Search results for: national health insurance research database

Authors: Jonas A. R. H. Lima, Maria Antonia Carravilla

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As productivity concepts are widely related to industrial savings, it is becoming particularly important in a more and more competitive world, to really understand how productivity can be well used in industrial management techniques. Nowadays, consumers are no more willing to pay for mistakes and inefficiencies. Therefore, one way for companies to stay competitive is to control and increase their productivity. This study aims to define clearly the productivity concept, understand how a company can affect productivity, and, if possible, identify the relation between each identified productivity factor. This will help managers, by clarifying the main issues behind productivity concepts and proposing a methodology to measure, control and increase productivity. The main questions to be answered are: what is the importance of productivity for the Portuguese Wood Furniture Industry? Is it possible to control productivity internally, or is it a phenomenon external to companies, hard or even impossible to control? How to understand, control and adjust productivity performance? How to make productivity to become one main asset for maximizing the use of the available resources? This essay will follow a constructive approach mostly based in the research hypothesis mentioned above. For that, a literature review is being done to find the main conceptual frameworks and empirical studies that already exist, and by doing so, highlight eventual knowledge or conflicting research to be addressed in this work. We expect to build theoretical explanations and test theoretical predictions from participants understandings and own experiences, by elaborating field surveys and interviews, to select adjusted productivity indicators and analyze the productivity evolution according the adjustments on other variables. Its intended the conduction of an exploratory work that can simultaneous clarify productivity concepts, objectives, and define frameworks. This investigation intends to migrate from merely academic concepts to a daily basis operational reality of the companies from the Portuguese Wood Furniture Industry highlighting productivity increased importance within modern engineering and industrial management. The ambition is to clarify, systemize and develop a management tool that may not only control but positively influence the way resources are used.

Keywords: industrial management, motivation, productivity, performance indicators, reward management, wood furniture industry

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Authors: Monika Simkute-Bukante

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Teachers significantly influence student achievements, personal development, and academic success. Consequently, they are subject to heightened expectations and scrutiny from governments, school administrations, parents, and even students. Increasing responsibilities and pressures impact teachers’ professional well-being, contributing to a global trend of increased teacher turnover and shortages due to stress and heavy workloads. Given the critical role of teachers in educating young people, it is essential to implement strategies to retain them. School administrations are pivotal in creating an environment conducive to optimal performance. However, there remains a gap in understanding how school administration leadership impacts teachers' professional well-being and its potential for improvement. This research aims to define teacher professional well-being, identify its attributes, and explore the factors influencing it, with a particular focus on the role of school administration. Employing the concept analysis method, this study reviews scholarly publications from 2019 to 2024 to articulate the components of teacher professional well-being. The findings highlight key attributes of teacher well-being, including self-efficacy, work engagement, job satisfaction, relationships with colleagues and students, support from administration, work autonomy, school climate, time pressure, workload, resilience, stress, burnout, and turnover intentions. The analysis demonstrates that school administration leadership directly affects these aspects by providing support in challenging situations, empowering teachers, offering recognition, facilitating open communication, and ensuring autonomy at work. In conclusion, the research shows that teachers' professional well-being is heavily dependent on relationships with school administration, colleagues, and students, as well as the overall school climate. It suggests that by enhancing these elements, school leaders can significantly improve teacher professional well-being. Recommendations are made for developing strategies to support these relationships, thereby fostering an environment that enhances teacher retention and effectiveness.

Keywords: concept analysis, teacher professional well-being, school administration leadership, well-being factors

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Authors: Ruswanto Ruswanto, Richa Mardianingrum, Tita Nofianti, Nur Rahayuningsih

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Tuberculosis (TB) is a chronic disease as a result of Mycobacterium tuberculosis. It can affect all age groups, and hence, is a global health problem that causes the death of millions of people every year. One of the drugs used in tuberculosis treatment is isonicotinohydrazide. In this study, N'-benzoylisonicotinohydrazide derivative compounds (a-l) were prepared using acylation reactions between isonicotinohydrazide and benzoyl chloride derivatives, through the reflux method. Molecular docking studies suggested that all of the compounds had better interaction with Mycobacterium tuberculosis enoyl-acyl carrier protein reductase (InhA) than isonicotinohydrazide. It can be concluded that N'-benzoylisonicotinohydrazide derivatives (a-l) could be used as anti-tuberculosis candidates. From the docking results revealed that all of the compounds interact well with InhA, with compound g (N'-(3-nitrobenzoyl)isonicotinohydrazide) exhibiting the best interaction.

Keywords: anti-tuberculosis , docking, InhA, N'-benzoylisonicotinohydrazide, synthesis

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Authors: Chinelo Igwenagu

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Teenage childbearing in developing countries has been a thing of great concern as it has often led to a number of socioeconomic problems both to the society and to the families affected. The outcome of teenage pregnancy has been generally associated with higher rates of maternal morbidity and mortality, greater risks for delivery complications, low-birth weight infants and child mortality. As a result of teenagers’ physiological and social immaturity and their lack of adequate prenatal care, health risks associated with their pregnancies and childbearing are more pronounced than those of older women. Therefore this study has examined the relationship between the age of teenagers and the outcome of teenage pregnancy. Based on this study, the result of the analysis shows that both teenagers and older mothers suffer similarly during child bearing. Hence improve medical care is paramount in all the situations.

Keywords: childbearing, mortality, Nigeria, pregnancy, prematurity, teenagers

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Authors: Elahe Kamari

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Research on translation process has been conducted for more than 20 years, investigating various issues and using different research methodologies. Most recently, researchers have started to use eye tracking to study translation processes. They believed that the observable, measurable data that can be gained from eye tracking are indicators of unobservable cognitive processes happening in the translators’ mind during translation tasks. The aim of this study was to investigate directionality in translation processes through using eye tracking. The following hypotheses were tested: 1) processing the target text requires more cognitive effort than processing the source text, in both directions of translation; 2) L2 translation tasks on the whole require more cognitive effort than L1 tasks; 3) cognitive resources allocated to the processing of the source text is higher in L1 translation than in L2 translation; 4) cognitive resources allocated to the processing of the target text is higher in L2 translation than in L1 translation; and 5) in both directions non-professional translators invest more cognitive effort in translation tasks than do professional translators. The performance of a group of 30 male professional translators was compared with that of a group of 30 male non-professional translators. All the participants translated two comparable texts one into their L1 (Persian) and the other into their L2 (English). The eye tracker measured gaze time, average fixation duration, total task length and pupil dilation. These variables are assumed to measure the cognitive effort allocated to the translation task. The data derived from eye tracking only confirmed the first hypothesis. This hypothesis was confirmed by all the relevant indicators: gaze time, average fixation duration and pupil dilation. The second hypothesis that L2 translation tasks requires allocation of more cognitive resources than L1 translation tasks has not been confirmed by all four indicators. The third hypothesis that source text processing requires more cognitive resources in L1 translation than in L2 translation and the fourth hypothesis that target text processing requires more cognitive effort in L2 translation than L1 translation were not confirmed. It seems that source text processing in L2 translation can be just as demanding as in L1 translation. The final hypothesis that non-professional translators allocate more cognitive resources for the same translation tasks than do the professionals was partially confirmed. One of the indicators, average fixation duration, indicated higher cognitive effort-related values for professionals.

