Search results for: levels of service

Authors: Fazilet Alachaher

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Within the constructivist perspective of teaching, which views skilled teaching as knowing what to do in uncertain and unpredictable situations, this research essay explores the topic of reflective teaching by investigating the following questions: (1) What is reflective teaching and why is it important? (2) Why should teachers be trained to be reflective and how can they be prepared to be reflective? (3) What is the role of the teaching context in teachers’ attempts to be reflective? This paper suggests that reflective teaching is important because of the various potential benefits to teaching. Through reflection, teachers can maintain their voices and creativeness thus have authority to affect students, curriculum and school policies. The discussions also highlight the need to prepare student teachers and their professional counterparts to be reflective, so they can develop the characteristics of reflective teaching and gain the potential benefits of reflection. This can be achieved by adopting models and techniques that are based on constructivist pedagogical approaches. The paper also suggests that maintaining teachers’ attempts to be reflective in a workplace context and aligning practice with pre-service teacher education programs require the administrators or the policy makers to provide the following: sufficient time for teachers to reflect and work collaboratively to discuss challenges encountered in teaching, fewer non-classroom duties, regular in-service opportunities, more facilities and freedom in choosing suitable ways of evaluating their students’ progress and needs.

Keywords: creative teaching, reflective teaching, constructivist pedagogical approaches, teaching context, teacher’s role, curriculum and school policies, teaching context effect

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Authors: Tzu-Hao Li, Yen-Ying Kung, Chang-Youh Tsai

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Oral dryness is a common chief complaint among patients with Sjőgren syndrome (SS), which is a disorder currently known as autoantibodies production; however, to author’s best knowledge, there has been no satisfying pharmacy to relieve the associated symptoms. Hence the effectiveness of other non-pharmacological interventions such as acupuncture should be accessed. We conducted a meta-analysis of randomized clinical trials (RCTs) which evaluated the effectiveness of xerostomia in SS. PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Chongqing Weipu Database (CQVIP), China Academic Journals Full-text Database, AiritiLibrary, Chinese Electronic Periodicals Service (CEPS), China National Knowledge Infrastructure (CNKI) Database were searches through May 12, 2018 to select studies. Data for evaluation of subjective and objective xerostomia was extracted and was assessed with random-effects meta-analysis. After searching, a total of 541 references were yielded and five RCTs were included, covering 340 patients dry mouth resulted from SS, among whom 169 patients received acupuncture and 171 patients were control group. Acupuncture group was associated with higher subjective response rate (odds ratio 3.036, 95% confidence interval [CI] 1.828 – 5.042, P < 0.001) and increased salivary flow rate (weighted mean difference [WMD] 3.066, 95% CI 2.969 – 3.164, P < 0.001), as an objective marker. In addition, two studies examined IgG levels, which were lower in the acupuncture group (WMD -166.857, 95% CI -233.138 - -100.576, P < 0.001). Therefore, in the present meta-analysis, acupuncture improves both subjective and objective markers of dry mouth with autoantibodies reduction in patients with SS and is considered as an option of non-pharmacological treatment for SS.

Keywords: acupuncture, meta-analysis, Sjogren syndrome, xerostomia

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Authors: Ayuko Itsuki, Sachiyo Aburatani

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Soil enzyme activities in Kasuga-yama Hill Primeval Forest (Nara, Japan) were examined to determine levels of mineralization and metabolism. Samples were selected from the soil surrounding laurel-leaved (B_B-1) and Carpinus japonica (B_B-2 and P_w) trees for analysis. Cellulase, β-xylosidase, and protease activities were higher in B_B-1 samples those in B_B-2 samples. These activity levels corresponded to the distribution of cellulose and hemicellulose in the soil horizons. Cellulase, β-xylosidase, and chymotrypsin activities were higher in soil from the P_w forest than in that from the B_B-2 forest. The relationships between the soil enzymes calculated by Spearman’s rank correlation indicate that the interactions between enzymes in B_B-2 samples were more complex than those in P_w samples.

Keywords: comparative analysis, enzyme activities, forest soil, Spearman's rank correlation

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Authors: Dovile Petkeviciute-Barysiene

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Legal technologies not only create new ways for accessing and providing legal services but also transform the role of legal practitioners. Both lawyers and users of legal services expect automated solutions to outperform people with objectivity and impartiality. Although fairness of the automated decisions is crucial, research on assessing various characteristics of automated processes related to the perceived fairness has only begun. One of the major obstacles to this research is the lack of comprehensive understanding of what legal actions are automated and could be meaningfully automated, and to what extent. Neither public nor legal practitioners oftentimes cannot envision technological input due to the lack of general without illustrative examples. The aim of this study is to map decision making stages and automation levels which are and/or could be achieved in legal actions related to pre-trial and trial processes. Major legal decisions and judgments are identified during the consultations with legal practitioners. The dual-process model of information processing is used to describe cognitive processes taking place while making legal decisions and judgments during pre-trial and trial action. Some of the existing legal technologies are incorporated into the analysis as well. Several published automation level taxonomies are considered because none of them fit well into the legal context, as they were all created for avionics, teleoperation, unmanned aerial vehicles, etc. From the information processing perspective, analysis of the legal decisions and judgments expose situations that are most sensitive to cognitive bias, among others, also help to identify areas that would benefit from the automation the most. Automation level analysis, in turn, provides a systematic approach to interaction and cooperation between humans and algorithms. Moreover, an integrated map of legal decisions and judgments, information processing characteristics, and automation levels all together provide some groundwork for the research of legal technology perceived fairness and acceptance. Acknowledgment: This project has received funding from European Social Fund (project No 09.3.3-LMT-K-712-19-0116) under grant agreement with the Research Council of Lithuania (LMTLT).

