Search results for: obstacles to healthcare accessibility

Authors: Babak Nemat

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Background and Purpose: Non-alcoholic fatty liver is one of the most common liver disorders, which, as the most important cause of death from liver disease, has unpleasant consequences and complications. The aim of this study was to investigate the effect of an educational intervention based on a health belief model to prevent non-alcoholic fatty liver among women. Materials and Methods: This experimental study was performed among 110 women referring to comprehensive health service centers in Malayer City, west of Iran, in 2023. Using the available sampling method, 110 participants were divided into experimental and control groups. The data collection tool included demographic characteristics and a questionnaire based on the health belief model. In the experimental group, three one-hour training sessions were conducted in the form of pamphlets, lectures, and group discussions. Data were analyzed using SPSS software version 21, by correlation tests, paired t-tests, and independent t-tests. Results: The mean age of participants was 38.07±6.28 years, and most of the participants were middle-aged, married, housewives with academic education, middle-income, and overweight. After the educational intervention, the mean scores of the constructs include perceived sensitivity (p=0.01), perceived severity (p=0.01), perceived benefits (p=0.01), guidance for internal (p=0.01), and external action (p=0.01), and perceived self-efficacy (p=0.01) in the experimental group were significantly higher than the control group. The score of perceived barriers in the experimental group decreased after training. The perceived obstacles score in the test group decreased after the training (15.2 ± 3.9 v.s 11.2 ± 3.3, (p<0.01). Conclusion: The findings of the study showed that the design and implementation of educational programs based on the constructs of the health belief model can be effective in preventing women from developing higher levels of non-alcoholic fatty liver.

Keywords: non-alcoholic fatty liver, health belief model, education, women

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Authors: Robin V. Cupido

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Online dispute resolution has been identified in many countries as a viable alternative for resolving conflicts which have arisen in the so-called digital age. This system of dispute resolution is developing alongside the Internet, and as new types of transactions are made possible by our increased connectivity, new ways of resolving disputes must be explored. Developed nations, such as the United States of America and the European Union, have been involved in creating these online dispute resolution mechanisms from the outset, and currently have sophisticated systems in place to deal with conflicts arising in a number of different fields, such as e-commerce, domain name disputes, labour disputes and conflicts arising from family law. Specifically, in the field of e-commerce, the Internet’s borderless nature has served as a way to promote cross-border trade, and has created a global marketplace. Participation in this marketplace boosts a country’s economy, as new markets are now available, and consumers can transact from anywhere in the world. It would be especially advantageous for developing nations to be a part of this global marketplace, as it could stimulate much-needed investment in these nations, and encourage international co-operation and trade. However, for these types of transactions to proliferate, an effective system for resolving the inevitable disputes arising from such an increase in e-commerce is needed. Online dispute resolution scholarship and practice is flourishing in developed nations, and it is clear that the gap is widening between developed and developing nations in this regard. The potential for implementing online dispute resolution in developing countries has been discussed, but there are a number of obstacles that have thus far prevented its continued development. This paper aims to evaluate the various political, infrastructural and socio-economic challenges faced in developing nations, and to question how these have impacted the acceptance and development of online dispute resolution, scholarship and training of online dispute resolution practitioners and, ultimately, developing nations’ readiness to participate in cross-border e-commerce.

Keywords: developing countries, feasibility, online dispute resolution, progress

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Authors: Zahrasadat Hosseini, Jie Yuan

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Point-of-care (POC) diagnostic devices based on lab-on-a-chip (LOC) technology have the potential to revolutionize medical diagnostics. However, the development of an ideal microfluidic system based on LOC technology for diagnostics purposes requires overcoming several obstacles, such as improving sensitivity, selectivity, portability, cost-effectiveness, and prototyping methods. While numerous studies have introduced technologies and systems that advance these criteria, existing systems still have limitations. Electrochemical enzyme-linked immunosorbent assay (e-ELISA) in a LOC device offers numerous advantages, including enhanced sensitivity, decreased turnaround time, minimized sample and analyte consumption, reduced cost, disposability, and suitability for miniaturization, integration, and multiplexing. In this study, we present a novel design and fabrication method for a microfluidic diagnostic platform that integrates screen-printed electrochemical carbon/silver chloride electrodes on flexible printed circuit boards with flexible, multilayer, polydimethylsiloxane (PDMS) microfluidic networks to accurately manipulate and pre-immobilize analytes for performing electrochemical enzyme-linked immunosorbent assay (e-ELISA) for multiplexed quantification of blood serum biomarkers. We further demonstrate fast, cost-effective prototyping, as well as accurate and reliable detection performance of this device for quantification of interleukin-6-spiked samples through electrochemical analytics methods. We anticipate that our invention represents a significant step towards the development of user-friendly, portable, medical-grade, POC diagnostic devices.

