Search results for: birth satisfaction

Authors: Shilpa Varghese, Adarsh Eregowda

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Introduction: The normal development and maturation of the central nervous system is significantly influenced by thyroid hormones. Small for gestational age (SGA) babies have a distinct hormonal profile than kids born at an acceptable birth weight for gestational age, according to several studies (AGA). In SGA babies, thyroid size is larger when expressed as a percentage of body weight, indicating that low thyroid hormone levels throughout foetal life may be partially compensated for. Numerous investigations have found that compared to full-term and preterm AGA neonates, SGA babies exhibit considerably decreased thyroid plasma levels. According to our hypothesis, term and preterm SGA newborns have greater thyroid-stimulating hormone (TSH) concentrations than those that are normal for gestational age (AGA) and a higher incidence of thyroid dysfunction. Need for the study: Clinically diagnosed Assessment of term SGA babies confirming thyroid dysfunction unclear Requirement and importance of ft4 along with tsh and comparative values of ft4 in SGA babies as compared to AGA babies unclear. Inclusion criteria : SGA infants including preterm (<37 weeks of gestation) term (37-40 weeks) – comparing with preterm and term AGA infants. 3.76 7.66 0 2 4 6 8 10 12 AGA Babies SGA Babies Mean Mean TSH Comparison 2.73 1.52 0 0.5 1 1.5 2 2.5 3 3.5 4 AGA Babies SGA Babies Mean Mean FT4 Comparison Discussion : According to this study, neonates with SGA had considerably higher TSH levels than newborns with AGA. Our findings have been supported by results from earlier research. The TSH level range was established to 7.5 mU/L in the study by Bosch-Giménez et al, found greater TSH concentrations in SGA newborns. Thyroid hormone levels from newborns that are tiny for gestational age were found to be higher than AGA in our investigation. According to Franco et al., blood T4 concentrations are lower in both preterm and term SGA infants, while TSH concentrations are only noticeably greater in term SGA infants compared to AGA ones. According to our study analysis, the SGA group had considerably greater FT4 concentrations. Therefore, our findings are consistent with those of the two studies that SGA babies have a higher incidence of transient hypothyroidism and need close follow-up. Conclusions: A greater frequency of thyroid dysfunction and considerably higher TSH values within the normal range were seen in preterm and term SGA babies. The SGA babies who exhibit these characteristics should have ongoing endocrinologic testing and periodic TFTs.

Keywords: thyroid hormone, thyroid function tests, small for gestationl age, appropriate for gestational age

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Authors: Firdaous Zair, Zoubir Elfelsoufi, Mohammed Fourka

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The allocation of resources is an issue that is needed on the tactical and operational strategic plan. This work considers the allocation of resources in the case of pure players, manufacturers and Click & Mortars that have launched online sales. The aim is to improve the level of customer satisfaction and maintaining the benefits of e-retailer and of its cooperators and reducing costs and risks. Our contribution is a decision support system and tool for improving the allocation of resources in logistics chains e-commerce B2C context. We first modeled the B2C chain with all operations that integrates and possible scenarios since online retailers offer a wide selection of personalized service. The personalized services that online shopping companies offer to the clients can be embodied in many aspects, such as the customizations of payment, the distribution methods, and after-sales service choices. In addition, every aspect of customized service has several modes. At that time, we analyzed the optimization problems of supply chain resource allocation in customized online shopping service mode, which is different from the supply chain resource allocation under traditional manufacturing or service circumstances. Then we realized an optimization model and algorithm for the development based on the analysis of the allocation of the B2C supply chain resources. It is a multi-objective optimization that considers the collaboration of resources in operations, time and costs but also the risks and the quality of services as well as dynamic and uncertain characters related to the request.

Keywords: e-commerce, supply chain, B2C, optimisation, resource allocation

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Authors: Ramanjaneyulu Mogili, G.V.R.K. Acharyulu

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Indian organized retail sector is growing at a faster pace and gaining popularity. Indian Brand Equity Foundation (IBEF) reveals that the current market size of Indian retail industry is about US$ 520 billion with for growth rate 14 to 15 percent annually by 2018 the Indian retail sector is likely to grow at a CAGR of 13% to reach a size of US$ 950 billion. Developments in Information Technology have enabled online Retail sector that empowers customers to order products, conduct transactions without the need to interact physically with the retailers. In recent years, the online shopping industry has gained popularity to the point where certain categories of customers would consider buying electronic products online rather than visiting the stores. Conventionally the physical location of a store is seen as a source of competitive advantage. Online Retailing service sites provide virtual shopping space to the customers. Online Retail services are gaining momentum in India, with internet penetration improving in the country and smartphones becoming affordable along with changing lifestyles and preferences of customers. Although online shoppers prefer the convenience and choice available in online shopping, certain issues raised due to the occurrence of service failure. The proposed study attempts to measure the service recovery and failure process of electronic goods in Indian retail channels.

Keywords: service recovery, customer satisfaction, e-shopping, service failure

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Authors: Mamidi Ramakrishna Rao, Jagdish Mamidi

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With advancing technology, the market environment for wind power generation systems has become highly competitive. The industry has been moving towards higher wind generator power ratings, in particular, off-shore generator ratings. Current off-shore wind turbine generators are in the power range of 10 to 12 MW. Unlike traditional induction motors, slow-speed permanent magnet surface mounted (PMSM) high-power generators are relatively challenging and designed differently. In this paper, PMSM generator design features have been discussed and analysed. The focus attention is on armature windings, harmonics, and permanent magnet. For the power ratings under consideration, the generator air-gap diameters are in the range of 8 to 10 meters, and active material weigh ~60 tons and above. Therefore, material weight becomes one of the critical parameters. Particle Swarm Optimization (PSO) technique is used for weight reduction and performance improvement. Four independent variables have been considered, which are air gap diameter, stack length, magnet thickness, and winding current density. To account for core and teeth saturation, preventing demagnetization effects due to short circuit armature currents, and maintaining minimum efficiency, suitable penalty functions have been applied. To check for performance satisfaction, a detailed analysis and 2D flux plotting are done for the optimized design.