Keywords: automation levels, information processing, legal judgment and decision making, legal technology

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Authors: Ferjani Hanen, El Arem Amira, Boussema Ayed Imen, Bacha Hassen

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Tacrolimus (TAC), a calcineurin inhibitor, is clinically used as an immunosuppressive agent in the transplant recipient, but its use associated-hepatotoxicity. Mycophenolate mofetil (MMF), an anti-metabolite, is a potent immunosuppressive drug. MMF is not hepatotoxic and is the most common adjunctive immunosuppressant for TAC. The effects of TAC and MMF combination in the liver is still not well understood. This work aimed to investigate their combined effect against in liver in rats Wistar after 24 h. The oral median lethal doses (LD50) of TAC and MMF alone were evaluated in rats are 240 mg/kg and 500 mg/kg respectively. Oral administration of the MMF at 50 mg/kg to male Wistar intoxicated with TAC at 60 mg/kg, demonstrated a significant protective effect by lowering the levels of hepatic markers enzymes (AST, ALT) in the serum rat. MMF attenuated oxidative stress by restoring the activities of SOD, CAT and by reducing the malondialdehyde (MDA) and protein carbonyl levels liver. This study provided evidence that MMF protects rat liver from TAC-induced injury and suggests a most combination use for organ transplantation.

Keywords: tacrolimus, mycophenolate mofetil, combination, liver, rat

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Authors: Sevil Inal, Leman Yantiri, Meral Kelleci

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Aim: In this study, it was aimed to qualitatively analyze the feelings, thoughts and meanings of the nurses who had experience in child hematology in the past. Method: In this qualitative study, in-depth interviews were conducted with 15 nurses between 29 and 53 years of age who had previously worked in child hematology-oncology unit. Interviews were conducted with a semi-structured interview form. Each interview lasted 20-30 minute. Some of the questions are: ‘What kind of experiences do you experience when you think about the periods you are working in hematology-oncology service?’ ‘Do you explain the reason for living these feelings?’ The data were analyzed with QSR NVivo 7 software. Results: From the perspective of the nurses who had experience working in the pediatric hematology-oncology service in the past, five main themes and sub-themes related to emotions and thoughts towards this experiment were identified in the study. 1) Positive and negative emotions: (a) fear and anxiety, (b) desperation, pity, guilt, (c) burnout, (d) longing; 2) Being coping 3) Professional implications 4) Meaning of life 5) Unmet needs and suggestions. Conclusions: Working in hematology should be viewed as a multidimensional situation that affects the way nurses view their profession and life, leading to a wide range of emotional lives. Data obtained from this study can be used to strengthen hematologic nurses.

Keywords: cancer, child, care, hematology, nursing

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Authors: Mazin Alqhazo, Ayat Bani Rashaid

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This study examines the levels of dopamine and serotonin in blood samples of children who stutter compared with normal fluent speakers. Blood specimens from 50 children who stutter (6 females, 44 males) and 50 normal children matched age and gender were collected for the purpose of the current study. The concentrations of dopamine and serotonin were measured using the 1100 series high-performance liquid chromatography coupled with ultraviolet detector instrument (HPLC-UV). It was revealed that dopamine level in the blood samples of stuttering group and fluent group was not significant (P = 0.769), whereas the level of serotonin was significantly higher in the blood samples of stuttering group than the blood samples of fluent normal group (P = 0.015). It is concluded that serotonin blockers could be used in future studies to evaluate its role as a medication for the treatment of stuttering.

Keywords: dopamine, serotonin, stuttering, fluent speakers

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Authors: Mohammed S. Assiri

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In EFL programs, rating scales used in writing assessment are often constructed by intuition. Intuition-based scales tend to provide inaccurate and divisive ratings of learners’ writing performance. Hence, following an empirical approach, this study attempted to develop a rating scale for elementary-level writing at an EFL program in Saudi Arabia. Towards this goal, 98 students’ essays were scored and then coded using comprehensive taxonomy of writing constructs and their measures. An automatic linear modeling was run to find out which measures would best predict essay scores. A nonparametric ANOVA, the Kruskal-Wallis test, was then used to determine which measures could best differentiate among scoring levels. Findings indicated that there were certain measures that could serve as either good predictors of essay scores or differentiators among scoring levels, or both. The main conclusion was that a rating scale can be empirically developed using predictive and discriminative statistical tests.

