Search results for: retention challenges in project management

Authors: Naheed Malik, Waheed Akhtar

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An introduction to the Islamic move towards the managing human resource is a preliminary attempt to provide managers with a useful way of managing and accepting employees. This knowledge would be helpful to even non-Muslim managers. Muslim managers are required not to know only the Islamic HR but also it is expected from them to apply the Islamic approach in managing the employees. Human resource is considered the most substantial asset of organizations. Studies have recommended that successful human resource management (HRM) leads to positive attitudes and behaviors at the workplace. On the contrary, unproductive use of human resources results in negative penalty in the form of lower job satisfaction, lower commitment, or even high employee turnover and even poor workforce quality.The study examined the Impact of Islamic HR practices on job satisfaction. Islamic HR variables encompass the aspects of performance appraisal, training and development, selection and recruitment. Data was obtained via self –administered questionnaires distributed among the employees of Banks in Pakistan which are practicing Islamic Banking. The sampling method employed was purposive sampling.Based on 240 responses obtained ,the study revealed that Islamic HRM deliberates the 40per cent of the variances in Job satisfaction .All variables excluding recruitment were found to be substantially pertinent to the dependent variable. The study also meditated the implications for future studies.

Keywords: islamic HRM, job satisfaction, islamic and conventional banks, Pakistan

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Authors: Andrea Ghermandi

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Constructed wetlands have long been recognized as sources of ancillary benefits such as support for recreational activities. To date, there is a lack of quantitative understanding of the extent and welfare impact of such benefits. Here, it is shown how geotagged, passively crowdsourced data from online social networks (e.g., Flickr and Panoramio) and Geographic Information Systems (GIS) techniques can: (1) be used to infer annual recreational visits to 273 engineered wetlands worldwide; and (2) be integrated with non-market economic valuation techniques (e.g., travel cost method) to infer the monetary value of recreation in these systems. Counts of social media photo-user-days are highly correlated with the number of observed visits in 62 engineered wetlands worldwide (Pearson’s r = 0.811; p-value < 0.001). The estimated, mean willingness to pay for access to 115 wetlands ranges between $5.3 and $374. In 50% of the investigated wetlands providing polishing treatment to advanced municipal wastewater, the present value of such benefits exceeds that of the capital, operation and maintenance costs (lifetime = 45 years; discount rate = 6%), indicating that such systems are sources of net societal benefits even before factoring in benefits derived from water quality improvement and storage. Based on the above results, it is argued that recreational benefits should be taken into account in the design and management of constructed wetlands, as well as when such green infrastructure systems are compared with conventional wastewater treatment solutions.

Keywords: constructed wetlands, cultural ecosystem services, ecological engineering, social media

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Authors: M. Dezvarei, S. Morovati

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In recent years, increasing usage of electrical energy provides a widespread field for investigating new methods to produce clean electricity with high reliability and cost management. Fuel cells are new clean generations to make electricity and thermal energy together with high performance and no environmental pollution. According to the expansion of fuel cell usage in different industrial networks, the identification and optimization of its parameters is really significant. This paper presents optimization of a proton exchange membrane fuel cell (PEMFC) parameters based on modified particle swarm optimization with real valued mutation (RVM) and clonal algorithms. Mathematical equations of this type of fuel cell are presented as the main model structure in the optimization process. Optimized parameters based on clonal and RVM algorithms are compared with the desired values in the presence and absence of measurement noise. This paper shows that these methods can improve the performance of traditional optimization methods. Simulation results are employed to analyze and compare the performance of these methodologies in order to optimize the proton exchange membrane fuel cell parameters.

Keywords: clonal algorithm, proton exchange membrane fuel cell (PEMFC), particle swarm optimization (PSO), real-valued mutation (RVM)

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Authors: Ivan Ramos Sampe Immanuel, Linung Kresno Adikusumo, Liston Sitanggang

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Achieving the production targets of oil and gas in an upstream oil and gas company represents a complex undertaking necessitating collaborative engagement from a multidisciplinary team. In addition to conducting exploration activities and executing well intervention programs, an upstream oil and gas enterprise must assess the feasibility of attaining predetermined production goals. The monitoring of production performance serves as a critical activity to ensure organizational progress towards the established oil and gas performance targets. Subsequently, decisions within the upstream oil and gas management team are informed by the received information pertaining to the respective production performance. To augment the decision-making process, the implementation of a production performance dashboard emerges as a viable solution, providing an integrated and centralized tool. The deployment of a production performance dashboard manifests as an instrumental mechanism fostering a user-friendly interface for monitoring production performance, while concurrently preserving the intrinsic characteristics of granular data. The integration of diverse data sources into a unified production performance dashboard establishes a singular veritable source, thereby enhancing the organization's capacity to uphold a consolidated and authoritative foundation for its business requisites. Additionally, the heightened accessibility of the production performance dashboard to business users constitutes a compelling substantiation of its consequential impact on facilitating the monitoring of organizational targets.

Keywords: production, performance, dashboard, data analytics

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Authors: Abraham Undu, Stephen Akuma

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Websites are becoming a major component of an organization’s success in our ever globalizing competitive world. The website symbolizes an organization, interacting or projecting an organization’s principles, culture, values, vision, and perspectives. It is an interface connecting organizations and their clients. The university, as an academic institution, makes use of a website to communicate and offer computing services to its stakeholders (students, staff, host community, university management etc). Unfortunately, website designers often give more consideration to the technology, organizational structure and business objectives of the university than to the usability of the site. Website designers end up designing university websites which do not meet the needs of the primary users. This empirical study investigated the Benue State University website from the point view of students. This research was realized by using a standardized website usability questionnaire based on the five factors of usability defined by WAMMI (Website Analysis and Measurement Inventory): attractiveness, controllability, efficiency, learnability and helpfulness. The result of the investigation showed that the university website (https://portal.bsum.edu.ng/) has neutral usability level because of the usability issues associated with the website. The research recommended feasible solutions to improve the usability of the website from the users’ perspective and also provided a modified usability model that will be used for better evaluation of the Benue State University website.

