Search results for: medical factors
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13352

Search results for: medical factors

11642 Threats to the Business Value: The Case of Mechanical Engineering Companies in the Czech Republic

Authors: Maria Reznakova, Michala Strnadova, Lukas Reznak

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Successful achievement of strategic goals requires an effective performance management system, i.e. determining the appropriate indicators measuring the rate of goal achievement. Assuming that the goal of the owners is to grow the assets they invested in, it is vital to identify the key performance indicators, which contribute to value creation. These indicators are known as value drivers. Based on the undertaken literature search, a value driver is defined as any factor that affects the value of an enterprise. The important factors are then monitored by both financial and non-financial indicators. Financial performance indicators are most useful in strategic management, since they indicate whether a company's strategy implementation and execution are contributing to bottom line improvement. Non-financial indicators are mainly used for short-term decisions. The identification of value drivers, however, is problematic for companies which are not publicly traded. Therefore financial ratios continue to be used to measure the performance of companies, despite their considerable criticism. The main drawback of such indicators is the fact that they are calculated based on accounting data, while accounting rules may differ considerably across different environments. For successful enterprise performance management it is vital to avoid factors that may reduce (or even destroy) its value. Among the known factors reducing the enterprise value are the lack of capital, lack of strategic management system and poor quality of production. In order to gain further insight into the topic, the paper presents results of the research identifying factors that adversely affect the performance of mechanical engineering enterprises in the Czech Republic. The research methodology focuses on both the qualitative and the quantitative aspect of the topic. The qualitative data were obtained from a questionnaire survey of the enterprises senior management, while the quantitative financial data were obtained from the Analysis Major Database for European Sources (AMADEUS). The questionnaire prompted managers to list factors which negatively affect business performance of their enterprises. The range of potential factors was based on a secondary research – analysis of previously undertaken questionnaire surveys and research of studies published in the scientific literature. The results of the survey were evaluated both in general, by average scores, and by detailed sub-analyses of additional criteria. These include the company specific characteristics, such as its size and ownership structure. The evaluation also included a comparison of the managers’ opinions and the performance of their enterprises – measured by return on equity and return on assets ratios. The comparisons were tested by a series of non-parametric tests of statistical significance. The results of the analyses show that the factors most detrimental to the enterprise performance include the incompetence of responsible employees and the disregard to the customers‘ requirements.

Keywords: business value, financial ratios, performance measurement, value drivers

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11641 Risk and Uncertainty in Aviation: A Thorough Analysis of System Vulnerabilities

Authors: C. V. Pietreanu, S. E. Zaharia, C. Dinu

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Hazard assessment and risks quantification are key components for estimating the impact of existing regulations. But since regulatory compliance cannot cover all risks in aviation, the authors point out that by studying causal factors and eliminating uncertainty, an accurate analysis can be outlined. The research debuts by making delimitations on notions, as confusion on the terms over time has reflected in less rigorous analysis. Throughout this paper, it will be emphasized the fact that the variation in human performance and organizational factors represent the biggest threat from an operational perspective. Therefore, advanced risk assessment methods analyzed by the authors aim to understand vulnerabilities of the system given by a nonlinear behavior. Ultimately, the mathematical modeling of existing hazards and risks by eliminating uncertainty implies establishing an optimal solution (i.e. risk minimization).

Keywords: control, human factor, optimization, risk management, uncertainty

Procedia PDF Downloads 245
11640 Afrikan Natural Medicines: An Innovation-Based Model for Medicines Production, Curriculum Development and Clinical Application

Authors: H. Chabalala, A. Grootboom, M. Tang

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The innovative development, production, and clinical utilisation of African natural medicines requires frameworks from systematisation, innovation, registration. Afrika faces challenges when it comes to these sectors. The opposite is the case as is is evident in ancient Asian (Traditional Chinese Medicine and Indian Ayurveda and Siddha) medical systems, which are interfaced into their respective national health and educational systems. Afrikan Natural Medicines (ANMs) are yet to develop systematisation frameworks, i.e. disease characterisation and medicines classification. This paper explores classical medical systems drawn from Afrikan and Chinese experts in natural medicines. An Afrikological research methodology was used to conduct in-depth interviews with 20 key respondents selected through purposeful sampling technique. Data was summarised into systematisation frameworks for classical disease theories, patient categorisation, medicine classification, aetiology and pathogenesis of disease, diagnosis and prognosis techniques and treatment methods. It was discovered that ancient Afrika had systematic medical cosmologies, remnants of which are evident in most Afrikan cultural health practices. Parallels could be drawn from classical medical concepts of antiquity, like Chinese Taoist and Indian tantric health systems. Data revealed that both the ancient and contemporary ANM systems were based on living medical cosmologies. The study showed that African Natural Healing Systems have etiological systems, general pathogenesis knowledge, differential diagnostic techniques, comprehensive prognosis and holistic treatment regimes. Systematisation models were developed out of these frameworks, and this could be used for evaluation of clinical research, medical application including development of curriculum for high-education. It was envisaged that frameworks will pave way towards the development, production and commercialisation of ANMs. This was piloted in inclusive innovation, technology transfer and commercialisation of South African natural medicines, cosmeceuticals, nutraceuticals and health infusions. The central model presented here in will assist in curriculum development and establishment of Afrikan Medicines Hospitals and Pharmaceutical Industries.