Keywords: analytic scoring, rating scales, writing assessment, writing constructs, writing performance

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Authors: George Onomah

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Background: The integration of information communication technology (ICT) in Mathematics education faces notable challenges, which this study aimed to dissect and understand. Objectives: The primary goal was to assess the internal and external factors affecting the adoption of ICT by in-service Mathematics teachers. Internal factors examined included teachers' pedagogical beliefs, prior teaching experience, attitudes towards computers, and proficiency with technology. External factors included the availability of technological resources, the level of ICT training received, the sufficiency of allocated time for technology use, and the institutional culture within educational environments. Methods: A descriptive survey design was employed to methodically investigate these factors. Data collection was carried out using a five-point Likert scale questionnaire, administered to a carefully selected sample of 100 in-service Mathematics teachers through a combination of purposive and convenience sampling techniques. Findings: Results from multiple regression analysis revealed a significant underutilization of ICT in Mathematics teaching, highlighting a pronounced deficiency in current classroom practices. Recommendations: The findings suggest an urgent need for educational department heads to implement regular and comprehensive ICT training programs aimed at enhancing teachers' technological capabilities and promoting the integration of ICT in Mathematics teaching methodologies.

Keywords: ICT, Mathematics, integration, barriers

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Authors: Myrto Vlazaki

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Tetanus is a non-transmissible, preventable bacterial disease with high mortality. In the U.K., the demographic group systematically accounting for a large proportion of the infections notified to the authorities over the years have been the elderly (> 60 years old). The 2009 seroepidemiological study for tetanus in England reports a gender-age interaction for the +70, with males having significantly higher anti-tetanus antibody levels than females. A systematic review of the literature was carried out to characterise: I. the seroepidemiology of tetanus in economically developed countries with similar immunisation schemes to the U.K., introduced in the 1960’s. II. the factors leading to differential vaccine uptake between males and females in 1910-1945 (corresponding to ages of 60-95 in 2005). III. the immune response elicited by anti-tetanus immunisation in males and females IV. the value of catch-up immunisation in the elderly Similar age- and gender- differences in anti-tetanus antibody levels are noted in other countries. Gender differences in immune responses elicited by vaccination are not consistent with the finding that elder females are less well protected against tetanus compared to their male counterparts. Attention is drawn to the selective anti-tetanus immunisation scheme introduced in the U.K. in 1938, specific to the World War II conscripts. The age-specific immunity gap observed amongst the +70 could be explained as the by-product of that early scheme targetting mostly males. Introducing anti-tetanus vaccination in the +70 in the U.K. could help bridge the immunity gap between males and females and reduce the overall tetanus susceptibility of this age group.

Keywords: elderly, immunisation, gender-specific differences, seroepidemiology, tetanus, World War II

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Authors: Ogbonna Olelewe

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This quality improvement project seeks to address the background and significance of promoting antidepressant (AD) medication adherence to reduce depression symptoms in patients diagnosed with major depression. This project aims to substantiate using daily encrypted short message service (SMS) text reminders to take prescribed antidepressant medications with the goal of increasing medication adherence to reduce depression scores in patients diagnosed with major depression, thereby preventing relapses and increasing remission rates. Depression symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9) scale. The PHQ-9 provides a total score of depression symptoms from mild to severe, ranging from 0 to 27. A -pretest/post-test design was used, with a convenience sample size of 35 adult patients aged 18 years old to 45 years old, diagnosed with MDD, and prescribed at least one antidepressant for one year or more. Pre- and post-test PHQ-9 scores were conducted to compare depression scores before and after the four-week intervention period. The results indicated improved post-intervention PHQ-9 scores, improved AD medication adherence, and a significant reduction in depression symptoms.

Keywords: major depressive disorder, antidepressants, short message services, text reminders, Medication adherence/non-adherence, Patient Health Questionnaire 9

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Authors: Chantarat Manvichien, Kevin Wongleedee

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The purpose of this research was to study Thai passengers’ level of understanding and awareness of the cabin crew safety briefing in the airplane during the preparation to take off and landing. It is important to know if Thai passengers pay attention to cabin crew safety briefing and to suggest a better way to draw their attention. The independent variables included gender, age, income, levels of education, travelling purpose, and travelling frequency while the dependent variables was level of awareness. A simple random sampling method was utilized to get 400 respondents. The findings revealed the ranking the first three levels of importance by highest mean to lowest mean as follows: (1) It is important to listen to cabin crew safety briefing; (2) Cabin crew briefing is interesting; (3) Information from cabin crew safety briefing is easy to understand. In addition, the overall means was 3.27 with 0.800 SD.

Keywords: cabin crew, safety briefing, Thai passengers, awareness

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Authors: E. A. Mlybari, M. S. Elbisy, A. H. Alshahri, O. M. Albarakati

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Sea level rise threatens to increase the impact of future storms and hurricanes on coastal communities. Accurate sea level change prediction and supplement is an important task in determining constructions and human activities in coastal and oceanic areas. In this study, support vector machines (SVM) is proposed to predict daily tidal levels along the Jeddah Coast, Saudi Arabia. The optimal parameter values of kernel function are determined using a genetic algorithm. The SVM results are compared with the field data and with back propagation (BP). Among the models, the SVM is superior to BPNN and has better generalization performance.