Keywords: Benue State University, modified usability model, usability, usability factors

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Authors: Shilpa Murthy, Hazlina Binti Abu Bakar, Juliet Mathew, Chandrashekhar Thummala Hlly Sreerama Reddy, Pathiyil Ravi Shankar

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Simulation is defined as a technique that replaces or expands real experiences with guided experiences that interactively imitate real-world processes or systems. Simulation enables learners to train in a safe and non-threatening environment. For decades, simulation has been considered an integral part of clinical teaching and learning strategy in medical education. The several types of simulation used in medical education and the clinical environment can be applied to several models, including full-body mannequins, task trainers, standardized simulated patients, virtual or computer-generated simulation, or Hybrid simulation that can be used to facilitate learning. Simulation allows healthcare practitioners to acquire skills and experience while taking care of patient safety. The recent COVID pandemic has also led to an increase in simulation use, as there were limitations on medical student placements in hospitals and clinics. The learning is tailored according to the educational needs of students to make the learning experience more valuable. Simulation in the pre-clinical years has challenges with resource constraints, effective curricular integration, student engagement and motivation, and evidence of educational impact, to mention a few. As instructors, we may have more reliance on the use of simulation for pre-clinical students while the students’ confidence levels and perceived competence are to be evaluated. Our research question was whether the implementation of simulation-based learning positively influences preclinical medical students' confidence levels and perceived competence. This study was done to align the teaching activities with the student’s learning experience to introduce more low-fidelity simulation-based teaching sessions for pre-clinical years and to obtain students’ input into the curriculum development as part of inclusivity. The study was carried out at International Medical University, involving pre-clinical year (Medical) students who were started with low-fidelity simulation-based medical education from their first semester and were gradually introduced to medium fidelity, too. The Student Satisfaction and Self-Confidence in Learning Scale questionnaire from the National League of Nursing was employed to collect the responses. The internal consistency reliability for the survey items was tested with Cronbach’s alpha using an Excel file. IBM SPSS for Windows version 28.0 was used to analyze the data. Spearman’s rank correlation was used to analyze the correlation between students’ satisfaction and self-confidence in learning. The significance level was set at p value less than 0.05. The results from this study have prompted the researchers to undertake a larger-scale evaluation, which is currently underway. The current results show that 70% of students agreed that the teaching methods used in the simulation were helpful and effective. The sessions are dependent on the learning materials that are provided and how the facilitators engage the students and make the session more enjoyable. The feedback provided inputs on the following areas to focus on while designing simulations for pre-clinical students. There are quality learning materials, an interactive environment, motivating content, skills and knowledge of the facilitator, and effective feedback.

Keywords: low-fidelity simulation, pre-clinical simulation, students satisfaction, self-confidence

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Authors: E. J. Spamer, J. M. Van Zyl, MHA Combrinck

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The Unit for Open Distance Learning (UODL) at the North-West University (NWU), South Africa was established in 2013 with its main function to deliver open distance learning (ODL) programmes to approximately 30 000 students from the Faculties of Education Sciences, Health Sciences, Theology and Arts and Culture. Quality operational and administrative processes are key components in the delivery of these programmes and they need to function optimally for students to be successful in their studies. Operational and administrative processes include aspects such as applications, registration, dissemination of study material, availability of electronic platforms, the management of assessment, and the dissemination of important information. To be able to ensure and enhance quality during these processes, it is vital to determine students’ perceptions with regards to these mentioned processes. A questionnaire was available online and also distributed to the 63 tuition centres. The purpose of this research was to determine the perceptions of ODL students from NWU regarding operational and administrative processes. 1903 students completed and submitted the questionnaire. The data was quantitatively analysed and discussed. Results indicated that the majority of students are satisfied with the operational and administrative processes; however, the results also indicated some areas that need improvement. The data gathered is important to identify strengths and areas for improvement and form part of a bigger strategy of qualitative assurance at the UODL.

Keywords: administrative support, ODL programmes, quantitative study, students' perceptions

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Authors: Ezequiel Garcia-Rodriguez, Lenin Hernandez-Ferreyra, Luis Ochoa-Franco

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The Sustainable Sewer Urban Systems (SSUS) are mechanisms integrated into the cities for manage rain water, reducing its runoff volume and velocity, enhancing the rain water quality and preventing flooding and other catastrophes associated to the rain, as well as improving the energy efficiency. The objective of SSUS is to mimic or to equal the runoff and infiltration natural conditions of the land before its urbanization, reducing runoff that may cause troubles within the houses, as well as flooding. At the same time, energy for warming homes and for pumping and treating water is reduced, contributing to the reduction of CO₂ emissions and therefore contributing to reduce the climate change. This paper contains an evaluation of the advantages that SSUS may offer within a zone of Morelia City, Mexico, applying support tools for decision making. The hydrological conditions prior to and after the urbanization of the study area were analyzed to propose the recommended SSUS. Different types of SSUS were proposed in this case study, assessing their effect on the rainwater flow behavior within the study area. SSUS usage in this case resulted, positively, in an important reduction of the magnitude and velocity of runoff, reducing therefore the risk of flooding. So that, it is recommended the implementation of SSUS in this case.

Keywords: energy efficiency, morelia, sustainablesewer, urban systems

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Authors: Prachi Abhishek Dave, Abhishek Dave

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Purpose: The purpose of this study is to elucidate the role of intravitreal injection Aflibercept in managing complex cases of Wet Age Related Macular Degeneration (ARMD) and the gratifying visual recovery experienced with a minimally invasive procedure. Methods: A 73-year-old gentleman presented with a drop in vision in the left eye for 25 days. On examination, his best corrected visual acuity (BCVA) in the Right eye (OD) was 6/60, and finger counting close to face in the Left eye (OS). On multimodal imaging, he was diagnosed to have a scarred Wet ARMD in OD and an active Wet ARMD with a large subretinal bleed secondary to Wet ARMD in OS. Treatment management options included monotherapy with an Injection Aflibercept or an intravitreal gas injection with tPA followed by Injection Aflibercept. Considering his one-eyed status, the patient decided to go for Aflibercept monotherapy. Results: After 3 monthly injections of injection Aflibercept, the subretinal bleed reduced, the subretinal fluid resolved, and his vision in OS improved to 6/9. He is on a regular follow-up and has not needed any further injections in OS and he maintains 6/9 vision. Conclusions: Conventional treatment guidelines for a large subretinal bleed dictate the use of gas followed by intravitreal Injection Aflibercept. However, gas has its own limitations of causing a rise in intraocular pressure and a transient loss of vision, which is particularly troublesome in one-eyed patients. Injection Aflibercept offers a much safer, less invasive, and elegant treatment option for such patients with equally good or even better visual outcomes.