Keywords: offshore wind generator, PMSM, PSO optimization, design optimization

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Authors: Supriadi Hardianto, Aditya Daniswara

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Today's workplace, flooded by millennial Generation or known also as Generation Y. A common problem that faced by the company towards Gen Y is a high turnover rate, attitudes problem, communication style, and different work style than the older generation. This is common in private sector. The objective of this study is to get a better understanding of the Gen Y Career Attitude at the workplace. The subject of this study is focusing on 430 respondent of Gen Y which age between 20 – 35 years old who works for a private company. The Questionnaire as primary data source captured 9 aspects of career attitude based on Career Attitudes Strategy Inventory (CASI). This Survey distributes randomly among Gen Y in the IT Industry (125 Respondent) and Manufacture Company (305 Respondent). A Random deep interview was conducted to get the better understanding of the etiology of their primary obstacles. The study showed that most of Indonesia Gen Y have a moderate score on Job satisfaction but in the other aspects, Gen Y has the lowest score on Skill Development, Career Worries, Risk-Taking Style, Dominant Style, Work Involvement, Geographical Barrier, Interpersonal Abuse, and Family Commitment. The top 5 obstacles outside that 9 aspects that faced by Gen Y are 1. Lower communication & networking support; 2. Self-confidence issues; 3. Financial Problem; 4. Emotional issues; 5. Age. We also found that parent perspective toward the way they are nurturing their child are not aligned with their child’s real life. This research fundamentally helps the organization and other Gen Y’s Stakeholders to have a better understanding of Gen Y Career Attitude at the workplace.

Keywords: career attitudes, CASI, Gen Y, career attitude at workplace

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Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami

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Fathers are at risk of depression during the postpartum period. Some studies have been reported maternal depression is the key predictor of paternal postpartum depression (PPD). This study aimed to estimate the prevalence and predictors of parental PPD and its association with maternal PPD. In a cross-sectional study, via a stratified random and convenience sampling method, participants referring to health centers during 2-8 weeks postpartum were recruited from March to October 2017. Paternal PPD and its relation to maternal PPD and other related factors were assessed using multiple logistic regression. Participants were 591 literate couples who referred to Mazandaran province primary health centers during to study period. Couples were screened for depression using Edinburgh Postnatal Depression Scale (EPDS). Fathers provided information on socio-demographic characteristics, life events, neonatal stressor, perceived stress (Perceived Stress Scale), social support (Multidimensional Scale of Perceived Social Support), and general health status using General Health Questionnaire (GHQ) as well. Data on mothers ‘demographic characteristics and obstetrics factors was also gathered. Overall, 93 fathers (15.7%) and 188 mothers (31.8%) reported depressive symptoms above the cut-off EPDS score of 12. In the multiple logistic regression model, older age [OR=1.20, (95%CI: 1.05- 1.36)], maternal depressive symptoms [OR=1.15, (95%CI: 1.04-1.27)], higher GHQ scores [OR=1.21, (95%CI: 1.11-1.33)] and increased recent life events [OR=1.42, (95%CI: 1.01-1.2.00)] were related to paternal PPD. A significant inverse association was found between number of children and paternal PPD [OR=0.20, (95%CI: 0.07-0.53)]. Depressive symptoms, especially in first-time fathers following the birth of a child, are not uncommon. Maternal depressive symptoms and paternal well-being were strong predictors of parental PPD. Creating opportunities for men to access special health care services, parental education to help adapting to parenthood, screening programs, and psychiatric/psychosocial interventions to decrease the suffering of depression for both depressed parents are recommended.

Keywords: depression, men, postpartum, risk factors, women

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Authors: Jiyoung Kim, Chae Weon Chung

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Labor pain is one of the most common concerns of pregnant women, thus women are in need of possible options they could take to control the pain. So, this study aimed to explore maternal perception of epidural anesthesia and to compare the childbirth outcomes according to the use of epidural anesthesia. For this descriptive study, women who were over 36 weeks of pregnancy were recruited from an out-patient obstetric clinic in a public hospital in Seoul. Women were included in the study if agreed to participate, were pregnant singleton, without pregnancy complication, and expecting a natural birth. Data collection was done twice, the first one at the prenatal care visit and the second one at an in-patient ward on 2nd day postpartum. The instrument of the beliefs about epidural anesthesia, one item of asking intention to use epidural anesthesia, demographics, and obstetrical characteristics were incorporated into a questionnaire. One nurse researcher performed data collection with the structured questionnaire after the approval of the institutional review board. At the initial data collection 133 women were included, while 117 were retained at the second point after excluded 13 women due to the occurrence of complications. Analyses were done by chi-square, t-test, and ANOVA using the SPSS program. Women were aged 32.5 years old, 22.2% were over 35 years old. The average gestational age was 38.5 weeks, and 67.5% were nulliparous. Out of 38 multiparous women, 20 women (52.6%) had received epidural anesthesia in the previous delivery. At the initial interview, 62.6% (n=73) of women wanted to receive epidural anesthesia while 22.4% answered not decided and 15.4% did not want to take the procedure. However, there were changes in proportions between women’s intention to take it and actual procedures done, particularly, two-thirds of women (n=26) who had been undecided were found to receive epidural anesthesia during labor. There was a significant difference in the perception of epidural anesthesia measured before delivery between women who received and not received it (t=3.68, p < .001). Delivery outcomes were statistically different between the two groups in delivery mode (chi-square=8.64, p=.01), O₂ supply during labor (chi-square =5.01, p=.03), duration of 2nd stage of labor (t=3.70, p < .001), and arterial cord blood pH (t=2.64, p=.01). Interestingly, there was no difference in labor pain perceived between women with and without epidural anesthesia. Considering the preference and use of epidural anesthesia, health professionals need to assess coping ability of women undergoing delivery and to provide accurate information about pain control to support their decision making and eventually to enhance delivery outcomes for mothers and neonates.

