on exploring new manufacturing processes for MOF-based gas sensors with the aim to improve sensitivity, selectivity and reduce operating temperatures.

Keywords: chemiresistors, gas sensors, graphene related materials, laser deposition, MAPLE, metal-organic frameworks, metal oxides, nanocomposites, sensing performance, transduction mechanism, volatile organic compounds

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Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

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Authors: Péricles Maia Andrade, Temístocles Damasceno Silva, Hector Luiz Rodrigues Munaro

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The school physical education is going through several changes over the years, and diversification of its content from specific interests is one of the reasons for these changes, soon, the formality in education do not have to stay out, but needs to open up the possibilities offered by the world, so the Mountain Bike, an adventure sport, offers several opportunities for intervention Its application in the school allows diverse interventions in front of the psychomotor development, besides opening possibilities for other contents, respecting the previous experiences of the students in their common environment. The choice of theme was due to affinity with the practice and experience of the Mountain Bike at different levels. Both competitive as recreational, professional standard and amateur, focus as principle the bases of the Cycling, coupled with the inclusion in the Centre for Studies in Management of Sport and Leisure and of the Southwest Bahia State University and the preview of the modality's potential to help the children’s psychomotor development. The goal of this research was to demonstrate like a pilot project the effects of the Mountain Bike as psychomotor instrument in physical education at one of the psychomotor valences, Balance, evaluating Immobility, Static Balance and Dynamic Balance. The methodology used Fonseca’s Psychomotor Battery in 10 students (n=10) of a brazilian public primary’s school, with ages between 9 and 11 years old to use the Mountain Biking contents. The balance’s skills dichotomized in Regular and Good. Regarding the variable Immobility, in the initial test, regardless of gender, 70% (n = 7) were considered Regular. After four months of activity, the Good profile, which had only 30% (n = 3) of the sample, evolved to 60% (n = 6). As in Static and Dynamic Balance there was an increase of 30% (n = 3) and 50% (n = 5) respectively for Good. Between genders, female evolution was better for Good in Immobility and in Static Equilibrium. Already the male evolution was better observed in the Dynamic Equilibrium, with 66.7% (n = 4) for Good. Respecting the particularities of the motor development, an indication of the positive effects of the MTB for the evolution in the balance perceived, necessitating studies with greater sampling.

Keywords: psychomotricity, balance, mountain biking, education

Procedia PDF Downloads 203