Search results for: clinical quality

Authors: Francis Angelo A. Sta. Ana

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Heavy metal pollutants are a major environmental concern in built-up areas in the Philippines. It causes negative effects on aquatic organisms and human health. Heavy metals concentrations of chromium, mercury, lead, copper, arsenic, zinc, cadmium, and nickel were investigated in Sta. Maria river, in Laguna. A total of 16 sediment samples were collected from the river at four stations. Atomic absorption spectroscopy (AAS) was used for element detection. It is found that copper is associated with chromium based on statistical analysis using principal component analysis (PCA). Conduct of Sediment Quality Guideline (SQG) revealed that chromium has high toxicity due to values higher than Sediment Quality Guidelines Probable Effect Level (SQG’s PEL). Copper, Nickel, and Pb fall on average toxicity while others are below PEL and effect range low (ERL).

Keywords: heavy metals, pollutants, sediment quality guidelines, atomic absorption spectroscopy

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Authors: Priscilla Akua Agyapong

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Background: In a country of nearly 34 million people, Ghana suffers from rapidly growing pediatric CHD cases and not enough pediatric specialists to attend to the burgeoning needs of these children. Most of the cases are either missed or diagnosed late, resulting in increased mortality. According to the National Cardiothoracic Centre, 1 in every 100,000 births in Ghana has CHD; however, there is limited data on the clinical presentation and its management, one of the many reasons I decided to do this case study coupled with the loss my 2 month old niece to multiple Ventricular Septal Defect 3 years ago due late diagnoses. Method: A retrospective cohort study was performed at the child health clinic of one of Ghana’s public tertiary Institutions using data from their electronic health record (EHR) from February 2021 to April 2022. All suspected or provisionally diagnosed cases were included in the analysis. Results: Records of over 3000 children were reviewed with an approximate male to female ratio of 1:1.53 cases diagnosed during the period of study, most of whom were less than 5 years of age. 25 cases had complete clinical records, with acyanotic septal defects being the most diagnosed. 62.5% of the cases were ventricular septal defects, followed by Patent Ductus Arteriosus (23%) and Atrial Septal Defects (4.5%). Tetralogy of Fallot was the most predominant and complex cyanotic CHD with 10%. Conclusion: The indeterminate coronary anatomy of infants makes it difficult to use only echocardiography and other conventional clinical methods in screening for CHDs. There are rising modernizations and new innovative ways that can be employed in Ghana for early detection, hence preventing the delay of a potential surgical repair. It is, therefore, imperative to create the needed awareness about these “SILENT CRISES” and help save the Ghanaian child’s life.

Keywords: congenital heart defect(CHD), ventricular septal defect(VSD), atrial septal defect(ASD), patent ductus arteriosus(PDA)

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Authors: Anna Wszołek

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For a very long time, the doctor-patient relationship had a paternalistic character. The events of the II World War, as well as fast development of the biotechnology and medicine caused an important change in that relationship. Human beings and their dignity were put in the centre of philosophical and legal debate. The increasing frequency of clinical trials led to the emergence of bioethics, which dealt with the topic of the possibilities and boundaries of such research in relation to individual’s autonomy. Thus, there was a transformation from a paternalistic relationship to a more collaborative one in which the patient has more room for self-determination. Today, patients are more and more aware of their rights and the obligations placed on doctors and the health care system, which is linked to an increase in medical malpractice claims. Unfortunately, these claims are not always justified. There is a strong concentration around the topic of patient’s good, however, at the other side there are doctors who feel, on the example of Poland, they might be easily accused and sued for medical malpractice even though they fulfilled their duties. Such situation may have a negative impact on the quality of health care services and patient’s interests. This research is going to present doctor’s perspective on the topic of medical malpractice allegations. It is supposed to show possible damage to a doctor’s reputation caused by frivolous and weakly justified medical malpractice accusations, as well as means to protect this reputation.

Keywords: doctor's reputation, medical malpractice, personal rights, unjustified allegations

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Authors: S. M. Satyam, K. L. Bairy, R. Pirasanthan, R. L. Vaishnav

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Zincovit tablets have been used as nutritional food supplement over a prolonged period of time. The aim of the present study was to investigate the cardio-protective effect of combined formulation of grape seed extract and Zincovit tablets (40, 80 and 160 mg/kg) using a Langendorff model of ischemia-reperfusion in Wistar rats. Following 21 days of pre-treatment, combined formulation of grape seed extract and Zincovit tablets significantly attenuated ischemia-reperfusion induced cardiac injury in terms of increased coronary flow rate (p < 0.01), decreased creatine kinase activity in coronary effluent (p < 0.05), decreased MDA (p < 0.001), 4-HNE (p < 0.001) and increased protein thiol content (p < 0.01) in comparison with the untreated (control) group. This study opens an avenue to clinical studies to demonstrate the validity of this paradigm as a nutritional food supplement, which could improve the clinical outcome of patients subjected to percutaneous angioplasty.