Keywords: epidural anesthesia, delivery outcomes, labor pain, perception

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Authors: S. El-Azzeh, A. Al-Aqqad, M. Salem, H. Al-Khaldi, S. Thaher

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Thermal comfort studies are very important during the early stages of the building’s design. If this study was ignored, problems will start to occur for the occupants in the future. In hot climates, where solar radiations are entering buildings all year long, occupant’s thermal comfort in office buildings needs to be examined. This study aims to investigate the thermal comfort at an existing office building at the Australian College of Kuwait and test its validity and improve occupant’s thermal satisfaction by covering windows with a heat rejection tint material that enables sunlight to pass through the office while reflecting solar heat outside. Environmental variables were measured using thermal comfort data logger INNOVA 1221 to find the predicted mean vote (PMV) in the selected location. Also, subjective variables were measured to find the actual mean vote (AMV) through surveys distributed among occupants in the selected case study office. All the variables collected were analyzed and classified according to international standards ISO 7730 and ASHRAE55. The results of this study showed improvement in both PMV and AMV. The mean value of PMV based on the original design was 0.691 which dropped to 0.32 after installation and it still at comfort zone. Also, the mean value of the AMV has improved for the first occupant, where before it was -0.46 and it became -1 which is cooler. For the other occupant, it was slightly warm with a mean value of 0.9 and it was improved and became cooler with a -0.25 mean value based on American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) seven-point scale.

Keywords: thermal comfort, office buildings, indoor environments, predicted mean vote

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Authors: Gia Sirbiladze

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Route planning problems are among the activities that have the highest impact on logistical planning, transportation, and distribution because of their effects on efficiency in resource management, service levels, and client satisfaction. In extreme conditions, the difficulty of vehicle movement between different customers causes the imprecision of time of movement and the uncertainty of the feasibility of movement. A feasibility level of vehicle movement on the closed route of the disaster-streaking zone is defined for the construction of an objective function. Experts’ evaluations of the uncertain parameters in q-rung ortho-pair fuzzy numbers (q-ROFNs) are presented. A fuzzy bi-objective combinatorial optimization problem of fuzzy vehicle routine problem (FVRP) is constructed based on the technique of possibility theory. The FVRP is reduced to the bi-criteria partitioning problem for the so-called “promising” routes which were selected from the all-admissible closed routes. The convenient selection of the “promising” routes allows us to solve the reduced problem in real-time computing. For the numerical solution of the bi-criteria partitioning problem, the -constraint approach is used. The main results' support software is designed. The constructed model is illustrated with a numerical example.

Keywords: q-rung ortho-pair fuzzy sets, facility location selection problem, multi-objective combinatorial optimization problem, partitioning problem

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Authors: Nattapong Techarattanased

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The purposes of this research are to make comparisons in respect of the behaviors on the use of the services of metered taxi classified by the demographic factor and to study the influence of the recognition on service quality having the effect on usage behaviors of metered taxi services of consumers in Bangkok Metropolitan Areas. The samples used in this research are 400 metered taxi service users in Bangkok Metropolitan Areas and use a questionnaire as the tool for collecting the data. Analysis statistics is mean and multiple regression analysis. Results of the research revealed that the consumers recognize the overall quality of services in each aspect include tangible aspects of the service, responses to customers, assurance on the confidence, understanding and knowing of customers which is rated at the moderate level except the aspect of the assurance on the confidence and trustworthiness which are rated at a high level. For the result of a hypothetical test, it is found that the quality in providing the services on the aspect of the assurance given to the customers has the effect on the usage behaviors of metered taxi services and the aspect of the frequency on the use of the services per month which in this connection. Such variable can forecast at one point nine percent (1.9%). In addition, quality in providing the services and the aspect of the responses to customers have the effect on the behaviors on the use of metered taxi services on the aspect of the expenses on the use of services per month which in this connection, such variable can forecast at two point one percent (2.1%).

Keywords: consumer behavior, metered taxi service, satisfaction, service quality

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Authors: Kan Yu, Khui Hung Lee, Eben Afrifa-Yamoah, Jing Guo, Katrina Harrison, Jack Goldblatt, Nicholas Pachter, Jitian Xiao, Guicheng Brad Zhang

