Search results for: hospital factors

Authors: Shorena Tsiklauri, Avtandil Sulaberidze, Nino Gomelauri

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In the years followed independence, an economic crisis and some conflicts led to the displacement of many people inside Georgia. The growing poverty, unemployment, low income and its unequal distribution limited access to basic social service have had a clear direct impact on Georgian population dynamics and its age-sex structure. Factors influencing the changing population age structure and urbanization include mortality, fertility, migration and expansion of urban. In this paper presents the main factors of changing the distribution by urban and rural areas. How different are the urban and rural age and sex structures? Does Georgia have the same age-sex structure among their urban and rural populations since 1950s?

Keywords: age and sex structure of population, georgia, migration, urban-rural population

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Authors: Tauseef-ur-Rehman, Rao Zahid Abbas, Wasim Babar, Arbab Sikandar

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Babesiosis is an infection due to the multiplication of tick borne parasite, Babesia sp., in erythrocytes of host (variety of vertebrates) including small ruminants and is responsible for decreased livestock output and hence economic losses. A cross-sectional study was designed in order to evaluate the prevalence of Babesia and its relation with various associated factors in district Toba Tek Singh, Central Punjab, Pakistan in 2009-2010. A total 10.84% (50/461) out of 461 examined cases for Babesia were found positive for Babesia infection. Month-wise peak prevalence was observed in July (17.95%), while no positive case was recorded in Dec-2009 and Jan-2010. The prevalence of infection in different goat breeds was found as non-significant (P < 0.05) for Babesia infection. The prevalence of Babesia was found significantly (P < 0.05) dependent to the goat age and sex. The feeding system, housing system, floor type and herd size revealed strong correlation with Babesia prevalence, while watering system and body conditions were found to be non-significant (P < 0.05), and hence it is suggested that with the improvement of management precautions Babesiosis can be avoided.

Keywords: Babesia, goat, prevalence, Pakistan, risk factors

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Authors: Styliani Kotrotsiou, Evagelia Kotrotsiou, Fani Mokia, Theodosis Paralikas, Konstantinos Tsaras

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Objective: The objective of this study was the investigation of the mental health of patients undergoing chronic or transient hemodialysis at Artificial Kidney Unit, as well as its relationship to the demographic characteristic of patients. Material and Method: The study took place in Larisa during the month of December in 2016 and the sample was composed of 60 patients undergoing in chronic or transient hemodialysis at Artificial Kidney Unit of the University General Hospital of Larisa. For the investigation of the physical and mental health of patients who participated in the study, the tool measurement << General Health Questionnaire- 28 >> (GHQ-28) was used. The questionnaires were administered with the interview method during the hemodialysis. This survey is designed for the existence or not of a mental disorder. It examines four factors (physical symptoms, anxiety, social dysfunction and depression). Results: The hemodialysis patients gave the following scores: -to the physical symptoms, women showed a higher average value than men (1,16 ± 1,26 against 0,49 ± 0,93), -at the anxiety scale, it seems that women are superior to men (1,68 ± 1,20 against 0,90 ± 1,22), -at the social dysfunction scale, the elderly patients ( > 65 years old) were presented a with higher average (2,59), and -at the depression scale, patients with a higher average value were those who lived in non-urban areas. The appearance of mental disorder, in relation to patient characteristics, did not show significant statistical correlation. The sex, the age and the place of residence affect more the assessment of mental health, while education did not seem to have any significant effect on the other. Conclusions: The hemodialysis process can significantly affect the patient’s Quality of Life and it can bring adverse changes in lifestyle, affecting the physical, social and psychological state of the individual. For that reason, hemodialysis should be aimed not only at extending life but in upgrading the Quality of Life.

Keywords: hemodialysis, chronic kidney disease, depression, social dysfunction, physical condition

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Authors: K. R. Mukuna

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Teachers are faced many challenges in the South African rural schools such as stress, depression, lack of resources, poor working relationships, inflexible curriculum etc. These could affect their wellbeing and effectiveness at the workplace. As a result, the study had a significance in the teacher’s lives, and community due teachers worked under conditions that are unfavourable to perform their jobs effectively. Despite these conditions, they still managed to do their jobs and the community is uplifted. However, this study aimed to explore factors that enable teachers to cope with workplace adversities at a rural school district in the Free State Province. It adopted a qualitative case study as a research design. Semi-structured interviews and colleges had employed as tools to collect data. Ten participants (n=10; 5 males and 5 females) were selected through purposive and convenience sampling. All participants selected from a South African rural school. Sesotho culture was their home language, and most of them had 5 years of teaching experiences. The thematic findings revealed that they developed abilities to cope with and adjust to the social and cultural environment. These included self-efficacy, developing problem-solving skills, awareness of strengths and asserts, self-managing of emotions, and self-confidence. This study concluded that these psychosocial factors contributed to coping with teacher’s diversities, and effectively stabilized their wellbeing in the schools.

