Search results for: paediatric basic life support
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15834

Search results for: paediatric basic life support

13914 Ecodesign of Bioplastic Films for Food Packaging and Shelf-life Extension

Authors: Sónia Ribeiro, Diana Farinha, Elsa Pereira, Hélia Sales, Filipa Figueiredo, Rita Pontes, João Nunes

Abstract:

Conventional plastic impacts on Planet, natural resources contamination, human health as well as animals are the most attractive environmental and health attention. The lack of treatment in the end-of-life (EOL) phase and uncontrolled discard allows plastic to be found everywhere in the world. Food waste is increasing significantly, with a final destination to landfills. To face these difficulties, new packaging solutions are needed with the objective of prolonging the shelf-life of products as well as equipment solutions for the development of the mentioned packaging. FLUI project thus presents relevance and innovation to reach a new level of knowledge and industrial development focused in Ecodesign. Industrial equipment field for the manufacture of new packaging solutions based on biodegradable plastics films to apply in the food sector. With lesser environmental impacts and new solutions that make it possible to prevent food waste, reduce the production e consequent poor disposal of plastic of fossil origin. It will be a paradigm shift at different levels, from industry to waste treatment stations, passing through commercial agents and consumers. It can be achieved through the life cycle assessment (LCA) and ecodesign of the products, which integrates the environmental concerns in the design of the product as well as through the entire life cycle. The FLUI project aims to build a piece of new bio-PLA extrusion equipment with the incorporation of bioactive extracts through the production of flexible mono- and multi-layer functional films (FLUI systems). The biofunctional and biodegradable films will prompt the extension of packaged products’ shelf-life, reduce food waste and contribute to reducing the consumption of non-degradable fossil plastics, as well as the use of raw material from renewable sources.

Keywords: food packing, bioplastics, ecodesign, circular economy

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13913 Modern Detection and Description Methods for Natural Plants Recognition

Authors: Masoud Fathi Kazerouni, Jens Schlemper, Klaus-Dieter Kuhnert

Abstract:

Green planet is one of the Earth’s names which is known as a terrestrial planet and also can be named the fifth largest planet of the solar system as another scientific interpretation. Plants do not have a constant and steady distribution all around the world, and even plant species’ variations are not the same in one specific region. Presence of plants is not only limited to one field like botany; they exist in different fields such as literature and mythology and they hold useful and inestimable historical records. No one can imagine the world without oxygen which is produced mostly by plants. Their influences become more manifest since no other live species can exist on earth without plants as they form the basic food staples too. Regulation of water cycle and oxygen production are the other roles of plants. The roles affect environment and climate. Plants are the main components of agricultural activities. Many countries benefit from these activities. Therefore, plants have impacts on political and economic situations and future of countries. Due to importance of plants and their roles, study of plants is essential in various fields. Consideration of their different applications leads to focus on details of them too. Automatic recognition of plants is a novel field to contribute other researches and future of studies. Moreover, plants can survive their life in different places and regions by means of adaptations. Therefore, adaptations are their special factors to help them in hard life situations. Weather condition is one of the parameters which affect plants life and their existence in one area. Recognition of plants in different weather conditions is a new window of research in the field. Only natural images are usable to consider weather conditions as new factors. Thus, it will be a generalized and useful system. In order to have a general system, distance from the camera to plants is considered as another factor. The other considered factor is change of light intensity in environment as it changes during the day. Adding these factors leads to a huge challenge to invent an accurate and secure system. Development of an efficient plant recognition system is essential and effective. One important component of plant is leaf which can be used to implement automatic systems for plant recognition without any human interface and interaction. Due to the nature of used images, characteristic investigation of plants is done. Leaves of plants are the first characteristics to select as trusty parts. Four different plant species are specified for the goal to classify them with an accurate system. The current paper is devoted to principal directions of the proposed methods and implemented system, image dataset, and results. The procedure of algorithm and classification is explained in details. First steps, feature detection and description of visual information, are outperformed by using Scale invariant feature transform (SIFT), HARRIS-SIFT, and FAST-SIFT methods. The accuracy of the implemented methods is computed. In addition to comparison, robustness and efficiency of results in different conditions are investigated and explained.

Keywords: SIFT combination, feature extraction, feature detection, natural images, natural plant recognition, HARRIS-SIFT, FAST-SIFT

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13912 Contextual and Personal Factors as Predictor of Academic Resilience among Female Undergraduates in Boko Haram Neighbourhood in North-Eastern Nigeria

Authors: Ndidi Ofole

Abstract:

Ongoing Boko Haram crisis and instability in North-Eastern Nigeria has placed additional stress on academic resilience of female undergraduates who are already challenged by gender discrimination in educational opportunities. Students without resilience lack stress hardiness to cope with academic challenges. There is a limited study on academic resilience targeting this disadvantaged population in Nigeria. Consequently, survey research design was employed to investigate the contextual and personal factors that could predict academic resilience among female undergraduates in Boko Haram Neighbourhood in North-Eastern, Nigeria. Five hundred and thirty female students with age range of 18 to 24 years ( = 19.2; SD=6.9) were randomly drawn from 3 Universities in North-Eastern Nigeria. They responded to five instruments, namely; Academic Resilience scale (r=0.72); Social Support questionnaire (r=0. 64); Social Connectedness questionnaire (r=0.75); Self-Efficacy scale (r=0. 68) and Emotional Regulation questionnaire (r=78). Results showed that there was significant positive relationship between the four independent variables and academic resilience. The variables jointly contributed 5.9% variance in the prediction of academic resilience. In terms of magnitude, social support was most potent while self-efficacy was the least. It concluded that the factors considered in this study are academic resilience facilitators. The outcomes of the study have both theoretical and practical implications.

