Search results for: hospital inventory

Authors: Ngwa Lodence Njwe

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This study investigated the response of hemodialysis patients to an established nutrition therapy guide accompanied by a 7-day menu plan administered for a month. End Stage Renal Disease (ESRD), also known as End Stage Kidney Disease (ESKD), is a non-communicable disease primarily caused by hypertension and diabetes, posing significant challenges in both developed and developing nations. Hemodialysis is a key treatment for these patients. In this experimental study, 100 hemodialysis patients from Douala General Hospital in Cameroon participated. A questionnaire was used to collect data on sociodemographic and anthropometric characteristics, health status, and dietary intake, while medical records provided biomedical data. The levels of the biochemical parameters (Phosphorus, calcium and hemoglobin) were determined before and one month after the distribution of the nutrition education guide and the use of a 7-day menu plan. The Phosphorus and Calcium levels were measured using an LTCC03 semi-automatic chemistry analyzer. Blood was collected from each patient into a test tube, allowed to clot and centrifuged. 50µl of the serum was aspirated by the analyzer for Ca and P level analysis, and results were read from the display. The hemoglobin level was measured using the URIT–12 hemoglobin Meter. The blood sample was collected by hand prick and placed in a strip, and the results were read from the screen. The means of the biochemical parameters were then computed. The most prevalent age group was 40-49 years, with males constituting 70% and females 30% of respondents. Among these patients, 80% were hypertensive, 3% had both hypertension and diabetes, 9% were hypertensive, diabetic, and obese, and 1% suffered from hypertension and heart failure. Analysis of anthropometric parameters revealed a high prevalence of underweight, overweight, and obesity, highlighting the urgent need for targeted nutrition interventions to modify cooking methods, enhance food choices, and increase dietary variety for improved quality of life. Before the nutrition therapy guide was implemented, average calcium levels were 73.05 mg/L for males and 89.44 mg/L for females; post-implementation, these values increased to 77.55 mg/L and 91.44 mg/L, respectively. Conversely, average phosphorus levels decreased from 42.05 mg/L for males and 43.55 mg/L for females to 41.05 mg/L and 39.3 mg/L, respectively, after the intervention. Additionally, average hemoglobin levels increased from 8.35 g/dL for males and 8.5 g/dL for females to 9.2 g/dL and 8.95 g/dL, respectively. The findings confirm that the nutrition therapy guide and the 7-day menu significantly impacted the biomedical parameters of hemodialysis patients, underscoring the need for ongoing nutrition education and counseling for this population.

Keywords: end stage kidney disease, nutrition therapy guide, nutritional status, anthropometric parameters, food frequency, biomedical data

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Authors: Mette Kjerholt, Thora Grothe Thomsen, Connie Bøttcher Berthelsen, Bibi Hølge Hazelton

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Academic nursing is a relatively new phenomenon in Denmark. Leadership and management training in nursing does not prepare Danish nurse leaders to become leaders for nurses with academic background, and some leaders may feel estranged with including this kind of nursing staff in clinical settings. Currently there is a debate regarding what academic nurses can contribute with in clinical practice, and some managers express concern regarding whether this will lead to less focus on clinical practice and more focus on theoretical issues that may not seem so relevant in a busy everyday clinical setting. The paper will present the experiences of integrating three advanced nurse practitioners with Ph.D. degrees (ANP) in three different clinical departments at a regional hospital in Denmark with no prior experiences with such profiles among its staff.

Keywords: leadership, advanced nurse practitioners, clinical practice, academic nursing

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Authors: Zahra BehboodiI-Moghadam, Zohre Khalajinia, Ali Reza Nikbakht Nasrabadi, Minoo Mohraz

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The purpose of our study was to explore and describe the experiences of pregnant women with HIV in Iran. A qualitative exploratory study with conventional content analysis was used. Twelve pregnant women with HIV who referred to perinatal care at the Imam Khomeini Hospital Behavioral Diseases Consultation: Center in Tehran were recruited to participate in in-depth interviews. The average age of the participants was 32.5 years. Four main themes were extracted from the data: “fear and hope, “stigma and discrimination, “marital life stability” and “trust”. The findings reveal the pregnant women living with HIV are vulnerable and need professional support. Improving the knowledge of healthcare professionals especially midwifes on pregnancy complications for women with HIV is crucial in order to provide high-quality care to pregnant women with HIV-positive.

Keywords: HIV, pregnancy, content analysis, experiences, Iran, qualitative research

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Authors: E. Yeşil, M. Özgök, M. Özdemir, B. Köse

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The aim of the present study was to compare nutritional status, tendency of depression and orthorexia nervosa in vegan, vegetarian and omnivorous. The sample consisted of 150 individuals (126 women, 24 men) who agreed to participate in the study between February and May of the year 2018. Fifty vegan, fifty vegetarian and fifty omnivore diet pattern were compared. In the first part, each participant was interviewed using a structured questionnaire to obtain demographic information about education, occupation and health conditions. In the second part Beck Depression Inventory (BDI) was used. In the third part ORTO-11 was used. In the fourth part, 24 Hours Dietary Record was used in order to determine the nutritional status of individuals. The vegans and vegetarians were interviewed about their diets. The mean body mass index of the vegan, vegetarian and omnivore were, 21,24 ± 3,25; 22,2 ± 4,1 and 22,8 ± 4,3 respectively (p > 0,05). The daily energy intakes of the vegan, vegetarian and omnivore diet were 1792,57 ± 784,8 kcal; 1691,9 ± 742,2 kcal and 1697,9 ± 695,6 kcal (p > 0.05). The mean BDI of the vegan, vegetarian and omnivore diet were 6,2 ± 6,2, 9,8 ± 10,1 and 8,8 ± 8,1, respectively (p > 0,05). The mean ORTO-11 of the vegan, vegetarian and omnivore diet were 25,9 ± 4,2, 27,2 ± 5,9 and 26,4 ± 5,3 (p > 0,05). There was a statistically significant correlation between BDI and ORTO-11 in vegan diet group (p: 0,01 r: 0,333). There was a positive correlation between BMI and BDI in the vegetarian group (p: 0,01 r: 0,363). Also in the vegetarian group; there was a negative correlation between age and ORTO-11 (p: 0,01 r: -0,316). A statistically significant negative correlation was found between waist circumference and ORTO-11 (p: 0,05 r: -0,316) in the omnivore diet group. Also there was a negative correlation between age and BDI (p: 0,05 r: -0,338) in this group. As a conclusion, positive correlation was found between BDI and ORTO-11 score of vegan participants. There were no differences between three groups in BDI or ORTO-11 score.