Keywords: psychosocial factors, teachers counselling, teacher stress, workplace adversity, rural school, teachers’ wellbeing, teachers’ resilience, teachers’ self-efficacy, social interaction

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Authors: G. Lambe, D. Mansukhani, A. Shetty, S. Khodaiji, C. Rodrigues, F. Kapadia

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Introduction: Sepsis is known to cause impairment of both innate and adaptive immunity and involves an early uncontrolled inflammatory response, followed by a protracting immunosuppression phase, which includes decreased expression of cell receptors, T cell anergy and exhaustion, impaired cytokine production, which may cause high risk for secondary infections due to reduced response to antigens. Although human cytomegalovirus (CMV) is widely recognized as a serious viral pathogen in sepsis and immunocompromised patients, the incidence of CMV reactivation in patients with sepsis lacking strong evidence of immunosuppression is not well defined. Therefore, it is important to determine an association between CMV reactivation and sepsis-induced immunosuppression. Aim: To determine the association between incidence of CMV reactivation and immune modulation in sepsis-induced immunosuppression with time. Material and Methods: Ten CMV-seropositive adult patients with severe sepsis were included in this study. Blood samples were collected on Day 0, and further weekly up to 21 days. CMV load was quantified by real-time PCR using plasma. The expression of immunosuppression markers, namely, HLA-DR, PD-1, and regulatory T cells, were determined by flow cytometry using whole blood. Results: At Day 0, no CMV reactivation was observed in 6/10 patients. In these patients, the median length for reactivation was 14 days (range, 7-14 days). The remaining four patients, at Day 0, had a mean viral load of 1802+2599 copies/ml, which increased with time. At Day 21, the mean viral load for all 10 patients was 60949+179700 copies/ml, indicating that viremia increased with the length of stay in the hospital. HLA-DR expression on monocytes significantly increased from Day 0 to Day 7 (p = 0.001), following which no significant change was observed until Day 21, for all patients except 3. In these three patients, HLA-DR expression on monocytes showed a decrease at elevated viral load (>5000 copies/ml), indicating immune suppression. However, the other markers, PD-1 and regulatory T cells, did not show any significant changes. Conclusion: These preliminary findings suggest that CMV reactivation can occur in patients with severe sepsis. In fact, the viral load continued to increase with the length of stay in the hospital. Immune suppression, indicated by decreased expression of HLA-DR alone, was observed in three patients with elevated viral load.

Keywords: CMV reactivation, immune suppression, sepsis immune modulation, CMV viral load

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Authors: Danjuma Moudu Momoh

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Participation in sports is of immense benefit to the soundness of individual mental and social wellness, particularly among youngsters. The 1980’s and 1990’s compared to 2000’s witnessed great involvement of youngsters in school games arising from the high administrative supports attached to sports. Previous studies in an attempt to increase youngster’s participation in sports had focused more on other factors rather than on administrative factors. This study, therefore, investigated the importance of administrative factors (availability of facilities, availability of equipment, funding, scheduling of sports programme and administrative style of school principals) on students’ sports participation in private and public secondary schools in Kwara State, Nigeria. Descriptive survey research design using validated and structured questionnaire, was adopted. Stratified random sampling technique was used to pick the students both male and female. A total of two thousand five hundred and sixty participants were involved in the study. A reliable coefficient of r=0.82 was obtained for the instruments using Cronbach Alpha. Data were analyzed using multiple regressions to test the hypotheses at 00.5 significant levels. At the end of the study, it was discovered that the relative contributions of administrative factors among the students were: availability of facilities (β=0.314), availability of equipment (β=0.444), funding (β=0.301), scheduling of sports programme (β=0.447), made relative contributions to the dependent variable, administrative style of school principal (β=0.077) did not make significant but minimal contribution to the student’s sports participation.

Keywords: administrative determinants, secondary school students, physical activity, sports participation

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Authors: Zaka Nisa, Farooq Sher

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Adverse drug reactions (ADRs) underreporting is a great challenge to Pharmacovigilance. Health care professionals have to consider ADR reporting as their professional obligation, an effective system of ADR reporting is important to improve patient health care and safety. The present study is designed to assess the knowledge, attitude, practice and factors associated with ADR reporting by health care professionals (physicians and pharmacists) in public and private hospitals of Pakistan. A pretested questionnaire was administered to 384 physicians and pharmacists in public and private hospitals. Respondents were evaluated for their knowledge, attitude, and practice related to ADR reporting. The data was analyzed using the SPSS statistical software, the factors which encourage and discourage respondents in reporting ADRs were determined. Most of the respondents have shown a positive attitude towards ADR reporting. The response rate was 95.32%. Of the 367 questionnaires, including 333 (86.5%) physicians and 34 (8.8%) pharmacists with the mean age 28.34 (SD= 6.69), most of the respondents showed poor ADR reporting knowledge (83.1%). The majority of respondents (78.2%) showed positive attitude towards ADR reporting and only (12.3%) hospitals have good ADR reporting practice. Knowledge of respondents in public hospitals (8.6%) was less as compare to those in the private hospitals (29.7%) (P < 0.001). Attitude of respondents in private hospitals was more positive (92.4%) than those in public hospitals (68.8%) (P < 0.001). No significant difference was observed in practicing of ADR reporting in public (11.8%) and private hospitals (13.1%) (P value 0.89). Seriousness of ADR, unusualness of reaction, new drug involvement and confidence in diagnosis of ADR were the factors which encourage respondents to report ADR, however, lack of knowledge regarding where and how to report ADR, lack of access to ADR reporting form, managing patients was more important than reporting ADR, legal liability issues were the factors which discourage respondents to report ADR. The study reveals poor knowledge and practice regarding ADR reporting. However positive attitude was seen regarding ADR reporting. There is a need of educational training for health care professionals as well as genuine and continuous efforts are required by Government and health authorities to ensure the proper implementation of ADR reporting system in all of the hospitals.