Keywords: wet ARMD, subretinal bleed, intravitreal injections, aflibercept, EYELEA, intravitreal gas

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Authors: Laila A. H. F. Dashti, Tom Jackson, Andrew West, Lisa Jackson

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Traceability systems are important in the agri-food and halal food sectors for monitoring ingredient movements, tracking sources, and ensuring food integrity. However, designing a traceability system for the halal food supply chain is challenging due to diverse stakeholder requirements and complex needs. Existing literature on stakeholder mapping and identifying requirements for halal food supply chains is limited. To address this gap, a pilot study was conducted to identify the objectives, requirements, and recommendations of stakeholders in the Kuwaiti halal food industry. The study collected data through semi-structured interviews with an international halal food manufacturer based in Kuwait. The aim was to gain a deep understanding of stakeholders' objectives, requirements, processes, and concerns related to the design of a traceability system in the country's halal food sector. Traceability systems are being developed and tested in the agri-food and halal food sectors due to their ability to monitor ingredient movements, track sources, and detect potential issues related to food integrity. Designing a traceability system for the halal food supply chain poses significant challenges due to diverse stakeholder requirements and the complexity of their needs (including varying food ingredients, different sources, destinations, supplier processes, certifications, etc.). Achieving a halal food traceability solution tailored to stakeholders' requirements within the supply chain necessitates prior knowledge of these needs. Although attempts have been made to address design-related issues in traceability systems, literature on stakeholder mapping and identification of requirements specific to halal food supply chains is scarce. Thus, this pilot study aims to identify the objectives, requirements, and recommendations of stakeholders in the halal food industry. The paper presents insights gained from the pilot study, which utilized semi-structured interviews to collect data from a Kuwait-based international halal food manufacturer. The objective was to gain an in-depth understanding of stakeholders' objectives, requirements, processes, and concerns pertaining to the design of a traceability system in Kuwait's halal food sector. The stakeholder mapping results revealed that government entities, food manufacturers, retailers, and suppliers are key stakeholders in Kuwait's halal food supply chain. Lessons learned from this pilot study regarding requirement capture for traceability systems include the need to streamline communication, focus on communication at each level of the supply chain, leverage innovative technologies to enhance process structuring and operations and reduce halal certification costs. The findings also emphasized the limitations of existing traceability solutions, such as limited cooperation and collaboration among stakeholders, high costs of implementing traceability systems without government support, lack of clarity regarding product routes, and disrupted communication channels between stakeholders. These findings contribute to a broader research program aimed at developing a stakeholder requirements framework that utilizes "business process modelling" to establish a unified model for traceable stakeholder requirements.

Keywords: supply chain, traceability system, halal food, stakeholders’ requirements

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Authors: Angela Maria Fasnacht

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Detection of anomalies due to contaminants’ presence, also known as early detection systems in water treatment plants, has become a critical point that deserves an in-depth study for their improvement and adaptation to current requirements. The design of these systems requires a detailed analysis and processing of the data in real-time, so it is necessary to apply various statistical methods appropriate to the data generated, such as Spearman’s Correlation, Factor Analysis, Cross-Correlation, and k-fold Cross-validation. Statistical analysis and methods allow the evaluation of large data sets to model the behavior of variables; in this sense, statistical treatment or analysis could be considered a vital step to be able to develop advanced models focused on machine learning that allows optimized data management in real-time, applied to early detection systems in water treatment processes. These techniques facilitate the development of new technologies used in advanced sensors. In this work, these methods were applied to identify the possible correlations between the measured parameters and the presence of the glyphosate contaminant in the single-pass system. The interaction between the initial concentration of glyphosate and the location of the sensors on the reading of the reported parameters was studied.

Keywords: glyphosate, emergent contaminants, machine learning, probes, sensors, predictive

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Authors: Elham S. Hasham, Anthony S. Hasham

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The construction industry is one of Australia’s fastest growing industries and its success is a result of a firm’s client satisfaction with focus on product determinants such as price and quality. Ensuring quality at every phase is a must and building rapport with the client will go a long way. To capitalise on the growing demand for Engineering Consulting Firms (ECFs), we should “redefine the bottom line by allowing client satisfaction, high-quality standards, and profits to be the top priorities”. Consequently, the emphasis should be on improving employee skills through various training provisions. Clients seek consistency and thus expect that all services should be similar in respect to quality and the ability of the service to meet their needs. This calls for empowerment and comfortable work conditions to motivate employees and give them incentive to deliver quality and excellent output. The methodology utilized is triangulation-a combination of both quantitative and qualitative research. The case study-Australian Consulting Engineers (ACE) was established in 1995 and has operations throughout Australia, the Philippines, Europe, U.A.E., K.S.A., and Lebanon. ACE is affiliated with key agencies and support organizations in the engineering industry with International Organization for Standardization (ISO) certifications in Safety and Quality Management. The objective of this study is significant as it sheds light on employee motivation and client satisfaction as imperative determinants of the success of an organization.

Keywords: leadership, motivation, organizational behavior, satisfaction

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Authors: Nazakat Ismailzada, Carol Jones

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Tomato drilling moth Tuta absoluta (Meyrick) (Lepidoptera: Gelechiidae) is the main pest of tomato plants in many countries. The larvae of tomato leaves, the stems inside, in the end buds, they opened the gallery in green and ripe fruit. In this way the harmful products can be fed with all parts of the tomato plant can cause damage to 80-100%. Pest harms all above ground parts of the tomato plant. After the seedlings are planted in areas and during blossoming holder traps with tomato moth’s rubber capsule inside should be placed in the area by using five-tomato moth’s feremon per ha. Then there should be carried out observations in the fields in every three days regularly. During the researches, it was showed that in field condition Carogen 20 SC besides high-level biological efficiency also has low ecological load for environment, and should be used against tomato moth in farms. Therefore it was showed that in field condition Carogen 20 SC besides high-level biological efficiency also has low ecological load for environment, and should be used against tomato moth in farms with insecticide expenditure norm 320 qr\ha. In farms should be used plant rotation, plant fields should be plowed on the 25-30 sm depth, before sowing seeds should be proceeded by insecticides. As element of integrated plant protection activities, should be used pheromones trap. In tomato plant fields as an insecticide should be used AGROSAN 240 SC and Carogen 20 SP.

Keywords: lepidoptera, Tuta absoluta, chemical control, integrated pest management

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Authors: Tasir Khan, Yejuan Wan, Kalim Ullah

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Hydrological frequency analysis has been conducted to estimate the minimum flow elevation of the Indus River in Pakistan to protect the ecosystem. The Maximum likelihood estimation (MLE) technique is used to estimate the best-fitted distribution for Minimum Ecological Flows at nine stations of the Indus River in Pakistan. The four selected distributions, Generalized Extreme Value (GEV) distribution, Generalized Logistics (GLO) distribution, Generalized Pareto (GPA) distribution, and Pearson type 3 (PE3) are fitted in all sites, usually used in hydro frequency analysis. Compare the performance of these distributions by using the goodness of fit tests, such as the Kolmogorov Smirnov test, Anderson darling test, and chi-square test. The study concludes that the Maximum Likelihood Estimation (MLE) method recommended that GEV and GPA are the most suitable distributions which can be effectively applied to all the proposed sites. The quantiles are estimated for the return periods from 5 to 1000 years by using MLE, estimations methods. The MLE is the robust method for larger sample sizes. The results of these analyses can be used for water resources research, including water quality management, designing irrigation systems, determining downstream flow requirements for hydropower, and the impact of long-term drought on the country's aquatic system.