Keywords: African Natural Medicines, Indigenous Knowledge Systems, Medical Cosmology, Clinical Application

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11639 Perceived Competence toward Helping an Accident Victim in Pre-Hospital Setting among Medical Graduates: A Cross Sectional Study from Jodhpur, Rajasthan

Authors: Neeti Rustagi, Naveen Dutt, Arvind Sinha, Mahaveer S. Rhodha, Pankaja R. Raghav

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Background: Pre-hospital trauma care services are in developing stage in fast-urbanizing cities of India including Jodhpur. Training of health professionals in providing necessary pre-hospital trauma care is an essential step in decreasing accident related morbidity and mortality. The current study explores the response of a medical graduate toward helping an accident victim in a pre-hospital setting before patient can be transferred to definitive trauma facility. Methodology: This study examines the perceived competence in predicting response to an accident victim by medical graduates in Jodhpur, Rajasthan. Participants completed measures of attitude, normative influence and perceived behavior control toward providing pre-hospital care to an accident victim. Likert scale was used to measure the participant responses. Preliminary and descriptive analysis were used using SPSS 21.0. Internal consistency of the responses received was measured using Cronbach’s alpha. Results: Almost all medical graduates agreed that road accidents are common in their area (male: 92%; female: 78%). More male medical graduates (28%) reported helping an accident victim as compared to female physicians (9%) in the previous three months. Majority of study participants (96%) reported that providing immediate care to an accident victim is essential to save the life of an individual. Experience of helping an accident victim was considered unpleasant by the majority of female participants (70%) as compared to male participants (36%). A large number of participants believed that their friends (80%) and colleagues (96%) would appreciate them helping an accident victim in a pre-hospital setting. A large number of participants also believed that they possess the necessary skills and competencies (80%) towards helping a roadside accident victim in the pre-hospital care environment. Perceived competence of helping a roadside accident victim until they are transferred to a health facility was reported by less than half of the participants (male: 56%; female: 43%). Conclusion: Medical graduates have necessary attitude, competencies, and intention of helping a roadside accident victim. The societal response towards helping a road side accident victim is also supportive. In spite of positive determinants, a large proportion of medical graduates have perceived lack of competence in helping a roadside accident victim. This is essential to explore further as providing pre-hospital care to a roadside accident victim is an essential step in establishing the continuum of care to an accident victim especially in countries where pre-hospital services are in developing phase.

Keywords: prehospital care, perceived behavior, perceived competence, medical graduates

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11638 Risk Factors and Outcome of Free Tissue Transfer at a Tertiary Care Referral Center

Authors: Majid Khan

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Introduction: In this era of microsurgery, free flap holds a remarkable spot in reconstructive surgery. A free flap is well suited for composite defects as it provides sufficient and well-vascularized tissue for coverage. We report our experience with the use of the free flaps for the reconstruction of composite defects. Methods: This is a retrospective case series (chart review) of patients who underwent reconstruction of composite defects with a free flap at Aga Khan University Hospital, Karachi (Pakistan) from January 01, 2015, to December 31, 2019. Data were collected for patient demographics, size of the defect, size of flap, recipient vessels, postoperative complications, and outcome of the free flap. Results: Over this period, 532 free flaps are included in this study. The overall success rate is 95.5%. The mean age of the patient was 44.86 years. In 532 procedures, there were 448 defects from tumor ablation of head and neck cancer. The most frequent free flap was the anterolateral thigh flap in 232 procedures. In this study, the risk factor hypertension (p=0.004) was found significant for wound dehiscence, preop radiation/chemotherapy (p=0.003), and malnutrition (p=0.005) were found significant for fistula formation. Malnutrition (p=0.02) and use of vein grafts (p=0.025) were significant factors for flap failure. Conclusion: Free tissue transfer is a reliable option for the reconstruction of large and composite defects. Hypertension, malnutrition, and preoperative radiotherapy can cause significant morbidity.

Keywords: free flap, free flap failure, risk factors for flap failure, free flap outcome

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11637 Immunoglobulins and Importance in Ruminants

Authors: M. Akoz, O. B. Citil, I. Aydin

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Colostrum secreted by the mammary glands after birth in the early days, a high proportion of fat, protein and ash containing a secretion containing low amounts of casein and lactose. Especially immunoglobulins contain high proportions. Maternal immunoglobulins own immune system to protect the newborn against neonatal disease until development are very important matter. However, colostrum is transferred to the offspring due to placental barrier in ruminants. Immunoglobulins are absorbed through the intestinal epithelium but absorption can vary under the influence of some factors. These factors are among the priority ones taking colostrum first time, amount, concentration, the metabolic status of the newborn. intestinal absorption of immunoglobulins occurs over the first 24 h high. Absorption from the gut after nine hours, 50% after 24 hours was only 11%. On the other hand pup's digestive system degrade the enzymes after 24 hours immunoglobulins. Bovine colostrum in the composition while basic immune IgG, IgA and IgM are also available. Total IgG in colostrum of ruminants, while in other species is a greater amount in blood serum.

Keywords: immunoglobulin, ruminants, colostrum, immune system

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11636 Assessment of Taiwan Railway Occurrences Investigations Using Causal Factor Analysis System and Bayesian Network Modeling Method

Authors: Lee Yan Nian

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Safety investigation is different from an administrative investigation in that the former is conducted by an independent agency and the purpose of such investigation is to prevent accidents in the future and not to apportion blame or determine liability. Before October 2018, Taiwan railway occurrences were investigated by local supervisory authority. Characteristics of this kind of investigation are that enforcement actions, such as administrative penalty, are usually imposed on those persons or units involved in occurrence. On October 21, 2018, due to a Taiwan Railway accident, which caused 18 fatalities and injured another 267, establishing an agency to independently investigate this catastrophic railway accident was quickly decided. The Taiwan Transportation Safety Board (TTSB) was then established on August 1, 2019 to take charge of investigating major aviation, marine, railway and highway occurrences. The objective of this study is to assess the effectiveness of safety investigations conducted by the TTSB. In this study, the major railway occurrence investigation reports published by the TTSB are used for modeling and analysis. According to the classification of railway occurrences investigated by the TTSB, accident types of Taiwan railway occurrences can be categorized into: derailment, fire, Signal Passed at Danger and others. A Causal Factor Analysis System (CFAS) developed by the TTSB is used to identify the influencing causal factors and their causal relationships in the investigation reports. All terminologies used in the CFAS are equivalent to the Human Factors Analysis and Classification System (HFACS) terminologies, except for “Technical Events” which was added to classify causal factors resulting from mechanical failure. Accordingly, the Bayesian network structure of each occurrence category is established based on the identified causal factors in the CFAS. In the Bayesian networks, the prior probabilities of identified causal factors are obtained from the number of times in the investigation reports. Conditional Probability Table of each parent node is determined from domain experts’ experience and judgement. The resulting networks are quantitatively assessed under different scenarios to evaluate their forward predictions and backward diagnostic capabilities. Finally, the established Bayesian network of derailment is assessed using investigation reports of the same accident which was investigated by the TTSB and the local supervisory authority respectively. Based on the assessment results, findings of the administrative investigation is more closely tied to errors of front line personnel than to organizational related factors. Safety investigation can identify not only unsafe acts of individual but also in-depth causal factors of organizational influences. The results show that the proposed methodology can identify differences between safety investigation and administrative investigation. Therefore, effective intervention strategies in associated areas can be better addressed for safety improvement and future accident prevention through safety investigation.