Keywords: depression, orthorexia nervosa, vegan, vegetarian

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Authors: Aakriti Chetan Shah, Elle Sein

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Background/purpose: Group B Streptococcus(GBS) is the leading cause of severe early onset infection in newborns, with the incidence of Early Onset Group B Streptococcus (EOGBS) in the UK and Ireland rising from 0.48 to 0.57 per 1000 births from 2000 to 2015. A WHO study conducted in 2017, has shown that 38.5% of cases can result in stillbirth and infant deaths. This is an important problem to consider as 20% of women worldwide have GBS colonisation and can suffer from these detrimental effects. Current Royal College of Obstetricians and Midwives (RCOG) guidelines do not recommend bacteriological screening for pregnant women due to its low sensitivity in antenatal screening correlating with the neonate having GBS but advise a patient information leaflet be given to pregnant women. However, a Healthcare Safety Investigation Branch (HSIB) 2019 learning report found that only 50% of trusts and health boards reported giving GBS information leaflets to all pregnant mothers. Therefore, this audit aimed to assess current practices of information dissemination about GBS at Chelsea & Westminster (C&W) Hospital. Methodology: A quantitative cross-sectional study was carried out using a questionnaire based on the RCOG GBS guidelines and the HSIB Learning report. The study was conducted in antenatal clinics at Chelsea & Westminster Hospital, from 29th January 2021 to 14th February 2021, with twenty-two practicing obstetricians and midwives participating in the survey. The main outcome measure was the proportion of obstetricians and midwives who disseminate information about GBS to pregnant women, and the reasons behind why they do or do not. Results: 22 obstetricians and midwives responded with 18 complete responses. Of which 12 were obstetricians and 6 were midwives. Only 17% of clinical staff routinely inform all pregnant women about GBS, and do so at varying timeframes of the pregnancy, with an equal split in the first, second and third trimester. The primary reason for not informing women about GBS was influenced by three key factors: Deemed relevant only for patients at high risk of GBS, lack of time in clinic appointments and no routine NHS screening available. Interestingly 58% of staff in the antenatal clinic believe it is necessary to inform all women about GBS and its importance. Conclusion: It is vital for obstetricians and midwives to inform all pregnant women about GBS due to the high prevalence of incidental carriers in the population, and the harmful effects it can cause for neonates. Even though most clinicians believe it is important to inform all pregnant women about GBS, most do not. To ensure that RCOG and HSIB recommendations are followed, we recommend that women should be given this information at 28 weeks gestation in the antenatal clinic. Proposed implementations include an information leaflet to be incorporated into the Mum and Baby app, an informative video and end-to-end digital clinic documentation to include this information sharing prompt.

Keywords: group B Streptococcus, early onset sepsis, Antenatal care, Neonatal morbidity, GBS

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Authors: Constantinos S. Mammas, Andreas Lazaris, Adamantia S. Mamma-Graham, Georgia Kostopanagiotou, Chryssa Lemonidou, John Mantas, Eustratios Patsouris

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The process to build a better safety culture, methods of error analysis, and preventive measures, starts with an understanding of the effects when human factors engineering refer to remote microscopic diagnosis in surgery and specially in organ transplantation for the evaluation of the grafts. Α high percentage of solid organs arrive at the recipient hospitals and are considered as injured or improper for transplantation in the UK. Digital microscopy adds information on a microscopic level about the grafts (G) in Organ Transplant (OT), and may lead to a change in their management. Such a method will reduce the possibility that a diseased G will arrive at the recipient hospital for implantation. Aim: The aim of this study is to analyze the ergonomics of digital microscopy (DM) based on virtual slides, on telemedicine systems (TS) for tele-pathological evaluation (TPE) of the grafts (G) in organ transplantation (OT). Material and Methods: By experimental simulation, the ergonomics of DM for microscopic TPE of renal graft (RG), liver graft (LG) and pancreatic graft (PG) tissues is analyzed. In fact, this corresponded to the ergonomics of digital microscopy for TPE in OT by applying virtual slide (VS) system for graft tissue image capture, for remote diagnoses of possible microscopic inflammatory and/or neoplastic lesions. Experimentation included the development of an OTE-TS similar experimental telemedicine system (Exp.-TS) for simulating the integrated VS based microscopic TPE of RG, LG and PG Simulation of DM on TS based TPE performed by 2 specialists on a total of 238 human renal graft (RG), 172 liver graft (LG) and 108 pancreatic graft (PG) tissues digital microscopic images for inflammatory and neoplastic lesions on four electronic spaces of the four used TS. Results: Statistical analysis of specialist‘s answers about the ability to accurately diagnose the diseased RG, LG and PG tissues on the electronic space among four TS (A,B,C,D) showed that DM on TS for TPE in OT is elaborated perfectly on the ES of a desktop, followed by the ES of the applied Exp.-TS. Tablet and mobile-phone ES seem significantly risky for the application of DM in OT (p<.001). Conclusion: To make the largest reduction in errors and adverse events referring to the quality of the grafts, it will take application of human factors engineering to procurement, design, audit, and awareness-raising activities. Consequently, it will take an investment in new training, people, and other changes to management activities for DM in OT. The simulating VS based TPE with DM of RG, LG and PG tissues after retrieval, seem feasible and reliable and dependable on the size of the electronic space of the applied TS, for remote prevention of diseased grafts from being retrieved and/or sent to the recipient hospital and for post-grafting and pre-transplant planning.