Keywords: translation processes, eye tracking, cognitive resources, directionality

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Authors: Edvard P. G. Bruun

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One of the best ways of improving our understanding of reinforced concrete is through large-scale experimental testing. The gathered information is critical in making inferences about structural mechanics and deriving the mathematical models that are the basis for finite element analysis programs and design codes. An effective way of measuring the strains across a region of a specimen is by using a system of surface mounted Linear Variable Differential Transformers (LVDTs). While a single LVDT can only measure the linear strain in one direction, by combining several measurements at known angles a Mohr’s circle of strain can be derived for the whole region under investigation. This paper presents a method that can be used by researchers, which improves the accuracy and removes experimental bias in the calculation of the Mohr’s circle, using four rather than three independent strain measurements. Obtaining high quality strain data is essential, since knowing the angular deviation (shear strain) and the angle of principal strain in the region are important properties in characterizing the governing structural mechanics. For example, the Modified Compression Field Theory (MCFT) developed at the University of Toronto, is a rotating crack model that requires knowing the direction of the principal stress and strain, and then calculates the average secant stiffness in this direction. But since LVDTs can only measure average strains across a plane (i.e., between discrete points), localized cracking and spalling that typically occur in reinforced concrete, can lead to unrealistic results. To build in redundancy and improve the quality of the data gathered, the typical experimental setup for a large-scale shell specimen has four independent directions (X, Y, H, and V) that are instrumented. The question now becomes, which three should be used? The most common approach is to simply discard one of the measurements. The problem is that this can produce drastically different answers, depending on the three strain values that are chosen. To overcome this experimental bias, and to avoid simply discarding valuable data, a more rigorous approach would be to somehow make use of all four measurements. This paper presents the derivation of a method to draw what is effectively a Mohr’s circle of 'best-fit', which optimizes the circle by using all four independent strain values. The four-strain optimized Mohr’s circle approach has been utilized to process data from recent large-scale shell tests at the University of Toronto (Ruggiero, Proestos, and Bruun), where analysis of the test data has shown that the traditional three-strain method can lead to widely different results. This paper presents the derivation of the method and shows its application in the context of two reinforced concrete shells tested in pure torsion. In general, the constitutive models and relationships that characterize reinforced concrete are only as good as the experimental data that is gathered – ensuring that a rigorous and unbiased approach exists for calculating the Mohr’s circle of strain during an experiment, is of utmost importance to the structural research community.

Keywords: reinforced concrete, shell tests, Mohr’s circle, experimental research

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Authors: Ziaullah, Shah Wahab Ali

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Micro-grid equipped with heterogeneous energy resources present the idea of small scale distributed energy management (DEM). DEM helps in minimizing the transmission and operation costs, power management and peak load demands. Micro-grids are collections of small, independent controllable power-generating units and renewable energy resources. Micro-grids also motivate to enable active customer participation by giving accessibility of real-time information and control to the customer. The capability of fast restoration against faulty situation, integration of renewable energy resources and Information and Communication Technologies (ICT) make micro-grid as an ideal system for distributed power systems. Micro-grids can have a bank of energy storage devices. The energy management system of micro-grid can perform real-time energy forecasting of renewable resources, energy storage elements and controllable loads in making proper short-term scheduling to minimize total operating costs. We present a review of existing micro-grids optimization objectives/goals, constraints, solution approaches and tools used in micro-grids for energy management. Cost-benefit analysis of micro-grid reveals that cooperation among different micro-grids can play a vital role in the reduction of import energy cost and system stability. Cooperative micro-grids energy trading is an approach to electrical distribution energy resources that allows local energy demands more control over the optimization of power resources and uses. Cooperation among different micro-grids brings the interconnectivity and power trading issues. According to the literature, it shows that open area of research is available for cooperative micro-grids energy trading. In this paper, we proposed and formulated the efficient energy management/trading module for interconnected micro-grids. It is believed that this research will open new directions in future for energy trading in cooperative micro-grids/interconnected micro-grids.

Keywords: distributed energy management, information and communication technologies, microgrid, energy management

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Authors: Subham Ghosh, Arnab Nandi

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Background: The proliferation of Wireless Body Area Networks (WBAN) and Internet of Things (IoT) applications demonstrates the potential for continuous monitoring of physical changes in the body. These technologies are vital for health monitoring tasks, such as identifying coughing and breathing activities, which are necessary for disease diagnosis and management. Monitoring activities such as coughing and deep breathing can provide valuable insights into a variety of medical issues. Wearable radio-based antenna sensors, which are lightweight and easy to incorporate into clothing or portable goods, provide continuous monitoring. This mobility gives it a substantial advantage over stationary environmental sensors like as cameras and radar, which are constrained to certain places. Furthermore, using compressive techniques provides benefits such as reduced data transmission speeds and memory needs. These wearable sensors offer more advanced and diverse health monitoring capabilities. Methodology: This study analyzes the feasibility of using a semi-flexible antenna operating at 2.4 GHz (ISM band) and positioned around the neck and near the mouth to identify three activities: coughing, deep breathing, and idleness. Vector network analyzer (VNA) is used to collect time-varying complex reflection coefficient data from perturbed antenna nearfield. The reflection coefficient (S11) conveys nuanced information caused by simultaneous variations in the nearfield radiation of three activities across time. The signatures are sparsely represented with gaussian windowed Gabor spectrograms. The Gabor spectrogram is used as a sparse representation approach, which reassigns the ridges of the spectrogram images to improve their resolution and focus on essential components. The antenna is biocompatible in terms of specific absorption rate (SAR). The sparsely represented Gabor spectrogram pictures are fed into a lightweight deep learning (DL) model for feature extraction and classification. Two antenna locations are investigated in order to determine the most effective localization for three different activities. Findings: Cross-validation techniques were used on data from both locations. Due to the complex form of the recorded S11, separate analyzes and assessments were performed on the magnitude, phase, and their combination. The combination of magnitude and phase fared better than the separate analyses. Various sliding window sizes, ranging from 1 to 5 seconds, were tested to find the best window for activity classification. It was discovered that a neck-mounted design was effective at detecting the three unique behaviors.

