Search results for: regional hospital

Authors: A. M. U. P. Kumari, Vidanapathirana. J., Amarasekara J., Karunanayaka L.

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Leptospirosis is a zoonotic infection with significant morbidity and mortality. As an occupational disease, it has become a global concern due to its disease burden in endemic countries and rural areas. The aim of this study was to assess disease burden in terms of DALYs of leptospirosis. A hospital-based descriptive cross-sectional study was conducted using 450 clinically diagnosed leptospirosis patients admitted to base and above hospitals in Monaragala district, Sri Lanka, using a pretested interviewer administered questionnaire. The patients were followed up till normal day today life after discharge. Estimation of DALYs was done using laboratory confirmed leptospirosis patients. Leptospirosis disease burden in the Monaragala district was 44.9 DALYs per 100,000 population which includes 33.18 YLLs and 10.9 YLDs. The incidence of leptospirosis in the Monaragala district during the study period was 59.8 per 100,000 population, and the case fatality rate (CFR) was 1.5% due to delay in health seeking behaviour; 75% of deaths were among males due to multi organ failure. The disease burden of leptospirosis in the Moneragala district was significantly high, and urgent efforts to control and prevent leptospirosis should be a priority.

Keywords: human leptospirosis, disease burden, disability adjusted life Years, Sri Lanka

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Authors: Shohra Qaderi

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Introduction: Tetanus is a severe infection characterized by the spasm of skeletal muscles that often progresses toward respiratory failure. Acute Renal failure (ARF) is an important complication associated Tetanus infection, occurring in 15%-39% of cases. Presentation of cases: A previous healthy 14-year-old boy was admitted to the Tetanus ward of a hospital in Kabul, presenting with severe muscle spasms. On day four of admission, he started having cola-colored urine with decreased urine output. Due to lack of peritoneal dialysis, he went under hemodialysis in view of rapidly raising in blood urea (from baseline 32 mg/dl to 150 mg/dl) and creatinine from (baseline 0.9 mg/dl to 6.2g/dl). Despite all efforts, he had a sudden cardiac arrest and passed away on day 6 of admission. Discussion: ARF is a complication of tetanus, reported to be mild and non-oliguric. Suggested pathological mechanisms include autonomic dysfunction and rhabdomyolysis, owing to uncontrolled muscle spasms. Autonomic dysfunction, most evident in the first two weeks of infection. Conclusion: The prevalence and mortality of tetanus is high in Afghanistan. Physicians and pediatricians need to be aware of this complication of tetanus so as to take appropriate preventive measures and recognize and manage it early.

Keywords: afghanistan, acute renal failure, child, mortality

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Authors: S. K. Maanju, K. Saha, Sonam Yadav

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Rapid urbanization growth and multi-faceted regional level industrialization is posing serious threat to natural groundwater resource in State of Rajasthan which constitute major semi-arid part of India. The groundwater resources of the State are limited and cannot withstand the present rate of exploitation for quite a long time. Recharging of groundwater particularly in the western part, where annual precipitation does not exceed a few centimeters, is extremely slow and cannot replenish the exploited quantum. Hence, groundwater in most of the parts of this region has become an exhausting resource. In major parts water table is lowering down rapidly and continuously. The human beings of this semi-arid region are used to suffering from extreme climatic conditions of arid to semi-arid nature and acute shortage of water. The quality of groundwater too in many areas of this region is not up to the standards prescribed by the health organizations like WHO and BIS. This semi-arid region is one of the highly fluoride contaminated area of India as well as have excess, nitrates, sulphates, chlorides and total dissolved solids at various locations. Therefore, concerted efforts are needed towards sustainable development of groundwater in this State of India.

Keywords: Rajasthan, water, exploitation, sustainable, development and resource

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Authors: Abdullah Nurus Salam Khan, Farhana Karim, Mohiuddin Ahsanul Kabir Chowdhury, S. Masum Billah, Nabila Zaka, Alexander Manu, Shams El Arifeen

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Globally, pre-eclampsia (PE) and ante-partum haemorrhage (APH) are two major causes of maternal mortality. Prompt identification and management of these conditions depend on competency of the birth attendants. Since these conditions are infrequent to be observed, clinical vignette based assessment could identify the extent of health worker’s competence in managing emergency obstetric care (EmOC). During June-August 2016, competence of 39 medical officers (MO) and 95 nurses working in obstetric ward of 15 government health facilities (3 district hospital, 12 sub-district hospital) was measured using clinical vignettes on PE and APH. The vignettes resulted in three outcome measures: total vignette scores, scores for diagnosis component, and scores for management component. T-test was conducted to compare mean vignette scores and linear regression was conducted to measure the strength and association of vignette scores with different cadres of health workers, facility’s readiness for EmOC and average annual utilization of normal deliveries after adjusting for type of health facility, health workers’ work experience, training status on managing maternal complication. For each of the seven component of EmOC items (administration of injectable antibiotics, oxytocic and anticonvulsant; manual removal of retained placenta, retained products of conception; blood transfusion and caesarean delivery), if any was practised in the facility within last 6 months, a point was added and cumulative EmOC readiness score (range: 0-7) was generated for each facility. The yearly utilization of delivery cases were identified by taking the average of all normal deliveries conducted during three years (2013-2015) preceding the survey. About 31% of MO and all nurses were female. Mean ( ± sd) age of the nurses were higher than the MO (40.0 ± 6.9 vs. 32.2 ± 6.1 years) and also longer mean( ± sd) working experience (8.9 ± 7.9 vs. 1.9 ± 3.9 years). About 80% health workers received any training on managing maternal complication, however, only 7% received any refresher’s training within last 12 months. The overall vignette score was 8.8 (range: 0-19), which was significantly higher among MO than nurses (10.7 vs. 8.1, p < 0.001) and the score was not associated with health facility types, training status and years of experience of the providers. Vignette score for management component (range: 0-9) increased with higher annual average number of deliveries in their respective working facility (adjusted β-coefficient 0.16, CI 0.03-0.28, p=0.01) and increased with each unit increase in EmOC readiness score (adjusted β-coefficient 0.44, CI 0.04-0.8, p=0.03). The diagnosis component of vignette score was not associated with any of the factors except it was higher among the MO than the nurses (adjusted β-coefficient 1.2, CI 0.13-2.18, p=0.03). Lack of competence in diagnosing and managing obstetric complication by the nurses than the MO is of concern especially when majority of normal deliveries are conducted by the nurses. Better EmOC preparedness of the facility and higher utilization of normal deliveries resulted in higher vignette score for the management component; implying the impact of experiential learning through higher case management. Focus should be given on improving the facility readiness for EmOC and providing the health workers periodic refresher’s training to make them more competent in managing obstetric cases.