Keywords: lab-on-a-chip, point-of-care diagnostics, electrochemical ELISA, biomarker quantification, fast prototyping

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Authors: Zahrasadat Hosseini, Jie Yuan

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Point-of-care (POC) diagnostic devices based on lab-on-a-chip (LOC) technology have the potential to revolutionize medical diagnostics. However, the development of an ideal microfluidic system based on LOC technology for diagnostics purposes requires overcoming several obstacles, such as improving sensitivity, selectivity, portability, cost-effectiveness, and prototyping methods. While numerous studies have introduced technologies and systems that advance these criteria, existing systems still have limitations. Electrochemical enzyme-linked immunosorbent assay (e-ELISA) in a LOC device offers numerous advantages, including enhanced sensitivity, decreased turnaround time, minimized sample and analyte consumption, reduced cost, disposability, and suitability for miniaturization, integration, and multiplexing. In this study, we present a novel design and fabrication method for a microfluidic diagnostic platform that integrates screen-printed electrochemical carbon/silver chloride electrodes on flexible printed circuit boards with flexible, multilayer, polydimethylsiloxane (PDMS) microfluidic networks to accurately manipulate and pre-immobilize analytes for performing electrochemical enzyme-linked immunosorbent assay (e-ELISA) for multiplexed quantification of blood serum biomarkers. We further demonstrate fast, cost-effective prototyping, as well as accurate and reliable detection performance of this device for quantification of interleukin-6-spiked samples through electrochemical analytics methods. We anticipate that our invention represents a significant step towards the development of user-friendly, portable, medical-grade POC diagnostic devices.

Keywords: lab-on-a-chip, point-of-care diagnostics, electrochemical ELISA, biomarker quantification, fast prototyping

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Authors: Naz Najma, Grace T. M. Dal Sasso, Maria de Lourdes de Souza

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The development of information and communication technologies and the accessibility of mobile devices has increased the possibilities of the teaching and learning process anywhere and anytime. Mobile and web application allows the production of constructive teaching and learning models in various educational settings, showing the potential for active learning in nursing. The objective of this study was to present the development of an educational technology (Savinglife®, an app) for learning cardiopulmonary resuscitation and advanced cardiovascular life support training. Savinglife® is a technological production, based on the concept of virtual learning and problem-based learning approach. The study was developed from January 2016 to November 2016, using five phases (analyze, design, develop, implement, evaluate) of the instructional systems development process. The technology presented 10 scenarios and 12 simulations, covering different aspects of basic and advanced cardiac life support. The contents can be accessed in a non-linear way leaving the students free to build their knowledge based on their previous experience. Each scenario is presented through interactive tools such as scenario description, assessment, diagnose, intervention and reevaluation. Animated ECG rhythms, text documents, images and videos are provided to support procedural and active learning considering real life situation. Accessible equally on small to large devices with or without an internet connection, Savinglife® offers a dynamic, interactive and flexible tool, placing students at the center of the learning process. Savinglife® can contribute to the student’s learning in the assessment and management of basic and advanced cardiac life support in a safe and ethical way.

Keywords: problem-based learning, cardiopulmonary resuscitation, nursing education, advanced cardiac life support, educational technology

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Authors: Mary Kiviiri Nakawuka, Mary Namugalu, Andrew Otiti

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BACKGROUND Cervical cancer is the fourth most common cancer in women and seventh overall among all cancers worldwide. It accounts for about 7.5% of all female-cancer deaths with 85% occurring in low and middle-income countries and the first most common female cancer in women aged 15 to 44 years in Uganda with an annual number of new cases at 3,915 and 2,275 annual number of cervical cancer deaths in 2012 (ICO INFORMATION CENTRE ON HPV AND CANCER, 2017).Despite the available free cervical cancer screening services whose uptake has been documented to improve the chances of successful treatment of pre-cancers and cancers among women of reproductive age, there is a low uptake of these services thus we sought to examine the uptake of cervical cancer services and associated factors among women of reproductive age (25-49) attending the ART clinic of KISWA HCII in Kampala, Uganda METHODS The research was carried out in the ART clinic of KISWA HCII among 385 participants. An analytical, cross-sectional study with quantitative methods of data collection was used. The study adopted a non-probability convenience sampling method to select participants. Quantitative data was collected through structured questionnaires. RESULTS 72.2% of the participants were found to have been screened for cervical cancer. 36 % of the screened women had a positive HPV or VIA result ,59.2% of the screened women had a negative HPV or VIA result and 4.8% had an invalid HPV test result. Only 39.5% of the participants had adequate overall knowledge about cervical cancer, more than a third of the participants (50%) had moderate or low knowledge and minority of them (10.5%) had no knowledge. There was no significant association between the uptake of cervical cancer screening services among participants and their socio-demographic characteristics. CONCLUSIONS Although majority of the women surveyed had been screened for cervical cancer, a comparatively large number of participants had inadequate knowledge about cervical cancer and therefore there is still need to continue teaching about cervical cancer and this may include education campaigns, improvements to the accessibility and convenience of the screening services.

Keywords: cervical cancer uptake, cervical cancer screening, women of reproductive age., cervical cancer knowledge

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Authors: Pornpote Nusen, Manop Kaewmoracharoen

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In recent years, there was an observable shift in fully developed countries from constructing new buildings to modifying existing buildings. The issue was that although an effective instrument like BIM (Building Information Modeling) was well developed for constructing new buildings, it was not widely used to renovate old buildings. BIM was accepted as an effective means to overcome common managerial problems such as project delay, cost overrun, and poor quality of the project life cycle. It was recently introduced in Thailand and rarely used in a renovation project. Today, in Thailand, BIM is mostly used for creating aesthetic 3D models and quantity takeoff purposes, though it can be an effective tool to use as a project management tool in planning and scheduling. Now the governmental sector in Thailand begins to recognize the uses of using BIM to manage a construction project, but the knowledge about the BIM implementation to governmental construction projects is underdeveloped. Further studies need to be conducted to maximize its advantages for the governmental sector. An educational extra large governmental building of 17,000 square-meters was used in this research. It is currently under construction for a two-year renovation project. BIM models of the building for the exterior and interior areas were created for the whole five floors. Then 4D BIM with combination of 3D BIM plus time was created for planning and scheduling. Three focus groups had been done with executive committee, contractors, and officers of the building to discuss the possibility of usage and usefulness of BIM approach over the traditional process. Several aspects were discussed in the positive sides, especially several foreseen problems, such as the inadequate accessibility of ways, the altered ceiling levels, the impractical construction plan created through a traditional approach, and the lack of constructability information. However, for some parties, the cost of BIM implementation was a concern, though, this study believes, its uses outweigh the cost.