Keywords: minimum ecological flow, frequency distribution, indus river, maximum likelihood estimation

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Authors: Manuel de Pazos-Liano, Manuel Cifuentes-Antonio, Juan Fisac-Gozalo, Sara Perales-Momparler, Carlos Martinez-Montero

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The first-ever game in the Wanda Metropolitano Stadium, the new home of the Club Atletico de Madrid, was played on September 16, 2017, thanks to the work of a multidisciplinary team that made it possible to combine urban development with sustainability goals. The new football ground sits on a 1.2 km² land owned by the city of Madrid. Its construction has dramatically increased the sealed area of the site (transforming the runoff coefficient from 0.35 to 0.9), and the surrounding sewer network has no capacity for that extra flow. As an alternative to enlarge the existing 2.5 m diameter pipes, it was decided to detain runoff on site by means of an integrated and durable infrastructure that would not blow up the construction cost nor represent a burden on the municipality’s maintenance tasks. Instead of the more conventional option of building a large concrete detention tank, the decision was taken on the use of pervious pavement on the 3013 car parking spaces for sub-surface water storage, a solution aligned with the city water ordinance and the Madrid + Natural project. Making the idea a reality, in only five months and during the summer season (which forced to pour the porous concrete only overnight), was a challenge never faced before in Spain, that required of innovation both at the material as well as the machinery side. The process consisted on: a) defining the characteristics required for the porous concrete (compressive strength of 15 N/mm2 and 20% voids); b) testing of different porous concrete dosages at the construction company laboratory; c) stablishing the cross section in order to provide structural strength and sufficient water detention capacity (20 cm porous concrete over a 5 cm 5/10 gravel, that sits on a 50 cm coarse 40/50 aggregate sub-base separated by a virgin fiber polypropylene geotextile fabric); d) hydraulic computer modelling (using the Full Hydrograph Method based on the Wallingford Procedure) to estimate design peak flows decrease (an average of 69% at the three car parking lots); e) use of a variety of machinery for the application of the porous concrete to achieve both structural strength and permeable surface (including an inverse rotating rolling imported from USA, and the so-called CMI, a sliding concrete paver used in the construction of motorways with rigid pavements); f) full-scale pilots and final construction testing by an accredited laboratory (pavement compressive strength average value of 15 N/mm2 and 0,0032 m/s permeability). The continuous testing and innovating construction process explained in detail within this article, allowed for a growing performance with time, finally proving the use of the CMI valid also for large porous car park applications. All this process resulted in a successful story that converts the Wanda Metropolitano Stadium into a great demonstration site that will help the application of the Spanish Royal Decree 638/2016 (it also counts with rainwater harvesting for grass irrigation).

Keywords: construction machinery, permeable carpark, porous concrete, SUDS, sustainable develpoment

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Authors: Pankhuri Dagaonkar, Charumani Singh, Poornima Krothapalli, Krishna Karthik

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The backbone of any retail e-commerce success story is a unique design of supply chain network, providing the business an unparalleled speed and scalability. Primary goal of the supply chain strategy is to meet customer expectation by offering fastest deliveries while keeping the cost minimal. Meeting this objective at the large market that India provides is the problem statement that we have targeted here. There are many models and optimization techniques focused on network design to identify the ideal facility location and size, optimizing cost and speed. In this paper we are presenting a tactical approach to optimize cost of an existing network for a predefined speed. We have considered both forward and reverse logistics of a retail e-commerce supply chain consisting of multiple fulfillment (warehouse) and delivery centers, which are connected via sortation nodes. The mathematical model presented here determines if the shipment from a node should get sorted directly for the last mile delivery center or it should travel as consolidated package to another node for further sortation (resort). The objective function minimizes the total cost by varying the resort percentages between nodes and provides the optimal resource allocation and number of sorts at each node.

Keywords: distribution strategy, mathematical model, network design, supply chain management

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Authors: Khalid Ali, Manar Jammal

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In order to meet the stringent latency and reliability requirements of the upcoming 5G networks, Open Radio Access Networks (O-RAN) have been proposed. The virtualization of O-RAN has allowed it to be treated as a Network Function Virtualization (NFV) architecture, while its components are considered Virtualized Network Functions (VNFs). Hence, intelligent Machine Learning (ML) based solutions can be utilized to apply different resource management and allocation techniques on O-RAN. However, intelligently allocating resources for O-RAN VNFs can prove challenging due to the dynamicity of traffic in mobile networks. Network providers need to dynamically scale the allocated resources in response to the incoming traffic. Elastically allocating resources can provide a higher level of flexibility in the network in addition to reducing the OPerational EXpenditure (OPEX) and increasing the resources utilization. Most of the existing elastic solutions are reactive in nature, despite the fact that proactive approaches are more agile since they scale instances ahead of time by predicting the incoming traffic. In this work, we propose and evaluate traffic forecasting models based on the ML algorithm. The algorithms aim at predicting future O-RAN traffic by using previous traffic data. Detailed analysis of the traffic data was carried out to validate the quality and applicability of the traffic dataset. Hence, two ML models were proposed and evaluated based on their prediction capabilities.

Keywords: O-RAN, traffic forecasting, NFV, ARIMA, LSTM, elasticity

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Authors: Soofia Malik

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The purpose of this study is to develop an instrument to measure undergraduate students’ attitudes toward mathematics (MAT) and to assess the data collected from the instrument for validity and reliability. The instrument is developed using five subscales: anxiety, enjoyment, self-confidence, value, and technology. The technology dimension is added as the fifth subscale of attitude toward mathematics because of the recent trend of incorporating online homework in mathematics courses as well as due to heavy reliance of higher education on using online learning management systems, such as Blackboard and Moodle. The sample consists of 163 (M = 82, F = 81) undergraduates enrolled in College Algebra course in the summer 2017 semester at a university in the USA. The data is analyzed to answer the research question: if and how do undergraduate students’ attitudes toward mathematics load using Principal Components Analysis (PCA)? As a result of PCA, three subscales emerged namely: anxiety/self-confidence scale, enjoyment, and value scale. After deleting the last five items or the last two subscales from the initial MAT scale, the Cronbach’s alpha was recalculated using the scores from 20 items and was found to be α = .95. It is important to note that the reliability of the initial MAT form was α = .93. This means that employing the final MAT survey form would yield consistent results in repeated uses. The final MAT form is, therefore, more reliable as compared to the initial MAT form.