Keywords: tides, prediction, support vector machines, genetic algorithm, back-propagation neural network, risk, hazards

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Authors: Anita Kéri

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Satisfying foreign student needs has been in the center of research interest in the past several years. Higher education institutions have been exploring factors influencing foreign student satisfactionto stay competitive on the educational market. Even though foreign student satisfaction and loyalty are topics investigated deeply in the literature, the academic years of 2020 and 2021 have revealed challenges never experienced before. With the COVID-19 pandemic, new factors have emerged that might influence foreign student satisfaction and loyalty in higher education. The aim of the current research is to shed lights on what factors influence foreign student satisfaction and loyalty in the post-pandemic educational era and to reveal if the effects of factors influencing satisfaction and loyalty have changed compared to previous findings. Initial results show that students are less willing to participate in online surveys during and after the pandemic. The return rate of the survey instrument is below 5%. Results also reveal that there is a slight difference in what factors have significant effects on school-related and non-school-related satisfaction and overall loyalty, measured pre- and post-pandemic times. The results of the current study help us determine what factors higher education institutions need to consider when planning the future service affordances for their foreign students that might influence their satisfaction and loyalty.

Keywords: pandemic, COVID-19, satisfacion, loyalty, service quality, higher education

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Authors: Alireza Barari, Ahmad Abdi

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Regular body trainings cause adaption in various system in body. One of the important effect of body training is its effect on immune system. It seems that cytokines usually release after long period exercises or some exercises which cause skeletal muscular damages. If some of the cytokines which cause responses such as inflammation of cells in skeletal muscles, with manipulating of training program, it can be avoided or limited from those exercises which induct cytokines release. Ginger plant is a kind of medicinal plants which is known as a anti inflammation plant. This plant is as most precedence medicinal plants in medicine science especially in inflammation cure. The aim of the present study was the effect of selected resistance training and consumption of ginger extract on IL-1α and TNFα untrained young women. The population includes young women interested in participating in the study with the average of 30±2 years old from Abbas Abad city among which 32 participants were chosen randomly and divided into 4 four groups, resistance training (R), resistance training and ginger consumption(RG), Ginger consumption(G)and Control group(C). The training groups performed circuit resistance training at the intensity of 65-75% one repeat maximum, 3 days a week for 6 weeks. Besides resistance training, subjects were given either ginseng (5 mg/kg per day) or placebo. Prior to and 48 hours after interventions body composition was measured and blood samples were taken in order to assess serum levels of IL-1α and TNFα. Plasma levels of cytokines were measured with commercially available ELISA Kits.IL-1α kit and TNFα kit were used in this research. To demonstrate the effectiveness of the independent variable and the comparison between groups, t-test and ANOVA were used. To determine differences between the groups, the Scheffe test was used that showed significant changes in any of the variables. we observed that circuit resistance training in R and RG groups can significant decreased in weight and body mass index in untrained females (p<0.05). The results showed a significant decreased in the mean level of IL-1α levels before and after the training period in G group (p=0.046) and RG group (p=0.022). Comparison between groups also showed there was significant difference between groups R-RG and RG-C. Intergroup comparison results showed that the mean levels of TNFα before and after the training in group G (p=0.044) and RG (p=0.037), significantly decreased. Comparison between groups also showed there was significant difference between groups R–RG , R-G ,RG-C and G-C. The research shows that circuit resistance training with reducing overload method results in systemic inflammation had significant effect on IL-1α levels and TNFα. Of course, Ginger can counteract the negative effects of resistance training exercise on immune function and stability of the mast cell membrane. Considerable evidence supported the anti-inflammatory properties of ginger for several constituents, especially gingerols, shogaols, paradols, and zingerones, through decreased cytokine gene TNF α and IL-1Α expression and inhibition of cyclooxygenase 1 and 2. These established biological actions suggest that ingested ginger could block the increase in IL-1α.

Keywords: resistance training, ginger, IL-1α , TNFα

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Authors: Chia-Hsun Chang

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Background: Combination of drug treatment, dietary management, and regular exercise can effectively control type II diabetes mellitus (T2DM). Performing daily physical activities other than structured exercise is much easier and whether daily physical activities including work, walking, housework, gardening, leisure exercise, or transportation have a similar effect on diabetes control is not well studied.Aims and Objectives: This study aims to determine whether daily physical activity undertaken by patients with T2DM is associated with their diabetes control. Design: A correlation study with prospective design. Methods: Purposive sampling of 206 patients with T2DM was recruited from a medical center in Central Taiwan. The International Physical Activity Questionnaire was used to assess daily levels of physical activities, and the Diabetes Compliance Questionnaire was used to assess medication and dietary compliance. Data of diabetes control (hemoglobin A1c, HbA1c)were followed up every three months for one year after recruitment. Results: In this study, the average age of the participants was 62.5 years (±10.4 years), and the average duration of diabetes since diagnosis was 13.2 years (±7.8), 112 of the participants were women (54.4%) and 94 of the participants were men (45.6%). The mean HbA1c level was 7.8% (±1.4), and 78.2% of the participants presented with unsatisfactory diabetes control. Because the participants were distributed across a wide age range, and their physical health, activity levels, and comorbidities might have varied with age, the participants were divided into two groups: 121 participants who were younger than 65 years (58.7%) and 85 participants who were older than 65 years (41.3%). Both younger (< 65 years) and older (> 65 years) patients with diabetes engaged in more moderate and low levels of physical activity (89.3% and 87%, respectively). Results showed that the levels of daily physical activity were not significantly associated with diabetes control after adjustment for medication and dietary compliance in both groups. Conclusion: Performing daily physical activity is not significantly correlated with diabetes control. Daily physical activity cannot completely replace exercise. Relevance to Clinical Practice: Health personnel must encourage patients to engage in exercise that is planned, structured, and repetitive for improving diabetes control.