Keywords: digital microscopy, organ transplantation, tele-pathology, virtual slides

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Authors: Thao Nguyen, Maximiliano Hyon, Sany Rajagukguk, Anna Melkonyan

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Introduction: Type 2 Diabetes is a well-established risk factor for severe SARS-CoV-2 infection. Uncontrolled hyperglycemia in patients with established or newly diagnosed diabetes is associated with poor outcomes, including increased mortality and hospital length of stay. Objectives: Our study aims to compare three different glycemic management strategies and their association with clinical outcomes in patients hospitalized for moderate to severe SARS-CoV-2 infection. Identifying optimal glycemic management strategies will improve the quality of patient care and improve their outcomes. Method: This is a retrospective observational study on patients hospitalized at Adventist Health White Memorial with severe SARS-CoV-2 infection from 11/1/2020 to 02/28/2021. The following inclusion criteria were used: positive SARS-CoV-2 PCR test, age >18 yrs old, diabetes or random glucose >200 mg/dL on admission, oxygen requirement >4L/min, and treatment with glucocorticoids. Our exclusion criteria included: ICU admission within 24 hours, discharge within five days, death within five days, and pregnancy. The patients were divided into three glycemic management groups: Group 1, managed solely by the Primary Team, Group 2, by Pharmacy; and Group 3, by Endocrinologist. Primary outcomes were average glucose on Day 5, change in glucose between Days 3 and 5, and average insulin dose on Day 5 among groups. Secondary outcomes would be upgraded to ICU, inpatient mortality, and hospital length of stay. For statistics, we used IBM® SPSS, version 28, 2022. Results: Most studied patients were Hispanic, older than 60, and obese (BMI >30). It was the first CV-19 surge with the Delta variant in an unvaccinated population. Mortality was markedly high (> 40%) with longer LOS (> 13 days) and a high ICU transfer rate (18%). Most patients had markedly elevated inflammatory markers (CRP, Ferritin, and D-Dimer). These, in combination with glucocorticoids, resulted in severe hyperglycemia that was difficult to control. Average glucose on Day 5 was not significantly different between groups primary vs. pharmacy vs. endocrine (220.5 ± 63.4 vs. 240.9 ± 71.1 vs. 208.6 ± 61.7 ; P = 0.105). Change in glucose from days 3 to 5 was not significantly different between groups but trended towards favoring the endocrinologist group (-26.6±73.6 vs. 3.8±69.5 vs. -32.2±84.1; P= 0.052). TDD insulin was not significantly different between groups but trended towards higher TDD for the endocrinologist group (34.6 ± 26.1 vs. 35.2 ± 26.4 vs. 50.5 ± 50.9; P=0.054). The endocrinologist group used significantly more preprandial insulin compared to other groups (91.7% vs. 39.1% vs. 65.9% ; P < 0.001). The pharmacy used more basal insulin than other groups (95.1% vs. 79.5% vs. 79.2; P = 0.047). There were no differences among groups in the clinical outcomes: LOS, ICU upgrade, or mortality. Multivariate regression analysis controlled for age, sex, BMI, HbA1c level, renal function, liver function, CRP, d-dimer, and ferritin showed no difference in outcomes among groups. Conclusion: Given high-risk factors in our population, despite efforts from the glycemic management teams, it’s unsurprising no differences in clinical outcomes in mortality and length of stay.

Keywords: glycemic management, strategies, hospitalized, SARS-CoV-2, outcomes

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Authors: Khalil Aryanfar, Shahrzad Sanjari, Pariya Gholipor, Elmira Hafez

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The present study aimed to investigate and compare the characteristics of entrepreneurship among students in senior secondary schools in the academic year 2008-2009 in Tabriz city. Research employed survey method respectively. The study population consisted of all students in the senior branch of theoretical, technical, professional and vocational (1033 patients) were included. Sample size of 493 was calculated according to Morgan table. Sampling method was random cluster and stratified sampling. Data collected by researcher made questionnaire based on the theory of MC clleland (1963) and Brvkhavs (1980). These tools would indicators be for achievement, Independence, disposition, creativity, risk-taking, self-control, tolerance for ambiguity, team work approach in the future. To determine the psychometric properties of the questionnaire, content validity of the survey was approved by relevant experts. In addition, to estimate the internal consistency of Cronbach's alpha coefficient was calculated for 84% of total inventory. Collected data Using mean, standard deviation and were analyzed by ANOVA. The results showed that there is a significant difference between students' entrepreneurial potential fields of theoretical, technical, professional and vocational level (0/01).

Keywords: entrepreneurship, achievement motivation, risk taking, creativity, self-control, independence, tolerance of ambiguity, foresight

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Authors: Riyadh Jamegh, AllaEldin Kassam, Sawsan Sabih

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In modern trends of market, organizations face high-pressure environment which is characterized by globalization, high competition, and customer orientation, so it is very crucial to control and know the weak and strong points of the supply chain in order to improve their performance. So the performance measurements presented as an important tool of supply chain management because it's enabled the organizations to control, understand, and improve their efficiency. This paper aims to identify supply chain performance measurement (SCPM) by using Fuzzy Analytical Hierarchical Process (FAHP). In our real application, the performance of organizations estimated based on four parameters these are cost parameter indicator of cost (CPI), inventory turnover parameter indicator of (INPI), raw material parameter (RMPI), and safety stock level parameter indicator (SSPI), these indicators vary in impact on performance depending upon policies and strategies of organization. In this research (FAHP) technique has been used to identify the importance of such parameters, and then first fuzzy inference (FIR1) is applied to identify performance indicator of each factor depending on the importance of the factor and its value. Then, the second fuzzy inference (FIR2) also applied to integrate the effect of these indicators and identify (SCPM) which represent the required output. The developed approach provides an effective tool for evaluation of supply chain performance measurement.