Keywords: adverse drugs reactions (ADR), pharmacovigilance, spontaneous ADR reporting, knowledge of ADR, attitude of health care profesionals, practice of ADR reporting

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Authors: Zahra Okba, Hassan El Ouizgani

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Anticipating an individual’s behavior to the environmental factors allows for having relevant ecological forecasts. The Dynamic Energy Budget model facilitates prediction, and it is mechanically dependent on biology to abiotic factors but is generally field verified under relatively stable physical conditions. Dynamic Energy Budget Theory (DEB) is a robust framework that can link the individual state to environmental factors, and in our work, we have tested its ability to account for variability by looking at model predictions in the Agadir Bay, which is characterized by a semi-arid climate and temperature is strongly influenced by the trade winds front and nutritional availability. From previous works in our laboratory, we have collected different biological DEB model parameters of Mytilus galloprovincialis mussel in Agadir Bay. We mathematically formulated the equations that make up the DEB model and then adjusted our analytical functions with the observed biological data of our local species. We also assumed the condition of constant immersion, and then we integrated the details of the tidal cycles to calculate the metabolic depression at low tide. Our results are quite satisfactory concerning the length and shape of the shell in one part and the gonadosomatic index in another part.

Keywords: dynamic energy budget, mussels, mytilus galloprovincialis, agadir bay, DEB model

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Authors: Thanasuwit Thabhiranrak

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This research aims to study factors that affected the operations of the cassava industrial enterprises in northeast of Thailand. Hypothesis was tested by regress analysis and also the analysis in order to determine the relationship between variables with Pearson correlation and show a class action in cassava process including the owner of business executives and supervisors. The research samples were 400 people in northeast region of Thailand. The research results revealed that success of entrepreneurs related to transformation leadership and knowledge management in a positive way at statistical significance level of 0.01 and respondents also emphasized on the importance of transformational leadership factors. The individual and the use of intelligence affect the success of entrepreneurs in cassava industry at statistical significance level of 0.05. The qualitative data were also collected by interviewing with operational level staff, supervisors, executives, and enterprise owners in the northeast of Thailand. The result was found that knowledge management was important in their business operations. Personnel in the organizations should learn from working experience, develop their skills, and increase knowledge from education.

Keywords: transformational leadership, knowledge management (KM), cassava, northeast of Thailand, industrial

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Authors: Arvind Aggarwal

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We have developed a comprehensive global healthcare delivery System based on information technology. It has medical consultation system where a virtual consultant can give medical consultation to the patients and Doctors at the digital medical centre after reviewing the patient’s EMR file consisting of patient’s history, investigations in the voice, images and data format. The system has the surgical operation system too, where a remote robotic consultant can conduct surgery at the robotic surgical centre. The instant speech and text translation is incorporated in the software where the patient’s speech and text (language) can be translated into the consultant’s language and vice versa. A consultant of any specialty (surgeon or Physician) based in any country can provide instant health care consultation, to any patient in any country without loss of time. Robotic surgeons based in any country in a tertiary care hospital can perform remote robotic surgery, through patient friendly telemedicine and tele-surgical centres. The patient EMR, financial data and data of all the consultants and robotic surgeons shall be stored in cloud. It is a complete comprehensive business model with healthcare medical and surgical delivery system. The whole system is self-financing and can be implemented in any country. The entire system uses paperless, filmless techniques. This eliminates the use of all consumables thereby reduces substantial cost which is incurred by consumables. The consultants receive virtual patients, in the form of EMR, thus the consultant saves time and expense to travel to the hospital to see the patients. The consultant gets electronic file ready for reporting & diagnosis. Hence time spent on the physical examination of the patient is saved, the consultant can, therefore, spend quality time in studying the EMR/virtual patient and give his instant advice. The time consumed per patient is reduced and therefore can see more number of patients, the cost of the consultation per patients is therefore reduced. The additional productivity of the consultants can be channelized to serve rural patients devoid of doctors.

Keywords: e-health, telemedicine, telecare, IT-based healthcare

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Authors: Witri Pratiwi, Shopa Nur Fauzah, Dini Norviatin

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WHO recommends breastfeeding exclusively for infants aged 0 to 6 months because breast milk is the best nutrition. There are several factors associated with the success of exclusive breastfeeding. This study aims to determine the factors associated with the success of exclusive breastfeeding. A cross-sectional study was conducted at 6 community health centers in Cirebon City, Indonesia. Primary data were obtained from a validated questionnaire given to mothers who have children aged 6 to 24 months. A total of 326 mothers participated in this study. Two hundred and eighteen (66.9%) mothers gave exclusive breastfeeding to their babies, and 108 (33.1%) did not give exclusive breastfeeding. The baby gender (p=0.240), birth weight (p=0.436), and place of birth (0.137) were not related to exclusive breastfeeding. Mode of delivery (p=0.029) and early initiation of breastfeeding (p=0.001) were significantly associated with exclusive breastfeeding. Infants with early initiation of breastfeeding are three times more likely to get exclusive breastfeeding compared to those who do not get breastfeeding early (p=0.001; OR=3.696 [95% CI 1.764 – 7.746]). Early initiation of breastfeeding is the most important factor in determining the success of exclusive breastfeeding. Promotion and education on the importance of early breastfeeding initiation to prospective mothers, families, and health workers are expected to be improved.

Keywords: early initiation of breastfeeding, exclusive breastfeeding, mode of delivery, Indonesia

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Authors: Ilim Moses Msughter

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The study was carried out to examine the availability of Ante-natal care services and the socio-cultural factors affecting the utilization of these services in Dutsin-Ma Local Government Area of Katsina State. Four specific objectives were outlined as thus to examine the availability of antenatal care services in Dutsin-Ma local government area, to identify the socio-cultural factors affecting the utilisation of ante-natal care services, to ascertain the challenges affecting utilisation of ante-natal care services and suggest strategies to improve efficiency in ante-natal service delivery and utilisation of same services. Data were collected from 110 respondents using a questionnaire and through the use of the interview. Data were analysed quantitatively and qualitatively. The findings revealed that ante-natal care services are available in the study area, but access to such services is hindered by several factors, which include religious and traditional beliefs, cost of services and poor attitudes of health care workers which has an adverse effect on people’s desire to visit ante-natal centres. The study recommended that Traditional Birth Attendants (TBA) need to be trained on how to handle pregnancy-related complications. It is also recommended that essential ante-natal drugs and services should be subsidised or made free by the government, and this must be closely monitored to ensure efficiency. Finally, human relation training should be organised for nurses and midwives to improve their attitudes towards patients during ante-natal visits.