Keywords: academic resilience, emotional regulation, school connectedness, self-efficacy , social support

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13911 Exploring the Lived Experiences of Breast Cancer Survivors Post-Treatment

Authors: Nova Grail S. Luminang, Gwyneth B. Gortiza, Alvin E. Haboc, Marinol K. Hate, Rhean Mitchel N. Joven, Kara Kate D. Lammao, Rosemarie M. Lambayung, Elmo Carl D. Lardizabal, Zyra B. Linggayo, Rizza Mae G. Liwag, Ronalyn O. Songcuan

Abstract:

Breast cancer survivorship represents a complex and continuous journey extending beyond the completion of treatment, involving coping with physical, emotional, and psychological aspects of life post-treatment. This study aimed to explore the lived experiences of breast cancer survivors after successful treatment in Tabuk City, focusing on their post-treatment experiences, coping mechanisms, and necessary lifestyle changes. Researchers have selected Tabuk City as their research locale. Utilizing Martin Heidegger’s descriptive phenomenological design, this qualitative research included six participants, allowing for data saturation. Purposive sampling was employed to select participants. Researchers used Colaizzi’s Phenomenological Method in analyzing the data in order to achieve a reliable understanding of the participants’ experiences. The findings revealed three main themes: going through post-treatment hurdles, building resilience, and transformative wellness adjustments. Breast cancer survivors faced significant challenges, including physical adversities, emotional turmoil, limited social life, memory lapses, decreased sexual intimacy, and economic constraints. To cope, survivors adjusted their thoughts and attitudes, accepted their situation, relied on religious beliefs, and joined the support group Kalinga Cancer Care Ministry INC. Additionally, they strived to return to a normal life and embraced gratitude. Survivors made essential changes to their daily routines, modifying their diets, exploring herbal remedies, and incorporating physical activities such as walking and household chores. These adjustments helped improve their overall well-being and prevent cancer recurrence. The researchers concluded that the journey of breast cancer survivors is marked by significant challenges and inspiring resilience. The impact of breast cancer treatment extends beyond physical recovery, encompassing profound emotional and social dimensions. Despite these difficulties, survivors demonstrate remarkable strength and adaptability, making positive lifestyle changes that offer a hopeful and inspiring narrative of recovery and perseverance.

Keywords: breast cancer, lived experiences, breast cancer survivor, post-treatment hurdles, emotional turmoil

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13910 The Influence of Having Sons or Daughters on Rural Mothers Life Quality after Birth: A Sample from Hebei Province in China

Authors: Jin Liang, Q. Li, Yue Qi, Liying Wang, Wenhua Yu, Xun Liu

Abstract:

Fertility is very important for women. The gender role of women gives them the fertility ability. Giving birth to a boy or a girl might have effect on the mother’s life in the past in China. However, with the shifting of traditional attitudes and views, the women's social status and living situation have been transformed. Although the pregnancy and childbirth can still bring them a major impact on their lives, the form and content of the impact have changed. So we investigated the rural women of Hebei province after birth to reflect their living situation changes before and after birth and the differences of their living situation from women in the past by using a self-made rural women life situation change questionnaire, the index of well-being, and the index of general effect questionnaire. It has shown that women’s living situation after babybirth in Hebei province is well in general, and their mind and body, as well as their interpersonal relationships and social status, were all enhanced. The women’s living situation after babybirth was positively related to and could anticipate subjective happiness, and specifically, the rural women’s mind and body, their interpersonal relationship and social status in rural women life situation change questionnaire are the main predicted factors to subjective happiness. Furthermore, the women’s self-identification on female roles was influenced by the children’s gender. Specifically, women with only one daughter had highest self-identification on female roles, consisting with their families' concept about children’s gender, which indicated family values have a great effect on women’s self-identification on female roles in rural. Moreover, the women’s living situation and subjective happiness are both impacted by home incomes.

Keywords: rural women, parturition, well-being, life quality

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13909 A Semantical Investigation on Physician Assisted Suicide in Canada between 1993 and 2015

Authors: Gabrielle Pilliat

Abstract:

The Supreme Court of Canada rendered unconstitutional the sections of the Canadian Criminal Code which prohibited the Physician-assisted suicide in February 2015. However, in 1993, the same Supreme Court of Canada ruled that Physician-assisted suicide should remain absolutely prohibited. In the light of these historical facts, we will explore how the Supreme Court of Canada was able to make two different decisions 20 years apart. To understand how Canada could rule so differently between 1993 and 2015 about Physician-assisted suicide, we will analyze the content of the Supreme Court of Canada decisions’ discourse of 1993 and of 2015. Our preliminary results indicate that A) the patient autonomy (or the personal choice) has taken over the idea of the preservation of life (or the sacred character of life) in 2015. B) That between 1993 and 2015, the physician is seen differently by the Judges; like an abusive murderer in 1993 and like an objective evaluator in 2015. C) That the patient is seen as a victim in 1993 and more like a hero in 2015.

Keywords: physician-assisted suicide, patient autonomy, choice, sacred character of life, dignity

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13908 Comparative Analysis of Automation Testing Tools

Authors: Amit Bhanushali

Abstract:

In the ever-changing landscape of software development, automated software testing has emerged as a critical component of the Software Development Life Cycle (SDLC). This research undertakes a comparative study of three major automated testing tools -UFT, Selenium, and RPA- evaluating them on usability, maintenance, and effectiveness. Leveraging existing JAVA-based applications as test cases, the study aims to guide testers in selecting the optimal tool for specific applications. By exploring key features such as source and licensing, testing expenses, object repositories, usability, and language support, the research provides practical insights into UFT, Selenium, and RPA. Acknowledging the pivotal role of these tools in streamlining testing processes amid time constraints and resource limitations, the study assists professionals in making informed choices aligned with their organizational needs.