Keywords: daily physical activity, diabetes control, international physical activity questionnaire (IPAQ), type II diabetes mellitus (T2DM)

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Authors: Ana Neves

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The European Union’s multi-level constitutionalism is grounded in an intricate network of vertical and horizontal legal relationships among different levels and types of public authorities. In a very significant way since the 2008 crisis, evolving institutional arrangements and institutional dynamics in the European Union have been progressively impacting Member States and the terms under which national public authorities are organised, interact and exercise their powers. This impact occurs in both macro and micro dimensions. Several examples are relevant here, such as the involvement of national Parliaments in the activities of the European Union, the enhanced integration of public administrations, the side effects of the Council framework decision on the European Arrest Warrant, the European Union Justice Scoreboard, the protection of whistle-blowers regulation, the enhanced cooperation on the establishment of the European Public Prosecutor’s Office, the regime for the protection of the Union budget and the European Rule of Law Mechanism. A common trend or denominator underlies the deepening of institutional interdependence and the increased interactions between the European Union, Member States, and public authorities at different levels. This seems to be conditionality as a general principle. The European multi-level constitutionalism must be considered in the light of this conditionality principle, which does not “imply a relationship of command and obedience”. Nevertheless, it might be more effective or be a very compelling principle. It is as if the extension of the shared rule is being accompanied by a contrapuntal dialogue. The different public authorities at various levels are being called to rethink and readjust themselves within a broader and more plural framework concerning understanding the limitation of power.

Keywords: european union -, multi-level hierarchy, conditionality, separation of powers

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Authors: Yasmine Ahmed Shemeis

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Determining the impact of productivity increases on wage levels is often difficult due to the unavailability of individual-level productivity data. Accordingly, we proxy for productivity using a self-perceived measure of health based on the postulated positive relationship between better health and productivity improvements. Using Egypt’s labour market data for the years 2012 and 2018 and utilizing a Maximum Likelihood Estimation method, we address two issues: the endogeneity of health in the estimation of wages and a sample selection bias. Our findings indicate the great value that better health has in enhancing wage levels in Egypt’s private sector. Also, we find that overlooking the endogeneity of health underestimates its effect on wages. Thus, the improvement of health states is likely to be beneficial in improving labour market outcomes in terms of wages as well as labour productivity in Egypt.

Keywords: labour, Productivity, Wages, Endogeneity, Sample Selection

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Authors: Sriram Kashyap Prasad, Ionut Florescu

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This study models the intraday asset prices as driven by Markov process. This work identifies the latent states of the Hidden Markov model, using limit order book data (trades and quotes) to continuously estimate the states throughout the day. This work builds a trading strategy using estimated states to generate signals. The strategy utilizes current state to recalibrate buy/ sell levels and the transition between states to trigger stop-loss when adverse price movements occur. The proposed trading strategy is tested on the Stevens High Frequency Trading (SHIFT) platform. SHIFT is a highly realistic market simulator with functionalities for creating an artificial market simulation by deploying agents, trading strategies, distributing initial wealth, etc. In the implementation several assets on the NASDAQ exchange are used for testing. In comparison to a strategy with static buy/ sell levels, this study shows that the number of limit orders that get matched and executed can be increased. Executing limit orders earns rebates on NASDAQ. The system can capture jumps in the limit order book prices, provide dynamic buy/sell levels and trigger stop loss signals to improve the PnL (Profit and Loss) performance of the strategy.

Keywords: algorithmic trading, Hidden Markov model, high frequency trading, limit order book learning

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Authors: Prashant Das, Tushar Singh, Virendra Byadwal

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The present study attempted to understand the role of cognitive flexibility and employee engagement in predicting employees’ turnover intentions. Employee turnover is a significant problem that many organizations are facing these days. Employee turnover is not only extremely expensive for the employer but also results in poor production levels. In developing countries like India, organizations once believed to have most stable employees, are facing major turnover problems. One such organization is banking organizations. Due to globalization, banks are now changing their work scenarios under which the employees have many different roles to perform. Cognitive flexibility which refers to an individual’s ability to shift cognitive sets and to adapt to one’s changing environment, thus seems to be an important factor that are responsible for the employee turnover in organizations. It is hypothesized that those with higher cognitive flexibility would be more able to adapt to the changing work demands of the organizations and thus would show less turnover intentions. Another factor that seems to be important in predicting turnover is employee engagement. Kahn referred to engagement in terms of the harnessing of organization members’ selves to their work roles [by which they] employ and express themselves physically, cognitively, and emotionally during role performances. Studies have shown a strong relationship between employee engagement and turnover intentions. Those with higher engagement with their jobs have found to show low turnover intentions. This study thus hypothesizes that employees with higher engagement will show lower levels of turnover intentions. A total of 150 bank employees (75 from private and 75 from public) participated in this study. They were administered Cognitive Flexibility Scale, Gallup Questionnaire and Intention to Stay Questionnaire along with another questionnaire asking for their demographic details. Results of the study revealed that employees with higher levels of cognitive flexibility and employee engagement show lover levels of turnover intentions. However, the effect is more prominent in case of employees of private banks. Demographic characteristics such as level of the employee and years of engagement in the current job have also been found to be influencing the relationship between cognitive flexibility, employee engagement and turnover intentions. Results of the study are interpreted in accordance to the prevalent literature and theoretical positions.