Keywords: college algebra, Cronbach's alpha reliability coefficient, Principal Components Analysis, PCA, technology in mathematics

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Authors: Marcial Blondet, Malena Serrano, Álvaro Rubiños, Elin Mattsson

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In Peru, there are more than two million houses made of adobe (sun dried mud bricks) or rammed earth (35% of the total houses), in which almost 9 million people live, mainly because they cannot afford to purchase industrialized construction materials. Although adobe houses are cheap to build and thermally comfortable, their seismic performance is very poor, and they usually suffer significant damage or collapse with tragic loss of life. Therefore, over the years, researchers at the Pontifical Catholic University of Peru and other institutions have developed many reinforcement techniques as an effort to improve the structural safety of earthen houses located in seismic areas. However, most rural communities live under unacceptable seismic risk conditions because these techniques have not been adopted massively, mainly due to high cost and lack of diffusion. The nylon rope mesh reinforcement technique is simple and low-cost, and two technological transference tools have been developed to diffuse it among rural communities: 1) Scale seismic simulations using a portable shaking table have been designed to prove its effectiveness to protect adobe houses; 2) A step-by-step illustrated construction manual has been developed to guide the complete building process of a nylon rope mesh reinforced adobe house. As a study case, it was selected the district of Pullo: a small rural community in the Peruvian Andes where more than 80% of its inhabitants live in adobe houses and more than 60% are considered to live in poverty or extreme poverty conditions. The research team carried out a one-day workshop in May 2015 and a two-day workshop in September 2015. Results were positive: First, the nylon rope mesh reinforcement procedure was proven simple enough to be replicated by adults, both young and seniors, and participants handled ropes and knots easily as they use them for daily livestock activity. In addition, nylon ropes were proven highly available in the study area as they were found at two local stores in variety of color and size.. Second, the portable shaking table demonstration successfully showed the effectiveness of the nylon rope mesh reinforcement and generated interest on learning about it. On the first workshop, more than 70% of the participants were willing to formally subscribe and sign up for practical training lessons. On the second workshop, more than 80% of the participants returned the second day to receive introductory practical training. Third, community members found illustrations on the construction manual simple and friendly but the roof system illustrations led to misinterpretation so they were improved. The technological transfer tools developed in this project can be used to train rural dwellers on earthquake-resistant self-construction with adobe, which is still very common in the Peruvian Andes. This approach would allow community members to develop skills and capacities to improve safety of their households on their own, thus, mitigating their high seismic risk and preventing tragic losses. Furthermore, proper training in earthquake-resistant self-construction with adobe would prevent rural dwellers from depending on external aid after an earthquake and become agents of their own development.

Keywords: adobe, Peruvian Andes, safe housing, technological transference

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Authors: Roop Kiran, Muhammad Shoaib Zafar, Nazish Idrees Chaudhary

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Depression is known to be the second most frequently occurring comorbid mental illness among patients suffering from chronic physical conditions. Around the world, depression is associated with chronic liver diseases as one of the dominant symptoms. This evidence brings attention to the research about various predictors for short life expectancy and poor quality of life in patients suffering from comorbid depression and CLD. Following are the objectives of this study i) measure the occurrence rate of comorbid depression among patients with CLD and ii) find the frequency of risk factors between patients with and without depression comorbid with CLD. This is a quantitative study with a cross-sectional design. The research data was collected through a measure called Hamilton Depression Rating Scale (HDRS) with a demographic Performa from 100 patients who visited the Department of Psychiatry for consultation at Mayo Hospital Lahore with a diagnosed CLD from the last four years. There were (42%) patients with CLD who had comorbid depression. Among depressed and non-depressed patients, significant differences were found (p<0.05) for unemployment in 25 (59.5%) males and 20 (34.5%) female patients, for co-morbidity in 25 (59.5%) males and 18 (31.0%) female patients, for illiteracy in 18 (42.9%) males and 13 (22.4%) female patients, for the history of CLD for more than the last 2years in 41 (97.6%) males and 47 (81.0%) female patients, for severity of CLD in 26 (61.9%) males and 20 (34.5%) female patients. This concludes that depression frequently occurs among patients with CLD. This study recommends considerable attention to plan preventative measures in the future and develop such intervention protocols that consider the management of risk factors that significantly influence comorbid depression with CLD.

Keywords: psychiatry, comorbid, health, quality of life

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Authors: Sharon Harel, Rachel Kizony, Yoram Feldman, Gabi Zeilig, Mordechai Shani

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Multiple Sclerosis (MS) is a neurological disease that may cause restriction in participation in daily activities of young adults. Main symptoms include fatigue, weakness and cognitive decline. The appearance of symptoms, their severity and deterioration rate, change between patients. The challenge of health services is to provide long-term rehabilitation services to people with MS. The objective of this presentation is to describe a course of tele-rehabilitation service of a woman with MS. Methods; R is a 48 years-old woman, diagnosed with MS when she was 22. She started to suffer from weakness of her non-dominant left upper extremity about ten years after the diagnosis. She was referred to the tele-rehabilitation service by her rehabilitation team, 16 years after diagnosis. Her goals were to improve ability to use her affected upper extremity in daily activities. On admission her score in the Mini-Mental State Exam was 30/30. Her Fugl-Meyer Assessment (FMA) score of the left upper extremity was 48/60, indicating mild weakness and she had a limitation of her shoulder abduction (90 degrees). In addition, she reported little use of her arm in daily activities as shown in her responses to the Motor Activity Log (MAL) that were equal to 1.25/5 in amount and 1.37 in quality of use. R. received two 30 minutes on-line sessions per week in the tele-rehabilitation service, with the CogniMotion system. These were complemented by self-practice with the system. The CogniMotion system provides a hybrid (synchronous-asynchronous), the home-based tele-rehabilitation program to improve the motor, cognitive and functional status of people with neurological deficits. The system consists of a computer, large monitor, and the Microsoft’s Kinect 3D sensor. This equipment is located in the client’s home and connected to a clinician’s computer setup in a remote clinic via WiFi. The client sits in front of the monitor and uses his body movements to interact with games and tasks presented on the monitor. The system provides feedback in the form of ‘knowledge of results’ (e.g., the success of a game) and ‘knowledge of performance’ (e.g., alerts for compensatory movements) to enhance motor learning. The games and tasks were adapted for R. motor abilities and level of difficulty was gradually increased according to her abilities. The results of her second assessment (after 35 on-line sessions) showed improvement in her FMA score to 52 and shoulder abduction to 140 degrees. Moreover, her responses to the MAL indicated an increased amount (2.4) and quality (2.2) of use of her left upper extremity in daily activities. She reported high level of enjoyment from the treatments (5/5), specifically the combination of cognitive challenges while moving her body. In addition, she found the system easy to use as reflected by her responses to the System Usability Scale (85/100). To-date, R. continues to receive treatments in the tele-rehabilitation service. To conclude, this case report shows the potential of using tele-rehabilitation for people with MS to provide strategies to enhance the use of the upper extremity in daily activities as well as for maintaining motor function.