Keywords: software testing tools, software development lifecycle (SDLC), test automation frameworks, automated software, JAVA-based, UFT, selenium and RPA (robotic process automation), source and licensing, object repository

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13907 Effective, Affordable, and Accessible Treatment for Pregnancy’s Commonest Complication: Online Synchronous Interpersonal Psychotherapy for Mothers with Postpartum Depression

Authors: Vivian Polak, Lena Verdeli, Wendy Lou, Caroline Lovett

Abstract:

Postnatal depression (PND) is a common complication of childbirth that increases the risk of future depressive episodes in women, postpartum depression in partners, as well as social, emotional, behavioural, language, and cognitive problems in offspring. Although psychotherapy, and in particular Group Interpersonal Psychotherapy (IPT-G), has been proven effective in treating PND, it remains largely inaccessible. However, research has indicated that online synchronous group therapy can be equally as effective as in-person therapy and is a more affordable and accessible modality of treatment. This study aimed to ascertain whether delivering IPT-G virtually when compared to treatment as usual, could more effectively reduce depressive and anxiety symptoms, enhance mother-infant attachment, improve the couple relationship, augment social support, improve overall functioning, and enhance the quality of life for women in rural and northern Ontario who are suffering from PND. By bridging the gap in access to mental health services during the postpartum period, this study seeks to improve the well-being of mothers and their families in rural and northern Ontario, Canada. A randomized controlled trial was conducted to determine whether virtual IPT-G plus treatment as usual would be more effective than treatment as usual alone in treating women with PND in Ontario, Canada. Preliminary results indicate that women who received virtual IPT-G had a clinically and statistically significant decrease in overall depressive symptoms compared to their counterparts who received only the treatment as usual. As such, providing online synchronous IPT-G in the perinatal period not only has the potential to improve women's outcomes in the present but also to decrease future health costs, reduce the burden on the educational and justice systems, and decrease the number of disability life years lost to postnatal depression.

Keywords: family wellbeing, group psychotherapy, interpersonal psychotherapy, postnatal depression, virtual psychotherapy

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13906 Young People and Their Parents Accessing Their Digital Health Data via a Patient Portal: The Ethical and Legal Implications

Authors: Pippa Sipanoun, Jo Wray, Kate Oulton, Faith Gibson

Abstract:

Background: With rapidly evolving digital health innovation, there is a need for digital health transformation that is accessible and sustainable, that demonstrates utility for all stakeholders while maintaining data safety. Great Ormond Street Hospital for Children aimed to future-proof the hospital by transitioning to an electronic patient record (EPR) system with a tethered patient portal (MyGOSH) in April 2019. MyGOSH patient portal enables patients 12 years or older (with their parent's consent) to access their digital health data. This includes access to results, documentation, and appointments that facilitate communication with their care team. As part of the Going Digital Study conducted between 2018-2021, data were collected from a sample of all relevant stakeholders before and after EPR and MyGOSH implementation. Data collection reach was wide and included the hospital legal and ethics teams. Aims: This study aims to understand the ethical and legal implications of young people and their parents accessing their digital health data. Methods: A focus group was conducted. Recruited participants were members of the Great Ormond Street Hospital Paediatric Bioethics Centre. Participants included expert and lay members from the Committee from a variety of professional or academic disciplines. Written informed consent was provided by all participants (n=7). The focus group was recorded, transcribed verbatim, and analyzed using thematic analysis. Results: Six themes were identified: access, competence and capacity - granting access to the system; inequalities in access resulting in inequities; burden, uncertainty and responding to change - managing expectations; documenting, risks and data safety; engagement, empowerment and understanding – how to use and manage personal information; legal considerations and obligations. Discussion: If healthcare professionals are to empower young people to be more engaged in their care, the importance of including them in decisions about their health is paramount, especially when they are approaching the age of becoming the consenter for treatment. Complexities exist in assessing competence or capacity when granting system access, when disclosing sensitive information, and maintaining confidentiality. Difficulties are also present in managing clinician burden, managing user expectations whilst providing an equitable service, and data management that meets professional and legal requirements. Conclusion: EPR and tethered-portal implementation at Great Ormond Street Hospital for Children was not only timely, due to the need for a rapid transition to remote consultations during the COVID-19 pandemic, which would not have been possible had EPR/MyGOSH not been implemented, but also integral to the digital health revolution required in healthcare today. This study is highly relevant in understanding the complexities around young people and their parents accessing their digital health data and, although the focus of this research related to portal use and access, the findings translate to young people in the wider digital health context. Ongoing support is required for all relevant stakeholders following MyGOSH patient portal implementation to navigate the ethical and legal complexities. Continued commitment is needed to balance the benefits and burdens, promote inclusion and equity, and ensure portal utility for patient benefit, whilst maintaining an individualized approach to care.