Keywords: administrative investigation, bayesian network, causal factor analysis system, safety investigation

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11635 Comparative Analysis of Forensic Medicine Course Evaluation: A Two Year Study

Authors: Prateek Rastogi

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Medical teaching in present era concentrates not only on teaching but on effective teaching. For effective teaching a combination of effective carefully designed curriculum, an educated educator, competent learner and fool proof evaluation system is required. Keeping these parameters in mind and study was undertaken at Kasturba Medical College, Mangalore among medical students. In this study, evaluation of Forensic Medicine syllabus along with its teaching and evaluation methodology was done using 20 different parameters. This questionnaire based study was done over a period of two years i.e. 2013 and 2014. Batch of students who just passed the forensic medicine subject was included for study. Carefully designed questionnaire contained questions related to course content, teaching methodology and evaluation system along with provisions to mention merits and demerits of subject. The feedbacks in first round were analyzed and suggestions were implemented before conducting the second round of study. Overall evaluation of course was done as well as it was compared with other subjects of second MBBS. It was noted that Scores improved in 2nd survey thus stressing the importance of course evaluation and student feedback in teaching improvement.

Keywords: teaching methodology, system of evaluation, course content, bioinformatics, biomedicine

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11634 Relational and Personal Variables Predicting Marital Satisfaction

Authors: Sezen Gulec, Bilge Uzun

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Almost all of the world population marries at least once in their lifetime. Nevertheless, in reality, only half of all marriages last a lifetime. The most important factor in marriage to manage is the satisfaction that they obtain. It is reality that marital satisfaction does not only related to maintain the relationship but also related to the social and work relationships. In this respect, the purpose of the present research is to find the personal and relational factors predicted marital satisfaction. The sample including 378 (178 male and 200 females) married individuals were administered to marital life scale, multidimensional perfectionism scale, trait forgivingness scale, adjective based personality test and relationship happiness questionnaire. The findings revealed marital happiness, forgiveness and extravertedness and emotional inconsistency factors were found to be significant predictors of marital satisfaction.

Keywords: marital satisfaction, happiness, perfectionism, forgiveness, five factor personality

Procedia PDF Downloads 661
11633 Comparison of the Hospital Patient Safety Culture between Bulgarian, Croatian and American: Preliminary Results

Authors: R. Stoyanova, R. Dimova, M. Tarnovska, T. Boeva, R. Dimov, I. Doykov

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Patient safety culture (PSC) is an essential component of quality of healthcare. Improving PSC is considered a priority in many developed countries. Specialized software platform for registration and evaluation of hospital patient safety culture has been developed with the support of the Medical University Plovdiv Project №11/2017. The aim of the study is to assess the status of PSC in Bulgarian hospitals and to compare it to that in USA and Croatian hospitals. Methods: The study was conducted from June 01 to July 31, 2018 using the web-based Bulgarian Version of the Hospital Survey on Patient Safety Culture Questionnaire (B-HSOPSC). Two hundred and forty-eight medical professionals from different hospitals in Bulgaria participated in the study. To quantify the differences of positive scores distributions for each of the 42 HSOPSC items between Bulgarian, Croatian and USA samples, the x²-test was applied. The research hypothesis assumed that there are no significant differences between the Bulgarian, Croatian and US PSCs. Results: The results revealed 14 significant differences in the positive scores between the Bulgarian and Croatian PSCs and 15 between the Bulgarian and the USA PSC, respectively. Bulgarian medical professionals provided less positive responses to 12 items compared with Croatian and USA respondents. The Bulgarian respondents were more positive compared to Croatians on the feedback and communication of medical errors (Items - C1, C4, C5) as well as on the employment of locum staff (A7) and the frequency of reported mistakes (D1). Bulgarian medical professionals were more positive compared with their USA colleagues on the communication of information at shift handover and across hospital units (F5, F7). The distribution of positive scores on items: ‘Staff worries that their mistakes are kept in their personnel file’ (RA16), ‘Things ‘fall between the cracks’ when transferring patients from one unit to another’ (RF3) and ‘Shift handovers are problematic for patients in this hospital’ (RF11) were significantly higher among Bulgarian respondents compared with Croatian and US respondents. Conclusions: Significant differences of positive scores distribution were found between Bulgarian and USA PSC on one hand and between Bulgarian and Croatian on the other. The study reveals that distribution of positive responses could be explained by the cultural, organizational and healthcare system differences.