Keywords: Bangladesh, emergency obstetric care, clinical vignette, competence of health workers

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Authors: T. Wanyama, B. Far

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Automatic irrigation systems usually conveniently protect landscape investment. While conventional irrigation systems are known to be inefficient, automated ones have the potential to optimize water usage. In fact, there is a new generation of irrigation systems that are smart in the sense that they monitor the weather, soil conditions, evaporation and plant water use, and automatically adjust the irrigation schedule. In this paper, we present an agent based smart irrigation system. The agents are built using a mix of commercial off the shelf software, including MATLAB, Microsoft Excel and KEPServer Ex5 OPC server, and custom written code. The Irrigation Scheduler Agent uses fuzzy logic to integrate the information that affect the irrigation schedule. In addition, the Multi-Agent system uses Open Platform Connectivity (OPC) technology to share data. OPC technology enables the Irrigation Scheduler Agent to communicate over the Internet, making the system scalable to a municipal or regional agent based water monitoring, management, and optimization system. Finally, this paper presents simulation and pilot installation test result that show the operational effectiveness of our system.

Keywords: community water usage, fuzzy logic, irrigation, multi-agent system

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Authors: Lei Liu

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Since the famous opening up and reform strategy of China, lots of migrants have flowed from rural areas to urban areas. In this paper, the author investigates the rural elderly left behind, which are defined aged people left alone at home while their adult children have to migrant outside. This phenomenon is a quite general and serious social problem that cannot be ignored, accompanied by the process of urbanization and regional transferring of rural labor. The Chinese internal migration not only exerts great influence to China’s economy and urbanization but also obviously reduces the labor and care to rural aged people. Contrary to assumptions in some migration and aging studies, which show the inevitable negative effects of migration upon the old age care, the author highlights unique features in their daily strategies of house holding to integrate into society with the analysis of the conception of social inclusion. Through life history interviews with elderly left behind in one rural village, this article sheds light on three different factors of social inclusion, namely, economic inclusion, social identity and political inclusion and shows its necessaries to fully understand the status of the social wellbeing of rural elderly left behind.

Keywords: labor migration, elderly left behind, social inclusion, rural China

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Authors: Yusuf A. Bako, Olubunmi O. Kolawole

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This study sought to establish the effect of recruitment and selection on the employee performance in hospitality industries. The success of any organization in this modern business environment depends on the caliber of the manpower that steer the affairs of the organization. History has shown that recruitment and selection as a function of human resources management practices have a pivotal role in determining the level of employee performance in an organization. The hospitality industries have been faced with challenges of performance due to unconventional selection and placement practices in terms of poor policy in selecting candidate, inconsistency in selection process, sidetracking employment test and interview, godfatherism and regional selection process etc. The overall objective of the study was to determine how recruitment and selection affect employee performance in hospitality industry in Ogun State, Nigeria. This study adopts descriptive and inferential research design while population was drawn from leading hotels in Ogun State, Nigeria. The samples size was 100 employees and questionnaire was used to collect data while Cronbach alpha was used to test the instrument. The result of the study reveals that correlation between employee performance and recruitment and selection were highly significant.

Keywords: employee performance, human resources management, practices, recruitment, selection

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Authors: Reda Dzingelevičienė, Vytautas Abromaitis, Nerijus Dzingelevičius, Kęstutis Baranauskis, Saulius Raugelė, Malgorzata Mlynska-Szultka, Sergej Suzdalev, Reza Pashaei, Sajjad Abbasi, Boguslaw Buszewski

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A unique hybrid technology was developed for the removal of COVID-19 specific contaminants from wastewater. Reactor testing was performed using model water samples contaminated with COVID-19 pharmaceuticals and microplastics. Different hydraulic retention times, concentrations of pollutants and dissolved ozone were tested. Liquid Chromatography-Mass Spectrometry, solid phase extraction, surface area and porosity, analytical tools were used to monitor the treatment efficiency and remaining sorption capacity of the spent adsorbent. The combination of advanced oxidation and adsorption processes was found to be the most effective, with the highest 90-99% and 89-95% molnupiravir and microplastics contaminants removal efficiency from the model wastewater. The research has received funding from the European Regional Development Fund (project No 13.1.1-LMT-K-718-05-0014) under a grant agreement with the Research Council of Lithuania (LMTLT), and it was funded as part of the European Union’s measure in response to the COVID-19 pandemic.