Keywords: building information modeling, extra large building, governmental building renovation, project management, renovation, 4D BIM

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Authors: Michal Christina Steven, Mohd. Yusof Hj Ibrahim, Haryati Abdul Karim, Prabakaran Dhanaraj, Kelly Alexius Mansin

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After 27 years, Malaysia reported polio cases in 2019 involving the children of the undocumented migrants living in Sabah. These undocumented migrants present a significant challenge in achieving the elimination of vaccine-preventable diseases (VPD). Due to the recent polio outbreak among the undocumented migrant children in Sabah, an in-depth interview was conducted among the caregivers of undocumented migrant children to identify the barriers and drivers towards vaccinating their children. Financial barriers, legal citizenship status, language barrier, the COVID-19 pandemic, and physical barriers have been the barriers to access vaccination services by undocumented migrants. Five significant drivers for undocumented migrants to vaccinate their children are social influence, fear of disease, parental trust in healthcare providers, good support, and vaccine availability. Necessary action should be taken immediately to address the problems of vaccinating the children of undocumented migrants to prevent the re-emergence of VPD.

Keywords: Malaysia, polio, Sabah, undocumented migrants

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Authors: Sunghyoun Lee, Byeongkee Yu, Chanjung Lee, Yeongtaek Lim

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Oyster mushrooms are one of the ingredients that Koreans prefer. The oyster mushroom cultivation house has multiple layers in order to increase the mushroom production per unit area. However, the growing shelves in the house act as obstacles and hinder the circulation of the interior air, which leads to the difference of cultivation environment between the upper part and lower part of the growing shelves. Due to this difference of environments, growth distinction occurs according to the area of the growing shelves. It is known that minute air circulation around the mushroom cap facilitates the metabolism of mushrooms and improves its quality. This study has utilized the computational fluid dynamics (CFD) program, that is, FLUENT R16, in order to analyze the improvement of the internal environment uniformity of the oyster mushroom cultivation house. The analyzed factors are velocity distribution, temperature distribution, and humidity distribution. In order to maintain the internal environment uniformity of the oyster mushroom cultivation house, it appeared that installing circulation fan at the upper part of the working passage towards the ceiling is effective. When all the environmental control equipment – unit cooler, inlet fan, outlet fan, air circulation fan, and humidifier - operated simultaneously, the RMS figure on the growing shelves appeared as follows: velocity 28.23%, temperature 30.47%, humidity 7.88%. However, when only unit cooler and air circulation fan operated, the RMS figure on the growing shelves appeared as follows: velocity 22.28%, temperature 0.87%, humidity 0.82%. Therefore, in order to maintain the internal environment uniformity of the mushroom cultivation house, reducing the overall operating time of inlet fan, outlet fan, and humidifier is needed, and managing the internal environment with unit cooler and air circulation fan appropriately is essential.

Keywords: air circulation fan, computational fluid dynamics, multi-layered shelves cultivation, oyster mushroom cultivation house

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Authors: Svanik Garg

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Static Test Pads are stationary mechanisms that hold a solid rocket motor, measuring the different parameters of its operation including thrust and temperature to better calibrate it for launch. This paper outlines a specific STP designed to test high powered rocket motors with a thrust upwards of 4000N and limited to 6500N. The design includes a specific portable mechanism with cost an integral part of the design process to make it accessible to small scale rocket developers with limited resources. Using curved surfaces and an ergonomic design, the STP has a delicately engineered façade/case with a focus on stability and axial calibration of thrust. This paper describes the design, operation and working of the STP and its widescale uses given the growing market of aviation enthusiasts. Simulations on the CAD model in Fusion 360 provided promising results with a safety factor of 2 established and stress limited along with the load coefficient A PCB was also designed as part of the test pad design process to help obtain results, with visual output and various virtual terminals to collect data of different parameters. The circuitry was simulated using ‘proteus’ and a special virtual interface with auditory commands was also created for accessibility and wide-scale implementation. Along with this description of the design, the paper also emphasizes the design principle behind the STP including a description of its vertical orientation to maximize thrust accuracy along with a stable base to prevent micromovements. Given the rise of students and professionals alike building high powered rockets, the STP described in this paper is an appropriate option, with limited cost, portability, accuracy, and versatility. There are two types of STP’s vertical or horizontal, the one discussed in this paper is vertical to utilize the axial component of thrust.

Keywords: static test pad, rocket motor, thrust, load, circuit, avionics, drag

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Authors: Yuguang Gao, Mingtao Deng

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The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.