Keywords: activity recognition, antenna, deep-learning, time-frequency

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Authors: Chutikarn Sriviboon, Witthaya Mekhum

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The purposes of this research were to analyze and evaluate successful factors in OTOP production process for the developing of learning center on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality. The research has been designed as a qualitative study to gather information from 30 OTOP producers in Bangkontee District, Samudsongkram Province. They were all interviewed on 3 main parts. Part 1 was about the production process including 1) production 2) product development 3) the community strength 4) marketing possibility and 5) product quality. Part 2 evaluated appropriate successful factors including 1) the analysis of the successful factors 2) evaluate the strategy based on Sufficiency Economic Philosophy and 3) the model of learning center on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality. The results showed that the production did not affect the environment with potential in continuing standard quality production. They used the raw materials in the country. On the aspect of product and community strength in the past 1 year, it was found that there was no appropriate packaging showing product identity according to global market standard. They needed the training on packaging especially for food and drink products. On the aspect of product quality and product specification, it was found that the products were certified by the local OTOP standard. There should be a responsible organization to help the uncertified producers pass the standard. However, there was a problem on food contamination which was hazardous to the consumers. The producers should cooperate with the government sector or educational institutes involving with food processing to reach FDA standard. The results from small group discussion showed that the community expected high education and better standard living. Some problems reported by the community included informal debt and drugs in the community. There were 8 steps in developing the model of learning center on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality.

Keywords: production process, OTOP, sufficiency economic philosophy, learning center

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Authors: Hannah M. Russell

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‘The Attach Project’ (TAP), is an educational intervention aimed at improving educational and socio-emotional outcomes for children who are looked after. TAP is underpinned by Attachment Theory and is adapted from Dyadic Developmental Psychotherapy (DDP), which is a treatment for children and young people impacted by complex trauma and disorders of attachment. TAP has been implemented in primary schools in Northern Ireland throughout the 2018/19 academic year. During this time, a design and implementation study has been conducted to assess the promise of effectiveness for the future dissemination and ‘scaling-up’ of the programme for a larger, randomised control trial. TAP has been designed specifically for implementation in a school setting and is comprised of a whole school element and a more individualised Key Adult-Key Child pairing. This design and implementation study utilises a mixed-methods research design consisting of quantitative, qualitative, and observational measures with stakeholder input and involvement being considered an integral component. The use of quantitative measures, such as self-report questionnaires prior to and eight months following the implementation of TAP, enabled the analysis of the strengths and direction of relations between the various components of the programme, as well as the influence of implementation factors. The use of qualitative measures, incorporating semi-structured interviews and focus groups, enabled the assessment of implementation factors, identification of implementation barriers, and potential methods of addressing these issues. Observational measures facilitated the continual development and improvement of ‘TAP training’ for school staff. Preliminary findings have provided evidence of promise for the effectiveness of TAP and indicate the potential benefits of introducing this type of attachment-based intervention across other educational settings. This type of intervention could benefit not only children who are looked after but all children who may be impacted by complex trauma or disorders of attachment. Furthermore, findings from this study demonstrate that it is possible for children to form a secondary attachment relationship with a significant adult in school. However, various implementation factors which should be addressed were identified throughout the study, such as the necessity of protected time being introduced to facilitate the development of a positive Key Adult- Key Child relationship. Furthermore, additional ‘re-cap’ training is required in future dissemination of the programme, to maximise ‘attachment friendly practice’ in the whole staff team. Qualitative findings have also indicated that there is a general opinion across school staff that this type of Key Adult- Key Child pairing could be more effective if it was introduced as soon as children begin primary school. This research has provided ample evidence for the need to introduce relationally based interventions in schools, to help to ensure that children who are looked after, or who are impacted by complex trauma or disorders of attachment, can thrive in the school environment. In addition, this research has facilitated the identification of important implementation factors and barriers to implementation, which can be addressed prior to the ‘scaling-up’ of TAP for a robust, randomised controlled trial.

Keywords: attachment, complex trauma, educational interventions, implementation

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Authors: Marc Romero-Estonllo, Judith Ramos-Castro, Yaiza San Miguel, Beatriz Rodríguez-Garrido, Carmela Monterroso

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Mining activity is among the main sources of trace and heavy metal(loid) pollution worldwide, which is a hazard to human and environmental health. That is why several projects have been emerging for the remediation of such polluted places. Phytomanagement strategies draw good performances besides big side benefits. In this work, a glasshouse assay with trace element polluted soils from an old Cu mine ore (NW of Spain) which forms part of the PhytoSUDOE network of phytomanaged contaminated field sites (PhytoSUDOE Project (SOE1/P5/E0189)) was set. The objective was to evaluate improvements induced by the following phytoremediation-related treatments. Three increasingly complex amendments alone or together with plant growth (Populus nigra L. alone and together with Tripholium repens L.) were tested. And three different rhizosphere bioinocula were applied (Plant Growth Promoting Bacteria (PGP), mycorrhiza (MYC), or mixed (PGP+MYC)). After 110 days of growth, plants were collected, biomass was weighed, and tree length was measured. Physical-chemical analyses were carried out to determine pH, effective Cation Exchange Capacity, carbon and nitrogen contents, bioavailable phosphorous (Olsen bicarbonate method), pseudo total element content (microwave acid digested fraction), EDTA extractable metals (complexed fraction), and NH4NO3 extractable metals (easily bioavailable fraction). On plant material, nitrogen content and acid digestion elements were determined. Amendment usage, plant growth, and bioinoculation were demonstrated to improve soil fertility and/or plant health within the time span of this study. Particularly, pH levels increased from 3 (highly acidic) to 5 (acidic) in the worst-case scenario, even reaching 7 (neutrality) in the best plots. Organic matter and pH increments were related to polluting metals’ bioavailability decrements. Plants grew better both with the most complex amendment and the middle one, with few differences due to bioinoculation. Using the less complex amendment (just compost) beneficial effects of bioinoculants were more observable, although plants didn’t thrive very well. On unamended soils, plants neither sprouted nor bloomed. The scheme assayed in this study is suitable for phytomanagement of these kinds of soils affected by mining activity. These findings should be tested now on a larger scale.