Keywords: motor function, multiple-sclerosis, tele-rehabilitation, daily activities

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Authors: Olga Kokoulina

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Today, algorithms are assuming a leading role in various areas of decision-making. Prompted by a promise to provide increased economic efficiency and fuel solutions for pressing societal challenges, algorithmic decision-making is often celebrated as an impartial and constructive substitute for human adjudication. But in the face of this implied objectivity and efficiency, the application of algorithms is also marred with mounting concerns about embedded biases, discrimination, and exclusion. In Europe, vigorous debates on risks and adverse implications of algorithmic decision-making largely revolve around the potential of data protection laws to tackle some of the related issues. For example, one of the often-cited venues to mitigate the impact of potentially unfair decision-making practice is a so-called 'right to explanation'. In essence, the overall right is derived from the provisions of the General Data Protection Regulation (‘GDPR’) ensuring the right of data subjects to access and mandating the obligation of data controllers to provide the relevant information about the existence of automated decision-making and meaningful information about the logic involved. Taking corresponding rights and obligations in the context of the specific provision on automated decision-making in the GDPR, the debates mainly focus on efficacy and the exact scope of the 'right to explanation'. In essence, the underlying logic of the argued remedy lies in a transparency imperative. Allowing data subjects to acquire as much knowledge as possible about the decision-making process means empowering individuals to take control of their data and take action. In other words, forewarned is forearmed. The related discussions and debates are ongoing, comprehensive, and, often, heated. However, they are also frequently misguided and isolated: embracing the data protection law as ultimate and sole lenses are often not sufficient. Mandating the disclosure of technical specifications of employed algorithms in the name of transparency for and empowerment of data subjects potentially encroach on the interests and rights of IPR holders, i.e., business entities behind the algorithms. The study aims at pushing the boundaries of the transparency debate beyond the data protection regime. By systematically analysing legal requirements and current judicial practice, it assesses the limits of the transparency requirement and right to access posed by intellectual property law, namely by copyrights and trade secrets. It is asserted that trade secrets, in particular, present an often-insurmountable obstacle for realising the potential of the transparency requirement. In reaching that conclusion, the study explores the limits of protection afforded by the European Trade Secrets Directive and contrasts them with the scope of respective rights and obligations related to data access and portability enshrined in the GDPR. As shown, the far-reaching scope of the protection under trade secrecy is evidenced both through the assessment of its subject matter as well as through the exceptions from such protection. As a way forward, the study scrutinises several possible legislative solutions, such as flexible interpretation of the public interest exception in trade secrets as well as the introduction of the strict liability regime in case of non-transparent decision-making.

Keywords: algorithms, public interest, trade secrets, transparency

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Authors: Shweta Jha, Digambar Darekar, Krishna Kadam

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Major Depressive Disorder (MDD) is one of the most common of psychiatric disorders. It has a wide range of symptoms, aetiologies and risk factors, and these reasons make MDD affect not only the primary patient, but also their family, caregivers and associates; by negatively impacting their self dignity, economic condition and self-confidence. Thus, it is important to help individuals suffering from MDD learn adaptive mechanism and deal effectively with their environment, with that aim this study focused on a comparative therapeutic intervention using Behaviour Activation (BA), Rational Emotive Behaviour Therapy (REBT) and Waiting list control (WLC) for management of MDD. This study apart from enhancing personal skills will also help us understand which therapeutic method would be more beneficial in treating and prolonging relapse in patients with MDD in Indian population. Fifteen individuals following application of inclusion and exclusion criteria were selected as study samples. They were randomly assigned to three treatment groups. Ten sessions of therapy, forty-five minutes each according to the proposed sessions plan were conducted for each group. The individuals selected as samples were re–assessed after 2 months and 6 months post intervention. The overall result showed that individuals treated with BA and REBT showed more improvement in comparison to those in WLC.

Keywords: behaviour activation, major depressive disorder, rational emotive behaviour therapy, therapeutic intervention

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Authors: Hsin-Yi Huang

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This study mainly discussed the disease-induced and surgery-induced physical, psychological, and spiritual issues faced by a patient who suffered from emphysema and respiratory failure and had underwent a right-lung transplantation surgery. Nursing care was provided from May 21 to May 29. Based on the observations, interviews, physical examinations, and evaluations that were carried out using Roy’s adaptation model, the following nursing issues were identified: risk of infection, lack of knowledge, and anxiety. Active care was provided and a good nursing relationship with the patient and the patient’s family was established. The four strategies of Bandura’s self-efficacy theory (self-transcendence, vicarious experience, verbal persuasion, and biofeedback) were employed. Instructions for the appropriate rehabilitation exercises were given, immunosuppressant concentration was monitored, and special measures were taken to prevent infection. The patient was encouraged to express feelings and was provided with sufficient information to alleviate anxiety. With assistance from nursing personnel and the medical team, the patient was successfully discharged from the hospital and thereafter embarked on the path of postoperative recovery. The patient learned about the importance of home self-care and regular follow-up outpatient visits, and patient management was implemented for discharge preparation services. This nursing case study may serve as a reference to nurses managing similar cases in future.

Keywords: anxiety, lung transplantation, Roy's adaptation model, self-efficacy theory

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Authors: J. P. Reges, L. C. S. Mazza, E. J. Braga, J. A. Bessa, A. R. Alexandria

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This paper proposes the development of control and automation of irrigation system located sunflower harvest in the Teaching Unit, Research and Extension (UEPE), the Apodi Plateau in Limoeiro do Norte. The sunflower extraction, which in turn serves to get the produced oil from its seeds, animal feed, and is widely used in human food. Its nutritional potential is quite high what makes of foods produced from vegetal, very rich and healthy. The focus of research is to make the autonomous irrigation system sunflower crop from programmable logic control energized with alternative energy sources, solar photovoltaics. The application of automated irrigation system becomes interesting when it provides convenience and implements new forms of managements of the implementation of irrigated cropping systems. The intended use of automated addition to irrigation quality and consequently brings enormous improvement for production of small samples. Addition to applying the necessary and sufficient features of water management in irrigation systems, the system (PLC + actuators + Renewable Energy) will enable to manage the quantitative water required for each crop, and at the same time, insert the use of sources alternative energy. The entry of the automated collection will bring a new format, and in previous years, used the process of irrigation water wastage base and being the whole manual irrigation process.