Keywords: collaborative medical alliance, disease related group, patient referral, simulation

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Authors: Axelle Bertrand, Tom Bauer, Carole Charbuillet, Martin Bonte, Marie Voyer, Nicolas Perry

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The complexity of Life Cycle Assessment (LCA) can be identified as the ultimate obstacle to massification. Due to these obstacles, the diffusion of eco-design and LCA methods in the manufacturing sectors could be impossible. This article addresses the research question: How to adapt the LCA method to generalize it massively and improve its performance? This paper aims to develop an approach for automating LCA in order to carry out assessments on a massive scale. To answer this, we proceeded in three steps: First, an analysis of the literature to identify existing automation methods. Given the constraints of large-scale manual processing, it was necessary to define a new approach, drawing inspiration from certain methods and combining them with new ideas and improvements. In a second part, our development of automated construction is presented (reconciliation and implementation of data). Finally, the LCA case study of a conduit is presented to demonstrate the feature-based approach offered by the developed tool. A computerized environment supports effective and efficient decision-making related to materials and processes, facilitating the process of data mapping and hence product modeling. This method is also able to complete the LCA process on its own within minutes. Thus, the calculations and the LCA report are automatically generated. The tool developed has shown that automation by code is a viable solution to meet LCA's massification objectives. It has major advantages over the traditional LCA method and overcomes the complexity of LCA. Indeed, the case study demonstrated the time savings associated with this methodology and, therefore, the opportunity to increase the number of LCA reports generated and, therefore, to meet regulatory requirements. Moreover, this approach also presents the potential of the proposed method for a wide range of applications.

Keywords: automation, EEE, life cycle assessment, life cycle inventory, massively

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Authors: Una Carthy

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A recent study of third level institutions in Ireland reveals that both age and aptitude can be overcome by teaching methodologies to motivate second language learners. This PhD investigation gathered quantitative and qualitative data from 14 Institutes of Technology over a three years period from 2011 to 2014. The fundamental research question was to establish the impact of institutional language policy on attitudes towards language learning. However, other related issues around second language acquisition arose in the course of the investigation. Data were collected from both lectures and students, allowing interesting points of comparison to emerge from both datasets. Negative perceptions among lecturers regarding language provision were often associated with the view that language learning belongs to primary and secondary level and has no place in third level education. This perception was offset by substantial data showing positive attitudes towards adult language learning. Lenneberg’s Critical Age Theory postulated that the optimum age for learning a second language is before puberty. More recently, scholars have challenged this theory in their studies, revealing that mature learners can and do succeed at learning languages. With regard to aptitude, a preoccupation among lecturers regarding poor literacy skills among students emerged and was often associated with resistance to second language acquisition. This was offset by a preponderance of qualitative data from students highlighting the crucial role which teaching approaches play in the learning process. Interestingly, the data collected regarding learning disabilities reveals that, given the appropriate learning environments, individuals can be motivated to acquire second languages, and indeed succeed at learning them. These findings are in keeping with other recent studies regarding attitudes towards second language learning among students with learning disabilities. Both sets of findings reinforce the case for language policies in the Institute of Technology (IoTs). Supportive and positive learning environments can be created in third level institutions to motivate adult learners, thereby overcoming perceived obstacles relating to age and aptitude.

Keywords: age, aptitude, second language acquisition, teaching methodologies

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Authors: Amr Mohamed Bakry Ibrahim, Yingzhou Ni, Hao Cheng, Li Liang

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Tuna oil (omega-3 oil) has become increasingly popular in the last ten years, because it is considered one of the treasures of food which has many beneficial health effects for the humans. Nevertheless, the susceptibility of omega-3 oils to oxidative deterioration, resulting in the formation of oxidation products, in addition to organoleptic problems including “fishy” flavors, have presented obstacles to the more widespread use of tuna oils in the food industry. This study sought to evaluate the potential impact of Mentha piperita oil on physicochemical characteristics and oxidative stability of tuna oil microcapsules formed by spray drying using the partial substitution to whey protein isolate by carboxymethyl cellulose and pullulan. The emulsions before the drying process were characterized regarding size and ζ-potential, viscosity, surface tension. Confocal laser scanning microscopy showed that all emulsions were sphericity and homogeneous distribution without any visible particle aggregation. The microcapsules obtained after spray drying were characterized regarding microencapsulation efficiency, water activity, color, bulk density, flowability, scanning surface morphology and oxidative stability. The microcapsules were spherical shape had low water activity (0.11-0.23 aw). The microcapsules containing both tuna oil and Mentha piperita oil were smaller than others and addition of pullulan into wall materials improved the morphology of microcapsules. Microencapsulation efficiency of powdered oil ranged from 90% to 94%. Using Mentha piperita oil in the process of microencapsulation tuna oil enhanced the oxidative stability using whey protein isolate only or with carboxymethyl cellulose or pullulan as wall materials, resulting in improved storage stability and mask fishy odor. Therefore, it is foreseen using tuna-Mentha piperita oil mixture microcapsules in the applications of the food industries.

Keywords: Mentha piperita oil, microcapsule, tuna oil, whey protein isolate

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Authors: Khaled Klib, Yousri Azzam, Ibrahim Maarouf

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Tourism is one of the most important and fastest growing economic activities in the world, which has a prominent role in the growth and development of countries and has become increasingly important as business and trade after the World War II. The tourism development is one of the most important aspects of urban development, which aims to plan and develop tourist attractions and improve the urban environment within cities. Tourism development has become a priority for the urban development policy of cities, particularly those which have many tourist potentials. Complementary services, such as infrastructure, roads’ networks, transportation, and communications are needed for these potentials to function properly. In order to achieve these functionalities, also a new planning for the new areas as an expansion is required, or developing and renovating the existing urban areas according to pre-prepared plans to avoid random expansion of the urban structure of the city. This paper aims to determine the tourist attractions of Al-Khomse city, by reviewing the most important tourist attractions such as the Roman city (Leptis Magna), the geographical location on the Mediterranean coast, the temperate climate and diversity of the natural environment. The paper also examines the reality of the infrastructure and tourist services in the city and its suitability to serve the tourism sector. The paper also includes a proposed for tourism development in the city as one of the city's urban expansion trends, which can guide the development strategy in the future. The paper concludes with a vision for the tourism development areas as one of the trends for urban expansion in the future. The paper also concludes tourism development will have an effective role in the growth and development of urban, economic and social, in addition to preserving the natural environment. The paper recommended the need to emphasize the role of tourism development as one of the pillars and trends for the development policy and expansion of Al-Khomse city, preservation of tourist attractions and natural resources and developing infrastructure and tourist services such as accommodation, entertainment, mobility, and accessibility.