Keywords: adsorption, hybrid reactor system, pharmaceuticals-microplastics, wastewater

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Authors: M. Van Zyl, M. H. A. Combrinck, E. J. Spamer

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Due to the need for higher education in South Africa, the country experiences a rapid growth in open distance learning, especially in rural areas. It is difficult for people to enrol fulltime at contact universities, owing to work and financial constraints. The Unit for Open Distance Learning (UODL) at the North-West University (NWU), Potchefstroom campus, South Africa was established in 2013 with its main function to deliver open distance learning programmes to 30 000 students from the Faculties of Education Sciences, Theology and Health Sciences. With the use of interactive whiteboards (IWBs), the NWU and UODL are now able to deliver lectures to students concurrently at 60 regional open learning centres across Southern Africa as well as to an unlimited number of individuals with Internet access worldwide. Although IWBs are not new, our initiative is to use them more extensively in order to create more contact between lecturers and students. To be able to ensure and enhance quality education it is vital to determine students’ perceptions on the delivery of programmes by means of IWBs. Therefore, the aim of the study is to explore students’ perceptions for the use of IWBs in the delivery of programmes in terms of Moore’s Theory of Transactional Distance.

Keywords: interactive white board, open distance learning, technology, transactional learning

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Authors: Pratistha Shrestha

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Background: Acrochordons (Skin tags) are common benign skin tumors usually occurring on the neck and major flexors of older people. These range in size from 1 mm to 1cm in diameter and are skin-colored or brownish. A possible association with diabetes mellitus has been suggested in previous studies, but the result is not conclusive. Objective: The aim of this study was to find out the association of diabetes mellitus with acrochordons. Material and Methods: One hundred and two patients were selected for the study. Among them, 51 (males–23 and females–28) with acrochordons were taken as cases, and 51 with other dermatologic diseases after matching age and sex were taken as controls. The patients were selected from OPD of the Department of Dermatology and Venereology in Universal College of Medical Sciences–Teaching Hospital (UCMS-TH). Blood glucose levels, including both fasting plasma glucose and 2-hour post-glucose load, were determined for both case and control and compared. Results: Patients with acrochordons had a significantly higher frequency of diabetes than the control group (p < 0.001). A total of 48.5% and 40% of patients with acrochordons having diabetes were obese and overweight, respectively. Conclusion: There is an increased risk of diabetes mellitus in patients with acrochordons. With regard to the importance of early diagnosis of diabetes, it is recommended a high level of suspicion for diabetes mellitus in patients with acrochordons.

Keywords: acrochordons, diabetes mellitus, obesity, skin tags

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Authors: Mustapha Shitu Suleiman, Francis Neshamba, Nestor Valero-Silva

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Small businesses are considered as engine of economic growth, contributing to employment generation, wealth creation, and poverty alleviation and food security in both developed and developing countries. Nigeria is facing many socio-economic problems and it is believed that by supporting small business development, as propellers of new ideas and more effective users of resources, often driven by individual creativity and innovation, Nigeria would be able to address some of its economic and social challenges, such as unemployment and economic diversification. Using secondary literature, this paper examines the role small businesses can play in the creation of jobs in North-West Nigeria to overcome issues of unemployment, which is the most devastating economic challenge facing the region. Most studies in this area have focused on Nigeria as a whole and only a few studies provide a regional focus, hence, this study will contribute to knowledge by filling this gap by concentrating on North-West Nigeria. It is hoped that with the present administration’s determination to improve the economy, small businesses would be used as vehicles for diversification of the economy away from crude oil to create jobs that would lead to a reduction in the country’s high unemployment level.

Keywords: job creation, north-west, Nigeria, small business, unemployment

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Authors: N. V. V. S. D. Prasad

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Field experiments were conducted at Regional Agricultural Research Station, Lam, Guntur, Andhra Pradesh, India for two seasons during 2011-13 to evaluate the efficacy of flupyradifurone SL 200 a new class of insecticide in butenolide group against leaf hoppers, aphids and whitefly in Cotton. The test insecticide flupyradifurone 200 was evaluated at three doses @ 150, 200 and 250 g ai/ha ha along with imidacloprid 200 SL @ 20g ai/ha, acetamiprid 20 SP @ 20g ai/ha, thiamethoxam 25 WG @ 25g ai/ha and monocrotophos 36 SL @ 360 g ai/ha as standards. Flupyradifurone SL 200 even at lower dose of 150g ai/ha exhibited superior efficacy against cotton leafhopper, Amrasca devastans than the neonicotinoids which are widely used for control of sucking pests in cotton. Against cotton aphids, Aphis gossypii. Flupyradifurone SL 200 @ 200 and 250 g ai/ha ha was proved to be effective and the lower dose @ 150g ai/ha performed better than some of the neonicotinoids. The effect of flupyradifurone SL 200 on cotton against whitefly, Bemisia tabaci was evident at higher doses of 200 and 250 g ai/ha and superior to all standard treatments, however, the lower dose is at par with neonicotinoids. The seed cotton yield of flupyradifurone 200 SL at all the doses tested was superior than imidacloprid 200 SL @ 20g ai/ha and acetamiprid 20 SP @ 20g ai/ha. There is no significant difference among the insecticidal treatments with regards to natural enemies. The results clearly suggest that flupyradifurone is a new tool to combat sucking pest problems in cotton and can well fit in IRM strategies in light of wide spread insecticide resistance in cotton sucking pests.