Keywords: fuzzy performance measurements, supply chain, fuzzy logic, key performance indicator

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Authors: Shu Tao

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Based on a global fuel consumption data product (PKU-FUEL-2007) compiled recently and a series of databases for emission factors of various sources, global emission inventories of a number of greenhouse gases and air pollutants, including CO2, CO, SO2, NOx, primary particulate matter (total, PM 10, and PM 2.5), black carbon, organic carbon, mercury, volatile organic carbons, and polycyclic aromatic hydrocarbons, from combustion sources have been developed. The inventories feather high spatial and sectorial resolutions. The spatial resolution of the inventories are 0.1 by 0.1 degree, based on a sub-national disaggregation approach to reduce spatial bias due to uneven distribution of per person fuel consumption within countries. The finely resolved inventories provide critical information for chemical transport modeling and exposure modeling. Emissions from more than 60 sources in energy, industry, agriculture, residential, transportation, and wildfire sectors were quantified in this study. With the detailed sectorial information, the inventories become an important tool for policy makers. For residential sector, a set of models were developed to simulate temporal variation of fuel consumption, consequently pollutant emissions. The models can be used to characterize seasonal as well as inter-annual variations in the emissions in history and to predict future changes. The models can even be used to quantify net change of fuel consumption and pollutant emissions due to climate change. The inventories has been used for model ambient air quality, population exposure, and even health effects. A few examples of the applications are discussed.

Keywords: air pollutants, combustion, emission inventory, sectorial information

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Authors: Avantika Verma

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Diabetic retinopathy (DR) and Central serous retinopathy (CSR) are 2 distinct entities, with difference in age of presentation, eitiopathogenesis and clinical features, but when occurring together, can be a diagnostic dilemma and requires careful evaluation. Case study of 3 patients with long standing diabetes (>15yrs) and features of Central serous retinopathy was done at Bangalore West Lions Superspeciality Eye Hospital, Bangalore, India in 2013. Even though diabetic retinopathy and CSR have different pathologies, they can coexist. The reason for coexistence could be the following: A patient with CSR as a young adult could develop DR in later years. Stress could be the contributing factor in older patient with diabetes.Stress could be a common factor for both, as it is one of the important factors in the pathogenesis of Maturity Onset Diabetes Miletus (MODY). In any situation, a careful evaluation is necessary to differentiate the cause of fundus picture, as treatment differs for the two diseases.

Keywords: central serous retinopathy, diabetic retinopathy, existence, stress

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Authors: Arum Perwitasari

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Learning L2 sounds is influenced by the first language (L1) sound system. This current study seeks to examine how the listeners with a different L1 vowel system perceive L2 sounds. The fact that English has a bigger number of vowel inventory than Javanese and Sundanese L1 might cause problems for Javanese and Sundanese English language learners perceiving English sounds. To reveal the L2 sound perception over time, we measured the mouse trajectories related to the hand movements made by Javanese and Sundanese language learners, two of Indonesian local languages. Do the Javanese and Sundanese listeners show higher velocity than the English listeners when they perceive English vowels which are similar and new to their L1 system? The study aims to map the patterns of real-time processing through compatible hand movements to reveal any uncertainties when making selections. The results showed that the Javanese listeners exhibited significantly slower velocity values than the English listeners for similar vowels /I, ɛ, ʊ/ in the 826-1200ms post stimulus. Unlike the Javanese, the Sundanese listeners showed slow velocity values except for similar vowel /ʊ/. For the perception of new vowels /i:, æ, ɜ:, ʌ, ɑː, u:, ɔ:/, the Javanese listeners showed slower velocity in making the lexical decision. In contrast, the Sundanese listeners showed slow velocity only for vowels /ɜ:, ɔ:, æ, I/ indicating that these vowels are hard to perceive. Our results fit well with the second language model representing how the L1 vowel system influences the L2 sound perception.

Keywords: velocity profiles, EFL learners, speech perception, experimental linguistics

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Authors: Anna Wendolowska, Dorota Czyzowska

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An intimate relationship is a significant factor that influences romantic partners’ well-being. In the face of stress, avoidant partners often employ a defense-against-intimacy strategy, leading to reduced relationship satisfaction, intimacy, interdependence, and longevity. Dyadic coping can buffer the negative effects of stress on relational satisfaction. Emotional competence mediates the relationship between insecure attachment and intimacy. In the current study, the link between attachment, different forms of dyadic coping, and various aspects of relationship satisfaction was examined. Both partners completed the attachment style questionnaire, the well matching couple questionnaire, and the dyadic coping inventory. The data was analyzed using the actor–partner interdependence model. The results highlighted a negative association between insecure-avoidant attachment style and intimacy. The actor effects of avoidant attachment on relational intimacy for women and for men were significant, whilst the partner effects for both spouses were not significant. The emotion-focused common dyadic coping moderated the relationship between avoidance of attachment and the partner's sense of intimacy. After controlling for the emotion-focused common dyadic coping, the actor effect of attachment on intimacy for men was slightly weaker, and the actor effect for women turned out to be insignificant. The emotion-focused common dyadic coping weakened the negative association between insecure attachment and relational intimacy. The impact of adult attachment and dyadic coping significantly contributes to subjective relational well-being.