Keywords: grape seed extract, myocardial ischemia-reperfusion injury, oxidative stress, Zincovit tablets

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Authors: Stoyanka Georgieva Vladeva, Elena Kirilova Kirilova, Nikola Kirilov Kirilov

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Summary: WHO (World Health Organization) recommends the elder people a certain amount of regular physical activity in order to prevent some of the health issues. Postmenopausal osteoporosis is one of the chronic diseases which requires the maintaining of regular physical activity. The regular activity combined with an adequate medical treatment greatly improves the quality of life of the patient. Objectives: Assessment of the effect of the regular physical activity recommended by WHO on the quality of life in patients with postmenopausal osteoporosis. Material and methods: For the period of one year 68 female patients treated with Denosumab have been monitored. The bone density has been measured with the DEXA method in accordance to the T-score. No patients having any oncologic diseases and secondary osteoporosis have been included in the study. The subjects have been divided into groups by their age. The first group – women aged under 65 years (27 subjects) and the second group – women aged over 65 years (41 subjects). All patients have been advised to maintain regular physical activity included in the recommendations of the WHO in accordance with the age and the disease. The quality of life has been assessed in the beginning and at the end of the one-year period using the SF 36V2 questionnaire. Results: Only 31% of the subjects have engaged into regular increased physical activities for the whole period. Among them are mostly patients of the second group (aged over 65 years, 71%). The women from the both groups who were engaging into regular activities for this one-year period all experience an improvement of the quality of life. These results show that older patients understand the necessity of the physical activity for their health. The comparison of the output data to the scales of physical activity, durability, body pain, vitality, social activity and emotional stability has found an improvement at the end of the period in all patients. The osteodensitometry showed general improvement of the T-score. Patients with additional visits to their rheumatologist have better results. Conclusion: Combination of regular physical activity in accordance to the recommendations of WHO and medical treatment including anti-osteoporotic drugs improves the quality of life of women with postmenopausal osteoporosis.

Keywords: elderly patients, osteoporosis, physical activity, quality of life

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Authors: Jamal A. Radaideh, Ziad N. Shatnawi

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Both indoor and outdoor air quality is investigated throughout residential areas of Al Hofuf city/ Eastern province of Saudi Arabia through a multi‐week multiple sites measurement and sampling survey. Concentration levels of five criteria air pollutants, including carbon dioxide (CO2), carbon monoxide (CO), nitrous dioxide (NO2), sulfur dioxide (SO2) and total volatile organic compounds (TVOC) were measured and analyzed during the study period from January to May 2014. For this survey paper, three different sites, roadside RS, urban UR, and rural RU were selected. Within each site type, six locations were assigned to carryout air quality measurements and to study varying indoor/outdoor air quality for each pollutant. Results indicate that a strong correlation between indoor and outdoor air exists. The I/O ratios for the considered criteria pollutants show that the strongest relationship between indoor and outdoor air is found by analyzing of carbon dioxide, CO2 (0.88), while the lowest is found by both NO2 and SO2 (0.7).

Keywords: criteria air pollutants, indoor/outdoor air pollution, indoor/outdoor ratio, Saudi Arabia

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Authors: Chandra Shekhar Verma, Umesh Chandra Mishra

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Blast Furnace performance mainly depends on the quality of sinter as a major portion of iron-bearing material occupies by it hence its quality w.r.t. Tumbler Index (TI), Reducibility Index (RI) and Reduction Degradation Index (RDI) are the key performance indicators of sinter plant. Now it became very tough to maintain the desired quality with the increasing alumina (Al₂O₃) content in iron fines and study is focused on it. Alumina is a refractory material and required more heat input to fuse thereby affecting the desired sintering temperature, i.e. 1300°C. It goes in between the grain boundaries of the bond and makes it weaker. Sinter strength decreases with increasing alumina content, and weak sinter generates more fines thereby reduces the net sinter production as well as plant productivity. Presence of impurities beyond the acceptable norm: such as LOI, Al₂O₃, MnO, TiO₂, K₂O, Na₂O, Hydrates (Goethite & Limonite), SiO₂, phosphorous and zinc, has led to greater challenges in the thrust areas such as productivity, quality and cost. The ultimate aim of this study is maintaining the sinter strength even with high Al₂O without hampering the plant productivity. This study includes mineralogy test of iron fines to find out the fraction of different phases present in the ore and phase analysis of product sinter to know the distribution of different phases. Corrections were done focusing majorly on varying Al₂O₃/SiO₂ ratio, basicity: B2 (CaO/SiO₂), B3 (CaO+MgO/SiO₂) and B4 (CaO+MgO/SiO₂+Al₂O₃). The concept of Alumina / Silica ratio, B3 & B4 found to be useful. We used to vary MgO, Al₂O₃/SiO₂, B2, B3 and B4 to get the desired sinter strength even at high alumina (4.2 - 4.5%) in sinter. The study concludes with the establishment of B4, and Al₂O₃/SiO₂ ratio in between 1.53-1.60 and 0.63- 0.70 respectively and have achieved tumbler index (Drum Index) 76 plus with the plant productivity of 1.58-1.6 t/m2/hr. at JSPL, Raigarh. Study shows that despite of high alumina in sinter, its physical quality can be controlled by maintaining the above-mentioned parameters.

Keywords: Basicity-2, Basicity-3, Basicity-4, Sinter

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Authors: J. Szoltysek, S. Twarog

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The happy city, as the desired effect of changes implemented by cities, involves the deliberate and purposeful evolution of material and spiritual space in which residents pursue happiness, as it is perceived collectively and individually. The quality of life (QoL) has, for many years, been researched as one of the dimensions of happiness. Both literature studies and the observation of how cities function lead to the conclusion that the happy city is the city of meetings. The importance of meeting spaces in cities for the quality of life has been confirmed also for Polish cities and, as a result, the conclusions may be drawn that public space should be planned in such a manner so as to tailor it – to the greatest possible degree – to the needs of the residents of Polish cities. The study embraced both Polish and foreign data concerning both the dimension of the quality of life in cities and the issues related to the existence of common spaces where meetings take place. Both quantitative and qualitative analytical techniques have been used to analyze and interpret the data collected. We sought the answers to the questions on the significance of the factors, identified by the respondents, which affect the QoL in a city. We identified 9 mega factors: being, work, education, recreation, health and safety, mobility, neighborhood, acceptance, agora. We established the preferences of the QoL in relation to the size of a city and the public spaces, that seem to be the cornerstone of the happy city.