Keywords: cotton, flupyradifurone, neonicotinoids, sucking pests

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Authors: Banu Pradheepa Kamarajan, Muthusamy Ananthasubramanian

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Biofilm forming Pseudomonads occupy the top third position in causing hospital acquired infections. P. aeruginosa is notoriously known for its tendency to develop drug resistance. Major classes of drug such as β-lactams, aminoglycosides, quinolones, and polymyxins are found ineffective against multi-drug resistance Pseudomonas. To combat the infections, rather than administration of a single antibiotic, use of combinations (tobramycin and essential oils from plants and/or silver nanoparticles, chitosan, nitric oxide, cis-2-decenoic acid) in single formulation are suggested to control P. aeruginosa biofilms. Conventional techniques to prevent hospital-acquired implant infections such as coatings with antibiotics, controlled release of antibiotics from the implant material, contact-killing surfaces, coating the implants with functional DNase I and, coating with glycoside hydrolase are being followed. Coatings with bioactive components besides having limited shelf-life, require cold-chain and, are likely to fail when bacteria develop resistance. Recently identified nano-scale physical architectures on the insect wings are expected to have potential bactericidal property. Nanopillars are bactericidal to Staphylococcus aureus, Bacillus subtilis, K. pnuemoniae and few species of Pseudomonas. Our study aims to investigate the survival rate of biofilm forming Pseudomonas aeruginosa strain over non-biofilm forming strain on the nanopillar architecture of dragonfly (Pantala flavescens) wing. Dragonflies were collected near house-hold areas and, insect identification was carried out by the Department of Entomology, Tamilnadu Agricultural University, Coimbatore, India. Two strains of P. aeruginosa such as PAO1 (potent biofilm former) and MTCC 1688 (non-weak biofilm former) were tested against the glass coverslip (control) and wings of dragonfly (test) for 48 h. The wings/glass coverslips were incubated with bacterial suspension in 48-well plate. The plates were incubated at 37 °C under static condition. Bacterial attachment on the nanopillar architecture of the wing surface was visualized using FESEM. The survival rate of P. aeruginosa was tested using colony counting technique and flow cytometry at 0.5 h, 1 h, 2 h, 7 h, 24 h, and 48 h post-incubation. Cell death was analyzed using propidium iodide staining and DNA quantification. The results indicated that the survival rate of non-biofilm forming P. aeruginosa is 0.2 %, whilst that of biofilm former is 45 % on the dragonfly wings at the end of 48 h. The reduction in the survival rate of biofilm and non-biofilm forming P. aeruginosa was 20% and 40% respectively on the wings compared to the glass coverslip. In addition, Fourier Transformed Infrared Radiation was used to study the modification in the surface chemical composition of the wing during bacterial attachment and, post-sonication. This result indicated that the chemical moieties are not involved in the bactericidal property of nanopillars by the conserved characteristic peaks of chitin pre and post-sonication. The nanopillar architecture of the dragonfly wing efficiently deters the survival of non-biofilm forming P. aeruginosa, but not the biofilm forming strain. The study highlights the ability of biofilm formers to survive on wing architecture. Understanding this survival strategy will help in designing the architecture that combats the colonization of biofilm forming pathogens.

Keywords: biofilm, nanopillars, Pseudomonas aeruginosa, survival rate

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Authors: Mazdak Ganjalikhani, Mohamad Namgar, Alireza Peyman

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Introduction: The present study was carried out to measure the levels of inflammatory markers Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in tear of keratoconus patients and investigate their relationship with the severity of keratoconus. Materials and Methods: This study was performed on 81 patients with keratoconus (cases) and 85 healthy individuals (controls) who were selected through the convenience sampling method from patients visiting the Feiz Ophthalmology Hospital affiliated with the Isfahan University of Medical Sciences. Tear levels of IL-6 and TNF-α were measured after collecting the patient's tears from the lower eyelid through the Schirmer I method using a filter paper (Schirmer tear test strip) without anesthesia. Findings: The mean levels of IL-6 and TNF-α were 26.77±8.16 and 34.58±9.82 in the control group and 103.22±51.94, and 183.76±54.61 in the case group, respectively, indicating a significant difference between two groups (p<0.05). In addition, there was a significant relationship between the severity of the keratoconus and the mean levels of TNF-α and IL-6 in the case group (p<0.05). Conclusion: According to the results, the mean levels of IL-6 and TNF-α were higher in keratoconus cases than in the controls, and the disease severity was significantly associated with the levels of inflammatory markers IL-6 and TNF-α.

Keywords: keratoonus, cataract, tumor necrotic factor, interleukin 6

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Authors: Lamia Bouzgarrou, Amira Omrane, Naima Bouatay, Chaima Harrathi, Samia Machroughl, Ahmed Mhalla