Keywords: tourism, tourist attractions, tourism development, urban expansion

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Authors: Edilei Reis, Jose Carlos Felix

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This paper explores Waldir Dupont’s translations of William Faulkner’s novels to Brazilian Portuguese language in order to comprehend how his translation project regarding Faulkner’s works has addressed modernist traits of the novelist fiction, particularly the ambivalence of language, multiple and fragmented points of view and syntax. Wladir Dupont (1939-2014) was a prolific Brazilian journalist who benefitted from his experiences as an international correspondent living abroad (EUA and Mexico) to become an acclaimed translator later in life. He received a Jabuiti Award (Brazilian most prestigious literary award) for his translation of ‘La Otra Voz’ (1994), by Mexican poet, critic and translator Octavio Paz, a writer to whom he devoted the first years of his carrier as a translator. As Dupont pointed out in some interviews, the struggles in finding a way out to overcome linguistic and cultural obstacles in the process of translating texts from Spanish to Portuguese was paramount for ascertaining his engagement in the long-term project of translating to Brazilian Portuguese the fiction of William Faulkner. His first enterprise was the translation of Faulkner’s trilogy Snopes: The Hamlet (1940) and The Town (1957), the first two novels, were published in 1997 as O povoado and A cidade; in 1999 the last novel, The mansion (1959), was published as A mansão. In 2001, Dupont tackled what is considered one of the most challenging novels by the author due to his use of multiple points of view, As I lay dying (1930). In 2003, The Reivers (1962) was published under the title Os invictos. His enterprise finishes in 2012 with the publication of an anthology of Faulkner’s thriller short-stories Knight’s Gambit (1932) as Lance mortal. Hence, in this paper we will consider the Dupont’s trajectory as a translator, paying special attention to the way in which his identity as such is constituted through the process of translating Faulkner’s works.

Keywords: literary translation, translator’s identity, William Faulkner, Wladir DuPont

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Authors: Farah Syazwani Hilmy Zaki

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Background: Compared to adult cardiopulmonary resuscitation (CPR), high-quality research and evidence on pediatric CPR remain relatively scarce. This knowledge gap hinders the development of optimal guidelines and best practices for resuscitating children. Objectives: To explore pediatric intensive care unit (PICU) CPR current practices in PICU of Institut Jantung Negara (IJN) Malaysia. Method: The research employed a qualitative approach, utilising case study research design. The data collection process involved in-depth interviews and reviewing the Resuscitation Feedback Form. Purposive sampling was used to select two cases consisting of 14 participants. The study participants comprised a cardiologist, one anaesthetist, and twelve nurses. The data collected were transcribed and entered into NVivo software to facilitate theme development. Subsequently, thematic analysis was conducted to analyse the data. Findings: The study yielded key findings regarding the enhancement of PICU CPR practices. These findings are categorised into four themes, namely routine procedures, resuscitation techniques, team dynamics, and individual contributions. Establishment of cohesive team is crucial in facilitating the effectiveness of resuscitation. According to participants, lack of confidence, skills and knowledge presents significant obstacles to effective PICU CPR. Conclusion: The findings of this study indicate that the participants express satisfaction with the current practices of PICU CPR. However, the research also highlights the need for enhancements in various areas, including routine procedures, resuscitation techniques, as well as team and individual factors. Furthermore, it was suggested that additional training be conducted on the resuscitation process to enhance the preparedness of the medical team.

Keywords: cardiopulmonary resuscitation, feedback, nurses, pediatric intensive care unit

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Authors: Nazish Saleem Abbas, Muhammad Haris Jamil, Hamid Sharif

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Digital watermarking is a technique that allows an individual to add and hide secret information, copyright notice, or other verification message inside a digital audio, video, or image. Today, with the advancement of technology, modern healthcare systems manage patients’ diagnostic information in a digital way in many countries. When transmitted between hospitals through the internet, the medical data becomes vulnerable to attacks and requires security and confidentiality. Digital watermarking techniques are used in order to ensure the authenticity, security and management of medical images and related information. This paper proposes a watermarking technique that embeds a watermark in medical images imperceptibly and securely. In this work, digital watermarking on medical images is carried out using the Least Significant Bit (LSB) with the Discrete Cosine Transform (DCT). The proposed methods of embedding and extraction of a watermark in a watermarked image are performed in the frequency domain using LSB by XOR operation. The quality of the watermarked medical image is measured by the Peak signal-to-noise ratio (PSNR). It was observed that the watermarked medical image obtained performing XOR operation between DCT and LSB survived compression attack having a PSNR up to 38.98.