Keywords: utilisation, religion, traditional birth attendant, ante-natal

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Authors: Mohammad Naeem Lakanwall, Jamshid Abdul-Ghafar

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Background: Endocrinopathies are a commonly occurring entity, particularly those of the thyroid gland; however, there is a lack of scientific literature from Afghanistan, a country with very limited health care facilities and resources. To our best knowledge, this is the first study aimed to describe the frequency of occurrence and factors associated with thyroid dysfunction in the Afghan population. The aim of this study is to estimate the frequency and to identify factors associated with thyroid dysfunction among individuals coming to a tertiary care facility in Kabul, Afghanistan. Methods: A cross-sectional study was conducted from July to Sep 2018 at the Department of Clinical Pathology, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan. Blood samples were obtained, serum TSH levels were analyzed, and the patients were divided into three diagnostic categories according to their serum TSH concentrations: 1) hypothyroidism, 2) hyperthyroidism, 3) normal. Results: A total of 127 individuals were included in the final analysis. The majority of study participants (77%) were females. A large number of the participants (92%) did not have a family history of thyroid dysfunction. 74% of the participants in the study had normal TSH levels classified as normal thyroid function, (14%) had lower TSH levels, and (12%) higher TSH levels, classified as hyper and hypothyroid, respectively. Conclusions: The findings of the current study showed a high frequency of thyroid dysfunctions from a single center. Further large-scale studies are needed to find out the prevalence and document this entity for better health outcomes in the country.

Keywords: Afghanistan, factors, frequency, hypothyroid, hyperthyroid, thyroid, thyroid stimulating hormone

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Authors: Mehrdad Abkenari, Mehmet Kunt, Mahdi Nourollahi

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Evaluating the environmental risk factors is a combination of analysis of transportation effects. Various definitions for risk can be found in different scientific sources. Each definition depends on a specific and particular perspective or dimension. The effects of potential risks present along the new proposed routes and existing infrastructures of large transportation projects like railways should be studied under comprehensive engineering frameworks. Despite various definitions provided for ‘risk’, all include a uniform concept. Two obvious aspects, loss and unreliability, have always been pointed in all definitions of this term. But, selection as the third aspect is usually implied and means how one notices it. Currently, conducting engineering studies on the environmental effects of railway projects have become obligatory according to the Environmental Assessment Act in developing countries. Considering the longitudinal nature of these projects and probable passage of railways through various ecosystems, scientific research on the environmental risk of these projects have become of great interest. Although many areas of expertise such as road construction in developing countries have not seriously committed to these studies yet, attention to these subjects in establishment or implementation of different systems have become an inseparable part of this wave of research. The present study used environmental risks identified and existing in previous studies and stations to use in next step. The second step proposes a new hybrid approach of analytical network process (ANP) and DEMATEL in fuzzy conditions for assessment of determined risks. Since evaluation of identified risks was not an easy touch, mesh structure was an appropriate approach for analyzing complex systems which were accordingly employed for problem description and modeling. Researchers faced the shortage of real space data and also due to the ambiguity of experts’ opinions and judgments, they were declared in language variables instead of numerical ones. Since fuzzy logic is appropriate for ambiguity and uncertainty, formulation of experts’ opinions in the form of fuzzy numbers seemed an appropriate approach. Fuzzy DEMATEL method was used to extract the relations between major and minor risk factors. Considering the internal relations of risk major factors and its sub-factors in the analysis of fuzzy network, the weight of risk’s main factors and sub-factors were determined. In general, findings of the present study, in which effective railway environmental risk indicators were theoretically identified and rated through the first usage of combined model of DEMATEL and fuzzy network analysis, indicate that environmental risks can be evaluated more accurately and also employed in railway projects.

Keywords: DEMATEL, ANP, fuzzy, risk

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Authors: Mwehe Mathenge, Ben G. J. S. Sonneveld, Jacqueline E. W. Broerse

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Smallholder farmers are important drivers of agriculture productivity, food security, and poverty reduction in Sub-Saharan Africa. However, they are faced with myriad challenges in their efforts at participating in agribusiness markets. How the geographic explicit factors existing at the local level interact to impede smallholder farmers' decision to participates (or not) in agribusiness markets is not well understood. Deconstructing the spatial complexity of the local environment could provide a deeper insight into how geographically explicit determinants promote or impede resource-poor smallholder farmers from participating in agribusiness. This paper’s objective was to identify, map, and analyze local spatial autocorrelation in factors that impede poor smallholders from participating in agribusiness markets. Data were collected using geocoded researcher-administered survey questionnaires from 392 households in Western Kenya. Three spatial statistics methods in geographic information system (GIS) were used to analyze data -Global Moran’s I, Cluster and Outliers Analysis (Anselin Local Moran’s I), and geographically weighted regression. The results of Global Moran’s I reveal the presence of spatial patterns in the dataset that was not caused by spatial randomness of data. Subsequently, Anselin Local Moran’s I result identified spatially and statistically significant local spatial clustering (hot spots and cold spots) in factors hindering smallholder participation. Finally, the geographically weighted regression results unearthed those specific geographic explicit factors impeding market participation in the study area. The results confirm that geographically explicit factors are indispensable in influencing the smallholder farming decisions, and policymakers should take cognizance of them. Additionally, this research demonstrated how geospatial explicit analysis conducted at the local level, using geographically disaggregated data, could help in identifying households and localities where the most impoverished and resource-poor smallholder households reside. In designing spatially targeted interventions, policymakers could benefit from geospatial analysis methods in understanding complex geographic factors and processes that interact to influence smallholder farmers' decision-making processes and choices.