Keywords: cognitive flexibility, employee engagement, organization, turnover intentions

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Authors: Khalid Soussi

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The study at hand has attempted to describe the acquisition of three EFL lexical knowledge aspects - meaning, synonymy and collocation – across three academic levels: Baccalaureate, second year and fourth year university levels in Morocco. The research also compares the development of the three lexical knowledge aspects between knowledge (reception) and use (production) and attempts to trace their order of acquisition. This has led to the use of three main data collection tasks: translation, acceptability judgment and multiple choices. The study has revealed the following findings. First, L1 and EFL mental lexicons are connected at the lexical knowledge depth. Second, such connection is active whether in language reception or use. Third, the connectivity between L1 and EFL mental lexicons tends to relatively decrease as the academic level of the learners increases. Finally, the research has revealed a significant 'order' of acquisition between the three lexical aspects, though not a very strong one.

Keywords: vocabulary acquisition, EFL lexical knowledge, mental lexicon, vocabulary knowledge depth

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Authors: Shin-Jer Yang, Kai-Tai Yang

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In response to a changing world and the fast growth of the Internet, more and more enterprises are replacing web-based services with cloud-based ones. Multi-tenancy technology is becoming more important especially with Software as a Service (SaaS). This in turn leads to a greater focus on the application of Identity and Access Management (IAM). Conventional Near-Field Communication (NFC) based verification relies on a computer browser and a card reader to access an NFC tag. This type of verification does not support mobile device login and user-based access management functions. This study designs an NFC-based third-party cloud identity and access management scheme (NFC-IAM) addressing this shortcoming. Data from simulation tests analyzed with Key Performance Indicators (KPIs) suggest that the NFC-IAM not only takes less time in identity identification but also cuts time by 80% in terms of two-factor authentication and improves verification accuracy to 99.9% or better. In functional performance analyses, NFC-IAM performed better in salability and portability. The NFC-IAM App (Application Software) and back-end system to be developed and deployed in mobile device are to support IAM features and also offers users a more user-friendly experience and stronger security protection. In the future, our NFC-IAM can be employed to different environments including identification for mobile payment systems, permission management for remote equipment monitoring, among other applications.

Keywords: cloud service, multi-tenancy, NFC, IAM, mobile device

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Authors: Jasmeet Kaur, Anup Singh, Shashikant Iyengar, Arun Kumar, Ira Sahay

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Latent autoimmune diabetes in adults (LADA) is an irreversible autoimmune disease that affects insulin production. LADA is characterized by the production of Glutamic acid decarboxylase (GAD) antibodies, which is similar to type 1 diabetes. Individuals with LADA may eventually develop overt diabetes and require insulin. In this condition, the pancreas produces little or no insulin, which is a hormone used by the body to allow glucose to enter cells and produce energy. While type 1 diabetes was traditionally associated with children and teenagers, its prevalence has increased in adults as well. LADA is frequently misdiagnosed as type 2 diabetes, especially in adulthood when type 2 diabetes is more common. LADA develops in adulthood, usually after age 30. Managing LADA involves metabolic control with exogenous insulin and prolonging the life of surviving beta cells, thereby slowing the disease's progression. This case study examines the impact of approximately 3 months of low-carbohydrate dietary intervention in a 42-year-old woman with LADA who was initially misdiagnosed as having type 2 diabetes. Her c-peptide was 0.13 and her HbA1c was 9.3% when this trial began. Low-carbohydrate interventions have been shown to improve blood sugar levels, including fasting, post-meal, and random blood sugar levels, as well as haemoglobin levels, blood pressure, energy levels, sleep quality, and satiety levels. The use of low-carbohydrate dietary intervention significantly reduces both hypo- and hyperglycaemia events. During the 3 months of the study, there were 2 to 3 hyperglycaemic events owing to physical stress and a single hypoglycaemic event. Low-carbohydrate dietary therapies lessen insulin dose inaccuracy, which explains why there were fewer hyperglycaemic and hypoglycaemic events. In three months, the glycated haemoglobin (HbA1c) level was reduced from 9.3% to 6.3%. These improvements occur without the need for caloric restriction or physical activity. Stress management was crucial aspect of the treatment plan as stress-induced neuroendocrine hormones can cause immunological dysregulation. Additionally, supplements that support immune system and reduce inflammation were used as part of the treatment during the trial. Long-term studies are needed to track disease development and corroborate the claim that such dietary treatments can prolong the honeymoon phase in LADA. Various factors can contribute to additional autoimmune attacks, so measuring c-peptide is crucial on a regular basis to determine whether insulin levels need to be adjusted.