Keywords: watermarking, image processing, DCT, LSB, PSNR

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Authors: Franziska Mais, Till Gramberg

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The paper presents the development of a sustainable business model for a platform-based application tailored for sawing companies in small and medium-sized enterprises (SMEs). The focus is on the integration of sustainability principles into the design of the business model to ensure a technologically advanced, legally sound, and economically efficient solution. Easy2IoT is a research project that aims to enable companies in the prefabrication sheet metal and sheet metal processing industry to enter the Industrial Internet of Things (IIoT) with a low-threshold and cost-effective approach. The methodological approach of Easy2IoT includes an in-depth requirements analysis and customer interviews with stakeholders along the value chain. Based on these insights, actions, requirements, and potential solutions for smart services are derived. The structuring of the business ecosystem within the application plays a central role, whereby the roles of the partners, the management of the IT infrastructure and services, as well as the design of a sustainable operator model are considered. The business model is developed using the value proposition canvas, whereby a detailed analysis of the requirements for the business model is carried out, taking sustainability into account. This includes coordination with the business model patterns, according to Gassmann, and integration into a business model canvas for the Easy2IoT product. Potential obstacles and problems are identified and evaluated in order to formulate a comprehensive and sustainable business model. In addition, sustainable payment models and distribution channels are developed. In summary, the article offers a well-founded insight into the systematic development of a sustainable business model for platform-based applications in SME sawmills, with a particular focus on the synergy of ecological responsibility and economic efficiency.

Keywords: business model, sustainable business model, IIoT, IIoT-platform, industrie 4.0, big data

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Authors: Yunyong Guo, Sudhakar Ganti, Bryan Guo

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The swift proliferation of telehealth Internet of Things (IoT) devices has sparked concerns regarding energy consumption and the need for streamlined data processing. This paper presents an energy-efficient model that integrates telehealth IoT devices into a platform based on fog and cloud computing. This integrated system provides a sustainable and robust solution to address the challenges. Our model strategically utilizes fog computing as a localized data processing layer and leverages cloud computing for resource-intensive tasks, resulting in a significant reduction in overall energy consumption. The incorporation of adaptive energy-saving strategies further enhances the efficiency of our approach. Simulation analysis validates the effectiveness of our model in improving energy efficiency for telehealth IoT systems, particularly when integrated with localized fog nodes and both private and public cloud infrastructures. Subsequent research endeavors will concentrate on refining the energy-saving model, exploring additional functional enhancements, and assessing its broader applicability across various healthcare and industry sectors.

Keywords: energy-efficient, fog computing, IoT, telehealth

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Authors: Muhammad Tariq A. Chaudhary

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The tremendous loss of life that resulted in the aftermath of recent earthquakes in developing countries is mostly due to the collapse of non-engineered and semi-engineered building structures. Such structures are used as houses, schools, primary healthcare centres and government offices. These building are classified structurally into two categories viz. non-engineered and semi-engineered. Non-engineered structures include: adobe, Unreinforced Masonry (URM) and wood buildings. Semi-engineered buildings are mostly low-rise (up to 3 story) light concrete frame structures or masonry bearing walls with reinforced concrete slab. This paper presents an overview of the typical damage observed in non-engineered structures and their most likely causes in the past earthquakes with specific emphasis on the performance of such structures in the 2005 Kashmir earthquake. It is demonstrated that seismic performance of these structures can be improved from life-safety viewpoint by adopting simple low-cost modifications to the existing construction practices. Incorporation of some of these practices in the reconstruction efforts after the 2005 Kashmir earthquake are examined in the last section for mitigating seismic risk hazard.

Keywords: Kashmir earthquake, non-engineered buildings, seismic hazard, structural details, structural strengthening

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Authors: Hakim Herbane

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Efforts to achieve sustainability in architecture must prove their effectiveness despite various methods attempted. Biomimicry, which looks to successful natural models to promote sustainability and innovation, faces obstacles in implementing sustainability despite its restorative approach to the relationship between humans and nature. In Nunavik, Inuit communities are exploring a sustainable production system that aligns with their aspirations and meets their demands of human, technological, technical, economic, and ecological factors. Biomimicry holds promise in line with Inuit philosophy, but its failure to implement sustainability requires further investigations to remedy its deficiencies. Our literature review underscores the importance of involving the community in defining sustainability and determining the best methods for its implementation. Additionally, vernacular architecture shows valuable orientations for achieving sustainability. Moreover, reintegrating Inuit communities and their traditional architectural practices, which have successfully balanced their built environment's diverse needs and constraints, could pave the way for a sustainable Inuit-built environment in Nunavik and advance architectural biomimicry principles simultaneously. This research aims at establishing a sustainability monitoring tool for Nordic architectural process by analyzing Inuit vernacular and biomimetic architecture, in addition to the input of stakeholders involved in Inuit architecture production in Nunavik, especially Inuit. The goal is to create a practical tool (an index) to aid in designing sustainable architecture, taking into account environmental, social, and economic perspectives. Furthermore, the study seeks to authenticate strong, sustainable design principles of vernacular and biomimetic architectures. The literature review uncovered challenges and identified new opportunities. The forthcoming discourse will focus on the careful and considerate incorporation of Inuit communities’ perceptions and indigenous building practices into our methodology and the latest findings of our research.

Keywords: sustainability, biomimicry, vernacular architecture, community involvement

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Authors: Tanya Beran, Michelle Drefs, Ghazwan Altabbaa, Nouf Al Harbi, Noof Al Baz, Elizabeth Oddone Paolucci

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Although research shows that interprofessional practice has desirable effects on patient care, its implementation can present challenges to its team members. In particular, they may feel pressured to agree with or conform to other members who share information that is contrary to their own understanding. Obtaining evidence of this phenomenon is challenging, as team members may underreport their conformity behaviors due to reasons such as social desirability. In this paper, a series of studies are reviewed in which several approaches to assessing conformity in the health care professions are tested. Simulations, questionnaires, and behavior checklists were developed to measure conformity behaviors. Insights from these studies show that a significant proportion of people conform either in the presence or absence of others, express a variety of verbal and nonverbal behaviors when considering whether to conform to others, may shift between conforming and moments later not conforming (and vice versa), and may not accurately report whether they conformed. A new method of measuring conformity using the implicit bias test is also discussed. People at all levels in the healthcare system are encouraged to develop both formal and informal.