Keywords: agribusiness markets, GIS, smallholder farmers, spatial statistics, disaggregated spatial data

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Authors: Sudawan Somjai

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This paper aims to find out level of influences of factors that affected core competency and competitiveness of Thai electricity and electronics, and to indentify factors that affected core competency and competitiveness of Thai electricity and electronics. Using systematic random sampling technique, the samples of this study were 400 employees in the selected 10 medium enterprises in the electricity and electronic industries of Thailand that applied an outsourcing system. All selected companies were located in Bangkok and the eastern part of Thailand. Interviews were also utilized with managing directors. Qualitative and quantitative approaches were both applied. Questionnaires were employed in data collection, whereas in-depth interviews and focus groups were used with key informants in management. The findings unveiled a high level of influence of the outsourcing system on labor flexibility, manpower management efficiency, capability of business processes, cost reduction, business risk elimination and core competency. These factors were found to have a relationship with business core competency for competitiveness in the Thai electricity and electronic industry. Suggestions of this paper were also presented.

Keywords: competitiveness, core competency, outsourcing, Thai electricity and electronic industry

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Authors: Nasrin Amirrajab, Yasaman Razavi Ghahfarokhi, Zahra Tootak, Maryam Hadian, Fatemeh Abooali Shamshiri

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Urinary tract infections (UTIs) have been reported in children with nephrotic syndrome. However, the only causes for the infection reported to date are bacteria, but not many prior reported occurrences of fungi or yeast as causative organisms. Hence, the present study aimed to describe the epidemiology of urinary tract fungal infections in a tertiary care pediatric. A single-center cross-sectional study was conducted at the nephrology ward of Aboozar Pediatric Hospital between March 21, 2021, and April 28, 2022. Urine was collected aseptically from children, inoculated onto culture media, and incubated at 37 °C for 18–48 hours. Yeast was identified following standard procedures. Antifungal susceptibility testing was determined by the disk diffusion method according to the CLSI guideline. Descriptive statistics and logistical regressions were used to estimate the crude ratio with a 95% confidence interval. P-value < 0.05 was considered significant. Among 68 individuals referred to the mycology lab, the result of direct examination and culture of all patients approved for C.albicans. Of these, 38 individuals (55.8%) were male, and 30 (44.2%) were female. The patients' age ranges were between one month and an 18-year-old. In the study of infection intensity, the patients were classified into three levels such as few (73.5%), moderate (20.6%), and many (5.9%). In the present study, all the patients were sensitive to Posaconazole. Also, the eagle effect was found in Amphotericin B, Voriconazole, and Fluconazole with frequencies of 91.7%, 91.7%, and 83%, respectively. In addition, just 8.3% of isolates were resistant to Itraconazole. It has not shown resistance in other mentioned medicine. The patients showed an intermediate response to Itraconazole (91.7%), Fluconazole (17%), Voriconazole (8.3%), and Amphotericin B (8.3%). There is a high prevalence of yeast infections in children with suspected UTIs. Also, boys are more likely to get yeast infections, and the severity of the infection is higher than girls. The present study demonstrated the importance of diagnosing and selecting the appropriate drug for urinary tract fungal infections in hospitalized children.

Keywords: urinary tract infections, children, fungal infections, yeast, antifungal susceptibility

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Authors: Aaron Yan

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Tennis elbow has been a leading injury and problem among amateur and even professional players. Many factors contribute to tennis elbow. In this research, we apply state of the art sensor-less computer vision and AI technology to study the biomechanics of a player’s tennis movements during training and competition as they relate to the causes of tennis elbow. We provide a framework for the analysis of key biomechanical parameters and their correlations with specific tennis stroke and movements that can lead to tennis elbow or elbow injury. We also devise a method for using AI to automatically detect player’s forms that can lead to tennis elbow development for on-court injury prevention.

Keywords: Tennis Elbow, Computer Vision, AI, 3DAT

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Authors: A. Juhász, M. Fogarasi

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Those causing fatal traffic accidents are traumatized, which negatively influences their cognitive functions and their personality. In order to clarify how much the trauma of causing a fatal accident effects their driving skills and personality traits, the results of a psychological aptitude and a personality test of drivers carelessly causing fatal accidents and of drivers not causing any accidents were compared separately. The sample (N = 354) consists of randomly selected drivers from the Transportation Aptitude and Examination Centre database who caused fatal accidents (Fatal group, n = 177) or did not cause accidents (Control group, n = 177). The aptitude tests were taken between 2014 and 2019. The comparison of the 2 groups was done according to 3 aspects: 1. Categories of aptitude (suitable, restricted, unsuited); 2. Categories of causes (ability, personality, ability and personality) within the restricted or unsuited (altogether: non-suitable subgroups); 3. Categories of ability and personality within the non-suitable subgroups regardless of the cause-category. Within ability deficiency, the two groups include those, whose ability factor is impaired or limited. This is also true in case of personality failure. Compared to the control group, the number of restricted drivers causing fatal accidents is significantly higher (p < .000) and the number of unsuited drivers is higher on a tendency-level (p = .06). Compared to the control group in the fatal non-suitable subgroup, the ratio of restricted suitability and the unsuitability due to ability factors is exclusively significantly lower (p < .000). The restricted suitability and the unsuitability due to personality factors are more significant in the fatal non-suitable subgroup (p < .000). Incapacity due to combination of ability and personality is also significantly higher in the fatal group (p = .002). Compared to the control group both ability and personality factors are also significantly higher in the fatal non-suitable subgroup (p < .000). Overall, the control group is more eligible for driving than drivers who have caused fatalities. The ability and personality factors are significantly higher in the case of fatal accident causers who are non-suitable for driving. Moreover the concomitance of ability and personality factors occur almost exclusively to drivers who caused fatal accidents. Further investigation is needed to understand the causes and how the aptitude test results for the fatal group could improve over time.