Keywords: automation, control, sunflower, irrigation, programming, renewable energy

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Authors: Alessandra Swiny, Michalis Georgiou, Yiorgos Hadjichristou

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This paper focuses on the questions raised through the work of Unit 5: ‘In/Out of crisis, emergent and adaptive’; an architectural research-based studio at the University of Nicosia. It focusses on sustainable architectural and urban explorations tackling with the ever growing crises in its various types, phases and locations. ‘Great crisis situations’ are seen as ‘great chances’ that trigger investigations for further development and evolution of the built environment in an ultimate sustainable approach. The crisis is taken as an opportunity to rethink the urban and architectural directions as new forces for inventions leading to emergent and adaptive built environments. The Unit 5’s identity and environment facilitates the students to respond optimistically, alternatively and creatively towards the global current crisis. Mark Wigley’s notion that “crises are ultimately productive” and “They force invention” intrigued and defined the premises of the Unit. ‘Weather and nature are coauthors of the built environment’ Jonathan Hill states in his ‘weather architecture’ discourse. The weather is constantly changing and new environments, the subnatures are created which derived from the human activities David Gissen explains. The above set of premises triggered innovative responses by the Unit’s students. They thoroughly investigated the various kinds of crisis and their causes in relation to their various types of Terrains. The tools used for the research and investigation were chosen in contradictive pairs to generate further crisis situations: The re-used/salvaged competed with the new, the handmade rivalling with the fabrication, the analogue juxtaposed with digital. Students were asked to delve into state of art technologies in order to propose sustainable emergent and adaptive architectures and Urbanities, having though always in mind that the human and the social aspects of the community should be the core of the investigation. The resulting unprecedented spatial conditions and atmospheres of the emergent new ways of living are deemed to be the ultimate aim of the investigation. Students explored a variety of sites and crisis conditions such as: The vague terrain of the Green Line in Nicosia, the lost footprints of the sinking Venice, the endangered Australian coral reefs, the earthquake torn town of Crevalcore, and the decaying concrete urbanscape of Athens. Among other projects, ‘the plume project’ proposes a cloud-like, floating and almost dream-like living environment with unprecedented spatial conditions to the inhabitants of the coal mine of Centralia, USA, not just to enable them to survive but even to prosper in this unbearable environment due to the process of the captured plumes of smoke and heat. Existing water wells inspire inversed vertical structures creating a new living underground network, protecting the nomads from catastrophic sand storms in the Araoune of Mali. “Inverted utopia: Lost things in the sand”, weaves a series of tea-houses and a library holding lost artifacts and transcripts into a complex underground labyrinth by the utilization of the sand solidification technology. Within this methodology, crisis is seen as a mechanism for allowing an emergence of new and fascinating ultimate sustainable future cultures and cities.

Keywords: adaptive built environments, crisis as opportunity, emergent urbanities, forces for inventions

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Authors: Justine Ugochukwu Osuagwu, Sazali Abd Wahab

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The performance and operation of NNPC have faced series of attacks by all stakeholders as many have observed lots of inefficiency not only on the part of the management but the staff. This has raised questions of whether their operations and performance are being seriously affected by lack of transformational leadership, and the political competition prevalent in the country. The author has applied the administrative leadership theory and institutional theory as a guide to this study and empirically relates such theories to the study. The study also has utilized the quantitative approach where questionnaires were distributed to 370 participants, and the correctly filled and returned questionnaires were used for the analysis using structural equation modeling. The path coefficient of transformational leadership to performance is strong and positive with β = 0.672; t-value = 14.245; p-value = 0.000. Also, the result found that political competition does not mediate the relationship between transformational leadership and performance of NNPC. (β = -0.008; t-value = -0.600; p- value > 0.05). However, the indirect path is all insignificant, meaning that transformational leadership has relationship with corporate performance.The study found that,while political competition does not serve as a mediator in the relationship between transformational leadership and corporate performance, these styles of leadership have a direct and positive impact on corporate performance. The direct relationship between transformational leadership and political competition was not discovered, despite the fact that political competition has a direct and significant impact, both positive and negative, on corporate performance. As a result, both political competition and transformational leadership have the potential to significantly alter corporate performance.

Keywords: performance, transformational leadership, political competition, corporation performance, Nigeria national petroleum corporation

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Authors: Dirk Bruland, Paulo Pinheiro, Ullrich Bauer

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Introduction: Over 3 million children, about one quarter of all students, experience at least one parent with mental disorder in Germany every year. Children of mentally-ill parents are at considerably higher risk of developing serious mental health problems. The different burden patterns and coping attempts often become manifest in children's school lives. In this context, schools can have an important protective function, but can also create risk potentials. In reference to Jorm, pupil-related teachers’ mental health literacy (Teacher-MHL) includes the ability to recognize change behaviour, the knowledge of risk factors, the implementation of first aid intervention, and seeking professional help (teacher as gatekeeper). Although teachers’ knowledge and increased awareness of this topic is essential, the literature provides little information on the extent of teachers' abilities. As part of a German-wide research consortium on health literacy, this project, launched in March for 3 years, will conduct evidence-based mental health literacy research. The primary objective is to measure Teacher-MHL in the context of pupil-related psychosocial factors at primary and secondary schools (grades 5 & 6), while also focussing on children’s social living conditions. Methods: (1) A systematic literature review in different databases to identify papers with regard to Teacher-MHL (completed). (2) Based on these results, an interview guide was developed. This research step includes a qualitative pre-study to inductively survey the general profiles of teachers (n=24). The evaluation will be presented on the conference. (3) These findings will be translated into a quantitative teacher survey (n=2500) in order to assess the extent of socio-analytical skills of teachers as well as in relation to institutional and individual characteristics. (4) Based on results 1 – 3, developing a training program for teachers. Results: The review highlights a lack of information for Teacher-MHL and their skills, especially related to high-risk-groups like children of mentally ill parents. The literature is limited to a few studies only. According to these, teacher are not good at identifying burdened children and if they identify those children they do not know how to handle the situations in school. They are not sufficiently trained to deal with these children, especially there are great uncertainties in dealing with the teaching situation. Institutional means and resources are missing as well. Such a mismatch can result in insufficient support and use of opportunities for children at risk. First impressions from the interviews confirm these results and allow a greater insight in the everyday school-life according to critical life events in families. Conclusions: For the first time schools will be addressed as a setting where children are especially "accessible" for measures of health promotion. Addressing Teacher-MHL gives reason to expect high effectiveness. Targeting professionals' abilities for dealing with this high-risk-group leads to a discharge for teacher themselves to handle those situations and increases school health promotion. In view of the fact that only 10-30% of such high-risk families accept offers of therapy and assistance, this will be the first primary preventive and health-promoting approach to protect the health of a yet unaffected, but particularly burdened, high-risk group.