Keywords: aided phytoremediation, mine pollution, phytostabilization, soil pollution, trace elements

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Authors: Andréanne Gagné, Jo Anni Joncas, Éric Tendon

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Teaching in vocational training requires an excellent mastery of the trade being taught, but also solid professional skills in pedagogy. Teachers are typically recruited on the basis of their trade expertise, and they do not necessarily have training or experience in pedagogy. In order to counter this lack, the Ministry of Education (Québec, Canada) requires them to complete a 120-credit university program to obtain their teaching certificate. They must complete this training in addition to their teaching duties. This training was rarely planned in the teacher’s life course, and each teacher approaches it differently: some are enthusiastic, but many feel reluctant discouragement and even frustration at the idea of committing to a training program lasting an average of 10 years to completion. However, Quebec is experiencing an unprecedented shortage of teachers, and the perseverance of vocational teachers in their careers requires special attention because of the conditions of their specific integration conditions. Our research examines the perceptions that vocational teachers in training have of their academic experience in pre-service teaching. It differs from previous research in that it focuses on the influence of the academic experience on the teaching employment experience. The goal is that by better understanding the university experience of teachers in vocational education, we can identify support strategies to support their school experience and their teaching. To do this, the research is based on the theoretical framework of the sociology of experience, which allows us to study the way in which these “teachers-students” give meaning to their university program in articulation with their jobs according to three logics of action. The logic of integration is based on the process of socialization, where the action is preceded by the internalization of values, norms, and cultural models associated with the training context. The logic of strategy refers to the usefulness of this experience where the individual constructs a form of rationality according to his objectives, resources, social position, and situational constraints. The logic of subjectivation refers to reflexivity activities aimed at solving problems and making choices. These logics served as a framework for the development of an online questionnaire. Three hundred respondents, newly enrolled in an undergraduate teaching program (bachelor's degree in vocational education), expressed themselves about their academic experience. This paper relates qualitative data (open-ended questions) subjected to an interpretive repertory analysis approach to descriptive data (closed-ended questions) that emerged. The results shed light on how the respondents perceive themselves as teachers and students, their perceptions of university training and the support offered, and the place that training occupies in their professional path. Indeed, their professional and academic paths are inextricably linked, and it seems essential to take them into account simultaneously to better meet their needs and foster the development of their expertise in pedagogy. The discussion focuses on the strengths and limitations of university training from the perspective of the logic of action. The results also suggest support strategies that can be implemented to better support the integration and retention of student teachers in professional education.

Keywords: teacher, vocational training, pre-service training, academic experience

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Authors: Shahrzad Zolfagharnassab, Abdul Rashid Mohamed Shariff, Reza Ehsani, Hawa Ze Jaffar, Ishak Aris

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Ripeness estimation of oil palm fresh fruit is important processes that affect the profitableness and salability of oil palm fruits. The adulthood or ripeness of the oil palm fruits influences the quality of oil palm. Conventional procedure includes physical grading of Fresh Fruit Bunches (FFB) maturity by calculating the number of loose fruits per bunch. This physical classification of oil palm FFB is costly, time consuming and the results may have human error. Hence, many researchers try to develop the methods for ascertaining the maturity of oil palm fruits and thereby, deviously the oil content of distinct palm fruits without the need for exhausting oil extraction and analysis. This research investigates the potential of infrared images (Thermal Images) as a predictor to classify the oil palm FFB ripeness. A total of 270 oil palm fresh fruit bunches from most common cultivar of oil palm bunches Nigresens according to three maturity categories: under ripe, ripe and over ripe were collected. Each sample was scanned by the thermal imaging cameras FLIR E60 and FLIR T440. The average temperature of each bunches were calculated by using image processing in FLIR Tools and FLIR ThermaCAM researcher pro 2.10 environment software. The results show that temperature content decreased from immature to over mature oil palm FFBs. An overall analysis-of-variance (ANOVA) test was proved that this predictor gave significant difference between underripe, ripe and overripe maturity categories. This shows that the temperature as predictors can be good indicators to classify oil palm FFB. Classification analysis was performed by using the temperature of the FFB as predictors through Linear Discriminant Analysis (LDA), Mahalanobis Discriminant Analysis (MDA), Artificial Neural Network (ANN) and K- Nearest Neighbor (KNN) methods. The highest overall classification accuracy was 88.2% by using Artificial Neural Network. This research proves that thermal imaging and neural network method can be used as predictors of oil palm maturity classification.

Keywords: artificial neural network, maturity classification, oil palm FFB, thermal imaging

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Authors: Fei Wan Ngai

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Background: Family and marital functioning has become an important public health issue because it is vital to child development and well-being. Objective: This study was designed to examine the changes in family and marital functioning among Chinese women during the transition to motherhood. Methods: A longitudinal design was used. A convenience sample of 202 Chinese childbearing women completed the Medical Outcomes Study Family and Marital Functioning Measures during pregnancy, at 6 weeks and at 6 months postpartum. Results: The results showed that women experienced substantial decline in their family and marital functioning from pregnancy to 6 weeks and 6 months postpartum. Conclusions: The findings of this study highlight the need for more attention to family and marital functioning among women after childbirth. Culturally relevant interventions should be developed to assist women in facing the challenges of new motherhood and achieving a better family and marital functioning.

Keywords: family and marital functioning, perinatal period, women

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Authors: Asif Iqbal

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Working capital management has its effect on liquidity as well as on profitability of a firm. In this research we have selected a sample of 100 respondents whose firms are listed on Karachi stock exchange. We have studied the effect of different variable s of working capital management. We find that organizations throughout the world as well as in Pakistan have to give immense recognition to the working capital management as it is an effective thing from their long term perspective especially to their shareholders to have a firm confidence over the companies for investment purpose.