Keywords: city, meetings, public spaces, social cohesion, quality of life

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Authors: Flávio A. F. da Ponte, Jackson Q. Malveira, José A. S. Ramos Filho, Monica C. G. Albuquerque

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The vegetable oils have many applications in industrial processes and due to this potential have constantly increased the demand for the use of low-quality oils, mainly in the production of biofuel. This work aims to the physicochemical evaluation of babassu oil (Orbinya speciosa) and coconut (Cocos nucifera) of low quality, as well the obtaining the free fatty acids 6 to 16 carbon atoms, with intention to be used as raw material for the biofuels production. The babassu oil and coconut low quality, as well the fatty acids obtained from these oils were characterized as their physicochemical properties and fatty acid composition (using gas chromatography coupled to mass). The NMR technique was used to assess the efficiency of fractional distillation under reduced pressure to obtain the intermediate carbonic chain fatty acids. The results showed that the bad quality in terms of physicochemical evaluation of babassu oils and coconut oils interfere directly in industrial application. However the fatty acids of intermediate carbonic chain (C6 to C16) may be used in cosmetic, pharmaceutical and particularly as the biokerosene fuel. The chromatographic analysis showed that the babassu oil and coconut oil have as major fatty acids are lauric acid (57.5 and 38.6%, respectively), whereas the top phase from distillation of coconut oil showed caprylic acid (39.1%) and major fatty acid.

Keywords: babassu oil (Orbinya speciosa), coconut oil (Cocos nucifera), fatty acids, biomass

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Authors: Tukur Husaini Nahuche

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The parent resources play a vital role in the life of the offspring. It help give children basic necessities of life like food, clothing, and housing. In a like manner financial assets allow parents to move into neighborhood with more affluent school systems, to pay school bills, purchase expensive technologies like personal computer, save money for tutoring books, magazines, journals, Newspapers etc. Making of proper provision in the home environment conducive for learning after school hours and creation of other outdoor activities for them are what necessitate in enhancing and accelerating children’s learning opportunities. Indeed, this paper intends to discuss parental investment in education, parent income resources, parental education, occupation, and income as relatively influencing children’s access to quality education. With the hope that families would provide equal opportunities for children irrespective of their sex, intelligence, subject choice,etc.

Keywords: parental investment, children's access, quality education

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Authors: Jun Young Chong, Seung Whan Kim

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Introduction: The use of personal protective equipment for respiratory infection control in cardiopulmonary resuscitation (CPR) is a physical burden to healthcare providers. It matters how long CPR quality according to recommended guidelines can be maintained under these circumstances. It was investigated whether chest compression time was appropriate for a 2-minute shift and how long it was maintained in accordance with the guidelines under such conditions. Methods: This prospective crossover simulation study was performed at a single center from September 2020 to October 2020. Five indicators of CPR quality were measured during the first and second sessions of the study period. All participants wore a Level D powered air-purifying respirator (PAPR), and the experiment was conducted using a Resusci Anne manikin, which can measure the quality of chest compressions. Each participant conducted two sessions. In session one, 2-minutes of chest compressions followed by a 2-minute rest was repeated twice; in session two, 1-minute of chest compressions followed by a 1-minute rest was repeated four times. Results: All 34 participants completed the study. The deep and sufficient compression rate was 65.9 ± 13.1 mm in the 1-minute shift group and 61.5 ± 30.5 mm in the 2-minute shift group. The mean depth was 52.8 ±4.3 mm in the 1-minute shift group and 51.0 ± 6.1 mm in the 2-minute shift group. In these two values, there was a statistically significant difference between the two sessions. There was no statistically significant difference in the other CPR quality values. Conclusions: It was suggested that the different standard of current 2-minute to 1-minute cycles due to a significant reduction in the quality of chest compression in cases of CPR with PAPR.

Keywords: cardiopulmonary resuscitation, chest compression, personal protective equipment, powered air-purifying respirator

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

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Rapid technological development and digitalization has affected also on higher education. During last twenty years multiple of electronic and mobile learning (e-learning, m-learning) platforms have been developed and have become prevalent in many universities and in the all fields of education. Ubiquitous learning (u-learning) is not that widely known or used. Ubiquitous learning environments (ULE) are the new era of computer-assisted learning. They are based on ubiquitous technology and computing that fuses the learner seamlessly into learning process by using sensing technology as tags, badges or barcodes and smart devices like smartphones and tablets. ULE combines real-life learning situations into virtual aspects and can be flexible used in anytime and anyplace. The aim of this study was to assess the effects of ubiquitous 360 o learning environment on higher education students’ clinical histotechnology competence. A quasi-experimental study design was used. 57 students in biomedical laboratory science degree program was assigned voluntarily to experiment (n=29) and to control group (n=28). Experimental group studied via ubiquitous 360o learning environment and control group via traditional web-based learning environment (WLE) in a 8-week educational intervention. Ubiquitous 360o learning environment (ULE) combined authentic learning environment (histotechnology laboratory), digital environment (virtual laboratory), virtual microscope, multimedia learning content, interactive communication tools, electronic library and quick response barcodes placed into authentic laboratory. Web-based learning environment contained equal content and components with the exception of the use of mobile device, interactive communication tools and quick response barcodes. Competence of clinical histotechnology was assessed by using knowledge test and self-report developed for this study. Data was collected electronically before and after clinical histotechnology course and analysed by using descriptive statistics. Differences among groups were identified by using Wilcoxon test and differences between groups by using Mann-Whitney U-test. Statistically significant differences among groups were identified in both groups (p<0.001). Competence scores in post-test were higher in both groups, than in pre-test. Differences between groups were very small and not statistically significant. In this study the learning environment have developed based on 360o technology and successfully implemented into higher education context. And students’ competence increases when ubiquitous learning environment were used. In the future, ULE can be used as a learning management system for any learning situation in health sciences. More studies are needed to show differences between ULE and WLE.