Keywords: adult attachment, dyadic coping, relational intimacy, relationship satisfaction

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Authors: Ademola Ibukunolu Atanda, Gbenga Nathaniel Adeola

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The study examined awareness of child rights as a determinant of effective student personnel services in public secondary schools in Southwestern Nigeria. It was survey research. The sample comprised 433 teachers, 137 school administrators, and 968 students who were drawn by simple random sampling techniques. The respondents were given copies of questionnaires tagged “school administrator/teacher’s awareness of child’s rights and student personnel services elements inventory.” Key Informant Interview (KII) was also employed. The data were analysed using frequency count, percentages, weighted average, grand mean, standard deviation, and Pearson Product Moment Correlation, while KII was qualitatively analysed. The findings of the study revealed that public secondary school administrator awareness of child rights was at a moderate level, but the awareness of child rights was low among the teachers. The study equally revealed that student personnel services are moderately provided in public secondary schools in Southwestern Nigeria, but security remains a major challenge. It was also found that there was a significant relationship between awareness of child rights and effective student personnel services. It was therefore recommended, based on the findings, that attention should be given to heightening awareness of child rights among public secondary school administrators and teachers for effective student personnel services. Copies of the Child Right Act 2003 should also be made available in all public secondary schools in Southwestern Nigeria, as the study revealed that the documents were not available.

Keywords: student personnel, child right, administrator awareness, practice of child right

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Authors: Umar Mamman

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The study investigated the impact of school environment and peer relations on antisocial behaviour of the students of science secondary schools in Katsina State. The study sought to achieve the following objectives: to determine whether school influences antisocial behaviour among science secondary school students, and to determine whether peer relation influences anti-social behaviour among science secondary school students. The study population composed of all the students in science secondary schools in Katsina State. The study used a sample of 378 students and 18 teachers randomly selected from eleven science secondary schools in Katsina state. Three instruments were used to collect data for the study, thus: socio-economic status background questionnaire, antisocial process screening device (APSD), and inventory of parent and peer relationship questionnaire. The study findings revealed that school environment has significant effect on antisocial behaviour of the students in science secondary school (F (7, 372) = 52.08, p ≤ .01), and there is a significant effect of peer relation on antisocial behaviour of the students in science secondary school (F (7, 372) = 14.229, p ≤ .01). Based on these findings the following major recommendations were made: School environment should be made attractive and conducive for learning and character development. Teachers, as role model, should desist from indecent acts. School environment should be made learner-centered and friendly. Functional guidance and counselling outfits need to be provided in all secondary schools in Katsina state.

Keywords: school environment, peer relation, anti-social behaviour, psychology

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Authors: Mwafak Shakoor

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The purpose of this study was to reduce patient waiting times, improve system throughput and improve resources utilization in radiology department. A discrete event simulation model was developed using Arena simulation software to investigate different alternatives to improve the overall system delivery based on adding resource scenarios due to the linkage between patient waiting times and resource availability. The study revealed that there is no addition investment need to procure additional scanner but hospital management deploy managerial tactics to enhance machine utilization and reduce the long waiting time in the department.

Keywords: discrete event simulation, radiology department, arena, waiting time, healthcare modeling, computed tomography

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Authors: Treder Natalia, Siemiński Mariusz

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Takotsubo cardiomyopathy (TC) is a recently defined clinical entity. First described by Japanese researchers, today is diagnosed worldwide in 1-2% of patients admitted with the preliminary diagnosis of Acute Coronary Syndrome. The etiology of takotsubo cardiomyopathy remains still largely unknown. Currently, the most likely cause of takotsubo is direct cytotoxicity caused by catecholamine surge triggered by emotional stress. There is a strong relation between recent severe emotional stress and TC. The aim of this study was to analysis the role of stress and personality as a risk factor of TT. The presented research involves 35 people who are diagnosed TC. All patients were women, mean age 60 years. The methods used in the research are popular psychological tests: Perceived Stress Scale, DS14 scale to measure type D personality, The Neo-Five Factor Inventory of Personality and psychological interview. The obtained results prove that stress events may directly precede or even release TC. The stressful events occurred directly before the symptoms in 75% examined. 65% assessed their family life as very stressful. Examiners have also a high level of experienced stress. Only 25% of the TC were classified as having type D personality but they have a high level of negative affectivity. The subjects had a high level of extraversion, openness to experiences and an average level of neuroticism. The results suggested that such a type of personality profile may predispose to the development of takotsubo cardiomyopathy. Patients with TT are the individuals who reveal joint tendency to the experience of negative emotions and very stressful family life.

Keywords: stress, personality trails, familiar problems, Takotsubo cardiomyopathy

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Authors: Timiebi Aganaba-Jeanty

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Accurate and transparent monitoring, reporting and verification of Greenhouse Gas (GHG) emissions and removals is a requirement of the United Nations Framework Convention on Climate Change (UNFCCC). Several countries are obligated to prepare and submit an annual national greenhouse gas inventory covering anthropogenic emissions by sources and removals by sinks, subject to a review conducted by an international team of experts. However, the process is not without flaws. The self-reporting varies enormously in thoroughness, frequency and accuracy including inconsistency in the way such reporting occurs. The world’s space agencies are calling for a new generation of satellites that would be precise enough to map greenhouse gas emissions from individual nations. The plan is delicate politically because the global system could verify or cast doubt on emission reports from the member states of the UNFCCC. A level playing field is required and an idea that an international system should be perceived as an instrument to facilitate fairness and equality rather than to spy on or punish. This change of perspective is required to get buy in for an international verification system. The research proposes the viability of a satellite system that provides independent access to data regarding greenhouse gas emissions and the policy and governance implications of its potential use as a monitoring and verification system for the Paris Agreement. It assesses the foundations of the reporting monitoring and verification system as proposed in Paris and analyzes this in light of a proposed satellite system. The use of remote sensing technology has been debated for verification purposes and as evidence in courts but this is not without controversy. Lessons can be learned from its use in this context.