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Background and Aims: Professionals of health care sector are exposed to psychosocial constraints like stress, harassment, violence, which can lead to many mental health problems such as, depression, addictive behavior, and burn-out. Moreover, it’s well established that caregivers affected to intensive care units are more likely to experience such constraints and mental health problems. For these caregivers, the mental health state may affect care quality and patient’s safety. This study aims either to identify occupational psychosocial constraints and their mental health consequences among paramedical and medical caregivers affected to intensive units in Tunisian public hospital. Methods: An exhaustive three months cross-sectional study conducted among medical and paramedical staffs of intensive care units in three Tunisian university hospitals. After informed consent collection, we evaluated work-related stress, workplace harassment, depression, anxious troubles, addictive behavior, and self-esteems through an anonymous self-completed inquiry form. Five validated questionnaires and scales were included in this form: Karasek's Job Content Questionnaire, Negative Acts Questionnaire, Rosenberg, Beck depression inventory and Hamilton Anxiety scale. Results: We included 129 intensive unit caregivers; with a mean age of 36.1 ± 1.1 years and a sex ratio of 0.58. Among these caregivers, 30% were specialist or under-specialization doctors. The average seniority in the intensive care was 6.1 ± 1.2 (extremes=1 to 40 years). Atypical working schedules were noted among 36.7% of the subjects with an imposed choice in 52.4% of cases. During the last 12 months preceding the survey, 51.7% of care workers were absent from work because of a health problem with stops exceeding 15 days in 11.7%. Job strain was objective among 15% of caregivers and 38.33% of them were victims of moral harassment. A low or very low self-esteem was noted among 40% of respondents. Moreover, active smoking was reported by 20% subjects, alcohol consumption by 13.3% and psychotropic substance use by 1.7% of them. According to Beck inventory and Hamilton Anxiety scale, we concluded that 61.7% of intensive care providers were depressed, with 'severe' depression in 13.3% of cases and 49.9% of them present anxious disorders. Multivariate analysis objective that, job strain was correlated with young age (p=0.005) and shorter work seniority (p=0.001). Workplace and moral harassment was more prevalent among females (p=0.009), under-specialization doctor (p=0.021), those affected to atypical schedules (p=0.008). Concerning depression, it was more prevalent among staff in job strain situation (p = 0.004), among smokers caregivers (p = 0.048), and those with no leisure activity (p < 0.001). Anxious disorders were positively correlated to chronic diseases history (p = 0.001) and work-bullying exposure (p = 0.004). Conclusions: Our findings reflected a high frequency of caregivers who are under stress at work and those who are victims of moral harassment. These health professionals were at increased risk for developing psychiatric illness such depressive and anxious disorders and addictive behavior. Our results suggest the necessity of preventive strategies of occupational psychosocial constraints in order to preserve professional’s mental health and maximize patient safety and quality of care.

Keywords: health care sector, intensive care units, mental health, psychosocial constraints

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Authors: Thomas Rockstuhl, Kok Yee Ng, Guido Gianasso, Soon Ang

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Two meta-analyses show that intercultural experience is not related to intercultural adaptation or performance in international assignments. These findings have prompted calls for a deeper grounding of research on international experience in the phenomenon of global work. Two issues, in particular, may limit current understanding of the relationship between international experience and global work performance. First, intercultural experience is too broad a construct that may not sufficiently capture the essence of global work, which to a large part involves sensemaking and managing intercultural conflicts. Second, the psychological mechanisms through which intercultural experience affects performance remains under-explored, resulting in a poor understanding of how experience is translated into learning and performance outcomes. Drawing on recognition primed decision-making (RPD) research, the current study advances a cognitive processing model to highlight the importance of intercultural conflict familiarity. Compared to intercultural experience, intercultural conflict familiarity is a more targeted construct that captures individuals’ previous exposure to dealing with intercultural conflicts. Drawing on RPD theory, we argue that individuals’ intercultural conflict familiarity enhances their ability to make accurate judgments and generate effective responses when intercultural conflicts arise. In turn, the ability to make accurate situation judgements and effective situation responses is an important predictor of global work performance. A relocation program within a multinational enterprise provided the context to test these hypotheses using a time-lagged, multi-source field study. Participants were 165 employees (46% female; with an average of 5 years of global work experience) from 42 countries who relocated from country to regional offices as part a global restructuring program. Within the first two weeks of transfer to the regional office, employees completed measures of their familiarity with intercultural conflicts, cultural intelligence, cognitive ability, and demographic information. They also completed an intercultural situational judgment test (iSJT) to assess their situation judgment and situation response. The iSJT comprised four validated multimedia vignettes of challenging intercultural work conflicts and prompted employees to provide protocols of their situation judgment and situation response. Two research assistants, trained in intercultural management but blind to the study hypotheses, coded the quality of employee’s situation judgment and situation response. Three months later, supervisors rated employees’ global work performance. Results using multilevel modeling (vignettes nested within employees) support the hypotheses that greater familiarity with intercultural conflicts is positively associated with better situation judgment, and that situation judgment mediates the effect of intercultural familiarity on situation response quality. Also, aggregated situation judgment and situation response quality both predicted supervisor-rated global work performance. Theoretically, our findings highlight the important but under-explored role of familiarity with intercultural conflicts; a shift in attention from the general nature of international experience assessed in terms of number and length of overseas assignments. Also, our cognitive approach premised on RPD theory offers a new theoretical lens to understand the psychological mechanisms through which intercultural conflict familiarity affects global work performance. Third, and importantly, our study contributes to the global talent identification literature by demonstrating that the cognitive processes engaged in resolving intercultural conflicts predict actual performance in the global workplace.

Keywords: intercultural conflict familiarity, job performance, judgment and decision making, situational judgment test

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Authors: Yunqi Wang

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As a vital region to the Chinese Belt and Road Initiative (BRI), members of the Association of Southeast Asian Nations (ASEAN) have responded to the grand strategy differently. Some expressed fervent support, while others played the 'hedging' card between great powers. This paper explores the underlying rationale behind such complexity by proposing two theoretical explanations: a Regionalism Hypothesis, where countries respond with hedging, balancing, and bandwagoning behaviours in line with national interests and norm-based 'ASEAN-Way'; and a Ladder-up Hypothesis, where countries consider the initiative as an incentive to remove bottlenecks of climbing up the economic ladder in Rostow's stage of the growth model. By analysing reactions from Myanmar, Laos, Indonesia, and Singapore, two patterns are observed. On an empirical note, the more developed economies are more inclined to the Regionalist explanation. On a theoretical note, there has been a gradual convergence between the two explanations, given the impact of economic globalisation on ASEAN. This paper will contribute to the current theoretical vacancy in the study of ASEAN and BRI by capturing the particular norms shared by this regional entity.