Keywords: children of mentally ill parents, health promotion, mental health literacy, school

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Authors: Husham Bayazed

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Purpose of Presentation: Obesity and overweight are among the biggest health challenges of the 21st century, according to the WHO. Obviously, obese individuals suffer different courses of disease – from infections and allergies to cancer- and even respond differently to some treatment options. Of note, obesity often seems to predispose and triggers several secondary diseases such as diabetes, arteriosclerosis, or heart attacks. Since decades it seems that immunological signals gear inflammatory processes among obese individuals with the aforementioned conditions. This review aims to shed light how obesity sparks or rewire the immune system and predisposes to such unpleasant health outcomes. Moreover, lessons from the Covid-19 pandemic ascertain that people living with pre-existing conditions such as obesity can develop severe acute respiratory syndrome (SARS), which needs to be elucidated how obesity and its adjuvant inflammatory process distortion contribute to enhancing severe COVID-19 consequences. Recent Findings: In recent clinical studies, obesity was linked to alter and sparks the immune system in different ways. Adipose tissue (AT) is considered as a secondary immune organ, which is a reservoir of tissue-resident of different immune cells with mediator release, making it a secondary immune organ. Adipocytes per se secrete several pro-inflammatory cytokines (IL-6, IL-4, MCP-1, and TNF-α ) involved in activation of macrophages resulting in chronic low-grade inflammation. The correlation between obesity and T cells dysregulation is pivotal in rewiring the immune system. Of note, autophagy occurrence in adipose tissues further rewire the immune system due to flush and outburst of leptin and adiponectin, which are cytokines and influencing pro-inflammatory immune functions. These immune alterations among obese individuals are collectively incriminated in triggering several metabolic disorders and playing role in increasing cancers incidence and susceptibility to different infections. During COVID-19 pandemic, it was verified that patients with pre-existing obesity being at greater risk of suffering severe and fatal clinical outcomes. Beside obese people suffer from increased airway resistance and reduced lung volume, ACE2 expression in adipose tissue seems to be high and even higher than that in lungs, which spike infection incidence. In essence, obesity with pre-existence of pro-inflammatory cytokines such as LI-6 is a risk factor for cytokine storm and coagulopathy among COVID-19 patients. Summary: It is well documented that obesity is associated with chronic systemic low-grade inflammation, which sparks and alter different pillars of the immune system and triggers different metabolic disorders, and increases susceptibility of infections and cancer incidence. The pre-existing chronic inflammation in obese patients with the augmented inflammatory response against the viral infection seems to increase the susceptibility of these patients to developing severe COVID-19. Although the new weight loss drugs and bariatric surgery are considered as breakthrough news for obesity treatment, but preventing is easier than treating it once it has taken hold. However, obesity and immune system link new insights dispute the role of immunotherapy and regulating immune cells treating diet-induced obesity.

Keywords: immunity, metabolic disorders, cancer, COVID-19

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Authors: Liane J. Ioannou, Jonathan Serpell, Cino Bendinelli, David Walters, Jenny Gough, Dean Lisewski, Win Meyer-Rochow, Julie Miller, Duncan Topliss, Bill Fleming, Stephen Farrell, Andrew Kiu, James Kollias, Mark Sywak, Adam Aniss, Linda Fenton, Danielle Ghusn, Simon Harper, Aleksandra Popadich, Kate Stringer, David Watters, Susannah Ahern

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BACKGROUND: There are significant variations in the management, treatment and outcomes of thyroid cancer, particularly in the role of: diagnostic investigation and pre-treatment scanning; optimal extent of surgery (total or hemi-thyroidectomy); use of active surveillance for small low-risk cancers; central lymph node dissections (therapeutic or prophylactic); outcomes following surgery (e.g. recurrent laryngeal nerve palsy, hypocalcaemia, hypoparathyroidism); post-surgical hormone, calcium and vitamin D therapy; and provision and dosage of radioactive iodine treatment. A proven strategy to reduce variations in the outcome and to improve survival is to measure and compare it using high-quality clinical registry data. Clinical registries provide the most effective means of collecting high-quality data and are a tool for quality improvement. Where they have been introduced at a state or national level, registries have become one of the most clinically valued tools for quality improvement. To benchmark clinical care, clinical quality registries require systematic measurement at predefined intervals and the capacity to report back information to participating clinical units. OBJECTIVE: The aim of this study was to develop a core set clinical indicators that enable measurement and reporting of quality of care for patients with thyroid cancer. We hypothesise that measuring clinical quality indicators, developed to identify differences in quality of care across sites, will reduce variation and improve patient outcomes and survival, thereby lessening costs and healthcare burden to the Australian community. METHOD: Preparatory work and scoping was conducted to identify existing high quality, clinical guidelines and best practice for thyroid cancer both nationally and internationally, as well as relevant literature. A bi-national panel was invited to participate in a modified Delphi process. Panelists were asked to rate each proposed indicator on a Likert scale of 1–9 in a three-round iterative process. RESULTS: A total of 236 potential quality indicators were identified. One hundred and ninety-two indicators were removed to reflect the data capture by the Australian and New Zealand Thyroid Cancer Registry (ANZTCR) (from diagnosis to 90-days post-surgery). The remaining 44 indicators were presented to the panelists for voting. A further 21 indicators were later added by the panelists bringing the total potential quality indicators to 65. Of these, 21 were considered the most important and feasible indicators to measure quality of care in thyroid cancer, of which 12 were recommended for inclusion in the final set. The consensus indicator set spans the spectrum of care, including: preoperative; surgery; surgical complications; staging and post-surgical treatment planning; and post-surgical treatment. CONCLUSIONS: This study provides a core set of quality indicators to measure quality of care in thyroid cancer. This indicator set can be applied as a tool for internal quality improvement, comparative quality reporting, public reporting and research. Inclusion of these quality indicators into monitoring databases such as clinical quality registries will enable opportunities for benchmarking and feedback on best practice care to clinicians involved in the management of thyroid cancer.

Keywords: clinical registry, Delphi survey, quality indicators, quality of care

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