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Background and Significance of the Study: Congenital Heart Defects (CHDs) are the most common malformation at birth and one of the leading causes of infant death. Although the exact etiology remains a significant challenge, epigenetic modifications, such as DNA methylation, are thought to contribute to the pathogenesis of congenital heart defects. At present, no existing DNA methylation biomarkers are used for early detection of CHDs. The existing CHD diagnostic techniques are time-consuming and costly and can only be used to diagnose CHDs after an infant was born. The present study employed a machine learning technique to analyse genome-wide methylation data in children with and without CHDs with the aim to find methylation biomarkers for CHDs. Methods: The Illumina Human Methylation EPIC BeadChip was used to screen the genome‐wide DNA methylation profiles of 24 infants diagnosed with congenital heart defects and 24 healthy infants without congenital heart defects. Primary pre-processing was conducted by using RnBeads and limma packages. The methylation levels of top 600 genes with the lowest p-value were selected and further investigated by using a random forest approach. ROC curves were used to analyse the sensitivity and specificity of each biomarker in both training and test sample sets. The functionalities of selected genes with high sensitivity and specificity were then assessed in molecular processes. Major Findings of the Study: Three genes (MIR663, FGF3, and FAM64A) were identified from both training and validating data by random forests with an average sensitivity and specificity of 85% and 95%. GO analyses for the top 600 genes showed that these putative differentially methylated genes were primarily associated with regulation of lipid metabolic process, protein-containing complex localization, and Notch signalling pathway. The present findings highlight that aberrant DNA methylation may play a significant role in the pathogenesis of congenital heart defects.

Keywords: biomarker, congenital heart defects, DNA methylation, random forest

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Authors: Shivani Kolarkar

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Splendid growth in Indian IT has generated women employment on a large scale in India and continues to do it. Indian IT industry has achieved this in spite of total masculine dominance in other Indian engineering industries, where the ratio of women employment is almost negligible as compared to men. Indian IT today proudly enjoys a strong pool of technically educated, intellectual, and skillful women employees. IT industry has encouraged technical education for women in India, to a great extent. The software industry has definitely contributed to developing a positive and dignified role and status of women employees in Indian IT industry. It has promoted women’s social and economic role and status. In spite of all, gender discrimination still persists in Indian IT, also, which is low as compared to other industries, but it is a matter of concern. An Indian woman is bound to carry dual roles which are equally over-stressed for IT women employees. Long working hours, night shifts, work pressures and insufficient safety majors and necessary facilities for women contributes to making her physical-mental life, family and married life troublesome. Which forces her either to cluster at low-end jobs in IT/elsewhere or to sacrifice her career. Nature, role and status of HRM needs to be broadened, deepened and shaped into research-oriented multidimensional perspective in the context of really enhancing role and status of Indian IT women with high appreciation of women employees’ dignity and entity.

Keywords: attrition, gender discrimination, HRM, Indian IT, software industry, job satisfaction, safety, technical education, women employment

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Authors: Farnoosh Faal

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Institutional and organizational change in social housing organizations can have a significant impact on both the organizations themselves and their stakeholders. This paper provides an overview of the impact of institutional and organizational change on social housing organizations and their stakeholders, including tenants, employees, and other community members. The paper examines the different types of institutional and organizational change that can occur in social housing organizations, such as changes in management structure, funding models, and service delivery methods. It also explores the potential benefits and drawbacks of these changes, including changes in efficiency, service quality, and tenant satisfaction. The paper further discusses the impact of institutional and organizational change on social housing organization stakeholders, including the effects on employee morale, tenant engagement, and community relationships. The paper highlights the importance of effective stakeholder engagement and communication in ensuring a smooth transition to new organizational models and systems. Finally, the paper discusses the challenges and opportunities presented by institutional and organizational change in social housing organizations and provides recommendations for organizations looking to navigate these changes successfully. These recommendations include prioritizing stakeholder engagement, investing in staff training and development, and maintaining a focus on the needs and priorities of tenants and communities. Overall, this paper emphasizes the importance of considering the impact of institutional and organizational change on social housing organizations and their stakeholders and highlights strategies for managing these changes in a way that maximizes benefits and minimizes negative impacts.

Keywords: social housing organizations, stakeholder engagement, institutional change, challenges, opportunities

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Authors: Sadia Munir

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The aim of this study is to investigate changes in placental development and vascular dysfunction which subsequently affect feto-maternal health in pregnancies complicated by gestational diabetes mellitus (GDM). Fetal and postnatal adverse health outcomes of GDM are shown to be associated with disturbances in placental structure and function. Children of women with GDM are more likely to be obese and diabetic in childhood and adulthood. GDM also increases the risk of adverse pregnancy outcomes, including preeclampsia, birth injuries, macrosomia and neonatal hypoglycemia, respiratory distress syndrome, neonatal cardiac dysfunction and stillbirth. Incidences of type 2 diabetes in the MENA region are growing at an alarming rate which is estimated to become more than double by 2030. Five of the top 10 countries for diabetes prevalence in 2010 were in the Gulf region. GDM also increases the risk of development of type 2 diabetes. Interestingly, more than half of the women with GDM develop diabetes later in their life. The human placenta is a temporary organ located at the interface between mother and fetal blood circulation. Placenta has a central role as both a producer as well as a target of several molecules that are involved in placental development and function. We have investigated performed a Pubmed search with key words placenta, GDM, placental villi, vascularization, cytokines, growth factors, inflammation, hypoxia, oxidative stress and pathophysiology. We have investigated differences in the development and vascularization of placenta, their underlying causes and impact on feto-maternal health through literature review. We have also identified gaps in the literature and research questions that need to be answered to completely understand the central role of placenta in the GDM. This study is important in understanding the pathophysiology of placenta due to changes in the vascularization of villi, surface area and diameter of villous capillaries in pregnancies complicated by GDM. It is necessary to understand these mechanisms in order to develop treatments to reverse their effects on placental malfunctioning, which in turn, will result in improved mother and child health.