Keywords: working capital management, Karachi stock exchange, shareholders, capital management

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Authors: B. Lefranc, C. Aufauvre-Poupon, C. Martin-Krumm, M. Trousselard

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Isolated and confined environments (ICE) present several challenges which may adversely affect human’s psychology and physiology. Submariners in Sub-Surface Ballistic Nuclear (SSBN) mission exposed to these environmental constraints must be able to perform complex tasks as part of their normal duties, as well as during crisis periods when emergency actions are required or imminent. The operational and environmental constraints they face contribute to challenge human adaptability. The impact of such a constrained environment has yet to be explored. Establishing a knowledge framework is a determining factor, particularly in view of the next long space travels. Ensuring that the crews are maintained in optimal operational conditions is a real challenge because the success of the mission depends on them. This study focused on the evaluation of the impact of stress on mental health and sensory degradation of submariners during a mission on SSBN using cardiac biosignal (heart rate variability, HRV) clustering. This is a pragmatic exploratory study of a prospective cohort included 19 submariner volunteers. HRV was recorded at baseline to classify by clustering the submariners according to their stress level based on parasympathetic (Pa) activity. Impacts of high Pa (HPa) versus low Pa (LPa) level at baseline were assessed on emotional state and sensory perception (interoception and exteroception) as a cardiac biosignal during the patrol and at a recovery time one month after. Whatever the time, no significant difference was found in mental health between groups. There are significant differences in the interoceptive, exteroceptive and physiological functioning during the patrol and at recovery time. To sum up, compared to the LPa group, the HPa maintains a higher level in psychosensory functioning during the patrol and at recovery but exhibits a decrease in Pa level. The HPa group has less adaptable HRV characteristics, less unpredictability and flexibility of cardiac biosignals while the LPa group increases them during the patrol and at recovery time. This dissociation between psychosensory and physiological adaptation suggests two treatment modalities for ICE environments. To our best knowledge, our results are the first to highlight the impact of physiological differences in the HRV profile on the adaptability of submariners. Further studies are needed to evaluate the negative emotional and cognitive effects of ICEs based on the cardiac profile. Artificial intelligence offers a promising future for maintaining high level of operational conditions. These future perspectives will not only allow submariners to be better prepared, but also to design feasible countermeasures that will help support analog environments that bring us closer to a trip to Mars.

Keywords: adaptation, exteroception, HRV, ICE, interoception, SSBN

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Authors: Ting-I Lin

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Purpose: This article explores the care experience of a 34-year-old female breast cancer patient who was admitted to the intensive care unit after undergoing a modified radical mastectomy. The patient discovered a lump in her right breast during a self-examination and, after mammography and ultrasound-guided biopsy, was diagnosed with a malignant tumor in the right breast. The tumor measured 1.5 x 1.4 x 2 cm, and the patient underwent a modified radical mastectomy. Postoperatively, she exhibited feelings of inferiority due to changes in her appearance. Method: During the care period, we engaged in conversations, observations, and active listening, using Gordon's Eleven Functional Health Patterns for a comprehensive assessment. In collaboration with the critical care team, a psychologist, and an oncology case manager, we conducted an interdisciplinary discussion and reached a consensus on key nursing issues. These included pain related to postoperative tumor excision and disturbed body image due to changes in appearance after surgery. Result: During the care period, a private space was provided to encourage the patient to express her feelings about her altered body image. Communication was conducted through active listening and a non-judgmental approach. The patient's anxiety level, as measured by the depression and anxiety scale, decreased from moderate to mild, and she was able to sleep for 6-8 hours at night. The oncology case manager was invited to provide education on breast reconstruction using breast models and videos to both the patient and her husband. This helped rebuild the patient's confidence. With the patient's consent, a support group was arranged where a peer with a similar experience shared her journey, offering emotional support and encouragement. This helped alleviate the psychological stress and shock caused by the cancer diagnosis. Additionally, pain management was achieved through adjusting the dosage of analgesics, administering Ultracet 37.5 mg/325 mg 1# Q6H PO, along with distraction techniques and acupressure therapy. These interventions helped the patient relax and alleviate discomfort, maintaining her pain score at a manageable level of 3, indicating mild pain. Conclusion: Disturbance in body image can cause significant psychological stress for patients. Through support group discussions, encouraging patients to express their feelings, and providing appropriate education on breast reconstruction and dressing techniques, the patient's self-concept was positively reinforced, and her emotions were stabilized. This led to renewed self-worth and confidence.

Keywords: breast cancer, modified radical mastectomy, acupressure therapy, Gordon's 11 functional health patterns

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Authors: Sardorbek Numonov, Hyohun Kim, Dongwha Shin, Yeonseok Kim, Ji-Su Ahn, Dongeun Choi, Byung-Woo Hong

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The detection of curvilinear structures often plays an important role in the analysis of images. In particular, it is considered as a crucial step for the diagnosis of chronic respiratory diseases to localize the fissures in chest CT imagery where the lung is divided into five lobes by the fissures that are characterized by linear features in appearance. However, the characteristic linear features for the fissures are often shown to be subtle due to the high intensity variability, pathological deformation or image noise involved in the imaging procedure, which leads to the uncertainty in the quantification of anatomical or functional properties of the lung. Thus, it is desired to enhance the linear features present in the chest CT images so that the distinctiveness in the delineation of the lobe is improved. We propose a recursive diffusion process that prefers coherent features based on the analysis of structure tensor in an anisotropic manner. The local image features associated with certain scales and directions can be characterized by the eigenanalysis of the structure tensor that is often regularized via isotropic diffusion filters. However, the isotropic diffusion filters involved in the computation of the structure tensor generally blur geometrically significant structure of the features leading to the degradation of the characteristic power in the feature space. Thus, it is required to take into consideration of local structure of the feature in scale and direction when computing the structure tensor. We apply an anisotropic diffusion in consideration of scale and direction of the features in the computation of the structure tensor that subsequently provides the geometrical structure of the features by its eigenanalysis that determines the shape of the anisotropic diffusion kernel. The recursive application of the anisotropic diffusion with the kernel the shape of which is derived from the structure tensor leading to the anisotropic scale-space where the geometrical features are preserved via the eigenanalysis of the structure tensor computed from the diffused image. The recursive interaction between the anisotropic diffusion based on the geometry-driven kernels and the computation of the structure tensor that determines the shape of the diffusion kernels yields a scale-space where geometrical properties of the image structure are effectively characterized. We apply our recursive anisotropic diffusion algorithm to the detection of curvilinear structure in the chest CT imagery where the fissures present curvilinear features and define the boundary of lobes. It is shown that our algorithm yields precise detection of the fissures while overcoming the subtlety in defining the characteristic linear features. The quantitative evaluation demonstrates the robustness and effectiveness of the proposed algorithm for the detection of fissures in the chest CT in terms of the false positive and the true positive measures. The receiver operating characteristic curves indicate the potential of our algorithm as a segmentation tool in the clinical environment. This work was supported by the MISP(Ministry of Science and ICT), Korea, under the National Program for Excellence in SW (20170001000011001) supervised by the IITP(Institute for Information and Communications Technology Promotion).