Keywords: greenhouse gas emissions, reporting, monitoring and verification, satellite, UNFCCC

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Authors: Mehdi Destani, Asghar Heydari

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Objective: The present study aimed to investigate the association between pathological personality dimensions and emotion dysregulation through the mediating role of Cyberchondria behaviors among users of virtual networks. Materials and methods: A descriptive–correlational research method was used in this study, and the statistical population consisted of all people active on social network sites in 2020. The sample size was 300 people who were selected through Convenience Sampling. Data collection was carried out in a survey method using online questionnaires, including the "Difficulties in Emotion Regulation Scale" (DERS), Personality Inventory for DSM-5 Brief Form (PID-5-BF), and Cyberchondria Severity Scale Brief Form (CSS-12). Data analysis was conducted using Pearson's Correlation Coefficient and Structural Equation Modeling (SEM). Findings: Findings suggested that pathological personality dimensions and Cyberchondria behaviors have a positive and significant association with emotion dysregulation (p<0.001). The presented model had a good fit with the data. The variable “pathological personality dimensions” with an overall effect (p<0.001, β=0.658), a direct effect (p<0.001, β=0.528), and an indirect mediating effect through Cyberchondria Behaviors (p<.001), β=0.130), accounted for emotion dysregulation among virtual network users. Conclusion: The research findings showed a necessity to pay attention to the pathological personality dimensions as a determining variable and Cyberchondria behaviors as a mediator in the vulnerability of users of social network sites to emotion dysregulation.

Keywords: cyberchondria, emotion dysregulation, pathological personality dimensions, social networks

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Authors: Godfrey Katende, Lillian Nakimera

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The process of caregiving may cause emotional distress in form of anxiety and depression among family carers of cancer patients. Little is known about the prevalence anxiety and depression among family carers of cancer patients in Uganda. This cross-sectional study aimed to determine the prevalence of anxiety and depression among family carers of cancer patients and related factors associated with abnormal levels of anxiety and depression. A total of 119 family carers from Uganda Cancer Institute (UCI) were assessed by the Hospital Anxiety and Depression Scale (HADS) standardized questionnaire. The prevalence of anxiety and depression among family carers was high (45% and 26 % respectively); (2) abnormal levels of anxiety (ALA) and depression (ALD) was significantly associated with being a relative carer. Incorporating evidence based psychological therapies targeting family carers into usual care of cancer patients is imperative.

Keywords: anxiety, cancer, carer, cross-sectional design, depression, Uganda

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Authors: Simon Ibor Akpama

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The study investigated the extent to which innovative teaching-learning techniques can influence and attenuate learning difficulties among adult learners participating in different literacy education programmes in Calabar Metropolis, Cross River State, Nigeria. A quasi-experimental design was adopted to collect data from a sample size of 150 participants of the programme. The sample was drawn using the simple random sampling method. As an experimental study, the 150 participants were divided into two equal groups –the first was the experimental group while the second was the control. A pre-test was administered to the two groups which were later exposed to a post-test after treatment. Two instruments were used for data collection. The first was the guide for the Literacy Learning Difficulties Inventory (LLDI). Three hypotheses were postulated and tested as .05 level of significance using Analysis of Covariance (ANOVA) test statistics. Results of the analysis firstly showed that the two groups (treatment and control) did not differ in the pre-test regarding their literacy learning difficulties. Secondly, the result showed that for each hypothesis, innovative teaching-learning techniques significantly influenced adult learners’ (participants) literacy learning difficulties. Based on these findings, the study recommends the use of innovative teaching-learning techniques in adult literacy education centres to mitigate the learning difficulties of adult learners in literacy education programmes in Calabar Metropolis.

Keywords: teaching, learning, techniques, innovative, difficulties, programme

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Authors: V. Moser-Siegmeth, M. C. Gambal, M. Jelovcak, B. Prytek, I. Swietalsky, D. Würzl, C. Fida, V. Mühlegger

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Adaptability is the capacity to adjust without great difficulty to changing circumstances. Within our project, we aimed to detect whether older people living within a long-term care hospital lose the ability to adapt. Theoretical concepts are contradictory in their statements. There is also lack of evidence in the literature how the adaptability of older people changes over the time. Following research questions were generated: Are older residents of a long-term care facility able to adapt to changes within their daily routine? How long does it take for older people to adapt? The study was designed as a convergent parallel mixed method intervention study, carried out within a four-month period and took place within seven wards of a long-term care hospital. As a planned intervention, a change of meal-times was established. The inhabitants were surveyed with qualitative interviews and quantitative questionnaires and diaries before, during and after the intervention. In addition, a survey of the nursing staff was carried out in order to detect changes of the people they care for and how long it took them to adapt. Quantitative data was analysed with SPSS, qualitative data with a summarizing content analysis. The average age of the involved residents was 82 years, the average length of stay 45 months. The adaptation to new situations does not cause problems for older residents. 47% of the residents state that their everyday life has not changed by changing the meal times. 24% indicate ‘neither nor’ and only 18% respond that their daily life has changed considerably due to the changeover. The diaries of the residents, which were conducted over the entire period of investigation showed no changes with regard to increased or reduced activity. With regard to sleep quality, assessed with the Pittsburgh sleep quality index, there is little change in sleep behaviour compared to the two survey periods (pre-phase to follow-up phase) in the cross-table. The subjective sleep quality of the residents is not affected. The nursing staff points out that, with good information in advance, changes are not a problem. The ability to adapt to changes does not deteriorate with age or by moving into a long-term care facility. It only takes a few days to get used to new situations. This can be confirmed by the nursing staff. Although there are different determinants like the health status that might make an adjustment to new situations more difficult. In connection with the limitations, the small sample size of the quantitative data collection must be emphasized. Furthermore, the extent to which the quantitative and qualitative sample represents the total population, since only residents without cognitive impairments of selected units participated. The majority of the residents has cognitive impairments. It is important to discuss whether and how well the diary method is suitable for older people to examine their daily structure.