Keywords: autoimmune, diabetes, LADA, low_carb, nutrition

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Authors: Mohamed Bendoukha, Mustapha Mosbah

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The Radiographic apparent assumed that the asymptomatic adjacent segment disease ASD is common after lumbar fusion, but this does not correlate with the functional outcomes while compensatory increased motion and stresses at the adjacent level of fusion is well-known to be associated to ASD. Newly developed, the hybrid stabilization are allocated to substituted for mostly the superior level of the fusion in an attempt to reduce the number of fusion levels and likelihood of degeneration process at the adjacent levels during the fusion with pedicle screws. Nevertheless, its biomechanical efficiencies still remain unknown and complications associated with failure of constructs such screw loosening and toggling should be elucidated In the current study, a finite element (FE) study was performed using a validated L2/S1 model subjected to a moment of 7.5 Nm and follower load of 400 N to assess the biomedical behavior of hybrid constructs based on dynamic topping off, semi rigid fusion. The residual range of motion (ROM), stress distribution at the fused and adjacent levels, stress distribution at the disc and the cage-endplate interface with respect to changes of bone quality were investigated. The hybrid instrumentation was associated with a reduction in compressive stresses compared to the fusion construct in the adjacent-level disc and showed high substantial axial force in the implant while fusion instrumentation increased the motion for both flexion and extension.

Keywords: intervertebral disc, lumbar spine, degenerative nuclesion, L4-L5, range of motion finite element model, hyperelasticy

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Authors: Jumazulhisham Abdul Shukor, Mohd. Sazali Said, Roshanizah Harun, Shuib Husin, Ahmad Razlee Ab Kadir

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This paper applies Taguchi Optimization Method in determining the best machining parameters for pocket milling process on Polypropylene (PP) using CNC milling machine where the surface roughness is considered and the Carbide inserts cutting tool are used. Three machining parameters; speed, feed rate and depth of cut are investigated along three levels; low, medium and high of each parameter (Taguchi Orthogonal Arrays). The setting of machining parameters were determined by using Taguchi Method and the Signal-to-Noise (S/N) ratio are assessed to define the optimal levels and to predict the effect of surface roughness with assigned parameters based on L9. The final experimental outcomes are presented to prove the optimization parameters recommended by manufacturer are accurate.

Keywords: inserts, milling process, signal-to-noise (S/N) ratio, surface roughness, Taguchi Optimization Method

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Authors: M. H. A. D. de Silva, R. P. Hewawasam, M. A. G. Iresha

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Macrosomia is common in infants born to not only women diagnosed with gestational diabetes mellitus but also non-diabetic obese women. Maternal Body Mass Index (BMI) correlates with the incidence of large for gestational age infants. Obesity has reached epidemic levels in modern societies. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. It is also established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given BMI indicating a genetic predisposition in the occurrence of obesity. The objective of this study is to determine the effect of maternal weight, weight gain during pregnancy, c-peptide and insulin concentrations in the cord blood on the birth of appropriate for and large for gestational age infants in a tertiary care center in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of insulin and C-peptide were measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured, and characteristics of the mother were collected. The relationship between insulin, C-peptide and anthropometrics were assessed by Spearman correlation. The multiple logistic regression analysis examined influences of maternal weight, weight gain during pregnancy, C-peptide and insulin concentrations in cord blood as covariates on the birth of large for gestational age infants. A significant difference (P<0.001) was observed between the insulin levels of infants born large for gestational age (18.73 ± 0.52 µlU/ml) and appropriate for gestational age (13.08 ± 0.56 µlU/ml). Consistently, A significant decrease in concentration (41.68%, P<0.001) was observed between C-peptide levels of infants born large for gestational age and appropriate for gestational age. Cord blood insulin and C-peptide levels had a significant correlation with birth weight (r=0.35, P<0.05) of the newborn at delivery. Maternal weight and BMI which are indicators of maternal nutrition were proven to be directly correlated with birth weight and length. To our knowledge, this relationship was investigated for the first time in a Sri Lankan setting and was also evident in our results. This study confirmed the fact that insulin and C-peptide play a major role in regulating fetal growth. According to the results obtained in this study, we can suggest that the increased BMI of the mother has a direct influence on increased maternal insulin secretion, which may subsequently affect cord insulin and C-peptide levels and also birth weight of the infant.

Keywords: C-peptide, insulin, large for gestational age, maternal weight

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Authors: A. Duncan, A. Blake, A. O'Gara, J. Fitzgerald

Abstract:

Introduction: Acute traumatic rib fractures have significant morbidity and mortality and are a commonly seen injury in trauma patients. Rib fracture pain can often be acute and can prove challenging to manage. We performed an audit on patients with acute traumatic rib fractures with the aim of composing a referral and treatment pathway for such patients. Methods: From January 2021 to January 2022, the pain medicine service encouraged early referral of all traumatic rib fractures to the pain service for a multi-modal management approach. A retrospective audit of analgesic management was performed on a select cohort of 24 patients, with a mean age of 67, of which 19 had unilateral rib fractures. Results: 17 of 24 patients (71%) underwent local, regional block as part of a multi-modal analgesia regime. Only one regional complication was observed, seen with hypotension occurring in one patient with a thoracic epidural. The group who did not undergo regional block had a length of stay (LOS) 17 days longer than those who did (27 vs. 10) and higher rates of pneumonia (29% vs. 18%). Conclusion: Early referral to pain specialists is an important component of the effective management of acute traumatic rib fractures. From our audit, it is evident that regional blocks can be effectively used in these cases as part of a multi-modal analgesia regime and may confer benefits in terms of respiratory complications and length of stay.