Keywords: patient safety culture, healthcare, HSOPSC, medical error

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11632 Access of Refugees in Rural Areas to Regular Medication during COVID-19 Era: International Organization for Migration, Jordan Experience

Authors: Rasha Shoumar

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Background: Since the onset of the Syria crisis in 2011, Jordan has hosted many Syrian refugees, many of which are residing in urban and rural areas. Vulnerability of refugees has increased due to the COVID-19 pandemic, adding to their already existing challenge in access to medical services, rendering them vulnerable to the complications of untreated medical conditions and amplifying their risk for severe COVID-19 disease. To improve health outcomes and access to health care services in a COVID-19 context, IOM (The International Organization for Migration) provided health services including awareness raising, direct primary health care through mobile teams and referrals to secondary services were extended to the vulnerable populations of refugees. Method: 6 community health volunteers were trained and deployed to different governorates to provide COVID-19 and non-communicable disease awareness and collect data rated to non-communicable disease and access to medical health services. Primary health care services were extended to 7 governorates through a mobile medical team, providing medical management. The collected Data was reviewed and analyzed. Results: 2150 refugees in rural areas were reached out by community health volunteers, out of which 78 received their medications through the Ministry of Health, 121 received their medications through different non-governmental organizations, 665 patients couldn’t afford buying any medications, 1286 patients were occasionally buying their medications when they were able to afford it. 853 patients received medications and follow up through IOM mobile clinics, the most common conditions were hypertension, diabetes, hyperlipidemia, anemia, heart disease, thyroid disease, asthma, seizures, and psychiatric conditions. 709 of these patients had more than 3 of the comorbidities. Multiple cases were referred for secondary and tertiary lifesaving interventions. Conclusion: Non communicable diseases are highly prevalent among refugee population in Jordan, access to medical services have proven to be a challenge in rural areas especially during the COVID-19 era, many of the patients have multiple uncontrolled medical conditions placing them at risk for complications and risk for severe COVID-19 disease. Deployment of mobile clinics to rural areas plays an essential role in managing such medical conditions, thus improving the continuum of health care approach, physical and mental wellbeing of refugees and reducing the risk for severe COVID-19 disease among this group, taking us one step forward toward universal health access.

Keywords: COVID-19, refugees, mobile clinics, primary health care

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11631 Navigating the Case-Based Learning Multimodal Learning Environment: A Qualitative Study Across the First-Year Medical Students

Authors: Bhavani Veasuvalingam

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Case-based learning (CBL) is a popular instructional method aimed to bridge theory to clinical practice. This study aims to explore CBL mixed modality curriculum in influencing students’ learning styles and strategies that support learning. An explanatory sequential mixed method study was employed with initial phase, 44-itemed Felderman’s Index of Learning Style (ILS) questionnaire employed across year one medical students (n=142) using convenience sampling to describe the preferred learning styles. The qualitative phase utilised three focus group discussions (FGD) to explore in depth on the multimodal learning style exhibited by the students. Most students preferred combination of learning stylesthat is reflective, sensing, visual and sequential i.e.: RSVISeq style (24.64%) from the ILS analysis. The frequency of learning preference from processing to understanding were well balanced, with sequential-global domain (66.2%); sensing-intuitive (59.86%), active- reflective (57%), and visual-verbal (51.41%). The qualitative data reported three major themes, namely Theme 1: CBL mixed modalities navigates learners’ learning style; Theme 2: Multimodal learners active learning strategies supports learning. Theme 3: CBL modalities facilitating theory into clinical knowledge. Both quantitative and qualitative study strongly reports the multimodal learning style of the year one medical students. Medical students utilise multimodal learning styles to attain the clinical knowledge when learning with CBL mixed modalities. Educators’ awareness of the multimodal learning style is crucial in delivering the CBL mixed modalities effectively, considering strategic pedagogical support students to engage and learn CBL in bridging the theoretical knowledge into clinical practice.

Keywords: case-based learning, learnign style, medical students, learning

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11630 Subjective Evaluation of Mathematical Morphology Edge Detection on Computed Tomography (CT) Images

Authors: Emhimed Saffor

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In this paper, the problem of edge detection in digital images is considered. Three methods of edge detection based on mathematical morphology algorithm were applied on two sets (Brain and Chest) CT images. 3x3 filter for first method, 5x5 filter for second method and 7x7 filter for third method under MATLAB programming environment. The results of the above-mentioned methods are subjectively evaluated. The results show these methods are more efficient and satiable for medical images, and they can be used for different other applications.

Keywords: CT images, Matlab, medical images, edge detection

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11629 A Cross-Cultural Investigation of Self-Compassion in Adolescents Across Gender

Authors: H. N. Cheung

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Self-compassion encourages one to accept oneself, reduce self-criticism and self-judgment, and see one’s shortcomings and setbacks in a balanced view. Adolescent self-compassion is a crucial protective factor against mental illness. It is, however, affected by gender. Given the scarcity of self-compassion scales for adolescents, the current study evaluates the Self-Compassion Scale for Youth (SCS-Y) in a large cross-cultural sample and investigates how the subscales of SCS-Y relate to the dimensions of depressive symptoms across gender. Through the internet-based Qualtrics, a total of 2881 teenagers aged 12 to 18 years were recruited from Hong Kong (HK), China, and the United Kingdom. A Multiple Indicator Multiple Cause (MIMIC) model was used to evaluate measurement invariance of the SCS-Y, and differential item functioning (DIF) was checked across gender. Upon the establishment of the best model, a multigroup structural equation model (SEM) was built between factors of SCS-Y and Multidimensional depression assessment scale (MDAS) which assesses four dimensions of depressive symptoms (emotional, cognitive, somatic and interpersonal). The SCS-Y was shown to have good reliability and validity. The MIMIC model produced a good model fit for a hypothetical six-factor model (CFI = 0.980; TLI = 0.974; RMSEA = 0.038) and no item was flagged for DIF across gender. A gender difference was observed between SCS-Y factors and depression dimensions. Conclusions: The SCS-Y exhibits good psychometric characteristics, including measurement invariance across gender. The study also highlights the gender difference between self-compassion factors and depression dimensions.

Keywords: self compassion, gender, depression, structural equation modelling, MIMIC model

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11628 Natural Factors of Interannual Variability of Winter Precipitation over the Altai Krai

Authors: Sukovatov K.Yu., Bezuglova N.N.