Keywords: ASEAN, belt and road initiative, hedging, Rostow's stages of growth, regionalism

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Authors: Gabriella Zarlenga, Martha L. Hall

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Introduction: Premature infants are at risk for neurodevelopmental deficits and hospital readmissions, which can increase the financial burden on the health care system and families. Kangaroo care (skin-to-skin contact) is a practice that can improve preterm infant health outcomes. Preterm infants can acquire adequate body temperature, heartbeat, and breathing regulation through lying directly on the mother’s abdomen and in between her breasts. Due to some infant’s condition, kangaroo care is not a feasible intervention. The purpose of this proof-of-concept research project is to create a device which simulates skin-to-skin contact for pre-term infants not eligible for kangaroo care, with the aim of promoting baby’s health outcomes, reducing the incidence of serious neonatal and early childhood illnesses, and/or improving cognitive, social and emotional aspects of development. Methods: The study design is a proof-of-concept based on a three-phase approach; (1) observational study and data analysis of the standard of care for 2 groups of pre-term infants, (2) design and concept development of a novel device for pre-term infants not currently eligible for standard kangaroo care, and (3) prototyping, laboratory testing, and evaluation of the novel device in comparison to current assessment parameters of kangaroo care. A single center study will be conducted in an area hospital offering Level III neonatal intensive care. Eligible participants include newborns born premature (28-30 weeks of age) admitted to the NICU. The study design includes 2 groups: a control group receiving standard kangaroo care and an experimental group not eligible for kangaroo care. Based on behavioral analysis of observational video data collected in the NICU, the device will be created to simulate mother’s body using electrical components in a thermoplastic polymer housing covered in silicone. It will be designed with a microprocessor that controls simulated respiration, heartbeat, and body temperature of the 'simulated caregiver' by using a pneumatic lung, vibration sensors (heartbeat), pressure sensors (weight/position), and resistive film to measure temperature. A slight contour of the simulator surface may be integrated to help position the infant correctly. Control and monitoring of the skin-to-skin contact simulator would be performed locally by an integrated touchscreen. The unit would have built-in Wi-Fi connectivity as well as an optional Bluetooth connection in which the respiration and heart rate could be synced with a parent or caregiver. A camera would be integrated, allowing a video stream of the infant in the simulator to be streamed to a monitoring location. Findings: Expected outcomes are stabilization of respiratory and cardiac rates, thermoregulation of those infants not eligible for skin to skin contact with their mothers, and real time mother Bluetooth to the device to mimic the experience in the womb. Results of this study will benefit clinical practice by creating a new standard of care for premature neonates in the NICU that are deprived of skin to skin contact due to various health restrictions.

Keywords: kangaroo care, wearable technology, pre-term infants, medical design

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Authors: Susana Almeida

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The right to adequate food is a human right protected under several international human rights treaties of universal or regional application. In addition, this social right is – as we intend to demonstrate – guaranteed under the Portuguese Constitution. Therefore, in order to assure the protection of this right, the Portuguese State must not only abstain from interfering with this human right (negative obligation) but also take action to secure the human right to adequate food (positive obligation). In this context, the Portuguese State has developed several governmental policies, such as taxing sugary drinks, setting the maximum amount of salt in the bread or creating the National Program for the Promotion of Healthy Food. Nevertheless, we intend to demonstrate that special attention should be given to advertising, as advertisements have an extreme influence on the consumers' decisions and hence on the food decisions. In this paper, besides explaining the cross construction of the human right to adequate food, we aim to examine the Advertising Portuguese Code and to study the several provisions that could be held by the Portuguese consumer to challenge some advertisements due to the violation of the right to health and the right to adequate food. Moreover, having in mind the influence of advertising on the food decisions and the serious problems that unhealthy food may bring (e.g., child obesity), one should ask if this legal framework should not be reviewed in order to lay out some restrictions on advertising, namely setting advices like in alcohol advertisements.

Keywords: advertising code, consumer law, right to adequate food, social human right

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Authors: Ozgu Turgut

Abstract:

Water scarcity is a problem for many regions which requires immediate action, and solutions cannot be postponed for a long time. It is known that farming consumes a significant portion of usable water. Although in recent years, the efforts to make the transition to dripping or spring watering systems instead of using surface watering started to pay off. It is also known that this transition is not necessarily translated into an increase in the capacity dedicated to other water consumption channels such as city water or power usage. In order to control and allocate the water resource more purposefully, new watering systems have to be used with monitoring abilities that can limit the usage capacity for each farm. In this study, a decision support model which relies on a bi-objective stochastic linear optimization is proposed, which takes crop yield and price volatility into account. The model generates annual planting plans as well as water usage limits for each farmer in the region while taking the total value (i.e., profit) of the overall harvest. The mathematical model is solved using the L-shaped method optimally. The decision support model can be especially useful for regional administrations to plan next year's planting and water incomes and expenses. That is why not only a single optimum but also a set of representative solutions from the Pareto set is generated with the proposed approach.