Keywords: anisotropic diffusion, chest CT imagery, chronic respiratory disease, curvilinear structure, fissure detection, structure tensor

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Authors: Roberta Gentry

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The presentation will begin with a brief literature review of the use of computer simulation in teacher education programs. This information will be summarized. Additionally, based on the literature review, advantages and disadvantages of using computer simulation in higher education will be shared. Finally, a study in which computer simulations software was used with 50 initial licensure teacher candidates in both an introductory course and a behavior management course will be shared. Candidates reflected on their experiences with using computer simulation. The instructor of the course will also share lessons learned.

Keywords: simulations, teacher education, teacher preparation, educational research

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Authors: Geuna Kim, Sanghyun Kim

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This study investigates various factors that may influence the ISM process, including the organization’s internal needs and external pressure, and examines the role of regulatory pressure in ISM development and performance. The 105 sets of data collected in a survey were tested against the research model using SEM. The results indicate that NP and TP had positive effects on the ISM process, except for perceived benefits. Regulatory pressure had a positive effect on the relationship between ISM awareness and ISM development and performance.

Keywords: information security management, need pull, technology push, regulatory pressure

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Authors: Robert Ogbanje Okwori

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The research studied expository and simulation method of teaching woodwork at Federal University of Technology, Minna, Niger State, Nigeria. The purpose of the study was to compare expository and simulation method of teaching woodwork and determine the method that is more effective in improving performance of students in woodwork. Two research questions and two hypotheses were formulated to guide the study. Fifteen objective questions and two theory questions were used for data collection. The questions set were on structure of timber. The study used the quasi experimental design. The population of the study consisted of 25 woodwork students of Federal University of Technology, Minna, Niger State, Nigeria and three hundred (300) level students were used for the study. The lesson plans for expository method and questions were validated by three lecturers in the Department of Industrial and Technology Education, Federal University of Technology, Minna, Nigeria. The validators checked the appropriates of test items and all the corrections and inputs were effected before administration of the instrument. Data obtained were analyzed using mean, standard deviation and t-test statistical tool. The null hypotheses were formulated and tested using t-test statistics at 0.05 level of significance. The findings of the study showed that simulation method of teaching has improved students’ performance in woodwork and the performance of the students was not influenced by gender. Based on the findings of the study, it was concluded that there was a significant difference in the mean achievement scores of students taught woodwork using simulation method. This implies that simulation method is more effective than expository method of teaching woodwork. Therefore, woodwork teachers should adopt simulation method of teaching woodwork towards better performance. It was recommended that simulation method should be used by woodwork lecturers to teach woodwork since students perform better using the method and also the teachers needs to be trained and re-trained in using simulation method for teaching woodwork. Teachers should be encouraged to use simulation method for their instructional delivery because it will allow them to identify their areas of strength and weakness when imparting knowledge to woodwork students. Government and different agencies should assist in procuring materials and equipment for wood workshops to enable students effectively practice what they have been taught using simulation method.

Keywords: comparative, expository, simulation, woodwork

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Authors: Brian Tung, Yam Wing Siu, Tsun Se Cheong

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Purpose: This research aims to explore how personal and environmental factors, especially the socio-economic changes and behavioral changes fostered by the COVID-19 outbreak pandemic, affect the financial vulnerability of a specific segment of people in financial distress. Innovative research methodology of machine learning will be applied to data collected from over 300 local individuals in Hong Kong seeking counseling or similar services in recent years. Results: First, machine learning has found that too much exposure to digital services and information on digitized services may lead to adverse effects on respondents’ financial vulnerability. Second, the improvement in financial literacy level provides benefits to the financially vulnerable group, especially those respondents who have started with a lower level. Third, serious addiction to digital technology can lead to worsened debt servicing ability. Machine learning also has found a strong correlation between debt servicing situations and income-seeking behavior as well as spending behavior. In addition, if the vulnerable groups are able to make appropriate investments, they can reduce the probability of incurring financial distress. Finally, being too active in borrowing and repayment can result in a higher likelihood of over-indebtedness. Conclusion: Findings can be employed in formulating a better counseling strategy for professionals. Debt counseling services can be more preventive in nature. For example, according to the findings, with a low level of financial literacy, the respondents are prone to overspending and unable to react properly to the e-marketing promotion messages pop-up from digital services or even falling into financial/investment scams. In addition, people with low levels of financial knowledge will benefit from financial education. Therefore, financial education programs could include tech-savvy matters as special features.

Keywords: personal finance, digitization of the economy, COVID-19 pandemic, addiction to digital technology, financial vulnerability

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Authors: Weber-Lewerenz Bianca

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Digitization is developing fast and has become a powerful tool for digital planning, construction, and operations. Its transformation bears high potentials for companies, is critical for success, and thus, requires responsible handling. This study provides an assessment of calls made in the sustainable development goals by the United Nations (SDGs), White Papers on AI by international institutions, EU-Commission and German Government requesting for the consideration and protection of values and fundamental rights, the careful demarcation between machine (artificial) and human intelligence and the careful use of such technologies. The study discusses digitization and the impacts of artificial intelligence (AI) in construction engineering from an ethical perspective by generating data via conducting case studies and interviewing experts as part of the qualitative method. This research evaluates critically opportunities and risks revolving around corporate digital responsibility (CDR) in the construction industry. To the author's knowledge, no study has set out to investigate how CDR in construction could be conceptualized, especially in relation to the digitization and AI, to mitigate digital transformation both in large, medium-sized, and small companies. No study addressed the key research question: Where can CDR be allocated, how shall its adequate ethical framework be designed to support digital innovations in order to make full use of the potentials of digitization and AI? Now is the right timing for constructive approaches and apply ethics-by-design in order to develop and implement a safe and efficient AI. This represents the first study in construction engineering applying a holistic, interdisciplinary, inclusive approach to provide guidelines for orientation, examine benefits of AI and define ethical principles as the key driver for success, resources-cost-time efficiency, and sustainability using digital technologies and AI in construction engineering to enhance digital transformation. Innovative corporate organizations starting new business models are more likely to succeed than those dominated by conservative, traditional attitudes.