Keywords: adaptability, intervention study, mixed methods, nursing home residents

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Authors: R. Frikha, H. Kamoun

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Background:Chronicmyeloidleukemia (CML), a hematologicaldisease, ischaracterized by t (9; 22) and relatedoncogene BCR-ABL formation. Although Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of CML, resistanceoccurs and possibly médiates by mutation in severalgenesindependently of the bcr-abl1 kinase mechanism. it has been reportedthat JAK2V617F/BCR-ABL double positivitymaybe a potential marker of resistance in CML. Aims: This studywasinvestigated the JAK2V617F mutation in TKI-resistant CML patients. Methods: A retrospectivestudywasconducted in the Hospital University of Sfax, south of Tunisia, including all CML TKI-resistant patients. A Sanger sequencingwasperformedusing a high-fidelity DNA polymerase. Results:Nineresistant CP-CML patients wereenrolled in thisstudy. The JAK2V617F mutation wasdetectedin 3 patients with TKI resistance. Conclusion:Despite the limit of ourstudy, ourfinding highlights the high frequency of JAK2V617F/BCR-ABL double positivity as an important marker of resistance. So; the combination of JAK and TKI inhibitorsmightbe effective and potentiallybeguided by molecular monitoring of minimal residual disease1.

Keywords: chronic myeloid leukemia, tyrosine kinase inhibitors, resistance, JAK2V617F, BCR-ABL

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Authors: Rattakorn Poonsuph

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Technological innovation plays a crucial role in virtual healthcare services. A growing number of telehealth platforms are concentrating on using digital tools to improve the quality and availability of care. As a result, telehealth represents an opportunity to redesign the way health services are delivered. The research objective is to discover a new business model for digital health services and related industries to participate with telehealth solutions. The business opportunity is valuable for healthcare investors as a startup company to further investigations or implement the telehealth platform. The paper presents a digital healthcare business model and business opportunities to related industries. These include digital healthcare services extending from a traditional business model and use cases of business opportunities to related industries. Although there are enormous business opportunities, telehealth is still challenging due to the patient adaption and digital transformation process within a healthcare organization.

Keywords: telehealth, Internet hospital, HealthTech, InsurTech

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Authors: Jessica Bain, Greg Thoma, Marty Matlock, Jeyam Subbiah, Ebenezer Kwofie

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The environmental impact and particulate matter emissions (PM) associated with the production and packaging of 1 kg of almonds were evaluated using life cycle assessment (LCA). The assessment began at the point of ready to harvest with a system boundary was a cradle-to-gate assessment of almond packaging in California. The assessment included three scenarios of off-ground harvesting of almonds. The three general off-ground harvesting scenarios with variations include the harvested almonds solar dried on a paper tarp in the orchard, the harvested almonds solar dried on the floor in a separate lot, and the harvested almonds dried mechanically. The life cycle inventory (LCI) data for almond production were based on previously published literature and data provided by Almond Board of California (ABC). The ReCiPe 2016 method was used to calculate the midpoint impacts. Using consequential LCA model, the global warming potential (GWP) for the three harvesting scenarios are 2.90, 2.86, and 3.09 kg CO2 eq/ kg of packaged almond for scenarios 1, 2a, and 3a, respectively. The global warming potential for conventional harvesting method was 2.89 kg CO2 eq/ kg of packaged almond. The particulate matter emissions for each scenario per hectare for each off-ground harvesting scenario is 77.14, 9.56, 66.86, and 8.75 for conventional harvesting and scenarios 1, 2, and 3, respectively. The most significant contributions to the overall emissions were from almond production. The farm gate almond production had a global warming potential of 2.12 kg CO2 eq/ kg of packaged almond, approximately 73% of the overall emissions. Based on comparisons between the GWP and PM emissions, scenario 2a was the best tradeoff between GHG and PM production.

Keywords: life cycle assessment, low moisture foods, sustainability, LCA

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Authors: Deepak Khare, Radha Krishan, Bhaskar Nikam

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The present study deals with the results of the Ortho-rectified Cartosat-1 PAN (2.5 m resolution) satellite data analysis for the extraction of canal networks under the Eastern Ganga Canal (EGC) command. Based on the information derived through the remote sensing data, in terms of the number of canals, their physical status and hydraulic connectivity from the source, irrigation potential (IP) created in the command was assessed by comparing with planned/design canal-wise irrigation potentials. All the geospatial information generated in the study is organized in a geodatabase. The EGC project irrigates the command through one main canal, five branch canals, 36 distributaries and 186 minors. The study was conducted with the main objectives of inventory and mapping of irrigation infrastructure using geographic information system (GIS), remote sensing and field data. Likewise, the assessment of irrigation potential created using the mapped infrastructure was performed as on March 2017. Results revealed that the canals were not only pending but were also having gap/s, and hydraulically disconnected in each branch canal and also in minors of EGC. A total of 16622.3 ha of commands were left untouched with canal water just due to the presence of gaps in the EGC project. The sum of all the gaps present in minor canals was 11.92 km, while in distributary, it was 2.63 km. This is a very good scenario that balances IP can be achieved by working on the gaps present in minor canals. Filling the gaps in minor canals can bring most of the area under irrigation, especially the tail reaches command.

Keywords: canal command, GIS, hydraulic connectivity, irrigation potential

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Authors: Christiana Wulty Diku

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This research mapped and documented archaeological heritage resources with associated indigenous knowledge in Lawra, an understudied Municipality in the Upper West Region of Ghana. Since the inception of Archaeology as a discipline in the 1930s at the University of Ghana, the Lawra Municipality has rarely been investigated archaeologically. Consequently, the unconsciousness and ignorance of indigenes on the relevance of these resources to national development has destroyed many significant archaeological sites, with agriculture and infrastructural developmental activities endangering countless of them. Drawing from a community archaeological approach, a collaborative archaeological investigation between local groups, communities and professionals (archaeologists) was conducted to recover these lost histories of settlements in the municipality, salvage and protect endangered archaeological heritage resources and sites from agricultural, exploitative and developmental activities. This was geared towards expanding on the limited research on northern Ghana and deepening our understanding on the existing symbiotic relationship between people and their heritage resources in past and present times. The study deploying ethnographic, archaeological and physical survey techniques as methods in six field seasons beginning from August 2013 to April 2023. This resulted in the reconstruction of the settlement history of Lawra with chronological dates, compilation of inventory on significant archaeological heritage resources with associated indigenous knowledge, mitigation of endangered archaeological sites and heritage resources through surface collections and the development of a photographic record, with associated metadata for purposes of preservation and future research.