Keywords: decision support, farming, water, tactical planning, optimization, stochastic, pareto

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Authors: H. N. S. Silva, S. N. Silva

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Introduction: 88.3% of physicians decided to choose a ‘no-code’ or a DNR order if hospitalized and would choose to die less aggressively at home. However, their wishes were mostly over ridden. Objective: To assess the attitudes of nurses towards the end-of-the-life care they would like to receive for themselves and their attitudes towards terminal illnesses. Methods: A mixed method approach was used. A closed and open-ended questionnaire was administered to 73 participants and 5 registered nurses, who have more than 10 years of experience, working in hospitals both in Sri Lanka and abroad, were interviewed. Results: 94.1% of the participants stated that they would like to die at home, spending their last hours at home surrounded by their loved ones and engaging in religious activities but 57.7% of unmarried nurse said they would agree on euthanasia if they had a terminal disease, and also 66.2% of them stated they would agree in DNR order if they happen to be admitted to the ICU, but 82.5% wanted to diagnose if they had a terminal illness or cancer but did not agree on euthanasia. Qualitative analysis confirmed the findings and revealed that despite having adequate confidence about the hospital care, nurses would choose to die at home, surrounded by their loved once and engaging in religious activities. Euthanasia was believed to be inappropriate as it is religiously incorrect and as death is a natural process. Conclusion: The perception of death among nurses depends on their religious belief.

Keywords: death, do not resuscitate, euthanasia, nurses

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Authors: Kexin Chen

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As an important method of transportation to solve the demand and supply contradiction generated in the rapid urbanization process, urban rail traffic system has been rapidly developed over the past ten years in China. During the rapid development, the space of urban rail Transit has encountered many problems, such as space simplification, sensory experience dullness, and poor regional identification, etc. This paper, focus on the study of the negative space of subway station and spatial softening, by comparing and learning from foreign cases. The article sorts out cases at home and abroad, make a comparative study of the cases, analysis more diversified setting of public art, and sets forth propositions on the domestic type of public art in the space of urban rail transit for reference, then shows the relationship of the spatial attribute in the space of urban rail transit and public art form. In this foundation, it aims to characterize more diverse setting ways for public art; then suggests the three public art forms corresponding properties, such as static presenting mode, dynamic image mode, and spatial softening mode; finds out the method of urban public art to optimize negative space.

Keywords: diversification, negative space, optimization strategy, public art planning

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Authors: Joshua Abraham, Craig Wales

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Abstract—SIGN Guideline 122 recommends that all patients who are admitted to hospital are assessed for venous thromboembolism risk within 24 hours of admission. NHS Greater Glasgow and Clyde provide guidance on this in the form of a proforma. Patients are then subsequently prescribed either thrombo-embolic-deterrent stockings (TEDS)/low molecular weight heparin (LMWH) for the prevention of VTE based on their score. A retrospective casenote audit of a random sample of fifty oncology and trauma inpatients at the QEUH in December 2019 was performed. 90% of patients had a risk assessment conducted as evidenced by a completed proforma. In 78% of these patients, the proforma fully completed. Overall 94% of patients had some for of thromboprophylaxis prescribed in the form of TEDS or LMWH. A lack of 100% compliance against the given standards highlighted potential implications for patient safety, but also medico-legal ramifications for staff. Clinical judgement can only be relied upon if there is written documentation as evidence. Further staff education and the suggestion of a written prompt to the clerk-in documentation will hopefully improve compliance, whilst a repeat audit should demonstrate any improvement.

Keywords: Maxillofacial , Thromboembolism, Thromboprophylaxis , Prescription

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Authors: Yuri Teraoka, Cheerawit Rattanapan, Aroonsri Mongkolchati

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This cross sectional analytic study was carried out to determine factors related to protective behavior on indoor pollution among pregnant women in Nakhon Pathom province, Thailand. A total of 319 pregnant women were enrolled at three antenatal care clinics in community hospital. Data were collected using simple random sampling from April 2015 to May 2015 using a structured self-administration questionnaire by well-trained research assistants. The result showed that around 73% pregnant women showed low level of low protective behavior on indoor pollution. Chi-square and multiple logistic regression were used to examine the factors and protective behavior on indoor pollution. After adjusting for confounding factors, this study found that tobacco smoking before pregnancy (AOR=2.15, 95% CI: 0.78-5.95) and low environmental health hazard (AOR=1.94, 95% CI: 1.09-3.49) were significant factors related to protective behavior on indoor pollution among pregnant women (p-value < 0.05). In conclusion, this study suggested that environmental health education campaign and environmental implementation program among pregnant woman are needed.

Keywords: Thailand, environmental health, protective behavior, pregnant women

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Authors: M. Novak, E. Munoz, A. Jana, M. Nelemans

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Cities and local governments the world over are interested to employ circular strategies as a means to bring about food security, create employment and increase resilience. The selection and implementation of circular strategies is facilitated by modeling the effects of strategies locally and understanding the impacts such strategies have had in other (comparable) cities and how that would translate locally. Urban areas are heterogeneous because of their geographic, economic, social characteristics, governance, and culture. In order to better understand the effect of circular strategies on urban systems, we create a dataset for over 300 cities around the world designed to facilitate circular strategy scenario modeling. This new dataset integrates data from over 20 prominent global national and urban data sources, such as the Global Human Settlements layer and International Labour Organisation, as well as incorporating employment data from over 150 cities collected bottom up from local departments and data providers. The dataset is made to be reproducible. Various clustering techniques are explored in the paper. The result is sets of clusters of cities, which can be used for further research, analysis, and support comparative, regional, and national policy making on circular cities.