Keywords: aptitude, unsuited, fatal accident, ability, personality

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Authors: Jeries J. Abou-Hanna

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Several techniques exist for determining stress-intensity factors in linear elastic fracture mechanics analysis. These techniques are based on analytical, numerical, and empirical approaches that have been well documented in literature and engineering handbooks. However, not all techniques share the same merit. In addition to overly-conservative results, the numerical methods that require extensive computational effort, and those requiring copious user parameters hinder practicing engineers from efficiently evaluating stress-intensity factors. This paper investigates the prospects of reducing the complexity and required variables to determine stress-intensity factors through the utilization of the stress gradient and a weighting function. The heart of this work resides in the understanding that fracture emanating from stress concentration locations cannot be explained by a single maximum stress value approach, but requires use of a critical volume in which the crack exists. In order to understand the effectiveness of this technique, this study investigated components of different notch geometry and varying levels of stress gradients. Two forms of weighting functions were employed to determine stress-intensity factors and results were compared to analytical exact methods. The results indicated that the “exponential” weighting function was superior to the “absolute” weighting function. An error band +/- 10% was met for cases ranging from a steep stress gradient in a sharp v-notch to the less severe stress transitions of a large circular notch. The incorporation of the proposed method has shown to be a worthwhile consideration.

Keywords: fracture mechanics, finite element method, stress intensity factor, stress gradient

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Authors: Khalid Bashir, Hammad Zahid

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Most of the investors consider that economic and financial information is the most important at the time of making investment decisions. But it is not true, as in the past two decades, the Behavioral aspects and the behavioral biases have gained an important place in the decision-making process of an investor. This study is basically conducted on this fact. The purpose of this study is to examine the impact of behavioral factors on the decision-making of the individual real estate investor in Pakistan. Some important behavioral factors like overconfidence, anchoring, gambler’s fallacy, home bias, loss aversion, regret aversion, mental accounting, herding and representativeness are used in this study to find their impact on the psychology of individual investors. The targeted population is the real estate investor of Pakistan, and a sample of 650 investors is selected on the basis of convenience sampling technique. The data is collected through the questionnaire with a response rate of 46.15 %. Descriptive statistical techniques and SEM are used to analyze the data by using statistical software. The results revealed the fact that some behavioral factors have a significant impact on the decision-making of investors. Among all the behavioral biases, overconfidence, anchoring, gambler’s fallacy, loss aversion and representativeness have a significant positive impact on the decision-making of the individual investor, while the rest of biases like home bias, regret aversion, mental accounting, herding have less impact on the decision-making process of an individual.

Keywords: behavioral finance, anchoring, gambler’s fallacy, loss aversion

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Authors: Lokvendra S. Budania, Yogesh K Gaude, Vamsidhar Chamala

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Introduction: Congenitally corrected transposition of great arteries (CCTGA) is a complex congenital heart disease where there are both atrioventricular and ventriculoarterial discordances, usually accompanied by other cardiovascular malformations. Case Report: A 24-year-old primigravida known case of CCTGA at 37 weeks of gestation was referred to our hospital for safe delivery. Her electrocardiogram showed HR-40/pm, echocardiography showed Ejection Fraction of 65% and CCTGA. Temporary pacemaker was inserted by cardiologist in catheterization laboratory, before giving trial of labour in view of complete heart block. She was planned for normal delivery, but emergency Caesarean section was planned due to non-reassuring foetal Cardiotocography Pre-op vitals showed PR-50 bpm with temporary pacemaker, Blood pressure-110/70 mmHg, SpO2-99% on room air. Nil per oral was inadequate. Patency of two peripheral IV cannula checked and left radial arterial line secured. Epidural Anaesthesia was planned, and catheter was placed at L2-L3. Test dose was given, Anaesthesia was provided with 5ml + 5ml of 2% Lignocaine with 25 mcg Fentanyl and further 2.5Ml of 0.5% Bupivacaine was given to achieve a sensory level of T6. Cesarean section was performed and baby was delivered. Cautery was avoided during this procedure. IV Oxytocin (15U) was added to 500 mL of ringer’s lactate. Hypotension was treated with phenylephrine boluses. Patient was shifted to post-operative care unit and later to high dependency unit for monitoring. Post op vitals remained stable. Temporary pacemaker was removed after 24 hours of surgery. Her post-operative period was uneventful and discharged from hospital. Conclusion: Rare congenital cardiac disorders require detail knowledge of pathophysiology and associated comorbidities with the disease. Meticulously planned and carefully titrated neuraxial techniques will be beneficial for such cases.