Keywords: patient portal, young people and their parents, ethical, legal

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13905 Estimation of Soil Moisture at High Resolution through Integration of Optical and Microwave Remote Sensing and Applications in Drought Analyses

Authors: Donglian Sun, Yu Li, Paul Houser, Xiwu Zhan

Abstract:

California experienced severe drought conditions in the past years. In this study, the drought conditions in California are analyzed using soil moisture anomalies derived from integrated optical and microwave satellite observations along with auxiliary land surface data. Based on the U.S. Drought Monitor (USDM) classifications, three typical drought conditions were selected for the analysis: extreme drought conditions in 2007 and 2013, severe drought conditions in 2004 and 2009, and normal conditions in 2005 and 2006. Drought is defined as negative soil moisture anomaly. To estimate soil moisture at high spatial resolutions, three approaches are explored in this study: the universal triangle model that estimates soil moisture from Normalized Difference Vegetation Index (NDVI) and Land Surface Temperature (LST); the basic model that estimates soil moisture under different conditions with auxiliary data like precipitation, soil texture, topography, and surface types; and the refined model that uses accumulated precipitation and its lagging effects. It is found that the basic model shows better agreements with the USDM classifications than the universal triangle model, while the refined model using precipitation accumulated from the previous summer to current time demonstrated the closest agreements with the USDM patterns.

Keywords: soil moisture, high resolution, regional drought, analysis and monitoring

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13904 The Last of Centuries Old Cardamom Farming in Eastern Nepal: Crop Disease, Coping Strategies and Institutional Innovation

Authors: K. C. Sony

Abstract:

This paper investigates the coping strategies of households confronting disease in large cardamom (Amomum Subulatum Roxb.) in eastern Nepal. Cardamom farmers draw on various coping strategies to reduce the impact of crop disease in their livelihoods. Yet farmers face tremendous decline in production with a constant effort for revival. Past evidences provides dearth of information about coping strategies employed by farmers and institutional intervention to combat disease. Using factual data from Ilam district, and conducting a political economic analysis, this research addresses the gap by 1) understanding the impact of crop disease in farmers’ livelihoods, 2) identifying the coping strategies adopted by farmers and, 3) examining the existing institutional arrangements to address the disease. Coping strategies vary by household’s status defined by size of land, alternative income, and access to supporting institutions. Measures adopted are burning the cardamom field, changing land use pattern, diversifying crops, and visiting institutions for support. The local government’s support is limited to providing trainings and producing new varieties of cardamom. During crisis, farmers expect institutions to help revive the cardamom production, despite customary practice to combat disease. To retain and improve the livelihoods of farmers, there needs to be institutional innovation at the community level and policies that endorse immediate and sustainable support during hazards.

Keywords: cardamom, coping strategy, disease, institutions, Nepal

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13903 On the End-of-Life Inventory Problem

Authors: Hans Frenk, Sonya Javadi, Semih Onur Sezer

Abstract:

We consider the so-called end of life inventory problem for the supplier of a product in its final phase of the service life cycle. This phase starts when the production of the items stops and continues until the warranty of the last sold item expires. At the beginning of this phase, the supplier places a final order for spare parts to serve customers coming with defective items. At any time during the final phase, the supplier may also decide to switch to an alternative and more cost-effective policy. This alternative policy may be in the form of replacing a defective item with a substitutable product or offering discounts / rebates on new generation products. In this setup, the objective is to find a final order quantity and also a switching time which will minimize the total expected discounted cost. We study this problem under a general cost structure in a continuous-time framework where arrivals of defective items are given by a non-homogeneous Poisson process. We consider four formulations which differ by the nature of the switching time. These formulations are studied in detail and properties of the objective function are derived in each case. Using these properties, we provide exact algorithms for efficient numerical implementations. Numerical examples are provided illustrating the application of these algorithms. In these examples, we also compare the costs associated with these different formulations.

Keywords: End-of-life inventory control, martingales, optimization, service parts

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13902 Culturally Responsive School Leadership in Indigenous Schools in Malaysia

Authors: Nalini Murugaiyah

Abstract:

Indigenous students require a positive school environment where meaningful learning ought to be there to minimise myriad challenges. Therefore, Orang Asli student’s school environment should be culturally responsive and equipped with student-centred activities or provide constructively designed curriculum and pedagogy. This study sought to extend the knowledge of culturally responsive school leadership practises which relevant and responsive to Orang Asli students through th lens of a theoretical framework, Culturally Responsive School Leadership. The aim of the proposed study is to examine and understand the real-world application of leadership practices that are relevant and responsive to Orang Asli students in Malaysia. This study will also include the often-voiceless voices’ of Orang Asli students, parents, and community leaders to gain a deeper understanding of the process and experience of engaging in culturally responsive school leadership. The study will explore the differences between school leaders, teachers, parents, and community leaders in relation to culturally responsive school environment, non-Orang Asli school leaders’ and teachers’ support to the needs of Orang Asli children, children’s perspectives of teachers’ practices in the classroom align with their culture; and, the demonstration of teacher’s culturally responsive behaviour in the classroom. A basic qualitative study is the proposed research design for this study, and the data is collected through semi-structured interviews and focus group interviews. This qualitative research is designed to gain in-depth knowledge about how the principal’s leadership is culturally responsive towards the school environment, which will improve the quality of education received by the Orang Asli community in Malaysia, hence reducing the drop-out rates in Orang Asli students.

Keywords: indigenous leadership, equity, inclusion, policy

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13901 Re-interpreting Ruskin with Respect to the Wall

Authors: Anjali Sadanand, R. V. Nagarajan

Abstract:

Architecture morphs with advances in technology and the roof, wall, and floor as basic elements of a building, follow in redefining themselves over time. Their contribution is bound by time and held by design principles that deal with function, sturdiness, and beauty. Architecture engages with people to give joy through its form, material, design structure, and spatial qualities. This paper attempts to re-interpret John Ruskin’s “Seven lamps of Architecture” in the context of the architecture of the modern and present period. The paper focuses on the “wall” as an element of study in this context. Four of Ruskin’s seven lamps will be discussed, namely beauty, truth, life, and memory, through examples of architecture ranging from modernism to contemporary architecture of today. The study will focus on the relevance of Ruskin’s principles to the “wall” in specific, in buildings of different materials and over a range of typologies from all parts of the world. Two examples will be analyzed for each lamp. It will be shown that in each case, there is relevance to the significance of Ruskin’s lamps in modern and contemporary architecture. Nature to which Ruskin alludes to for his lamp of “beauty” is found in the different expressions of interpretation used by Corbusier in his Villa Stein façade based on proportion found in nature and in the direct expression of Toyo Ito in his translation of an understanding of the structure of trees into his façade design of the showroom for a Japanese bag boutique. “Truth” is shown in Mies van der Rohe’s Crown Hall building with its clarity of material and structure and Studio Mumbai’s Palmyra House, which celebrates the use of natural materials and local craftsmanship. “Life” is reviewed with a sustainable house in Kerala by Ashrams Ravi and Alvar Aalto’s summer house, which illustrate walls as repositories of intellectual thought and craft. “Memory” is discussed with Charles Correa’s Jawahar Kala Kendra and Venturi’s Vana Venturi house and discloses facades as text in the context of its materiality and iconography. Beauty is reviewed in Villa Stein and Toyo Ito’s Branded Retail building in Tokyo. The paper thus concludes that Ruskin’s Lamps can be interpreted in today’s context and add richness to meaning to the understanding of architecture.

Keywords: beauty, design, facade, modernism

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13900 Possible Impact of Shunt Surgeries on the Spatial Learning of Congenitally-Blind Children

Authors: Waleed Jarjoura

Abstract:

In various cases of visual impairments, the individuals are referred to expert Ophthalmologists in order to establish a correct diagnosis. Children with visual-impairments confront various challenging experiences in life since early childhood throughout lifespan. In some cases, blind infants, especially due to congenital hydrocephalus, suffer from high intra-cranial pressure and, consequently, go through a ventriculo-peritoneal shunt surgery in order to limit the neurological symptoms or decrease the cognitive impairments. In this article, a detailed description of numerous crucial implications of the V/P shunt surgery, through the right posterior-inferior parieto-temporal cortex, on the observed preliminary capabilities that are pre-requisites for the acquisition of literacy skills in braille, basic Math competencies, braille printing which suggest Gerstmann syndrome in the blind. In addition, significant difficultiesorientation and mobility skills using the Cane, in general, organizational skills, and social interactions were observed. The primary conclusion of this report focuses on raising awareness among neuro-surgeons towards the need for alternative intracranial routes for V/P shunt implantation in blind infants that preserve the right posterior-inferior parieto-temporal cortex that is hypothesized to modulate the tactual-spatial cues in braille discrimination. A second conclusion targets educators and therapists that address the acquired dysfunctionsin blind individuals due to V/P shunt surgeries.

Keywords: congenital blindness, hydrocephalus, shunt surgery, spatial orientation

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13899 A Rare Entity: Case Report on Anaesthetic Management in Robinow Syndrome

Authors: Vidhi Chandra, Arshpreet Singh Grewal

Abstract:

A five-year-old male child born from non-consanguineous marriage, who presented with complaints of growth retardation and no appreciable increase in the penile size since birth and he was posted for de-gloving of penis with dissection of corpora under anaesthesia. After thorough preoperative evaluation it was revealed that patient had peculiar facial dysmorphism that of Robinow Syndrome, high arched palate, Mallampati grade III, mesomelic limbs, scoliotic spine and short stature. All routine investigation were within normal limit, electrocardiography (ECG) and 2D-Echocardiography (ECHO) were normal. In antero-posterior roentgenogram chest showed butterfly and hemivertebrae at multiple levels. The patient was considered to be ASA II. On the day of surgery after ensuring fasting of 6 hours, patient was taken in operation theatre, all standard ASA monitoring was done with ECG, non-invasive blood pressure, peripheral oxygen saturation (SpO2) and body temperature. The patient was pre-oxygenated with 100% oxygen with anatomical face mask. General anaesthesia was induced with Sevoflurane 1-8%, and airway was secured with an appropriate size supraglottic airway and anaesthesia was maintained with nitrous oxide and oxygen in 1:1 ratio along with sevoflurane 2%. An ultrasound guided caudal block was given owing to the skeletal deformities making it difficult even under USG guidance. Post operatively patient was given supportive care with proper hydration, antibiotics, anti-inflammatory and analgesics. He was discharged the next day and followed up weekly for a month. DISCUSSION Robinow syndrome is genetically inherited as autosomal dominant, autosomal recessive or heterogenous disorder involving tyrosine kinase ROR2 gene located on chromosome 9. It has low incidence with no preponderance for any gender. Though intelligence is normal but developmental delay and mental retardation occurs in 20%cases

Keywords: Robinow Syndrome, dwarfism, paediatric, anaesthesia

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13898 Postharvest Losses and Handling Improvement of Organic Pak-Choi and Choy Sum

Authors: Pichaya Poonlarp, Danai Boonyakiat, C. Chuamuangphan, M. Chanta

Abstract:

Current consumers’ behavior trends have changed towards more health awareness, the well-being of society and interest of nature and environment. The Royal Project Foundation is, therefore, well aware of organic agriculture. The project only focused on using natural products and utilizing its highland biological merits to increase resistance to diseases and insects for the produce grown. The project also brought in basic knowledge from a variety of available research information, including, but not limited to, improvement of soil fertility and a control of plant insects with biological methods in order to lay a foundation in developing and promoting farmers to grow quality produce with a high health safety. This will finally lead to sustainability for future highland agriculture and a decrease of chemical use on the highland area which is a source of natural watershed. However, there are still shortcomings of the postharvest management in term of quality and losses, such as bruising, rottenness, wilting and yellowish leaves. These losses negatively affect the maintenance and a shelf life of organic vegetables. Therefore, it is important that a research study of the appropriate and effective postharvest management is conducted for an individual organic vegetable to minimize product loss and find root causes of postharvest losses which would contribute to future postharvest management best practices. This can be achieved through surveys and data collection from postharvest processes in order to conduct analysis for causes of postharvest losses of organic pak-choi, baby pak-choi, and choy sum. Consequently, postharvest losses reduction strategies of organic vegetables can be achieved. In this study, postharvest losses of organic pak choi, baby pak-choi, and choy sum were determined at each stage of the supply chain starting from the field after harvesting, at the Development Center packinghouse, at Chiang Mai packinghouse, at Bangkok packing house and at the Royal Project retail shop in Chiang Mai. The results showed that postharvest losses of organic pak-choi, baby pak-choi, and choy sum were 86.05, 89.05 and 59.03 percent, respectively. The main factors contributing to losses of organic vegetables were due to mechanical damage and underutilized parts and/or short of minimum quality standard. Good practices had been developed after causes of losses were identified. Appropriate postharvest handling and management, for example, temperature control, hygienic cleaning, and reducing the duration of the supply chain, postharvest losses of all organic vegetables should be able to remarkably reduced postharvest losses in the supply chain.

Keywords: postharvest losses, organic vegetables, handling improvement, shelf life, supply chain

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13897 Medical Decision-Making in Advanced Dementia from the Family Caregiver Perspective: A Qualitative Study

Authors: Elzbieta Sikorska-Simmons

Abstract:

Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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13896 Assessing the Gap between the Policies and Existing Living Conditions of Migrant Construction Workers: A Case Study of Vijayawada

Authors: Ayushi Mishra

Abstract:

Migrant construction workers or construction labors are one of the majority of the working population in our urban and rural areas. Even after being the majority, their involvement in the upbringing of the economy is hardly ever documented or recognized. Non-permanent or migrant workers face loads of exploitations and susceptibilities than other informal sector workers in India which in turn has affected the productivity of the labors. The relation of their employment and migration and the links of these dynamics to their housing and other basic needs in the city are mostly unstated. Even the urban planning and housing policies do not make thoughtful provision for them, they forcing them to live in extremely wretched conditions. And even if the policies are made, it frequently happens that they are not implemented. As the issue is very much prevalent in today’s time in India with so many large-scale and labor extensive projects going on, this study focuses on the assessment of the gap between the existing government policies and the current scenario of the construction workers in ongoing projects of Vijayawada, Andhra Pradesh. A few of the policies for construction workers conditions a lot of things, out of which only a few are functional which makes this study to assess the reason behind the unorganized living condition and poor physical, the social and mental health of construction workers of Vijayawada. In present, the dignity of construction labors is compromised every day on construction sites, in terms of work and basic rights which leads to many other problems in future. So to work for the betterment of this community, knowledge on the differences is very much required and hence this study is a little effort to replenish the difference and compare the policies with the existing conditions of construction labors in Vijayawada.

Keywords: construction, labours, policy, productivity

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13895 The System-Dynamic Model of Sustainable Development Based on the Energy Flow Analysis Approach

Authors: Inese Trusina, Elita Jermolajeva, Viktors Gopejenko, Viktor Abramov

Abstract:

Global challenges require a transition from the existing linear economic model to a model that will consider nature as a life support system for the development of the way to social well-being in the frame of the ecological economics paradigm. The objective of the article is to present the results of the analysis of socio-economic systems in the context of sustainable development using the systems power (energy flows) changes analyzing method and structural Kaldor's model of GDP. In accordance with the principles of life's development and the ecological concept was formalized the tasks of sustainable development of the open, non-equilibrium, stable socio-economic systems were formalized using the energy flows analysis method. The methodology of monitoring sustainable development and level of life were considered during the research of interactions in the system ‘human - society - nature’ and using the theory of a unified system of space-time measurements. Based on the results of the analysis, the time series consumption energy and economic structural model were formulated for the level, degree and tendencies of sustainable development of the system and formalized the conditions of growth, degrowth and stationarity. In order to design the future state of socio-economic systems, a concept was formulated, and the first models of energy flows in systems were created using the tools of system dynamics. During the research, the authors calculated and used a system of universal indicators of sustainable development in the invariant coordinate system in energy units. In order to design the future state of socio-economic systems, a concept was formulated, and the first models of energy flows in systems were created using the tools of system dynamics. In the context of the proposed approach and methods, universal sustainable development indicators were calculated as models of development for the USA and China. The calculations used data from the World Bank database for the period from 1960 to 2019. Main results: 1) In accordance with the proposed approach, the heterogeneous energy resources of countries were reduced to universal power units, summarized and expressed as a unified number. 2) The values of universal indicators of the life’s level were obtained and compared with generally accepted similar indicators.3) The system of indicators in accordance with the requirements of sustainable development can be considered as a basis for monitoring development trends. This work can make a significant contribution to overcoming the difficulties of forming socio-economic policy, which is largely due to the lack of information that allows one to have an idea of the course and trends of socio-economic processes. The existing methods for the monitoring of the change do not fully meet this requirement since indicators have different units of measurement from different areas and, as a rule, are the reaction of socio-economic systems to actions already taken and, moreover, with a time shift. Currently, the inconsistency or inconsistency of measures of heterogeneous social, economic, environmental, and other systems is the reason that social systems are managed in isolation from the general laws of living systems, which can ultimately lead to a systemic crisis.