Keywords: gestational diabetes mellitus, placenta, vasculature, villi

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Authors: Hasnizan Aksah, Adi Irfan Che Ani

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Refurbished historic government buildings should perform as intended to support the organization’s goals that enhance occupant satisfaction. However, these buildings may have issues associated with functional performance evaluation. The aim of this study is to develop a Post Occupancy Evaluation (POE) sustainability assessment tool for functional performance evaluation of refurbished historic government buildings. Developing an assessment tool requires a strategic methodology for a logical and cohesive tool that incorporating relevant theories and practical experiences. In this study, mixed method approaches use to collect all necessary data to achieve the objectives of this study. The design of sampling involves are interviews and survey questionnaires to relevant professionals in order to evaluate the criteria and problem encircled in functional performance evaluation. Then, the involvement of expert panels is required in establishing the assessment tool. During the process of investigation on the functional performance criteria, it was discovered that is seen to be critical in aspects of comfort, safety, and services. The proposed assessment tool has a significant role in providing opportunities for the improvement of building performance especially on functional performance for the future historic government building refurbishment project. It is hoped that the tool developed from this study will give benefits to related professionals, public agencies, local municipality, and relevant interested parties in historic building management.

Keywords: refurbished historic government buildings, functional performance, Post Occupancy Evaluation, sustainability

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Authors: Ruben Molina, Melissa Ochoa

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The rapid expansion and facilities that the Chinese government has granted to its inhabitants to travel abroad has brought benefits to the economies of the countries where these tourists travel. Due to the great economic spill that these tourists make in their travels and the great potential they possess, they become one of the most attractive segments in the world, causing countries to seek to attract them for the profits. The Chinese tourist is a tourist who seeks to know the culture, culinary experiences, traditions and folklore of the place where they travel, more than seeking sun and beach. Mexico is a country that has a great mix of tourist products and services, which favors that the tourism offer focuses on the satisfaction of the needs and preferences of the different segments of international tourists who arrive in Mexico: sun and beach tourism and also cultural tourism. Mexico has 51 sites inscribed on the World Heritage List, of which 12 are natural, 37 are cultural and 2 are mixed. Despite the great tourist attraction of the country and the strategic importance of the sector for the economy, Mexico has not managed to have a large number of tourists or income from international tourism for 15 years. One way to increase the travel industry is to attract the Chinese tourist to Mexico, which is considered a priority by countries like the United States, France and Spain due to the advantages they entail. Therefore, this article will describe the tastes, preferences and habits of Chinese tourists coming to the most popular destinations in Mexico through a Likert scale and it will be described which are the most attractive cultural factors in Mexico for the Chinese tourists and will be proposing strategies of attraction for Mexico and its destinations.

Keywords: attraction, Chinese tourist, cultural tourism, strategic, Mexico

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Authors: Anupam Sibal

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Whatever is measured tends to improve. With a view to objectively measuring and improving clinical quality across the Apollo Group Hospitals, the initiative of ACE @ 25 (Apollo Clinical Excellence@25) was launched on Jan 09. ACE @ 25 is a clinically balanced scorecard incorporating 25 clinical quality parameters involving complication rates, mortality rates, one-year survival rates and average length of stay after major procedures like liver and renal transplant, CABG, TKR, THR, TURP, PTCA, endoscopy, large bowel resection and MRM covering all major specialties. Also included are hospital acquired infection rates, pain satisfaction and medication errors. Benchmarks have been chosen from the world’s best hospitals. There are weighted scores for outcomes color coded green, orange and red. The cumulative score is 100. Data is reported monthly by 43 Group Hospitals online on the Lighthouse platform. Action taken reports for parameters falling in red are submitted quarterly and reviewed by the board. An audit team audits the data at all locations every six months. Scores are linked to appraisal of the medical head and there is an “ACE @ 25” Champion Award for the highest scorer. Scores for different parameters were variable from green to red at the start of the initiative. Most hospitals showed an improvement in scores over the last four years for parameters where they had showed scores in red or orange at the start of the initiative. The overall scores for the group have shown an increase from 72 in 2010 to 81 in 2015.

Keywords: benchmarks, clinical quality, lighthouse, platform, scores

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Authors: Kwok W. Mui, Ling T. Wong, F. Xiao, Chin T. Cheung, Ho C. Yu

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This study addresses a concept of the Sustainable Building Environmental Model (SBEM) developed to optimize energy consumption in air conditioning and ventilation (ACV) systems without any deterioration of indoor environmental quality (IEQ). The SBEM incorporates two main components: an adaptive comfort temperature control module (ACT) and a new carbon dioxide demand control module (nDCV). These two modules take an innovative approach to maintain satisfaction of the Indoor Environmental Quality (IEQ) with optimum energy consumption, they provide a rational basis of effective control. A total of 2133 sets of measurement data of indoor air temperature (Ta), relative humidity (Rh) and carbon dioxide concentration (CO2) were conducted in some Hong Kong offices to investigate the potential of integrating the SBEM. A simulation was used to evaluate the dynamic performance of the energy and air conditioning system with the integration of the SBEM in an air-conditioned building. It allows us make a clear picture of the control strategies and performed any pre-tuned of controllers before utilized in real systems. With the integration of SBEM, it was able to save up to 12.3% in simulation and 15% in field measurement of overall electricity consumption, and maintain the average carbon dioxide concentration within 1000ppm and occupant dissatisfaction in 20%.