Keywords: congenitally corrected transposition of great arteries, complete heart block, emergency LSCS, epidural anaesthesia

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Authors: Kavitha Thamadharan, Nurazean Maarop

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The implementation of e-assessment as tool to support the process of teaching and learning in university has become a popular technological means in universities. E-Assessment provides many advantages to the users especially the flexibility in teaching and learning. The e-assessment system has the capability to improve its quality of delivering education. However, there still exists a drawback in terms of security which limits the user acceptance of the online learning system. Even though there are studies providing solutions for identified security threats in e-learning usage, there is no particular model which addresses the factors that influences the acceptance of e-assessment system by lecturers from security perspective. The aim of this study is to explore security aspects of e-assessment in regard to the acceptance of the technology. As a result a conceptual model of secure acceptance of e-assessment is proposed. Both human and security factors are considered in formulation of this conceptual model. In order to increase understanding of critical issues related to the subject of this study, interpretive approach involving convergent mixed method research method is proposed to be used to execute the research. This study will be useful in providing more insightful understanding regarding the factors that influence the user acceptance of e-assessment system from security perspective.

Keywords: secure technology acceptance, e-assessment security, e-assessment, education technology

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Authors: Bundit Pungnirund, Boonyada Pahasing

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The objective of this research is to study factors related to behaviors of Thai travelers traveling to Koh Kret Island, Nonthaburi Province. The subjects of this study included 400 Thai travelers coming to Koh Kred. Questionnaires were used to collect data which were analyzed by computer program to find mean and correlation coefficient by Pearson. The results showed that Thai travelers reported their opinions and attitudes in high level on the marketing service mix, product, price, place, promotion, personal, physical evidence, and process. They reported on travelling motivation factor, tourist attraction, and facility at high level. Moreover, marketing service mix, product, price, place, promotion, personal, physical, and process including travelling motivation factor, tourist attraction, and facility had positive relationship with the frequency in travelling at statistically significant level (0.01), though in a low relationship but in the same direction.

Keywords: factors, behaviors, Thai travelers, Koh Kled, Nonthaburi Province

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Authors: Carolyn Scott, Rachel Nugent

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The agricultural industry in Ireland and worldwide is one of the most dangerous occupations with respect to occupational health and safety accidents and fatalities. Many accident causation models have been developed in safety research to understand the underlying and contributory factors that lead to the occurrence of an accident. Due to the uniqueness of the agricultural sector, current accident causation theories cannot be applied. This paper presents an accident causation model named the Irish Farm Accident Causation Model (IFACM) which has been specifically tailored to the needs of Irish farms. The IFACM is a theoretical and practical model of accident causation that arranges the causal factors into a graphic representation of originating, shaping, and contributory factors that lead to accidents when unsafe acts and conditions are created that are not rectified by control measures. Causes of farm accidents were assimilated by means of a thorough literature review and were collated to form a graphical representation of the underlying causes of a farm accident. The IFACM was validated retrospectively through case study analysis and peer review. Participants in the case study (n=10) identified causes that led to a farm accident in which they were involved. A root cause analysis was conducted to understand the contributory factors surrounding the farm accident, traced back to the ‘root cause’. Experts relevant to farm safety accident causation in the agricultural industry have peer reviewed the IFACM. The accident causation process is complex. Accident prevention requires a comprehensive understanding of this complex process because to prevent the occurrence of accidents, the causes of accidents must be known. There is little research on the key causes and contributory factors of unsafe behaviours and accidents on Irish farms. The focus of this research is to gain a deep understanding of the causality of accidents on Irish farms. The results suggest that the IFACM framework is helpful for the analysis of the causes of accidents within the agricultural industry in Ireland. The research also suggests that there may be international applicability if further research is carried out. Furthermore, significant learning can be obtained from considering the underlying causes of accidents.

Keywords: farm safety, farm accidents, accident causation, root cause analysis

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Authors: Olga Giovani

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In this research, Bronfenbrenner's theory will be used to investigate the individual, microsystemic, and exosystemic factors that may affect adolescents' academic achievement as well as their expectations in Greece. First, the topic of academic achievement in an adolescent developmental context will be set as the target of the proposed study while focusing on the aspects of community influences on adolescents. More specifically, the effect of available resources and the perceived sense of safety and support will be further investigated. Then the issue of family factors will be analyzed, as they are subjectively perceived by the adolescents, focusing on the perceived parental style, parental monitor, and involvement as a mesosystemic factor. In turn, the school will also be discussed with emphasis on the perceived school climate and support as well as the academic aspects of student achievement. Finally, the adolescent's individual perspective will be taken into consideration in developmental terms, examining their perceptions regarding their community/neighborhood, their family, their school, as well as their sense of self-concept and self-esteem as these are expressed through their academic performance and prosocial behavior. The aim of the proposed research is to study these associations through the prism of the systemic perspective, the relationship between aspects of educational achievement and socioeconomic background, with an emphasis on the role of the community, which has not been adequately researched in the Greek context. Community will be defined by the available community resources (recreational activities, public library, local orchestras, free entrance museums, etc.), adolescents' own perception of social support, safety, and support inside that community. These perceptions need to be investigated since they may serve as possible predictors of a child's current cognitive, developmental, and psycho-social outcomes, such as their perceived self-concept and self-esteem, as well as on their future expectations related to the entrance to university and job expectations.

Keywords: bioecological model, developmental psychology, ecosystemic approach, student achievement, microsystemic factors, mesosystemic factors, individual perceptions

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Authors: Sai AKhila Budaraju

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Heritage sites are an integral part of cities and carry a sense of identity to the cities/ towns, but the process of urbanization is a carrying potential threat for the loss of these heritage sites/monuments. Both Central and State Governments listed the historic Golconda fort as National Important Monument and the Heritage precinct with eight heritage-listed buildings and two historical sites respectively, for conservation and preservation, due to the presence of IT Corridor 6kms away accommodating more people in the precinct is under constant pressure. The heritage precinct possesses high property values, being a prime location connecting the IT corridor and CBD (central business district )areas. The primary objective of the study was to assess and identify the factors that are affecting the heritage precinct through Mapping and documentation, Identifying and assessing the factors through empirical analysis, Ordinal regression analysis and Hedonic Pricing Model. Ordinal regression analysis was used to identify the factors that contribute to the changes in the precinct due to urbanization. Hedonic Pricing Model was used to understand and establish a relation whether the presence of historical monuments is also a contributing factor to the property value and to what extent this influence can contribute. The above methods and field visit indicates the Physical, socio-economic factors and the neighborhood characteristics of the precinct contributing to the property values. The outturns and the potential elements derived from the analysis of the Development Control Rules were derived as recommendations to Integrate both Old and newly built environments.