Keywords: archaeological heritage resources, indigenous knowledge, lawra municipality, community archaeology

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Authors: Torsten Mielitz, Dietmar Schulz, York C. Roth

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Market forecasts show a significant increase in the demand for aircraft within the next two decades and production rates will be adapted accordingly. Improvements and optimizations in the industrial system are becoming more important to cope with future challenges in manufacturing and assembly. Highest quality standards have to be met for aerospace parts, whereas cost effective production in industrial systems and methodologies are also a key driver. A look at other industries like e.g., automotive shows well established processes to streamline existing manufacturing systems. In this paper, the implementation of 'PULL' principles in an existing manufacturing process chain for a large scale composite part is presented. A nonlinear extrapolation based on 'Little's Law' showed a risk of a significant increase of parts needed in the process chain to meet future demand. A project has been set up to mitigate the risk whereas the methodology has been changed from a traditional milestone approach in the beginning towards an agile way of working in the end in order to facilitate immediate benefits in the shop-floor. Finally, delivery rates could be increased avoiding more semi-finished parts in the process chain (work in progress & inventory) by the successful implementation of the 'PULL' philosophy in the shop-floor between the work stations. Lessons learned during the running project as well as implementation and operations phases are discussed in order to share best practices.

Keywords: aerospace composite part manufacturing, PULL principles, shop-floor implementation, lessons learned

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Authors: Camille Plant, Katherine McGill, Pek Ang

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Oncology patients face a host of unique challenges, which are physical, psychological and philosophical in nature. This preliminary study aimed to explore the psychiatric morbidity of oncology patients in an outpatient setting at a major public hospital in Australia. The study found that 33 patients were referred to a Psychiatrist by a Clinical Psychologist or treating Oncologist. These patients attended an outpatient Psychiatry appointment at the Calvary Mater Hospital, Newcastle, over a 7 month period (June 2017-January 2018). Of these, 45% went on to have a follow-up appointment. The Clinical Global Impressions Scale (CGI) was used to gather symptom severity scores at baseline and at follow-up. The CGI is a clinician determined instrument that provides an assessment of global functioning. It is comprised of two companion one-item measures: the CGI-Severity (CGI-S) rates mental illness severity, and the CGI-Improvement (CGI-I) rates change in condition or improvement from initiation of treatment. Patients referred to a Psychiatrist were observed to be on average in the Markedly ill approaching Severely ill range (CGI-S average of 5.5). However, those patients who attended a follow-up appointment were on average only Moderately Ill at baseline (CGI-S average of 3.9). Despite these follow patients not being severely mentally ill initially, the contact was helpful, as their CGI-S scores improved on average to the Mildly Ill range (CGI-S average of 2.8). A Mixed ANOVA revealed that there was a significant improvement in mental illness severity post-follow-up appointment (Greenhouse-Geisser .000). There was a near even proportion of males and females attending appointments (58% female), and slightly more females attended a follow-up (60% female). Males were on average more mentally ill at baseline compared to females at baseline (male average M=3.86, female average M=3.56), and males had a greater reduction in mental illness severity on average compared to females (male average M=2.71, female average 3.00). This was approaching significance (.073) and would be important to explore with a larger sample size. Change in clinical condition for follow-up patients was also recorded. It was found that more than half of patients (53%) were observed to experience Minimal improvement in attending at least one follow-up appointment. There was no change for 27% of patients, and there were no patients who were worse at follow up. As this was a preliminary study with small sample size, future research conducted could explore whether there are any significant gender differences, such as whether males experience the significantly greater reduction in symptoms of mental illness compared to females, as well as any effects of cancer stage or type on psychiatric outcomes. Future research could also investigate outcomes for those patients who concurrently access a Clinical Psychologist alongside the Psychiatrist. A limitation of the study is that the outcome measure is a brief item rating completed by the clinician.

Keywords: clinical global impressions scale, psychiatry, morbidity, oncology, outcomes, psychiatry

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Authors: Keisuke Takahata, Hiroshi Suetsugu

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Forest height is an important parameter for forest biomass estimation, and precise elevation data is essential for accurate forest height estimation. There are several globally or nationally available digital elevation models (DEMs) like SRTM and ASTER. However, its accuracy is reported to be low particularly in mountainous areas where there are closed canopy or steep slope. Recently, space-borne LiDAR, such as the Global Ecosystem Dynamics Investigation (GEDI), have started to provide sparse but accurate ground elevation and canopy height estimates. Several studies have reported the high degree of accuracy in their elevation products on their exact footprints, while it is not clear how this sparse information can be used for wider area. In this study, we developed a digital terrain model correction algorithm by spatially interpolating the difference between existing DEMs and GEDI elevation products by using Gaussian Process (GP) regression model. The result shows that our GP-based methodology can reduce the mean bias of the elevation data from 3.7m to 0.3m when we use airborne LiDAR-derived elevation information as ground truth. Our algorithm is also capable of quantifying the elevation data uncertainty, which is critical requirement for biomass inventory. Upcoming satellite-LiDAR missions, like MOLI (Multi-footprint Observation Lidar and Imager), are expected to contribute to the more accurate digital terrain model generation.

Keywords: digital terrain model, satellite LiDAR, gaussian processes, uncertainty quantification

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