Keywords: conformity, decision-making, inter-professional teams, simulation

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Authors: Sohal Latif

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Solar power is in the form of photovoltaic, also known as PV, which is a form of renewable energy that applies solar panels in producing electricity from the sun. It has a vital role in fulfilling the present need for clean and renewable energy to get rid of conventional and non-renewable energy sources that emit high levels of greenhouse gases. Solar energy is embraced because of its availability, easy accessibility, and effectiveness in the provision of power, chiefly in country areas. In solar charging, device charge entails a change of light power into electricity using photovoltaic or PV panels, which supply direct current electric power or DC. Here, the solar charge controller has a very crucial role to play regarding the voltages and the currents coming from the solar panels to take up the changing needs of a battery without overcharging the same. Certain devices, such as inverters, are required to transform the DC power produced by the solar panels into an AC to serve the normal electrical appliances and the current power network. This project was initiated for a project of a solar charge controller and power converter with the MULTISIM. The formation of this project begins with a literature survey to obtain basic knowledge about power converters, charge controllers, and photovoltaic systems. Fundamentals of the operation of solar panels include the process by which light is converted into electricity and a comparison of PWM and MPPT chargers with controllers. Knowledge of rectifiers is built to help achieve AC-to-DC and DC-AC change. Choosing a resistor, capacitance, MOSFET, and OP-AMP is done by the need of the system. The circuit diagrams of converters and charge controllers are designed using the Multisim program. Pulse width modulation, Bubba oscillator circuit, and inverter circuits are modeled and simulated. In the subsequent steps, the analysis of the simulation outcomes indicates the efficiency of the intended converter systems. The various outputs from the different configurations, with the transformer incorporated as well as without it, are then monitored for effective power conversion as well as power regulation.

Keywords: solar charge controller, MULTISIM, converter, inverter

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Authors: Sangbok Lee

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There has been much effort on process improvement for outpatient clinics to provide quality and acute care to patients. One of the efforts is no-show analysis or prediction. This work analyzes patient no-shows along with patient health conditions. The health conditions refer to clinical symptoms that each patient has, out of the followings; hyperlipidemia, diabetes, metastatic solid tumor, dementia, chronic obstructive pulmonary disease, hypertension, coronary artery disease, myocardial infraction, congestive heart failure, atrial fibrillation, stroke, drug dependence abuse, schizophrenia, major depression, and pain. A dataset from a regional hospital is used to find the relationship between the number of the symptoms and no-show probabilities. Additional analysis reveals how each symptom or combination of symptoms affects no-shows. In the above analyses, cross-classification of patients by age and gender is carried out. The findings from the analysis will be used to take extra care to patients with particular health conditions. They will be forced to visit clinics by being informed about their health conditions and possible consequences more clearly. Moreover, this work will be used in the preparation of making institutional guidelines for patient reminder systems.

Keywords: healthcare system, no show analysis, process improvment, statistical data analysis

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Authors: Therese Scali

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Over the years, the European Union has continued to extend its action on lesbian, gay men, bisexual and transgender (LGBT) rights to a range of areas including access to justice, asylum, freedom of expression and assembly, parenting, and mutual recognition of civil status within the EU. The European Parliament has been a driving force behind such action adopting a range of resolutions calling for continued progress in this field. In particular, Belgium has been one of the first countries to legalize same-sex parenting and to create a general framework for action against negative attitudes towards gay and lesbian parents. The present paper aims at highlighting public healthcare workers’ attitudes towards different types of same-sex headed families in Belgium, and the content of their interventions in schools. Results revealed that attitudes can go from supportive to unsupportive, and participants do not show the same degree of support towards the different types of same-sex parenting. This contribution highlights work’s implication for public policy by understanding the resources and challenges that health-care professionals face in their work.

Keywords: attitudes, gay and lesbian parents, health-care workers, homophobia, prevention

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Authors: Giorgi Bregadze

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Tourism is the most viable and sustainable economic development option for Georgia and one of the main sources of foreign exchange earnings. Events are considered as one of the most effective ways to attract foreign visitors to the country, and, recently, the government of Georgia has begun investing in this sector very actively. This article stresses the necessity of research based economic policy in the tourism sector. In this regard, it is of paramount importance to measure the economic effects of the events which are subsidized by taxpayers’ money. The economic effect of events can be analyzed from two perspectives; financial perspective of the government and perspective of economic effects of the tourism administration. The article emphasizes more realistic and all-inclusive focus of the economic effect analysis of the tourism administration as it concentrates on the income of residents and local businesses, part of which generate tax revenues for the government. The public would like to know what the economic returns to investment are. In this article, the methodology used to describe the economic effects of UEFA Super Cup held in Tbilisi, will help to answer this question. Methodology is based on three main principles and covers three stages. Using the suggested methodology article estimates the direct economic effect of UEFA Super cup on Georgian economy. Although the attempt to make an economic effect analysis of the event was successful in Georgia, some obstacles and insufficiencies were identified during the survey. The article offers several recommendations that will help to refine methodology and improve the accuracy of the data. Furthermore, it is very important to receive the correct standard of measurement of events in Georgia. In this caseü non-ethical acts of measurement which are widely utilized by different research companies will not trigger others to show overestimated effects. It is worth mentioning that to author’s best knowledge, this is the first attempt to measure the economic effect of an event held in Georgia.