Keywords: competence, higher education, histotechnology, ubiquitous learning, u-learning, 360o

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Authors: Mojtaba Soltani, Edi Suhaimi Bakar, Hamid Reza Naji

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Date Palm Wood (D.P.W) specimens were impregnated with Phenol formaldehyde (PF) resin at 15% level, using vacuum/pressure method. Three levels of moisture content (MC) (50%, 60%, and 70% ) before pressing stage and three hot pressing times (15, 20, and 30 minutes) were the variables. The boards were prepared at 20% compression rate. The physical properties of specimens such as spring back, thickness swelling and water absorption, and mechanical properties including MOR, MOE were studied and compared between variables. The results indicated that the percentage of MC levels before compression set was the main factor on the properties of the Date Palm Compreg. Also, the results showed that this compregnation method can be used as a good method for making high-quality bio-composite from Date Palm Wood.

Keywords: Date palm, phenol formaldehyde resin, high-quality bio-composite, physical and mechanical properties

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Authors: Philippe Judlin, Olivier Morel

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Background: In France, the resident curriculum (RC) in Obstetrics and Gynecology (OBGYN) takes five years. In the course of the last 15 years, this RC has undergone major changes, characterized mainly by successive reductions of work hours. The program used to comprise long and frequent shifts, huge workload, poor supervision and erratic theoretical teaching. A decade ago, the French Ministry of Heath recommended a limitation of shift duration up to 24 hours and a minimum of 11 hours off duty between shifts. Last year, in order to comply with European Union directives, new recommendations have further limited residents’ work hours to 48 hours per week. Methods: Assessment of the residency program adjustments recently made to accommodate the recommendations while improving the training quality in resorting to new methods. Results: The challenge facing program directors was to provide an all-encompassing curriculum to OBGYN residents despite fewer work hours. Program has been dramatically redesigned, and several measures have been put in place: -The resident rotation system has been redesigned. Residents used to make 6-month rotations between 10-12 Departments of OBGYN or Surgery. Fewer Departments, those providing the best teaching, have been kept in the new RC. -Extensive inhouse supervision has been implemented for all kinds of clinical activities. Effectual supervision of residents has proved to be an effective tool to improve the quality of training. -The tutorship system, with academic members individually overseeing residents during their curriculum, has been perfected. It allows a better follow-up of residents’ progresses during the 5-year program. -The set up of an extensive program of lectures encompassing all maters in Obstetrics & Gynecology. These mandatory lectures are available online in a dedicated website. Therefore, face-to-face lectures have been limited in order to fit in the 48-hour limit. -The use of simulation has been significantly increased in obstetrics, materno-fetal medicine and surgery (stressing especially laparoscopic training). -Residents’ feedback has been taken into account in the setup of the new RC. Conclusion: This extensive overhaul of the Obstetrics and Gynecology RC has been in place since last year only. Nevertheless, the new program seems to adequately take into account the new recommendations while providing a better and more consistent teaching to the OBGYN residents.

Keywords: education, laparoscopy, residency, simulation

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Authors: Pronab Ganguly, Ahmed A. Moustafa

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Holistic management of schizophrenia involves mainstream pharmacological intervention, complimentary medicine intervention, therapeutic intervention and other psychosocial factors such as accommodation, education, job training, employment, relationship, friendship, exercise, overall well-being, smoking, substance abuse, suicide prevention, stigmatisation, recreation, entertainment, violent behaviour, arrangement of public trusteeship and guardianship, day-day-living skill, integration with community, and management of overweight due to medications and other health complications related to medications amongst others. Our review shows that there is no integrated survey by combining all these factors. An international web-based survey was conducted to evaluate the significance of all these factors and present them in a unified manner. It is believed this investigation will contribute positively towards holistic management of schizophrenia. There will be two surveys. In the pharmacological intervention survey, five popular drugs for schizophrenia will be chosen and their efficacy as well as harmful side effects will be evaluated on a scale of 0 -10. This survey will be done by psychiatrists. In the second survey, each element of therapeutic intervention and psychosocial factors will be evaluated according to their significance on a scale of 0 - 10. This survey will be done by care givers, psychologists, case managers and case workers. For the first survey, professional bodies of psychiatrists in English speaking countries will be contacted to request them to ask their members to participate in the survey. For the second survey, professional bodies of clinical psychologist and care givers in English speaking countries will be contacted to request them to ask their members to participate in the survey. Additionally, for both the surveys, relevant professionals will be contacted through personal contact networks. For both the surveys, mean, mode, median, standard deviation and net promoter score will be calculated for each factor and then presented in a statistically significant manner. Subsequently each factor will be ranked according to their statistical significance. Additionally, country specific variation will be highlighted to identify the variation pattern. The results of these surveys will identify the relative significance of each type of pharmacological intervention, each type of therapeutic intervention and each type of psychosocial factor. The determination of this relative importance will definitely contribute to the improvement in quality of life for individuals with schizophrenia.