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Winter precipitation variability over the Altai Krai was investigated by retrieving temporal patterns. The spectral singular analysis was used to describe the variance distribution and to reduce the precipitation data into a few components (modes). The associated time series were related to large-scale atmospheric and oceanic circulation indices by using lag cross-correlation and wavelet-coherence analysis. GPCC monthly precipitation data for rectangular field limited by 50-550N, 77-880E and monthly climatological circulation index data for the cold season were used to perform SSA decomposition and retrieve statistics for analyzed parameters on the time period 1951-2017. Interannual variability of winter precipitation over the Altai Krai are mostly caused by three natural factors: intensity variations of momentum exchange between mid and polar latitudes over the North Atlantic (explained variance 11.4%); wind speed variations in equatorial stratosphere (quasi-biennial oscillation, explained variance 15.3%); and surface temperature variations for equatorial Pacific sea (ENSO, explained variance 2.8%). It is concluded that under the current climate conditions (Arctic amplification and increasing frequency of meridional processes in mid-latitudes) the second and the third factors are giving more significant contribution into explained variance of interannual variability for cold season atmospheric precipitation over the Altai Krai than the first factor.

Keywords: interannual variability, winter precipitation, Altai Krai, wavelet-coherence

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11627 The Factors Affecting the Use of Massive Open Online Courses in Blended Learning by Lecturers in Universities

Authors: Taghreed Alghamdi, Wendy Hall, David Millard

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Massive Open Online Courses (MOOCs) have recently gained widespread interest in the academic world, starting a wide range of discussion of a number of issues. One of these issues, using MOOCs in teaching and learning in the higher education by integrating MOOCs’ contents with traditional face-to-face activities in blended learning format, is called blended MOOCs (bMOOCs) and is intended not to replace traditional learning but to enhance students learning. Most research on MOOCs has focused on students’ perception and institutional threats whereas there is a lack of published research on academics’ experiences and practices. Thus, the first aim of the study is to develop a classification of blended MOOCs models by conducting a systematic literature review, classifying 19 different case studies, and identifying the broad types of bMOOCs models namely: Supplementary Model and Integrated Model. Thus, the analyses phase will emphasize on these different types of bMOOCs models in terms of adopting MOOCs by lecturers. The second aim of the study is to improve the understanding of lecturers’ acceptance of bMOOCs by investigate the factors that influence academics’ acceptance of using MOOCs in traditional learning by distributing an online survey to lecturers who participate in MOOCs platforms. These factors can help institutions to encourage their lecturers to integrate MOOCs with their traditional courses in universities.

Keywords: acceptance, blended learning, blended MOOCs, higher education, lecturers, MOOCs, professors

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11626 Design and Development of Data Mining Application for Medical Centers in Remote Areas

Authors: Grace Omowunmi Soyebi

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Data Mining is the extraction of information from a large database which helps in predicting a trend or behavior, thereby helping management make knowledge-driven decisions. One principal problem of most hospitals in rural areas is making use of the file management system for keeping records. A lot of time is wasted when a patient visits the hospital, probably in an emergency, and the nurse or attendant has to search through voluminous files before the patient's file can be retrieved; this may cause an unexpected to happen to the patient. This Data Mining application is to be designed using a Structured System Analysis and design method, which will help in a well-articulated analysis of the existing file management system, feasibility study, and proper documentation of the Design and Implementation of a Computerized medical record system. This Computerized system will replace the file management system and help to easily retrieve a patient's record with increased data security, access clinical records for decision-making, and reduce the time range at which a patient gets attended to.

Keywords: data mining, medical record system, systems programming, computing

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11625 An Investigation of Commitment to Marital Relationship Precedents through Self-Expansion in Students from the Medical Science University of Iran

Authors: Mehravar Javid, Laura Reid Harris, Zahra Khodadadi, Rachel Walton

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The study aimed to explore commitment precedence through self-expansion among students at the Medical Science University of Shiraz, Iran. Method: The statistical population was comprised of students at Shiraz University of Medical Science during the academic years 2013 to 2014. Using random sampling, 133 married students (50 males and 83 females) were selected. The commitment condition of this studied group was assessed using Adam and Jones' (1999) Marital Commitment Dimensions Scale (DCI), and self-expansion was measured using Aron and Lewandowski's (2002) Self-Expansion Questionnaire. Simple regression analyses investigated commitment precedence via self-expansion. Results: The data revealed a positive correlation between total commitment (r=0.35, p < 0.01), the subscales of commitment to the spouse (r=0.43, p < 0.01), and commitment to marriage (r=0.31, p < 0.01). Regression analyses indicated that perceived self-expansion positively correlated with commitment to marital relationships in married students. The findings suggest that an increased possibility of self-expansion in a marital relationship corresponds with heightened commitment.

Keywords: commitment to marital relationship, married students, relationship dynamics, self-expansion

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11624 Contributing Factors Affecting the Safety in Construction Sites of Bangladesh

Authors: Farzana Rahman, Mohammed Hossain Ezaz, Dipak Halder, Proshanta Mondal

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Site safety is an important function regardless of project size. A key goal, which must be met for a successful project, is to finish the project with a good safety record. Construction safety is an important issue in all over the world. Today, developed countries strictly follow the safety procedure to avoid any hazard, accident or fatality. However, for a least developed country like Bangladesh, still accidents and fatalities are quite high due to lack of safety management. With the increased volume of construction work in Bangladesh, the need for proper attention in safety issues has become essential for human, economic and other consideration. Recently lots of accidents are taking place in construction sites of Bangladesh causing severe injury to death to the workers and pedestrians. There are a number of reasons/factors that these high numbers are widespread to the construction industry that are not found in most other businesses. The objective of this research work is to identify and explore the various factor that affect the construction site safety in Bangladesh. A questionnaire surveys was conducted to the reputed construction companies of Bangladesh to examine the present safety situation in construction sites. Nine factors were selected for the survey. The finding shows that 78% of organizations’ from the respondents are conscious about the safety procedure and they usually provide safety measures for the workers. Promotion of safety measures at the working site results in a better working environment, higher productivity and greater contentment among the workers.