Keywords: sustainability, system dynamic, power, energy flows, development

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13894 Exploratory Case Study: Judicial Discretion and Political Statements Transforming the Actions of the Commissioner for the South African Revenue Service

Authors: Werner Roux Uys

Abstract:

The Commissioner for the South African Revenue Service (SARS) holds a high position of trust in South African society and a lack of trust by taxpayers in the Commissioner’s actions or conduct could compromise SARS’ management of public finances. Tax morality – which is implicit in the social contract between taxpayers and the state – includes distinct phenomena that can cause a breakdown if there is a perceived lack of action on the part of the Commissioner to ensure public finances are kept safe. To promote tax morality, the Commissioner must support the judiciary in the exercise of its discretion to punish fraudulent tax activities and corrupt tax practices. For several years the political meddling in the Commissioner’s actions and conduct have caused perceived abuse of power at SARS, and taxpayers believed their hard-earned income paid over to SARS would be fruitless and wasteful expenditure. The purpose of this article is to identify and analyse previous decisions held by the South African judiciary regarding the Commissioner’s actions and conduct in tax matters, as well as consider important political statements and newspaper bulletins for the purpose of this research. The study applies a qualitative research approach and exploratory case study technique. Keywords were selected and inserted in the LexisNexis electronic database to systematically identify applicable case law where the ratio decidendi of the court referred to the actions and/or conduct of the Commissioner. Specific real-life statements, including political statements and newspaper bulletins, were selected to support the topic at hand. The purpose of the study is to educate the public about the perceptions that have transformed taxpayers’ behaviour towards the Commissioner for SARS since South Africa’s fledgling constitutional democracy was inaugurated in 1994. The study adds to the literature by identifying key characteristics or distinct phenomena regarding the actions and conduct of the Commissioner affecting taxpayers’ behaviour, including discretionary decision-making. From the findings, it emerged that SARS must abide by its (own) laws and that there is a need to educate not only South African taxpayers about tax morality, but also the public in general.

Keywords: commissioner, SARS, action and conduct, judiciary, discretionry, decsion-making

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13893 Sublethal Effects of Clothianidin and Summer Oil on the Demographic Parameters and Population Projection of Bravicoryne Brassicae(Hemiptera: Aphididae)

Authors: Mehdi Piri Ouchtapeh, Fariba Mehrkhou, Maryam Fourouzan

Abstract:

The cabbage aphid, Bravicoryne brassicae (Hemiptera: Aphididae), is known as an economically important and oligophagous pest of different cole crops. The polyvolitine characteristics of B. brassicae resulted in resistance to insecticides. For this purpose, in this study, the sub-lethal concentration (LC25) of two insecticides, clothianidin and summer oil, on the life table parameters and population projection of cabbage aphid were studied at controlled condition (20±1 ℃, R.H. 60 ±5 % and a photoperiod of 16:8 h (L:D). The dipping method was used in bioassay and life table studies. Briefly, the leaves of cabbage containing 15 the same-aged (24h) adults of cabbage aphid (four replicates) were dipped into the related concentrations of insecticides for 10 s. The sub-lethal (LC25) obtained concentration were used 5.822 and 108.741 p.p.m for clothianidin and summer oil, respectively. The biological and life table studies were done using at least 100, 93 and 82 the same age of eggs for control, summer oil and clothianidin treatments respectively. The life history data of the greenhouse whitefly cohorts exposed to sublethal concentration of the aforementioned insecticides were analyzed using the computer program TWOSEX–MSChart based on the age-stage, two-sex life table theory. The results of this study showed that the used insecticides affected the developmental time, survival rate, adult longevity, and fecundity of the F1 generation. The developmental time on control, clothianidin and summer oil treatments was obtained (5.91 ± 0.10 days), (7.64 ± 0.12 days) and (6.66 ± 0.10 days), respectively. The sublethal concentration of clothianidin resulted in decreasing of adult longevity (8.63 ± 0.30 days), fecundity (14.14 ± 87 nymphs), survival rate (71%) and the life expectancy (10.26 days) of B. brassicae, as well. Additionally, usage of LC25 insecticides led to decreasing of the net reproductive rate (R0) of the cabbage aphid compared to summer oil and control treatments. The intrinsic rate of increase (r) (day-1) was decreased in F1 adults of cabbage aphid compared with other treatments. Additionally, the population projection results were accordance with the population growth rate of cabbage aphid. Therefore, the findings of this research showed that, however, both of the insecticides were effective on cabbage aphid population, but clothianidin was more effective and could be consider in the management of aforementioned pest.

Keywords: the cabbage aphid, sublethal effects, survival rate, population projection, life expectancy

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13892 Feasibility of Iron Scrap Recycling with Considering Demand-Supply Balance

Authors: Reina Kawase, Yuzuru Matsuoka

Abstract:

To mitigate climate change, to reduce CO2 emission from steel sector, energy intensive sector, is essential. One of the effective countermeasure is recycling of iron scrap and shifting to electric arc furnace. This research analyzes the feasibility of iron scrap recycling with considering demand-supply balance and quantifies the effective by CO2 emission reduction. Generally, the quality of steel made from iron scrap is lower than the quality of steel made from basic oxygen furnace. So, the constraint of demand side is goods-wise steel demand and that of supply side is generation of iron scap. Material Stock and Flow Model (MSFM_demand) was developed to estimate goods-wise steel demand and generation of iron scrap and was applied to 35 regions which aggregated countries in the world for 2005-2050. The crude steel production was estimated under two case; BaU case (No countermeasures) and CM case (With countermeasures). For all the estimation periods, crude steel production is greater than generation of iron scrap. This makes it impossible to substitute electric arc furnaces for all the basic oxygen furnaces. Even though 100% recycling rate of iron scrap, under BaU case, CO2 emission in 2050 increases by 12% compared to that in 2005. With same condition, 32% of CO2 emission reduction is achieved in CM case. With a constraint from demand side, the reduction potential is 6% (CM case).