Keywords: schizophrenia, holistic management, antipsychotics, quality of life

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Authors: Shih Meng-Chi, Nai-Chia Chao

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The study constructed an arts integrative curriculum for early childhood educators and kindergarten teachers to the exciting possibilities of the use of the art integration method. The art integrative curriculum applied art integration that combines and integrates various elements of music, observation, sound, art, instruments, and creation. The program consists of college courses that combine the use of technology with children’s literature, multimedia, music, dance, and drama presentation. This educational program is being used in kindergartens during the pre-service kindergarten teacher training. The study found that arts integrated curriculum was benefit for connecting across domains, multi-sensory experiences, teaching skills, implementation and creation on children art education. The art Integrating instruction helped to provide students with an understanding of the whole framework and improve the teaching quality.

Keywords: art integration, teaching quality assurance, early childhood education, arts integrated curriculum

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Authors: M. Petunia Tsweleng

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Statement of the Problem: Research and aid organisations report that children and adolescents orphaned due to HIV and AIDS are particularly vulnerable as they are often exposed to negative effects of both HIV and AIDS and orphanhood. Without much-needed parental love, care, and support, these children and adolescents are at risk of poor developmental outcomes. A cursory look at the available literature on AIDS-orphaned adolescents, and the quality of caregiving relationships with caregivers, shows that this is a relatively under-researched terrain. This article is a review of the literature on caregiving relationships of adolescents orphaned due to AIDS and their current primary caregivers. It aims to inform community programmes and policymakers by providing insight into the qualities of these relationships. Methodology: A comprehensive search of both peer-reviewed and non-peer-reviewed literature was conducted through EBSCOhost, SpringLINK, PsycINFO, SAGE, PubMed, Elsevier ScienceDirect, JSTOR, Wiley Online Library databases, and Google Scholar. The combination of keywords used for the search were: (caregiving relationships); (orphans OR AIDS orphaned children OR AIDS orphaned adolescents); (primary caregivers); and (quality caregiving); (orphans); (HIV and AIDS). The search took place between 24 January and 28 February 2022. Both qualitative and quantitative research studies published between 2010 and 2020 were reviewed. However, only qualitative studies were selected in the end -as they presented more profound findings concerning orphan-caregiver relationships. The following three stages of meta-synthesis analysis were used to analyse data: refutational syntheses, reciprocal syntheses, and line of argument. Results: The search resulted in a total of 2090 titles, of which 750 were duplicates and therefore subtracted. The researcher reviewed all the titles and abstracts of the remaining 1340 articles. 329 articles were identified as relevant, and full texts were reviewed. Following the review of the full texts, 313 studies were excluded for relevance and 4 for methodology. Twelve articles representing 11 studies fulfilled the inclusion criteria and were selected. These studies, representing different countries across the globe, reported similar forms of hardships experienced by caregivers economically, psychosocially, and healthwise. However, the studies also show that the majority of caregivers found contentment in caring for orphans, particularly grandmother carers, and were thus enabled to provide love, care, and support despite hardships. This resulted in positive caregiving relationships -as orphans fared well emotionally and psychosocially. Some relationships, however, were found negative due to unhealed emotional wounds suffered by both caregivers and orphans and others due to the caregiver’s lack of interest in providing care. These findings were based on self-report data from both orphans and caregivers. Conclusion: Findings suggest that intervention efforts need to be intensified to: alleviate poverty in households that are affected by HIV and AIDS pandemic, strengthen the community psychosocial support programmes for orphans and their caregivers; and integrate clinical services with community programmes for the healing of emotional and psychological wounds. Contributions: Findings inform community programmes and policymakers by providing insight into the qualities of the mentioned relationships as well as identifying factors commonly associated with high-quality caregiving and poor-quality caregiving.

Keywords: systematic review, caregiving relationships, orphans and primary caregivers, AIDS

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Authors: Syue-Wen Lin

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Objective: This article discusses the nursing experience of caring for a uterine cancer patient who experienced cardiogenic shock and was weaned off ECMO. The patient was placed on ECMO due to cardiogenic shock and initially struggled with anxiety caused by the physical discomfort from the disease and multiple medical devices, as well as the isolation in the ICU and restrictions on physical activity. Over time, the patient was able to wean off ECMO and perform daily activities and rehabilitation independently. Methods: The nursing period was from January 6 to January 9. Through observation, direct care, interviews, physical assessments, and case reviews, the intensive care team and bypass personnel conducted a comprehensive assessment using Gordon's 11 functional health patterns. The assessment identified three main nursing health problems: pain, anxiety, and decreased cardiac tissue perfusion. Results: The author consulted a psychologist to employ open communication techniques and empathetic care to build a trusting nurse-patient relationship. A patient-centered intensive cancer care plan was developed. Pain was assessed using a pain scale, and pain medications were adjusted in consultation with a pharmacist. Lavender essential oil therapy, light music, and pillows were used to distract and alleviate pain. The patient was encouraged to express feelings and family members were invited to increase visits and provide companionship to reduce the uncertainty caused by cancer and illness. Vital signs were closely monitored, and nursing interventions were provided to maintain adequate myocardial perfusion. Post-ECMO, the patient was encouraged to engage in rehabilitation and cardiopulmonary training. Conclusion: A key takeaway from the care process is the importance of observing not only the patient's vital signs but also their psychological state, especially when dealing with cancer patients on ECMO. The patient's greatest source of comfort was the presence of family, which helped alleviate anxiety. Healthcare providers play multiple critical roles as advocates, coordinators, educators, and counselors, listening to and accepting the patient’s emotional responses. The report aims to provide clinical cancer nurses with a reference to improve the quality of care and alleviate cancer-related discomfort.