Keywords: construction sites, fatalities, safety issues, safety situation

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11623 Gender Stereotypes in Reproductive Medicine with Regard to Parental Age

Authors: Monika Michałowska, Anna Alichniewicz

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Detrimental outcomes of advanced maternal age on the chances of fertilization, pregnancy as well as mother and fetus health have been recognized for several decades. It seemed interesting to investigate whether there is a comparable awareness of the detrimental influence on the reproductive outcomes of late fatherhood, given that it has been already ten years since an intense and growing interest concerning later-age fatherhood commenced in medical research. To address that issue a two-step research was done. First, we performed a review of the subject literature to answer the following questions: 1) What age is defined as advanced?; 2) Is the same age defined as advanced in both genders?; 3) What terminology concerning age issues is used?; 4) Is the same age terminology used regarding both genders? The second part of our studies was devoted to the views of medical students. This part of our research comprised both quantitative and qualitative studies. Opinions of medical students in one of the Polish medical universities on several issues connected with assisted reproduction technology (ART) were gathered: 1) students’ attitude to in vitro fertilization (IVF) for women over 40 and for postmenopausal women; 2) students’ attitude to late fatherhood; 3) students’ reasoning given against acceptability of IVF procedure for all of these group of patients involved in an IVF procedure. Our analyses revealed that: First, there is no universal definition of the term ‘advanced age’; secondly, there is a general tendency to adopt different age limits depending on whether they refer to maternal or paternal age, but no justification is provided by the researchers explaining why they set different age limits for women and men; thirdly, the image of postponed fatherhood stands in stark contrast to postponed motherhood - while postponed fatherhood is frequently portrayed as a reasonable and conscious decision enabling a stable family environment for a child, the reasonableness of postponed motherhood is often questioned; finally, the bias regarding maternal versus paternal age is deeply embedded in medical students’ attitude to IVF for women over 40 and for postmenopausal women.

Keywords: gender stereotypes, reproductive medicine, maternal age, paternal age

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11622 Determinants of Investment in Vaca Muerta, Argentina

Authors: Ivan Poza Martínez

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The international energy landscape has been significantly affected by the Covid-19 pandemic and te conflict in Ukraine. The Vaca Muerta sedimentary formation in Argentina´s Neuquén province has become a crucial area for energy production, specifically in the shale gas ad shale oil sectors. The massive investment required for theexploitation of this reserve make it essential to understand te determinants of the investment in the upstream sector at both local ad international levels. The aim of this study is to identify the qualitative and quantitative determinants of investment in Vaca Muerta. The research methodolody employs both quantiative ( econometrics ) and qualitative approaches. A linear regression model is used to analyze the impact in non-conventional hydrocarbons. The study highlights that, in addition to quantitative factors, qualitative variables, particularly the design of a regulatory framework, significantly influence the level of the investment in Vaca Muerta. The analysis reveals the importance of attracting both domestic and foreign capital investment. This research contributes to understanding the factors influencing investment inthe Vaca Muerta regioncomapred to other published studies. It emphasizes to role of qualitative varibles, such as regulatory frameworks, in the development of the shale gas and oil sectors. The study uses a combination ofquantitative data , such a investment figures, and qualitative data, such a regulatory frameworks. The data is collected from various rpeorts and industry publications. The linear regression model is used to analyze the relationship between the variables and the investment in Vaca Muerta. The research addresses the question of what factors drive investment in the Vaca Muerta region, both from a quantitative and qualitative perspective. The study concludes that a combination of quantitative and qualitative factors, including the design of a regulatory framework, plays a significant role in attracting investment in Vaca Muerta. It highlights the importance of these determinants in the developmentof the local energy sector and the potential economic benefits for Argentina and the Southern Cone region.

Keywords: vaca muerta, FDI, shale gas, shale oil, YPF

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11621 Analysis of the Factors Affecting the Public Bicycle Projects in Chinese Cities

Authors: Xiujuan Wang, Weiguo Wang, Lei Yu, Xue Liu

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There are many purported benefits of public bike systems, therefore, it has seen a sharp increase since 2008 in Hangzhou, China. However, there are few studies on the public bicycle system in Chinese cities. In order to make recommendations for the development of public bicycle systems, this paper analyzes the influencing factors by using the system dynamics method according to the main characteristics of Chinese cities. The main characteristics of Chinese cities lie in the city size and process of urbanization, traffic mode division, demographic characteristics, bicycle infrastructure and right of way, regime structure. Finally, under the context of Chinese bike sharing systems, these analyses results can help to design some feasible strategies for the planner to the development of the public bicycles.

Keywords: engineering of communication and transportation system, bicycle, public bike, characteristics of Chinese cities, system dynamics

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11620 The Decline of Verb-Second in the History of English: Combining Historical and Theoretical Explanations for Change

Authors: Sophie Whittle

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Prior to present day, English syntax historically exhibited an inconsistent verb-second (V2) rule, which saw the verb move to the second position in the sentence following the fronting of a type of phrase. There was a high amount of variation throughout the history of English with regard to the ordering of subject and verb, and many explanations attempting to account for this variation have been documented in previous literature. However, these attempts have been contradictory, with many accounts positing the effect of previous syntactic changes as the main motivations behind the decline of V2. For instance, morphosyntactic changes, such as the loss of clitics and the loss of empty expletives, have been loosely connected to changes in frequency for the loss of V2. The questions surrounding the development of non-V2 in English have, therefore, yet to be answered. The current paper aims to bring together a number of explanations from different linguistic fields to determine the factors driving the changes in English V2. Using historical corpus-based methods, the study analyses both quantitatively and qualitatively the changes in frequency for the history of V2 in the Old, Middle, and Modern English periods to account for the variation in a range of sentential environments. These methods delve into the study of information structure, prosody and language contact to explain variation within different contexts. The analysis concludes that these factors, in addition to changes within the syntax, are responsible for the position of verb movement. The loss of V2 serves as an exemplar study within the field of historical linguistics, which combines a number of factors in explaining language change in general.