Keywords: sustainable building environmental model (SBEM), adaptive comfort temperature (ACT), new demand control ventilation (nDCV), energy saving

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Authors: Liudmila A.Guzikova

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Being federative state Russia includes more than 80 subjects which are widely diverse by climatic conditions, demographic characteristics, cultural traditions, intensity of migration, economic development and investment attraction and other parameters. Now, in the regions of the country all forms of housing problem are present - housing mismatch to sanitary and hygienic standards, overcrowding, forced residence in financially burdensome housing, homelessness, -although the extent of these symptoms varies widely. Heterogeneity of regional conditions in combination with specifics of regional housing situation requires to concentrate the study of housing problem on the regional level. Traditionally housing market and mortgage are considered as the instruments of housing problem solving. The question arises how the housing market and mortgage market contribute to solving the housing problem in the regions of Russia. Though the purchase of dwelling in ownership should not be regarded as a universal method of the housing problem solving, the purchase of dwelling both by own funds or by use of mortgage can reduce the problem and enhance public satisfaction of living conditions. The aim of the study is to identify differences and similarities in the development of regional housing markets and mortgage lending in the regions of Russia and to evaluate their impact on the status of the housing problem. To achieve the aim of the study the methods of correlation and regression analysis are used. The data of federal statistics constitutes the information base of research. The results of the study contribute to better understanding of the interrelations in housing sphere and can be used to work out social and economic development programs in the regions.

Keywords: housing market, housing problem, mortgage, regional economy

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Authors: Nor Kalsum M. Isa, Mohd Yazid M. Yunos, Anuar Alias, Mazdi Marzuki, Kamarul Ismail, Mohd H. Ibrahim

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Green building is an emerging concept with the ultimate target to achieve sustainable development by integrating sustainability goals and principles into project development. Basically, a green building is a building that is designed, constructed and operated to boost environmental, economic, health and productivity performance over conventional buildings. The buildings have been proven to be successful in contributing towards sustainability and project success. The purpose of this study was to determine the benefits of sustainability application in building projects, looking towards project success from the perspective of Malaysian key project stakeholders. The study also aimed to explore the establishment of sustainability goals in the green building projects in Malaysia. The Triple Bottom Line (TBL) Concept of Sustainability was used as the foundation theoretical framework. Surveys, interviews and multiple case study methods were employed. A sample of 188 Malaysian building project stakeholders was selected for questionnaire surveys, and 15 stakeholders from three award-winning green building projects in Malaysia were involved in the interviews. The study found that the majority of the respondents were less aware that the sustainability integration in the building project can significantly affect cost reduction, schedule effectiveness and stakeholders’ satisfaction with the performance of buildings as at the same level as the quality performance. Of the four sustainability goals, the environmental aspect was given more priority than others in the development of the green building projects.

Keywords: green building, sustainability, project stakeholders, Malaysia

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Authors: Balkibekova Venera Serikpaevna

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Background: Autism Spectrum Disorder (ASD) poses significant challenges in both diagnosis and treatment. Existing therapeutic interventions often target specific symptoms, necessitating the exploration of alternative approaches. This study investigates the RITM (Rhythm Integration Tapping Music) developed by Balkibekova, aiming to create imitation, social engagement and a wide range of emotions through brain development. Methods: A randomized controlled trial was conducted with 100 participants diagnosed with ASD, aged 1 to 4 years. Participants were randomly assigned to either the RITM therapy group or a control group receiving standard care. The RITM therapy, rooted in tapping rhythm to music such as: marche on the drums, waltz on bells, lullaby on musical triangle, dancing on tambourine, polka on wooden spoons. Therapy sessions were conducted over a 3 year period, with assessments at baseline, midpoint, and post-intervention. Results: Preliminary analyses reveal promising outcomes in the RITM therapy group. Participants demonstrated significant improvements in social interactions, speech understanding, birth of speech, and adaptive behaviors compared to the control group. Careful examination of subgroup analyses provides insights into the differential effectiveness of the RITM approach across various ASD profiles. Conclusions: The findings suggest that RITM therapy, as developed by Balkibekova, holds promise as intervention for ASD. The integrative nature of the approach, addressing multiple domains simultaneously, may contribute to its efficacy. Further research is warranted to validate these preliminary results and explore the long-term impact of RITM therapy on individuals with ASD. This abstract presents a snapshot of the research, emphasizing the significance, methodology, key findings, and implications of the RITM therapy method for consideration in an autism conference.

Keywords: RITM therapy, tapping rhythm, autism, mirror neurons, bright emotions, social interactions, communications

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Authors: Joelle Fong

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Older persons are at greatest risk of becoming frail. As survival to the age of 80 and beyond continues to increase, the health and frailty of older Americans has garnered much recent attention among policy makers and healthcare administrators. This paper examines patterns in old-age frailty within a multistate actuarial model that characterizes the stochastic process of biological ageing. Using aggregate population-level U.S. mortality data, we implement a stochastic aging model to examine cohort trends and gender differences in frailty distributions for older Americans born 1865 – 1894. The stochastic ageing model, which draws from the fields of actuarial science and gerontology, is well-established in the literature. The implications for public health insurance programs are also discussed. Our results suggest that, on average, women tend to be frailer than men at older ages and reveal useful insights about the magnitude of the male-female differential at critical age points. Specifically, we note that the frailty statuses of males and females are actually quite comparable from ages 65 to 80. Beyond age 80, however, the frailty levels start to diverge considerably implying that women are moving quicker into worse states of health than men. Tracking average frailty by gender over 30 successive birth cohorts, we also find that frailty levels for both genders follow a distinct peak-and-trough pattern. For instance, frailty among 85-year old American survivors increased in years 1954-1963, decreased in years 1964-1971, and again started to increase in years 1972-1979. A number of factors may have accounted for these cohort differences including differences in cohort life histories, differences in disease prevalence, differences in lifestyle and behavior, differential access to medical advances, as well as changes in environmental risk factors over time. We conclude with a discussion on the implications of our findings on spending for long-term care programs within the broader health insurance system.