Keywords: ECMO, uterine cancer, palliative care, Gordon's 11 functional health patterns

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Authors: Jing Jin

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The incorporation of artificial intelligence (AI) and machine learning (ML) in aircraft manufacturing and aerospace supply chains leads to the generation of a substantial amount of data among various tiers of suppliers and OEMs. Identifying the high-quality information challenges decision-makers. The application of AI/ML models necessitates access to 'high-quality' information to yield desired outputs. However, the process of information sharing introduces complexities, including distortion through various communication channels and biases introduced by both human and AI entities. This phenomenon significantly influences the quality of information, impacting decision-makers engaged in configuring supply chain systems. Traditionally, distorted information is categorized as 'low-quality'; however, this study challenges this perception, positing that distorted information, contributing to stakeholder goals, can be deemed high-quality within supply chains. The main aim of this study is to identify and evaluate the dimensions of information quality crucial to the UK aerospace supply chain. Guided by a central research question, "What information quality dimensions are considered when defining information quality in the UK aerospace supply chain?" the study delves into the intricate dynamics of information quality in the aerospace industry. Additionally, the research explores the nuanced impact of information distortion on stakeholders' decision-making processes, addressing the question, "How does the information distortion phenomenon influence stakeholders’ decisions regarding information quality in the UK aerospace supply chain system?" This study employs deductive methodologies rooted in positivism, utilizing a cross-sectional approach and a mono-quantitative method -a questionnaire survey. Data is systematically collected from diverse tiers of supply chain stakeholders, encompassing end-customers, OEMs, Tier 0.5, Tier 1, and Tier 2 suppliers. Employing robust statistical data analysis methods, including mean values, mode values, standard deviation, one-way analysis of variance (ANOVA), and Pearson’s correlation analysis, the study interprets and extracts meaningful insights from the gathered data. Initial analyses challenge conventional notions, revealing that information distortion positively influences the definition of information quality, disrupting the established perception of distorted information as inherently low-quality. Further exploration through correlation analysis unveils the varied perspectives of different stakeholder tiers on the impact of information distortion on specific information quality dimensions. For instance, Tier 2 suppliers demonstrate strong positive correlations between information distortion and dimensions like access security, accuracy, interpretability, and timeliness. Conversely, Tier 1 suppliers emphasise strong negative influences on the security of accessing information and negligible impact on information timeliness. Tier 0.5 suppliers showcase very strong positive correlations with dimensions like conciseness and completeness, while OEMs exhibit limited interest in considering information distortion within the supply chain. Introducing social network analysis (SNA) provides a structural understanding of the relationships between information distortion and quality dimensions. The moderately high density of ‘information distortion-by-information quality’ underscores the interconnected nature of these factors. In conclusion, this study offers a nuanced exploration of information quality dimensions in the UK aerospace supply chain, highlighting the significance of individual perspectives across different tiers. The positive influence of information distortion challenges prevailing assumptions, fostering a more nuanced understanding of information's role in the Industry 4.0 landscape.

Keywords: information distortion, information quality, supply chain configuration, UK aerospace industry

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Authors: Ayesha Asif, Muhammad Zeeshan

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The sensitivity of hospital-microenvironments for all types of pollutants, due to the presence of patients with immune deficiencies, makes them complex indoor spaces. Keeping in view, this study investigated indoor air quality (IAQ) of two most sensitive places, i.e., operation theater (OT) and intensive care unit (ICU), of a publically managed hospital. Taking CO₂ concentration as air quality indicator and temperature (T) and relative humidity (RH) as thermal comfort parameters, continuous monitoring of the three variables was carried out. Measurements were recorded at an interval of 1 min for weekdays and weekends, including occupational and non-occupational hours. Outdoor T and RH measurements were also used in the analysis. Results show significant variation (p < 0.05) in CO₂, T and RH values over the day during weekdays while no significant variation (p > 0.05) have been observed during weekends of both the monitored sites. Maximum observed values of CO₂ in OT and ICU were found to be 2430 and 624 ppm, T as 24.7ºC and 28.9ºC and RH as 29.6% and 32.2% respectively.

Keywords: indoor air quality, CO₂ concentration, hospital building, comfort assessment

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Authors: Maha Alaoui Ismaili, Bouchta Saidi, Mohamed Zahar, Abed Hamama

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Thirty one samples of raw camel milk obtained from the region of Laâyoune (South of Morocco) were examined for their microbial quality and presence of some pathogenic bacteria (Staphylococcus aureus and Salmonella sp.). pH of the samples ranged from 6.31 to 6.64 and their titratable acidity had a mean value of 18.56 °Dornic. Data obtained showed a strong microbial contamination with an average total aerobic flora of 1.76 108 ufc ml-1 and a very high fecal counts: 1.82 107 ; 3.25 106 and 3.75 106 ufc.ml-1 in average for total coliforms, fecal coliforms and enterococci respectively. Yeasts and moulds were also found at average respective levels of 3.13 106 and 1.60 105 ufc.ml-1. Salmonella sp. and S. aureus was detected respectively in 13% and 30% of the milk samples. These results indicate clearly the lack of hygienic conditions of camel milk production and storage in this region. Lactic acid bacteria were found at the following average numbers: 4.25 107 ; 4.45 107 and 3.55 107 ufc.ml-1 for Lactococci, Leuconostocs and Lactobacilli respectively.