Keywords: corpora, English, language change, mixed-methods, syntax, verb-second

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11619 Common Used Non-Medical Practice and Perceived Benefits in Couples with Fertility Problems in Turkey

Authors: S. Fata, M. A. Tokat, N. Bagardi, B. Yilmaz

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Nowadays, various traditional practices are used throughout the world with aim to improve fertility. Various traditional remedies, acupuncture, religious practices such as sacrifice are frequently used. Studies often evaluate the traditional practices used by the women. But the use of this non-medical practice by couples and specific application reasons of this methods has been less investigated. The aim of this study was to evaluate the common used non-medical practices and determine perceived benefits by couples with fertility problems in Turkey. This is a descriptive study. Research data were collected between May-July 2016, in Izmir Ege Birth Education and Research Hospital Assisted Reproduction Clinic, from 151 couples with fertility problem. Personal Information Form and Non-Medical Practices Used for Fertility Evaluation Form was used. Number 'GOA 2649' permission letter from Dokuz Eylul University Non-Invasive Research Ethics Board, permission letter from the institution and the written consent from participants has been received to carry out the study. In the evaluation of the data, frequencies and proportions analysis were used. The average age of women participating in the study was 32.87, the 35.8% were high school graduates, 60.3% were housewife and the 58.9% lived in city. The 30.5% of husbands were high school graduates, the 96.7% were employed and the 60.9% lived in city. The 78.1% of couples lived as a nuclear family, the average marriage year was 7.58, in 33.8% the fertility problem stems from women, 42.4% of them received a diagnosis for 1-2 years, 35.1% were being treated for 1-2 years. The 35.8% of women reported use of non-medical applications. The 24.4% of women used figs, onion cure, hacemat, locust, bee-pollen milk, the 18.2% used herbs, the 13.1% vowed, the 12.1% went to the tomb, the 10.1% did not bath a few days after the embryo transfer, the 9.1% used thermal water baths, the 5.0% manually corrected the womb, the 5.0% printed amulets by Hodja, the 3.0% went to the Hodja/pilgrims. Among the perceived benefits of using non-medical practices; facilitate pregnancy and implantation, improve oocyte quality were the most recently expressed. Women said that they often used herbs to develop follicles, did not bath after embryo transfer with aim to provide implantation, and used thermal waters to get rid of the infection. Compared to women, only the 25.8% of men used the non-medical practice. The 52.1% reported that they used peanuts, hacemat, locust, bee-pollen milk, the 14.9% used herbs, the 12.8% vowed, the 10.1% went to the tomb, the 10.1% used thermal water baths. Improve sperm number, motility and quality were the most expected benefits. Men said that they often used herbs to improve sperm number, used peanuts, hacemat, locust, bee-pollen milk to improve sperm motility and quality. Couples in Turkey often use non-medical practices to deal with fertility problems. Some of the practices considered as useful can adversely affect health. Healthcare providers should evaluate the use of non-medical practices and should inform if the application is known adverse effects on health.

Keywords: fertility, couples, non-medical practice, perceived benefit

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11618 Walls against Legal Identity: A Qualitative Study on Children of Refugees without Birth Registration in Malaysia

Authors: Rodziana M. Razali, Tamara J. Duraisingham

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Malaysia is not a signatory to the 1951 Refugee Convention and its 1967 Protocol despite receiving the largest share of refugee inflows in Southeast Asia aside from Thailand. In Peninsular Malaysia, the majority of refugees and asylum seekers are from Myanmar, with Rohingya refugees recording the highest number compared to all other ethnicities. In the eastern state of Sabah, the presence of refugees who have long established themselves in the state is connected to those who escaped military persecution in southern Philippines in the 1970’s and 1980’s. A combination of legal and non-legal factors has created and sustained an adverse atmosphere of deprivation of legal identity for children of migrants including refugees born in Malaysia. This paper aims to qualitatively analyse the barriers to birth registration as the cornerstone of every person’s legal identity for children of refugees born in this country, together with the associated human rights implications. Data obtained through semi-structured interviews with refugees in Kota Kinabalu, Sabah and Rohingya refugees in Peninsular Malaysia shall be studied alongside secondary sources. Results show that births out of medical facilities, suspension of birth records, illiteracy, lack of awareness on the importance and procedures of birth registration, inability to meet documentary requirements, as well as fear of immigration enforcement, are the key factors hindering birth registration. These challenges exist against the backdrop of restrictive integration policy to avoid destabilising demographic and racial balance, political sentiment stirring xenophobic prejudices, as well as other economic and national security considerations. With no proof of their legal identity, the affected children grow up in a legal limbo, facing multiple human rights violations across generations. This research concludes that the country’s framework and practice concerning birth registration is in need of serious reform and improvement to reflect equality and universality of access to its birth registration system. Such would contribute significantly towards meeting its commitments to the post-2015 sustainable development agenda that pledges to 'Leave no one behind', as well as its recently announced National Human Rights Action Plan.