Keywords: actuarial modeling, cohort analysis, frail elderly, health

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Authors: Amauri Josafat Gomez Aguilar, Jean Pierre Kenné

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This research presents the development of a self-sustainable manufacturing system from a circular economy perspective, structured by a multi-stage serial production system consisting of a series of machines under deterioration in charge of producing a single product and a reverse remanufacturing system constituted by the same productive systems of the first scheme and different tooling, fed by-products collected at the end of their life cycle, and non-conforming elements of the first productive scheme. Since the advanced production manufacturing system is unable to satisfy the customer's quality expectations completely, we propose the development of a mixed integer linear mathematical model focused on the optimal search and assignment of quality stations and preventive maintenance operation to the machines over a time horizon, intending to segregate the correct number of non-conforming parts for reuse in the remanufacturing system and thereby minimizing production, quality, maintenance, and customer non-conformance penalties. Numerical experiments are performed to analyze the solutions found by the model under different scenarios. The results showed that the correct implementation of a closed manufacturing system and allocation of quality inspection and preventive maintenance operations generate better levels of customer satisfaction and an efficient manufacturing system.

Keywords: closed loop, mixed integer linear programming, preventive maintenance, quality inspection

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Authors: Stephanie Giordano, Eric Lam, Rosa Plasencia

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An important piece of active aging is ensuring people have the right support to meet individual needs. Using NCI-AD data, we will look at measures of satisfaction with community access and needed services among people with physical disabilities receiving LTSS in the US. National Core Indicators—Aging and Disabilities (NCI-AD) is a voluntary effort by State Medicaid, aging, and disability agencies across the US to measure and track their own performance. NCI-AD uses a standardized survey – the Adult Consumer Survey (ACS), to hear directly from people receiving services about the quality of services and supports they receive. Data from the 2018-19 ACS found that compared to people without a physical disability, those with a physical disability were more likely to make choices about the services they receive, including when and how often they receive those services. Yet people with a physical disability were less likely to report they get enough assistance with everyday activities (e.g., shopping, housework, and taking medications) and self-care (e.g., dressing or bathing) and more likely to report that services and supports do not fully meet their needs and goals. A further breakdown by age shows that people 40-65 years old with a physical disability experienced even greater barriers to being as active in the community as they would like to be, indicating a need to better support people as they age with or into a disability. We will explore how these and other outcomes were affected by COVID-19, take a closer look at outcomes by demographics (e.g., race/ethnicity, gender, and mental health diagnoses) and discuss implications on the future needs of service systems.

Keywords: quality-of-life, long-term services and supports, person-centered, community

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Authors: Yogesh C. Sharma, A. Seetharaman

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The decision-making process in humans is a complicated system influenced by a variety of intrinsic and extrinsic factors. Human decisions have a ripple effect on subsequent decisions. In this study, the scope of human decision making is limited to employees. In an organisation, a person makes a variety of decisions from the time they are hired to the time they retire. The goal of this research is to identify various elements that influence decision-making. In addition, the environment in which a decision is made is a significant aspect of the decision-making process. Employees in today's workplace use artificial intelligence (AI) systems for automation and decision augmentation. The impact of AI systems on the decision-making process is examined in this study. This research is designed based on a systematic literature review. Based on gaps in the literature, limitations and the scope of future research have been identified. Based on these findings, a research framework has been designed to identify various factors affecting employee decision making. Employee decision making is influenced by technological advancement, data-driven culture, human trust, decision automation-augmentation, and workplace motivation. Hybrid human-AI systems require the development of new skill sets and organisational design. Employee psychological safety and supportive leadership influences overall job satisfaction.

Keywords: employee decision making, artificial intelligence (AI) environment, human trust, technology innovation, psychological safety

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Authors: Mari A. Virtanen, Elina Haavisto, Eeva Liikanen, Maria Kääriäinen

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Ubiquitous learning and the use of ubiquitous learning environments herald a new era in higher education. Ubiquitous environments fuse together authentic learning situations and digital learning spaces where students can seamlessly immerse themselves into the learning process. Definitions of ubiquitous learning are wide and vary in the previous literature and learning environments are not systemically described. The aim of this scoping review was to identify the criteria and the use of ubiquitous learning environments in higher education contexts. The objective was to provide a clear scope and a wide view for this research area. The original studies were collected from nine electronic databases. Seven publications in total were defined as eligible and included in the final review. An inductive content analysis was used for the data analysis. The reviewed publications described the use of ubiquitous learning environments (ULE) in higher education. Components, contents and outcomes varied between studies, but there were also many similarities. In these studies, the concept of ubiquitousness was defined as context-awareness, embeddedness, content-personalization, location-based, interactivity and flexibility and these were supported by using smart devices, wireless networks and sensing technologies. Contents varied between studies and were customized to specific uses. Measured outcomes in these studies were focused on multiple aspects as learning effectiveness, cost-effectiveness, satisfaction, and usefulness. This study provides a clear scope for ULE used in higher education. It also raises the need for transparent development and publication processes, and for practical implications of ubiquitous learning environments.