Keywords: camel milk, microbial quality, Salmonella, Staphylococcus aureus

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Authors: Mehrnaz Mostafavi, Mahtab Shabani, Alireza Azani, Fatemeh Ghafari

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Artificial intelligence (AI) can transform breast cancer diagnosis and therapy by providing sophisticated solutions for screening, imaging interpretation, histopathological analysis, and treatment planning. This literature review digs into the many uses of AI in breast cancer treatment, highlighting the need for collaboration between AI scientists and healthcare practitioners. It emphasizes advances in AI-driven breast imaging interpretation, such as computer-aided detection and diagnosis (CADe/CADx) systems and deep learning algorithms. These have shown significant potential for improving diagnostic accuracy and lowering radiologists' workloads. Furthermore, AI approaches such as deep learning have been used in histopathological research to accurately predict hormone receptor status and categorize tumor-associated stroma from regular H&E stains. These AI-powered approaches simplify diagnostic procedures while providing insights into tumor biology and prognosis. As AI becomes more embedded in breast cancer care, it is crucial to ensure its ethical, efficient, and patient-focused implementation to improve outcomes for breast cancer patients ultimately.

Keywords: breast cancer, artificial intelligence, cancer diagnosis, clinical practice

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Authors: C. Rekha, G. N. Krishnamurthy

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This paper attempts to develop a different approach for key scheduling algorithm which uses both Blowfish and AES algorithms. The main drawback of Blowfish algorithm is, it takes more time to create the S-box entries. To overcome this, we are replacing process of S-box creation in blowfish, by using key dependent S-box creation from AES without affecting the basic operation of blowfish. The method proposed in this paper uses good features of blowfish as well as AES and also this paper demonstrates the performance of blowfish and new algorithm by considering different aspects of security namely Encryption Quality, Key Sensitivity, and Correlation of horizontally adjacent pixels in an encrypted image.

Keywords: AES, blowfish, correlation coefficient, encryption quality, key sensitivity, s-box

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Authors: Shilpa Avarebeel

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Background: India is one of the seven identified countries in South-East Asia region, regularly reporting dengue infection and may soon transform into a major niche for dengue epidemics. Objective: To study the clinical profile of dengue in our setting with special reference to respiratory complication. Study design: Descriptive and exploratory study, for one year in 2014. All patients confirmed as dengue infection were followed and their clinical profile, along with outcome was determined. Study proforma was designed based on the objective of the study and it was pretested and used after modification. Data was analyzed using statistical software SPSS-Version 16. Data were expressed as mean ±S .D for parametric variables and actual frequencies or percentage for non-parametric data. Comparison between groups was done using students’ t-test for independent groups, Chie square test, one-way ANOVA test, Karl Pearson’s correlation test. Statistical significance is taken at P < 0.05. Results: Study included 134 dengue positive cases. 81% had dengue fever, 18% had dengue hemorrhagic fever, and one had dengue shock syndrome. Most of the cases reported were during the month of June. Maximum number of cases was in the age group of 26-35 years. Average duration of hospital stay was less than seven days. Fever and myalgia was present in all the 134 patients, 16 had bleeding manifestation. 38 had respiratory symptoms, 24 had breathlessness, and 14 had breathlessness and dry cough. On clinical examination of patients with respiratory symptoms, all twenty-eight had hypoxia features, twenty-four had signs of pleural effusion, and four had ARDS features. Chest x-ray confirmed the same. Among the patients with respiratory symptoms, the mean platelet count was 26,537 c/cmm. There was no statistical significant difference in the platelet count in those with ARDS and other dengue complications. Average four units of platelets were transfused to all those who had ARDS in view of bleeding tendency. Mechanical ventilator support was provided for ARDS patients. Those with pleural effusion and pulmonary oedema were given NIV (non-invasive ventilation) support along with supportive care. However, steroids were given to patients with ARDS and 10 patients with signs of respiratory distress. 100%. Mortality was seen in patients with ARDS. Conclusion: Dengue has to be checked for those presenting with fever and breathlessness. Supportive treatments remain the cornerstone of treatment. Platelet transfusion has to be given only by clinical judgment. Steroids have no role except in early ARDS, which is controversial. Early NIV support helps in speedy recovery of dengue patients with respiratory distress.

Keywords: adult respiratory distress syndrome, dengue fever, non-invasive ventilation, pulmonary complication

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Authors: Lorena Alemán de la Garza, Marcela Georgina Gómez-Zermeño

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This paper presents the SolarSPELL case study that aims to generate information on the use of indicators that help evaluate the pedagogical quality of a digital library resources. SolarSPELL is a solar-powered digital library with WiFi connectivity. It offers a variety of open educational resources selected for their potential for the digital transformation of educational practices and the achievement of the 2030 Agenda for Sustainable Development, adopted by all United Nations Member States. The case study employed a quantitative methodology and the research instrument was applied to 55 teachers, directors and librarians. The results indicate that it is possible to strengthen the pedagogical quality of open educational resources, through actions focused on improving temporal and technological parameters. They also reveal that users believe that SolarSPELL improves the teaching-learning processes and motivates the teacher to improve his or her development. This study provides valuable information on a tool that supports teaching-learning processes and facilitates connectivity with renewable energies that improves the teacher training in active methodologies for ecosystem learning.