Keywords: construction engineering, digitization, digital transformation, artificial intelligence, ethics, corporate digital responsibility, digital innovation

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Authors: Abiola O. Temitayo-Oboh, Olugbenga L. Abodunrin, Wasiu O. Adebimpe, Micheal C. Asuzu

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Introduction: Many women who are sexually active would prefer to avoid becoming pregnant but are not using any method of contraception. These women are considered to have an unmet need for contraception. In an ideal situation, all women who want to space or limit their births and are exposed to the risk of conception would use some kind of conception; in practice, however, some women fail to use contraception which put them at risk of having mistimed or unwanted births, induced abortion, or maternal death. This study, therefore, aimed to assess the determinants of unmet need for contraception among currently married women in rural and urban communities of Osun State, South-West Nigeria. Methods: This was an analytical cross-sectional comparative study, which was carried out among currently married women. Three hundred and twenty respondents each were selected for the rural and urban groups from four Local Government Areas using multi-stage sampling technique. Data were collected using a pre-tested semi-structured interviewer-administered questionnaire and focus group discussion (FGD) guide; data analysis was done with Statistical Package for Social Sciences (SPSS) version 17.0 and detailed content analysis method respectively. Statistical analysis of the difference between proportions was done by the use of the Chi-square test and T-test was used to compare the means of the continuous variables. The study also utilized descriptive, bivariate and multivariate analytical techniques to examine the effect of some variables on unmet need. Level of statistical significance was set at p-value < 0.05 for all values. Results: Two hundred and ninety-six (92.5%) of the rural and 306 (95.6%) of the urban study population had heard of contraception, 365 (57.0 %) of the total respondents had good knowledge [162 (50.6 %) for rural respondents and 203 (63.4 %) for urban respondents]. This difference was statistically significant (p < 0.001). Five hundred and twenty-one (81.4%) respondents had a positive attitude towards contraception [243 (75.9%) in the rural and 278 (86.9%) in the urban area], and the difference was also statistically significant (p < 0.001). Only 47 (14.7%) and 59 (18.4%) of rural and urban women were current contraceptive users respectively. The total unmet need for contraception among rural women was 138 (43.1%) of which 82 (25.6%) was for spacing and 56 (17.5%), for limiting. While the total unmet need for contraception among urban women was 145 (45.3%) of which 96 (30.0%) was for spacing and 49 (15.3%) for limiting. Number of living children, knowledge of contraceptive methods, discussion with health workers about family planning, couples discussion about family planning and availability of family planning services were found to be predictors of women’s unmet need for contraception (p < 0.05). Conclusion: It is, therefore, recommended that there is need to intensify reproductive health education in bridging the knowledge gap, improving attitude and modifying practices regarding use of contraception in Nigeria. Hence, this will help to enhance the utilization of family planning services among Nigerian women.

Keywords: contraception, married women, Nigeria, rural, urban, unmet need

Procedia PDF Downloads 198

Authors: Annika Stechemesser, Rachel Pounds, Emma Lucas, Chris Dawson, Julia Lipecki, Pavle Vrljicak, Jan Brosens, Sean Kehoe, Jason Yap, Lawrence Young, Sascha Ott

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Advances in technology make it now possible to retrieve the genetic information of thousands of single cancerous cells. One of the key challenges in single cell analysis of cancerous tissue is to determine the number of different cell types and their characteristic genes within the sample to better understand the tumors and their reaction to different treatments. For this analysis to be possible, it is crucial to filter out background noise as it can severely blur the downstream analysis and give misleading results. In-depth analysis of the state-of-the-art filtering methods for single cell data showed that they do, in some cases, not separate noisy and normal cells sufficiently. We introduced an algorithm that filters and clusters single cell data simultaneously without relying on certain genes or thresholds chosen by eye. It detects communities in a Shared Nearest Neighbor similarity network, which captures the similarities and dissimilarities of the cells by optimizing the modularity and then identifies and removes vertices with a weak clustering belonging. This strategy is based on the fact that noisy data instances are very likely to be similar to true cell types but do not match any of these wells. Once the clustering is complete, we apply a set of evaluation metrics on the cluster level and accept or reject clusters based on the outcome. The performance of our algorithm was tested on three datasets and led to convincing results. We were able to replicate the results on a Peripheral Blood Mononuclear Cells dataset. Furthermore, we applied the algorithm to two samples of ovarian cancer from the same patient before and after chemotherapy. Comparing the standard approach to our algorithm, we found a hidden cell type in the ovarian postchemotherapy data with interesting marker genes that are potentially relevant for medical research.

Keywords: cancer research, graph theory, machine learning, single cell analysis

Procedia PDF Downloads 113

Authors: Beverly Black

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Teen dating violence (TDV) is a significant public health problem with severe negative impact on youths’ mental and physical health and well-being. Exacerbating the negative impact of TDV victimization is the fact that teens rarely report the violence. They are fearful to tell friends or family, especially parents. The family context is the first place where children learn about interpersonal relationships, and therefore, parental response of teens’ life experiences influences teens’ actions and development. This study examined youths’ perspectives on parental responses to TDV. Effective parental responses to TDV may increase the likelihood that youth will leave abusive relationships. Method. Eleven gender-separate focus groups were conducted with 27 females and 28 males, ages 12 to 17, to discuss parental responses to teen dating violence. Youth were recruited from a metropolitan community in the southwestern part of the United States. Focus groups questions asked the middle and high school youth how they would want their parents to respond to them if they approached them about various incidents of dating violence. All focus groups were transcribed. Using QSR-N10, two researchers’ analyzed data first using open and axial coding techniques to find overarching themes. Researchers triangulated the coded data to ensure accurate interpretations of the participants’ messages and used the scenario questions to structure the coded results. Results. Most youths suggested that parents should simply talk with them; they recognized the importance of communication. Teens wanted parents to ask questions, educate them about healthy relationships, share their personal experiences, and give teens advice (tell them to break up, limit contact with perpetrator, go to police). Younger youth expressed more willingness to listen to parental advice. Older youth wanted their parents to give them the opportunity to make their decisions. Many of the teens’ comments focused on the importance of parents protecting the teen, providing support and empathy for the teen, and especially refraining from overreacting (not yelling, not getting angry and staying calm). Implications. Parents need to know how to effectively respond to youth needing to leave unhealthy relationships. Demanding that their children end a relationship may not be a realistic approach to TDV. A parent’s ineffective response, when approached by an adolescent for assistance in TDV, may influence a youth to dismiss parents and other adults as viable options for seeking assistance. Parents and prevention educators can learn from hearing youths’ voices about effective responses to TDV.