Keywords: heritage planning, heritage conservation, hedonic pricing model, ordinal regression analysis

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Authors: Shailendra Kumar Mishra

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In this paper, we focus on how contextual factors like the physical presence of other perceivers and then developed induced emotional empathy towards a person with disabilities may reduce the automatic negative stereotypes and then response towards that person. We demonstrated in study 1 that negative attitude based on negative stereotypes assessed on ATDP-test questionnaires on five points Linkert-scale are significantly less negative when participants were tested with a group of perceivers and then tested alone separately by applying 3 (positive, indifferent, and negative attitude levels) X 2 (physical presence condition and alone) factorial design of ANOVA test. In the second study, we demonstrate, by applying regression analysis, in the presence of other perceivers, whether in a small group, participants showed more induced emotional empathy through stronger prosociality towards a high distress target like a person with disabilities in comparison of that of other stigmatized persons such as racial biased or gender-biased people. Thus results show that automatic affective response in the form of induced emotional empathy in perceiver and contextual factors like the presence of other perceivers automatically activate stronger prosocial norms and egalitarian goals towards physically challenged persons in comparison to other stigmatized persons like racial or gender-biased people. This leads to less negative attitudes and behaviour towards a person with disabilities.

Keywords: contextual factors, high distress target, induced emotional empathy, stronger prosociality

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Authors: Masoud Hassanzade Novin, Bahloul Salmani

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The process of the translation is not merely the linguistic aspects. It is also considered in the cultural framework of both the source and target text cultures. The translation process and translated texts are confronted the new aspect in 20th century which is considered mostly in the patronage framework and ideological grillwork of the target language. To have these factors scrutinized in the process of the translation both micro-element factors and macro-element factors can be taken into consideration. For the purpose of this study through a qualitative type of research based on critical discourse analysis approach, the case study of the novel “1984” written by George Orwell was chosen as the corpus of the study to have the contrastive analysis by its Persian translated texts. Results of the study revealed some distortions embedded in the target texts which were overshadowed by ideological aspect and patronage network. The outcomes of the manipulated terms were different in various categories which revealed the manipulation aspects in the texts translated.

Keywords: critical discourse analysis, ideology, patronage network, translated texts

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Authors: A. Abubakar, A. Parsa, S. Walker

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Despite advances made in the diagnosis and management of drug-sensitive tuberculosis (TB) over the past decades, treatment of multidrug-resistant tuberculosis (MDR-TB) remains challenging and complex particularly in high burden countries including Nigeria. Treatment of MDR-TB is cost-prohibitive with success rate generally lower compared to drug-sensitive TB and if care is not taken it may become the dominant form of TB in future with many treatment uncertainties and substantial morbidity and mortality. Addressing these challenges requires collaborative efforts thorough sustained researches to evaluate the current treatment guidelines, particularly in high burden countries and prevent progression of resistance. To our best knowledge, there has been no research exploring the acceptability, effectiveness, and cost-effectiveness of community-based-MDR-TB treatment model in Nigeria, which is among the high burden countries. The previous similar qualitative study looks at the home-based management of MDR-TB in rural Uganda. This research aimed to explore patient’s views and acceptability of community-based-MDR-TB treatment model and to evaluate and compare the effectiveness and cost-effectiveness of community-based versus hospital-based MDR-TB treatment model of care from the Nigerian perspective. Knowledge of patient’s views and acceptability of community-based-MDR-TB treatment approach would help in designing future treatment recommendations and in health policymaking. Accordingly, knowledge of effectiveness and cost-effectiveness are part of the evidence needed to inform a decision about whether and how to scale up MDR-TB treatment, particularly in a poor resource setting with limited knowledge of TB. Mixed methods using qualitative and quantitative approach were employed. Qualitative data were obtained using in-depth semi-structured interviews with 21 MDR-TB patients in Nigeria to explore their views and acceptability of community-based MDR-TB treatment model. Qualitative data collection followed an iterative process which allowed adaptation of topic guides until data saturation. In-depth interviews were analyzed using thematic analysis. Quantitative data on treatment outcomes were obtained from medical records of MDR-TB patients to determine the effectiveness and direct and indirect costs were obtained from the patients using validated questionnaire and health system costs from the donor agencies to determine the cost-effectiveness difference between community and hospital-based model from the Nigerian perspective. Findings: Some themes have emerged from the patient’s perspectives indicating preference and high acceptability of community-based-MDR-TB treatment model by the patients and mixed feelings about the risk of MDR-TB transmission within the community due to poor infection control. The result of the modeling from the quantitative data is still on course. Community-based MDR-TB care was seen as the acceptable and most preferred model of care by the majority of the participants because of its convenience which in turn enhanced recovery, enables social interaction and offer more psychosocial benefits as well as averted productivity loss. However, there is a need to strengthen this model of care thorough enhanced strategies that ensure guidelines compliance and infection control in order to prevent the progression of resistance and curtail community transmission.

Keywords: acceptability, cost-effectiveness, multidrug-resistant TB treatment, community and hospital approach

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