Keywords: educational innovation, digital library, pedagogical quality, solar energy, teacher training, sustainable development

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Authors: M. Pagasa Nanette Rotairo

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The research focuses on the effectiveness, responsiveness, adequacy, and appropriateness of customer service of selected fast food restaurant using William Dunn’s four evaluation criteria tantamount to the focus of the research. Due to efficiency the fast food restaurants offer and the increasing demand for acquiring its services, the researcher conducted a study on the effectiveness of customer service of five popular restaurants in Metro Manila. Using descriptive method, the research is furthered in par with evaluation and implementation of different instruments effective for data gathering to further scientific judgment. Results of this research indicate that consumers consider the quality service as the major reason in patronizing fast food restaurants while they consider cleanliness and customer satisfaction as their least concern. Details of this study provided support on how the proposed operational model can further improve the services of fast food restaurants.

Keywords: customer satisfaction, customer service, restaurant management, business operations

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Authors: Mariam Aljumaa

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Industrial wastewater has been increased rapidly in the last decades, however, the generated wastewater is not treated properly on site before transfer it to the treatment plant. In this study, the most common industries (dairy, soft drinks, detergent, and petrochemical) has been studied in term of wastewater quality. The main aim of this study is to characterize and evaluate the quality of the most common industrial wastewater in Kuwait. Industrial wastewater samples were collected from detergents, dairy, beverage, and petrochemical factories. The collected wastewater samples were analyzed for temperature, EC, pH, DO, BOD, COD, TOC, TS, TSS, volatile suspended solids (VSS), total volatile solids (TVS), NO2, NO3, NH3, N, P, K, CaCO3, heavy metals, Total coliform, Fecal coliform, and E.coli bacteria. The results showed that petrochemical industry has the highest concentration of organic and nutrients, followed by detergents wastewater, then dairy, and finally, soft drink wastewater. Regarding the heavy metals, the results showed that dairy wastewater had the highest concentration, specifically in Zinc, Arsenic, and Cadmium. In term of biological analysis, the dairy industry had the highest concentration of total coliform, followed by soft drinks industry, then shampoo industry, and finally petrochemical industry.

Keywords: industrial wastewater, characterization, heavy metals, wastewater quality

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Authors: Seyed Yasin Yazdi-Amirkhiz, Azirah Hashim

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This study purported to comparatively investigate the influence of collaborative writing on the quality of individual writing of four female Iranian and four female Malaysian students. The first semester students at a private university in Malaysia, who were homogeneous in terms of age, gender, study discipline, and language proficiency, were divided into two Iranian and two Malaysian dyads. The dyads performed collaborative writing tasks for 15 sessions; after three consecutive collaborative writing sessions, each participant was asked to individually attempt a writing task. Both collaborative and individual writing tasks comprised isomorphic graphic prompts (IELTS Academic Module task 1). Writing quality of the five individually-produced texts during the study was scored in terms of task achievement (TA), cohesion/coherence (C/C), grammatical range/accuracy (GR/A), and lexical resources (LR). The findings indicated a hierarchy of development in TA and C/C among all the students, while LR showed minor improvement only among three of Malaysian students, and GR/A barely exhibited any progress among all the participants. Intermittent progressions and regressions were also discerned in the trajectory of their writing development. The findings are discussed in the light of the socio-cultural and emergentist perspectives, the typology of tasks used as well as the role of the participants’ level of language proficiency.

Keywords: collaborative writing, writing quality, individual writing, collaboration

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Authors: M. Aherrahrou

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Moroccan education is currently facing many difficulties and problems due to traditional methods of teaching. Neuro -Linguistic Programming (NLP) appears to hold much potential for education at all levels. In this paper, the major aim is to explore the effect of certain Neuro -Linguistic Programming techniques in one educational institution in Morocco. Quantitative and Qualitative methods are used. The findings prove the effectiveness of this new approach regarding Moroccan education, and it is a promising tool to improve the quality of learning.

Keywords: learning and teaching environment, Neuro- Linguistic Programming, education, quality of learning

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Authors: N. P. Tien, S. Songsermpong, T. H. Quan

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Mung bean vermicelli is a popular food in Asian countries and is made from mung bean starch. The preparation process involves several steps, including drying, which affects the structure and quality of the vermicelli. This study aims to examine the effects of different drying technologies on the rehydration time and quality of mung bean vermicelli. Three drying technologies, namely hot air drying, microwave continuous drying, and microwave vacuum drying, were used for the drying process. The vermicelli strands were dried at 45°C for 12h in a hot air dryer, at 70 Hz of conveyor belt speed inverter in a microwave continuous dryer, and at 30 W.g⁻¹ of microwave power density in a microwave vacuum dryer. The results showed that mung bean vermicelli dried using hot air drying had the longest rehydration time of 12.69 minutes. On the other hand, vermicelli dried through microwave continuous drying and microwave vacuum drying had shorter rehydration times of 2.79 minutes and 2.14 minutes, respectively. Microwave vacuum drying also resulted in larger porosity, higher water absorption, and cooking loss. The tensile strength and elasticity of vermicelli dried using hot air drying were higher compared to microwave drying technologies. The sensory evaluation did not reveal significant differences in most attributes among the vermicelli treatments. Overall, microwave drying technology proved to be effective in reducing rehydration time and producing good-quality mung bean vermicelli.

Keywords: mung bean vermicelli, drying, hot air, microwave continuous, microwave vacuum

Procedia PDF Downloads 79