Keywords: biased economic effect analysis, expenditure of local citizens, time switchers and casuals, UEFA super cup

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Authors: Yalisa Tonsorn

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The objectives of this study are 1) to study the readiness of Thai tour operators in order to prepare for being ASEAN members, 2) to study opportunity and obstacles of the management of Thai tour operators, and 3) to find approach for developing value chain in order to enhance the management efficiency of Thai tour operators in order to support free trade within the framework of ASEAN cooperation. The research methodology is mixed between qualitative method and quantitative method. In-depth interview was done with key informants, including management supervisors, medium managers, and officers of the travel agencies. The questionnaire was conducted with 300 sampling. According to the study, it was found that the approach for developing value chain to enhance the management efficiency of Thai travel agencies in order to support free trade within the framework of ASEAN cooperation, the tour operators must give priority to the customer and deliver the service exceeding the customer’s expectation. There are 2 groups of customers: 1) external customers referring to tourist, and 2) internal customers referring to staff who deliver the service to the customers, including supervisors, colleagues, or subordinates. There are 2 issues which need to be developed: 1) human resource development in order to cultivate the working concept by focusing on importance of customers, and excellent service providing, and 2) working system development by building value and innovation in operational process including services to the company in order to deliver the highest impressive service to both internal and external customers. Moreover, the tour operators could support the increased number of tourists significantly. This could enhance the capacity of the business and affect the increase of competition capability in the economic dimension of the country.

Keywords: AEC (ASEAN Economic Eommunity), core activities, support activities, values chain

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Authors: Mary Katherine Hoth

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Despite racial and ethnic disparities in American psychiatry being well-documented, there remains an apathetic attitude among nurses and providers within the field to engage in active antiracism and provide equitable, recovery-oriented care. It is insufficient to be a “colorblind” nurse or provider and state that call care provided is identical for every patient. Maintaining an attitude of “colorblindness” perpetuates the racism prevalent throughout healthcare and leads to negative patient outcomes. The purpose of this literature review is to highlight the how the historical beginnings of psychiatry have evolved into the disparities seen in today’s practice, as well as to provide some insight on methods that providers and nurses can employ to actively participate in challenging these racial disparities. Background The application of psychiatric medicine to White people versus Black, Indigenous, and other People of Color has been distinctly different as a direct result of chattel slavery and the development of pseudoscience “diagnoses” in the 19th century. This weaponization of the mental health of Black people continues to this day. Population The populations discussed are Black, Indigenous, and other People of Color, with a primary focus on Black people’s experiences with their mental health and the field of psychiatry. Methods A literature review was conducted using CINAHL, EBSCO, MEDLINE, and PubMed databases with the following terms: psychiatry, mental health, racism, substance use, suicide, trauma-informed care, disparities and recovery-oriented care. Articles were further filtered based on meeting the criteria of peer-reviewed, full-text availability, written in English, and published between 2018 and 2023. Findings Black patients are more likely to be diagnosed with psychotic disorders and prescribed antipsychotic medications compared to White patients who were more often diagnosed with mood disorders and prescribed antidepressants. This same disparity is also seen in children and adolescents, where Black children are more likely to be diagnosed with behavior problems such as Oppositional Defiant Disorder (ODD) and White children with the same presentation are more likely to be diagnosed with Attention Hyperactivity Disorder. Medications advertisements for antipsychotics like Haldol as recent as 1974 portrayed a Black man, labeled as “agitated” and “aggressive”, a trope we still see today in police violence cases. The majority of nursing and medical school programs do not provide education on racism and how to actively combat it in practice, leaving many healthcare professionals acutely uneducated and unaware of their own biases and racism, as well as structural and institutional racism. Conclusions Racism will continue to grow wherever it is given time, space, and energy. Providers and nurses have an ethical obligation to educate themselves, actively deconstruct their personal racism and bias, and continuously engage in active antiracism by dismantling racism wherever it is encountered, be it structural, institutional, or scientific racism. Agents of change at the patient care level not only improve the outcomes of Black patients, but it will also lead the way in ensuring Black, Indigenous, and other People of Color are included in research of methods and medications in psychiatry in the future.

Keywords: disparities, psychiatry, racism, recovery-oriented care, trauma-informed care

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Authors: Salma M. Wakil

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Advances in the field of genetics overwhelmed detecting large number of inherited disorders at the molecular level and directed to the development of innovative technologies. These innovations have led to gene sequencing, prenatal mutation detection, pre-implantation genetic diagnosis; population based carrier screening and genome wide analyses using microarrays. Microarrays are widely used in establishing clinical and diagnostic setup for genetic anomalies at a massive level, with the advent of cytoscan molecular karyotyping as a clinical utility card for detecting chromosomal aberrations with high coverage across the entire human genome. Unlike a regular karyotype that relies on the microscopic inspection of chromosomes, molecular karyotyping with cytoscan constructs virtual chromosomes based on the copy number analysis of DNA which improves its resolution by 100-fold. We have been investigating a large number of patients with Developmental Delay and Intellectual disability with this platform for establishing micro syndrome deletions and have detected number of novel CNV’s in the Arabian population with the clinical relevance.

Keywords: microarrays, molecular karyotyping, developmental delay, genetics

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