Keywords: higher education, learning environment, scoping review, ubiquitous learning, u-learning

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Authors: Simone Medio

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If we observe many modern cities from above, we are typically confronted with a sea of asphalt-clad flat rooftops. In contrast to the modernist expectation of a populated flat roof, flat rooftops in modern multi-story buildings are rarely used. On the contrary, they typify a desolate and abandoned landscape encouraging mechanical system allocation. Flat roof technology continues to be seen as a state-of-fact in most multi-storey building designs and its greening its prevalent environmental justification. This paper aims to seek a change in the approach to flat roofing. It makes a case for the opportunity at hand for architectonically resolute, sheltered, livable spaces that make a better use of the environment at rooftop level. The researcher is looking for the triggers that allow for that change to happen in the design process of case study buildings. The paper begins by exploring Han Slawick covered roof terrace in Amsterdam as a simple and essential example of transforming the flat roof in a usable, inhabitable space. It investigates the design challenges and the logistic, financial and legislative hurdles faced by the architect, and the outcomes in terms of building performance and occupant use and satisfaction. The researcher uses a grounded research methodology with direct interview process to the architect in charge of the building and the building user. Energy simulation tools and calculation of running costs are also used as further means of validating change.

Keywords: environmental design, flat rooftop persistence, roof re-habitation, tectonics

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Authors: Hong Wu, Naiji Lu

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Improvement of health behavior among people with chronic diseases is vital for increasing longevity and enhancing quality of life. This paper researched the causal effects of informal care on the compliance with doctor’s health advices – smoking control, dietetic regulation, weight control and keep exercising – among older people with chronic diseases in China, which is facing the challenge of aging. We addressed the selection bias by using propensity score matching in the estimation process. We used the 2011-2012 national baseline data of the China Health and Retirement Longitudinal Study. Our results showed informal care can help improve health behavior of older people. First, informal care improved the compliance of smoking controls: whether smoke, frequency of smoking, and the time lag between wake up and the first cigarette was all lower for these older people with informal care; Second, for dietetic regulation, older people with informal care had more meals every day than older people without informal care; Third, three variables: BMI, whether gain weight and whether lose weight were used to measure the outcome of weight control. There were no significant difference between group with informal care and that without for BMI and the possibility of losing weight. Older people with informal care had lower possibility of gain weight than that without; Last, for the advice of keeping exercising, informal care increased the probability of walking exercise, however, the difference between groups for moderate and vigorous exercise were not significant. Our results indicate policy makers who aim to decrease accidents should take informal care to elders into account and provide an appropriate policy to meet the demand of informal care. Our birth policy and postponed retirement policy may decrease the informal caregiving hours, so adjustments of these policies are important and urgent to meet the current situation of aged tendency of population. In addition, government could give more support to develop organizations to provide formal care, such as nursing home. We infer that formal care is also useful for health behavior improvements.

Keywords: chronic diseases, compliance, CHARLS, health advice, informal care, older people, propensity score matching

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Authors: Siti Hazar Sitorus, Marini Kristina Situmeang, Mukhammad Fatkhullah, Arfan Fadli

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This study aims to examine how the Batak tribe in the Village Lumban Sitorus Parmaksian District, Toba Samosir (Tobasa) interpret the culture of drinking Tuak as a social interaction. This research uses qualitative method with case study approach. Through this approach, the researchers obtained primary data by looking at and observing the social interaction that occurs when the activity of drinking tuak takes place on the daily life of the Batak Toba community in the village of Lumban Sitorus. The technique of data collecting is done by observation and in-depth interview. This study focuses on Batak Toba community, especially men who daily drink tuak. The results obtained from this study is Batak Toba society has a habit of drinking Tuak (a type of alcoholic beverage derived from water sapphire juice that is fermented). In Batak Toba society, tuak is not only considered as an alcoholic drink which is usually drunk in the afternoon at lapotuak (tuak shop), but tuak is also understood as a drink of honor in a traditional party at Toba Batak society. On the other hand, the activity of drinking of tuak was also considered as a medium or a means of connecting the formation of a sense of solidarity among the people of LumbanSitorous Village. In its existence, drinking tuak is defined as a mean that can facilitate the establishment to open communication with fellow members of Batak Toba community, such as at leisure, birth party, death or as medicine. Specifically, tuak in a special sense in Batak Toba society is also a symbol of intimacy, gratitude, and respect which is manifested in the activity of daily drinking tuak. In Indonesia, if we refer to the Criminal Code in articles 300 and 536 it is clear that whoever intentionally sells and consumes intoxicating / alcoholic drinks will be subject to a maximum jail term of one year. It became interesting then when looking at Indonesia as a country that has a diversity of cultures in which the law implies the prohibition of alcoholic / intoxicating beverages. However, the existence of drinking of tuak as a drink that categorized intoxicating in Batak Toba society still continues to.

Keywords: tradition of drinking tuak, meaning of tuak, Batak society, cultural studies

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Authors: Mehrdad Taghipour, Mina Rostami, Mahdi Eskandarlou

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Partial-thickness skin graft is the cornerstone for scalp defect repair. Given the potential side effects following harvesting from these sites, this study aimed to compare the outcomes of graft harvesting from scalp and lower limb. This clinical trial was conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to Plastic Surgery Clinic at Besat Hospital, Hamadan, Iran during 2018-2019. Sampling was done by simple randomization using random digit table. The donor site in case group and control group was scalp and lower limb respectively. Overall, 28 patients (70%) were male and 12 (30%) were female. Basal cell carcinoma (BCC) and trauma were the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The mean diameter of defect was 24.28±45.37 mm for all of the patients. The difference between diameters of defect in both groups were statistically meaningful while no such difference between graft diameters was seen. The graft “Take” was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale and the satisfaction was higher in them per Likert scale. Scalp can safely be used as donor site for skin graft to be used for scalp defects associated with better results and lower complication rates compared to other donor sites.

Keywords: donor site, graft, scalp, partial thickness

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