Keywords: birth registration, children, Malaysia, refugees

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11617 Socio-Economic and Psychological Factors of Moscow Population Deviant Behavior: Sociological and Statistical Research

Authors: V. Bezverbny

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The actuality of the project deals with stable growing of deviant behavior’ statistics among Moscow citizens. During the recent years the socioeconomic health, wealth and life expectation of Moscow residents is regularly growing up, but the limits of crime and drug addiction have grown up seriously. Another serious Moscow problem has been economical stratification of population. The cost of identical residential areas differs at 2.5 times. The project is aimed at complex research and the development of methodology for main factors and reasons evaluation of deviant behavior growing in Moscow. The main project objective is finding out the links between the urban environment quality and dynamics of citizens’ deviant behavior in regional and municipal aspect using the statistical research methods and GIS modeling. The conducted research allowed: 1) to evaluate the dynamics of deviant behavior in Moscow different administrative districts; 2) to describe the reasons of crime increasing, drugs addiction, alcoholism, suicides tendencies among the city population; 3) to develop the city districts classification based on the level of the crime rate; 4) to create the statistical database containing the main indicators of Moscow population deviant behavior in 2010-2015 including information regarding crime level, alcoholism, drug addiction, suicides; 5) to present statistical indicators that characterize the dynamics of Moscow population deviant behavior in condition of expanding the city territory; 6) to analyze the main sociological theories and factors of deviant behavior for concretization the deviation types; 7) to consider the main theoretical statements of the city sociology devoted to the reasons for deviant behavior in megalopolis conditions. To explore the level of deviant behavior’ factors differentiation, the questionnaire was worked out, and sociological survey involved more than 1000 people from different districts of the city was conducted. Sociological survey allowed to study the socio-economical and psychological factors of deviant behavior. It also included the Moscow residents’ open-ended answers regarding the most actual problems in their districts and reasons of wish to leave their place. The results of sociological survey lead to the conclusion that the main factors of deviant behavior in Moscow are high level of social inequality, large number of illegal migrants and bums, nearness of large transport hubs and stations on the territory, ineffective work of police, alcohol availability and drug accessibility, low level of psychological comfort for Moscow citizens, large number of building projects.

Keywords: deviant behavior, megapolis, Moscow, urban environment, social stratification

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11616 Integrated Mass Rapid Transit System for Smart City Project in Western India

Authors: Debasis Sarkar, Jatan Talati

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This paper is an attempt to develop an Integrated Mass Rapid Transit System (MRTS) for a smart city project in Western India. Integrated transportation is one of the enablers of smart transportation for providing a seamless intercity as well as regional level transportation experience. The success of a smart city project at the city level for transportation is providing proper integration to different mass rapid transit modes by way of integrating information, physical, network of routes fares, etc. The methodology adopted for this study was primary data research through questionnaire survey. The respondents of the questionnaire survey have responded on the issues about their perceptions on the ways and means to improve public transport services in urban cities. The respondents were also required to identify the factors and attributes which might motivate more people to shift towards the public mode. Also, the respondents were questioned about the factors which they feel might restrain the integration of various modes of MRTS. Furthermore, this study also focuses on developing a utility equation for respondents with the help of multiple linear regression analysis and its probability to shift to public transport for certain factors listed in the questionnaire. It has been observed that for shifting to public transport, the most important factors that need to be considered were travel time saving and comfort rating. Also, an Integrated MRTS can be obtained by combining metro rail with BRTS, metro rail with monorail, monorail with BRTS and metro rail with Indian railways. Providing a common smart card to transport users for accessing all the different available modes would be a pragmatic solution towards integration of the available modes of MRTS.

Keywords: mass rapid transit systems, smart city, metro rail, bus rapid transit system, multiple linear regression, smart card, automated fare collection system

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11615 Culture of Manager of a Medium or Small Enterprises

Authors: Omar Bendjimaa, Karzabi Abdelatif

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Small and medium enterprises have witnessed several developments in recent years thanks to the policies and programs of support given by the state, and that is due to their importance in local and national development. Nevertheless, the success and development of these firms depends on a number of factors, especially the human element, for instance, the culture of the manager has its origin in the culture of the community and is of crucial influence in these firms. In fact, this culture is nothing more than a set of values, perceptions, beliefs, symbols and practices repeated, in addition to the knowledge it has received from the readings and the modern means of education. All these factors have an impact on the effectiveness of governance, its resolutions, instructions and performance of its function as a manager of a medium or small enterprise is inevitably affected by these cultural values, it is the driving force, the leader, and the observer at the same time.

Keywords: small and medium enterprises, the culture of the manager, the culture of the community, values, perceptions, beliefs, symbols, performance

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11614 Developing a Theory for Study of Transformation of Historic Cities

Authors: Sana Ahrar

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Cities are undergoing rapid transformation with the change in lifestyle and technological advancements. These transformations may be experienced or physically visible in the built form. This paper focuses on the relationship between the social, physical environment, change in lifestyle and the interrelated factors influencing the transformation of any historic city. Shahjahanabad as a city has undergone transformation under the various political powers as well as the various policy implementations after independence. These visible traces of transformation diffused throughout the city may be due to socio-economic, historic, political factors and due to the globalization process. This study shall enable evolving a theory for the study of transformation of Historic cities such as Shahjahanabad: which has been plundered, rebuilt, and which still thrives as a ‘living heritage city’. The theory developed will be the process of studying the transformation and can be used by planners, policy makers and researchers in different urban contexts.

Keywords: heritage, historic cities, Shahjahanabad, transformation

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11613 Heat Transfer Correlations for Exhaust Gas Flow

Authors: Fatih Kantas

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Exhaust systems are key contributors to ground vehicles as a heat source. Understanding heat transfer in exhaust systems is related to defining effective parameter on heat transfer in exhaust system. In this journal, over 20 Nusselt numbers are investigated. This study shows advantages and disadvantages of various Nusselt numbers in different range Re, Pr and pulsating flow amplitude and frequency. Also (CAF) Convective Augmentation Factors are defined to correct standard Nusselt number for geometry and location of exhaust system. Finally, optimum Nusselt number and Convective Augmentation Factors are recommended according to Re, Pr and pulsating flow amplitude and frequency, geometry and location effect of exhaust system.

Keywords: exhaust gas flow, heat transfer correlation, Nusselt, Prandtl, pulsating flow

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