Keywords: rib fractures, regional blocks, thoracic epidural, erector spina block

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Authors: Dipendra Kumar Yadav, Rajani Ghimire, Saroj Yadav

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Background: The concern about adolescent on reproductive health has grown due to unprecedented increasing rates of early pregnancies and sexually transmitted Infections and they do not have adequate awareness and knowledge about it. Access to these services as well as information about them is, therefore, crucial for adolescents to utilize and benefit from sexual and reproductive health services. The objective of the study was to assess the reproductive health knowledge, attitude and health services utilization among adolescents in rural and urban areas of Kaski district. Materials and Methods: A community-based descriptive cross-sectional study was conducted among adolescents (10-19 years of age) in rural and urban areas of Kaski district, Nepal. The period of data collection was October to November, 2014. Altogether 419 participants were taken for the study. Results: The mean age of the respondents was 15.86 and standard deviation was ±2.305. More than half (58.7 %) of the respondents were females and 41.3 % were males. Out of 419, majority (78.8%) of the respondents were known about family planning, among them only 70 % of respondents were aware about family planning methods. Fifty-one percentages of the respondents were aware about the sexually transmitted diseases. Before giving a birth there is need to consult with partner with this fact 68.7 % of the respondents were agree, 23.6 % of them were neutral and very few (7.6%) of them were disagree. Nearly twenty six percentage of the respondents were faced the reproductive health problems within one month. Out of 107 respondents, 57.9 % did not utilize reproductive health services because of different reasons. Conclusions: The overall level of knowledge towards reproductive health among adolescents was found low. However, levels of attitude towards different reproductive health components were found favorable. Only 42.1% of the respondents were utilized reproductive health services among those who was faced the reproductive health problems within one month which was low coverage of reproductive health services utilization.

Keywords: reproductive health knowledge, reproductive health attitudes, adolescent, service utilization

Procedia PDF Downloads 400

Authors: Dennis Glen G. Ramos, Angelica S. Mendoza, Juliene Marie A. Alvarez, Claudette A. Nagal, Kayzee C. Blanza, Jayson M. Narbonita, John Anthony D. Dayot, Rebecca M. Reduca, Jermaine Jem M. Flojo, Michael E. Resultan, Clyde C. Fomocod, Cindy A. Vinluan, Jeffrie Aleona Mari C. Maclang

Abstract:

RN HEALS, an acronym for Registered Nurses for Health Enhancement and Local Service, is expected to address the shortage of skilled and experienced nurses in 1,221 rural and unserved or underserved communities for one year. The study would like to explore the lived experiences of the nurses deployed under this program.The study is a Descriptive Qualitative Research. Interview was utilized as a data gathering tool. Six community nurses who are deployed under the RN HEALS program are included in the study. Van Kaam method was used as data management. Data gathering was done from October to December 2013.Two themes emerged in the study; Value and Challenge. Under Value, it had three sub-themes; Job Satisfaction, Upholding Competency, including Personal Development and Professional Growth, and Employability. While under Challenge, it had one sub-theme, Job Stress. The study concludes that nurses adapt to strategies to pursue personal and professional competence and an evolutionary journey. The researchers recommend that Health Administrators improve the work environment of nurses to lessen the challenges experienced by nurses.

Keywords: lived experience, RN HEALS, health enhancement, local service

Procedia PDF Downloads 506

Authors: Ahmad Nawid Mirzad, Akira Goto, Takuto Endo, Hitoshi Ano, Hiromu Katamoto, Takenori Yamauchi

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The objective of this study was to evaluate the effects of live yeast supplementation on oxidative stress biomarker and antioxidant vitamin levels as well as lactation performance in Holstein Friesian cows during the summer season in Fukuoka prefecture. Sixteen lactating cows weighing 707.50 ± 13.09 kg (Mean ± SE) were used and randomly assigned to either supplemented (n = 8) or control (n = 8) group. The cows in supplemented group were administered with live yeast product at 10 g/d per cow from middle of July to middle of September for eight weeks. In treatment group, serum levels of derivatives of reactive oxygen metabolites (d-ROMs) were lower at week six. In addition, serum levels of glucose and retinol were higher at week eight and those of α-tocopherol were higher at week 2 in treatment group. During study period daily average milk yield decreased in both groups. Daily average milk yield 63 days after the onset of supplementation in treatment and control groups were 23.5 and 22.2 kg, respectively. The reduction rate of milk yield in treatment group tended to be lower (17.6 vs. 20.0%). These results suggest that live yeast supplementation may reduce oxidative stress and improve energy metabolism in lactating dairy cows during the summer season.

Keywords: cow, live yeast, milk, oxidative stress, summer season

Procedia PDF Downloads 157