Keywords: adolescents dating abuse, adolescent and parent communication, parental responses to teen dating violence, teen dating violence

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Authors: Kristina Sutiene, Lina Dapkute

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The paper investigates the current demographic trends that exert the sustainability of pension systems in most EU regions. Several drivers usually compose the demographic challenge, coming from the structure and trends of population in the country. As the case of research, three main variables of demographic risk in Lithuania have been singled out and have been used in making up the analysis. Over the last two decades, the country has presented a peculiar demographic situation characterized by pessimistic fertility trends, negative net migration rate and rising life expectancy that make the significant changes in labor-age population. This study, therefore, sets out to assess the relative impact of these risk factors both individually and in aggregate, while assuming economic trends to evolve historically. The evidence is presented using data of pension funds that operate in Lithuania and are financed by defined-contribution plans. To achieve this goal, the discrete-time pension fund’s value model is developed that reflects main operational modalities: contribution income from current participants and new entrants, pension disbursement and administrative expenses; it also fluctuates based on returns from investment activity. Age-structured Leslie population dynamics model has been integrated into the main model to describe the dynamics of fertility, migration and mortality rates upon age. Validation has concluded that Leslie model adequately fits the current population trends in Lithuania. The elasticity of pension system is examined using Loimaranta efficiency as a measure for comparison of plausible long-term developments of demographic risks. With respect to the research question, it was found that demographic risks have different levels of influence on future value of aggregated pension funds: The fertility rates have the highest importance, while mortality rates give only a minor impact. Further studies regarding the role of trying out different economic scenarios in the integrated model would be worthwhile.

Keywords: asset liability modelling, Leslie model, pension funds, population dynamics

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Authors: Hee Soo Kim, Ha Young Kyung

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This paper examines the role of positive emotions in human psychology. By understanding Fredrickson and Lyubomirsky et al.’s on positive emotions, one can better understand people’s intuitive understanding, mental health and well-being. Fredrickson asserts that positive emotions create positive affects and personal resources, and Lyubomirsky et al. relate such positive resources to the creation of happiness and personal development. This paper finds that positive emotions play a significant role in the learning process, and they are instrumental in creating a long-lasting repertoire of personal resources and play an essential role in the development of the intuitive understanding of life variables, resilience in coping with life challenges, and ability to build more successful lives.

Keywords: Positive emotions, positive affects, personal resources, negative emotions, development

Procedia PDF Downloads 309

Authors: James Kinyua Gitonga, Toshio Fujimi

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Vulnerability assessment and analysis is essential to solving the degree of damage and loss as a result of natural disasters. Urban flooding causes a major economic loss and casualties, at Mathare residential area in Nairobi, Kenya. High population caused by rural-urban migration, Unemployment, and unplanned urban development are among factors that increase flood vulnerability in Mathare area. This study aims to analyse flood risk physical vulnerabilities in Mathare based on scientific data, research data that includes the Rainfall data, River Mathare discharge rate data, Water runoff data, field survey data and questionnaire survey through sampling of the study area have been used to develop the risk curves. Three structural types of building were identified in the study area, vulnerability and risk curves were made for these three structural types by plotting the relationship between flood depth and damage for each structural type. The results indicate that the structural type with mud wall and mud floor is the most vulnerable building to flooding while the structural type with stone walls and concrete floor is least vulnerable. The vulnerability of building contents is mainly determined by the number of floors, where households with two floors are least vulnerable, and households with a one floor are most vulnerable. Therefore more than 80% of the residential buildings including the property in the building are highly vulnerable to floods consequently exposed to high risk. When estimating the potential casualties/injuries we discovered that the structural types of houses were major determinants where the mud/adobe structural type had casualties of 83.7% while the Masonry structural type had casualties of 10.71% of the people living in these houses. This research concludes that flood awareness, warnings and observing the building codes will enable reduce damage to the structural types of building, deaths and reduce damage to the building contents.

Keywords: flood loss, Mathare Nairobi, risk curve analysis, vulnerability

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Authors: Usha S. Adiga, Sachidanada Adiga

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Introduction: Diabetes Mellitus (DM) is one of the most common non-communicable diseases which imposes a large economic burden on the global health-care system. Cost of illness studies in India have assessed the health care cost of DM, but have certain limitations due to lack of standardization of the methods used, improper documentation of data, lack of follow up, etc. The objective of the study was to estimate the cost of illness of uncomplicated versus complicated type 2 diabetes mellitus in Coastal Karnataka, India. The study also aimed to find out the trend of cost of illness of the disease over a decade. Methodology: A prevalence based bottom-up approach study was carried out in two tertiary care hospitals located in Coastal Karnataka after ethical approval. Direct Medical costs like annual laboratory costs, pharmacy cost, consultation charges, hospital bed charges, surgical /intervention costs of 238 diabetics and 340 diabetic patients respectively from two hospitals were obtained from the medical record sections. Patients were divided into six groups, uncomplicated diabetes, diabetic retinopathy(DR), nephropathy(DN), neuropathy(DNeu), diabetic foot(DF), and ischemic heart disease (IHD). Different costs incurred in 2008 and 2017 in these groups were compared, to study the trend of cost of illness. Kruskal Wallis test followed by Dunn’s test were used to compare median costs between the groups and Spearman's correlation test was used for correlation studies. Results: Uncomplicated patients had significantly lower costs (p <0.0001) compared to other groups. Patients with IHD had highest Medical expenses (p < 0.0001), followed by DN and DF (p < 0.0001 ). Annual medical costs incurred were 1.8, 2.76, 2.77, 1.76, and 4.34 times higher in retinopathy, nephropathy, diabetic foot, neuropathy and IHD patients as compared to the cost incurred in managing uncomplicated diabetics. Other costs also showed a similar pattern of rising. A positive correlation was observed between the costs incurred and duration of diabetes, a negative correlation between the glycemic status and cost incurred. The cost incurred in the management of DM in 2017 was found to be elevated 1.4 - 2.7 times when compared to that in 2008. Conclusion: It is evident from the study that the economic burden due to diabetes mellitus is substantial. It poses a significant financial burden on the healthcare system, individual and society as a whole. There is a need for the strategies to achieve optimal glycemic control and operationalize regular and early screening methods for complications so as to reduce the burden of the disease.

Keywords: COI, diabetes mellitus, a bottom up approach, economics

Procedia PDF Downloads 116