Keywords: data integration, urban innovation, cluster analysis, circular economy, city profiles, scenario modelling

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Authors: A. Wahid Uddin

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Osmotic dilator for cervical ripening bypasses the initial hormonal exposure necessary for a routine method of induction. The study was a clinical intervention with an osmotic dilator followed by prospective observation. The aim was to calculate the percentage of women who had successful cervical ripening using modified BISHOP score as evidenced by artificial rupture of membrane. The study also estimated the delivery interval following a single administration of osmotic dilators. Randomly selected patients booked for induction of labour accepting the intervention were included in the study. The study population comprised singleton term pregnancy, cephalic presentation, intact membranes with a modified BISHOP score of less than 6. Initial sample recruited was 30, but 6 patients left the study and the study was concluded on 24 patients. The data were collected in a pre-designed questionnaire and analysis were expressed in percentages along with using mean value for continuous variables. In 70 % of cases, artificial rupture of the membrane was possible and the mean time from insertion of the osmotic dilator to the delivery interval was 30 hours. The study concluded that an osmotic dilator could be a suitable alternative for hormone-based induction of labour.

Keywords: dilator, induction, labour, osmotic

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Authors: Ajibade Adeyemo

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The paper examined local terms used for spaces, forms and building practices in southwest Nigeria as cultural semiotics. Housing has more cultural meaning than mere shelter as shown in building terms such as ‘roof over my head’. The study is significant in the study area because its people were traditionally orally centered until ‘culture contact’ led to graphical presentation and appreciation in the form of drawings which is a modern language of architecture. This semiotic study will facilitate the understanding of the wholesomeness of traditional building practices and thoughts. This is in the culture of the traditional multi-sensory appreciation of architecture, urban design and the arts. It will analyze traditional aphoristic words and terms which are like proverbs which are significant in language because of their metaphorical essence. Many of such terms in the dominant Yoruba language of the study area are oftentimes phenomenal reducing universal terms like the earth and heaven to the simple module of housing. These words could be worth investigating because they are symbolic serve as codes which are cultural tool of regional ethnic significance. Sassure’s and Pierce’s concepts of Semiotics in line with Eco’s concept of semiotics of metaphor shall be deployed.

Keywords: traditional terms, spaces, forms, artifacts, cultural semiotics, southwest

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Authors: Wan Shan Chiang, Charn Ting Wang, Wei-Chih Kan, Hui-Chen Huang

Abstract:

Dialysis patients have risk in Zoster virus because of low immune. Valacyclovir (product name: Valtex) 500mg/tab, an anti-zoster virus medicine, is digested in kidney and it has side-effect of nervous system in patients with malfunction kidneys. Although the clinical basis of the proposed administration, we found that patients still have side effects. So we want to explore the appropriate dose of peritoneal dialysis patients. We read small samples of case reports and analyze 8 cases in our hospital, some patients’ Kt/v, match the standard of dialysis, and still go to the toilet, they still have side effect seriously with 500mg portion. The solution to this includes stopping medicine, reduction of medicine, increase of liquid change and timely hemodialysis and all of them speed up the recovery. The safety of medication needs extra attention of medical care employee. If they can tell the doctor if the patient has urine or not in his or her Kt/v, the doctor can prescribe the medicine accordingly. About the limitation, due to the lack of cases and related pharmacokinetics numbers. Therefore, for peritoneal patients, we think 500mg/48hoursis the saves. We also want to remind pharmaceuticals to revise the portion taken by patients, so that the doctor may judge the use.

Keywords: herpes zoster, Valacyclovir, peritoneal dialysis, health education

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Authors: Noratiqah Mohd Ariff, Abdul Aziz Jemain, Mohd Aftar Abu Bakar

Abstract:

The construction of Intensity-Duration-Frequency (IDF) curves is one of the most common and useful tools in order to design hydraulic structures and to provide a mathematical relationship between rainfall characteristics. IDF curves, especially those in Peninsular Malaysia, are often built using moving windows of rainfalls. However, these windows do not represent the actual rainfall events since the duration of rainfalls is usually prefixed. Hence, instead of using moving windows, this study aims to find regionalized distributions for IDF curves of extreme rainfalls based on storm events. Homogeneity test is performed on annual maximum of storm intensities to identify homogeneous regions of storms in Peninsular Malaysia. The L-moment method is then used to regionalized Generalized Extreme Value (GEV) distribution of these annual maximums and subsequently. IDF curves are constructed using the regional distributions. The differences between the IDF curves obtained and IDF curves found using at-site GEV distributions are observed through the computation of the coefficient of variation of root mean square error, mean percentage difference and the coefficient of determination. The small differences implied that the construction of IDF curves could be simplified by finding a general probability distribution of each region. This will also help in constructing IDF curves for sites with no rainfall station.

Keywords: IDF curves, L-moments, regionalization, storm events

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Authors: Ajit Kumar Yadav, Priyanka Yadav, F. Ram

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In present study is an effort to analyse the burden of diseases in the state. Disability Adjusted Life Years (DALY) is estimated non-communicable diseases. Multi-rounds (52nd, 60th and 71st round) of the National Sample Surveys (NSSO), conducted in 1995-96, 2004 and 2014 respectively, and Million Deaths Study (MDS) of 2001-03, 2006 and 2013-14 datasets are used. Descriptive and multivariate analyses are carried out to identify the determinants of different types of self-reported morbidity and DALY. The prevalence was higher for population aged 60 and above, among females, illiterates, and rich across the time period and for all the selected morbidities. The results were found to be significant at P<0.001. The estimation of DALY revealed that, the burden of communicable diseases was higher during infancy, noticeably among males than females in 2002. However, females aged 1-5 years were more vulnerable to report communicable diseases than the corresponding males. The age distribution of DALY indicates that individuals aged below 5 years and above 60 year were more susceptible to ill health. The growing incidence of non-communicable diseases especially among the older generations put additional burden on the health system in the state. The state has to grapple with the unsettled preventable infectious diseases in one hand and growing non-communicable in other hand.

Keywords: disease burden, non-communicable, communicable, India and region

Procedia PDF Downloads 254