Keywords: iron scrap recycling, CO2 emission reduction, steel demand, MSFM demand

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13891 Multi-Level Air Quality Classification in China Using Information Gain and Support Vector Machine

Authors: Bingchun Liu, Pei-Chann Chang, Natasha Huang, Dun Li

Abstract:

Machine Learning and Data Mining are the two important tools for extracting useful information and knowledge from large datasets. In machine learning, classification is a wildly used technique to predict qualitative variables and is generally preferred over regression from an operational point of view. Due to the enormous increase in air pollution in various countries especially China, Air Quality Classification has become one of the most important topics in air quality research and modelling. This study aims at introducing a hybrid classification model based on information theory and Support Vector Machine (SVM) using the air quality data of four cities in China namely Beijing, Guangzhou, Shanghai and Tianjin from Jan 1, 2014 to April 30, 2016. China's Ministry of Environmental Protection has classified the daily air quality into 6 levels namely Serious Pollution, Severe Pollution, Moderate Pollution, Light Pollution, Good and Excellent based on their respective Air Quality Index (AQI) values. Using the information theory, information gain (IG) is calculated and feature selection is done for both categorical features and continuous numeric features. Then SVM Machine Learning algorithm is implemented on the selected features with cross-validation. The final evaluation reveals that the IG and SVM hybrid model performs better than SVM (alone), Artificial Neural Network (ANN) and K-Nearest Neighbours (KNN) models in terms of accuracy as well as complexity.

Keywords: machine learning, air quality classification, air quality index, information gain, support vector machine, cross-validation

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13890 Integration of Virtual Learning of Induction Machines for Undergraduates

Authors: Rajesh Kumar, Puneet Aggarwal

Abstract:

In context of understanding problems faced by undergraduate students while carrying out laboratory experiments dealing with high voltages, it was found that most of the students are hesitant to work directly on machine. The reason is that error in the circuitry might lead to deterioration of machine and laboratory instruments. So, it has become inevitable to include modern pedagogic techniques for undergraduate students, which would help them to first carry out experiment in virtual system and then to work on live circuit. Further advantages include that students can try out their intuitive ideas and perform in virtual environment, hence leading to new research and innovations. In this paper, virtual environment used is of MATLAB/Simulink for three-phase induction machines. The performance analysis of three-phase induction machine is carried out using virtual environment which includes Direct Current (DC) Test, No-Load Test, and Block Rotor Test along with speed torque characteristics for different rotor resistances and input voltage, respectively. Further, this paper carries out computer aided teaching of basic Voltage Source Inverter (VSI) drive circuitry. Hence, this paper gave undergraduates a clearer view of experiments performed on virtual machine (No-Load test, Block Rotor test and DC test, respectively). After successful implementation of basic tests, VSI circuitry is implemented, and related harmonic distortion (THD) and Fast Fourier Transform (FFT) of current and voltage waveform are studied.

Keywords: block rotor test, DC test, no load test, virtual environment, voltage source inverter

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13889 Children Beliefs about Illness, Treatments and Vaccines after the Experience of Covid 19 Pandemic

Authors: Margarida Maria Cabugueira Csutódio dos Santos, Joana Filipa Pintéus Pereira

Abstract:

The way children understand the concept of health and illness influences their reaction in contexts where these concepts are present (e.g.,illness; vaccination). The recognition of the importance of children's beliefs/representations about health and disease has led to the development of models that seek to explain the development process of these concepts. In the construction of their representations, children are influenced not only by their cognitive competence but also by their life experiences. In the last 3 years, children have experienced a pandemic health crisis that has exposed them to anomalous and stressful situations. Objective: the aim of this study was (1) to identify children’s representations about disease (including symptoms, causes, control/treatment) and prevention (including health procedures and vaccines) and (2) whether COVID19 is mentioned and influences their representations. Methodology: a qualitative study in which 67 children with 7 to 10 years old (mean 8,8) participated. A semi-structured interview was used following the Bibace and Walsh model, focusing on the representation of the disease and its prevention. Results show a marked influence of the lived experience with regard to causes of the disease, disease control and treatment, and adherence to vaccination. Age-dependent differences were found with older children being able to talk about illness and contamination process and younger displaying more basic, concrete and rigid representations. Conclusions: The results of this study bring clues to the adequacy of communication with the child in the context of health and illness and discriminately in a future health pandemic crisis.

Keywords: childen, health beliefs, pediatrics, covid19, vaccines

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13888 Digital Control Techniques for Power Electronic Devices

Authors: Rakesh Krishna, Abhishek Poddar

Abstract:

The paper discusses the work carried out on the implementation of control techniques like Digital Pulse Width Modulation (PWM) and Digital Pulse Fired control(PFC). These techniques are often used in devices like inverters, battery chargers, DC-to-DC converters can also be implemented on household devices like heaters. The advantage being the control and improved life span of device. In case of batteries using these techniques are known to increase the life span of battery in mobiles and other hand-held devices. 8051 microcontroller is used to implement these methods.Thyristors are used for switching operations.

Keywords: PWM, SVM, PFC, bidirectional inverters, snubber

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13887 Deep Learning Strategies for Mapping Complex Vegetation Patterns in Mediterranean Environments Undergoing Climate Change

Authors: Matan Cohen, Maxim Shoshany

Abstract:

Climatic, topographic and geological diversity, together with frequent disturbance and recovery cycles, produce highly complex spatial patterns of trees, shrubs, dwarf shrubs and bare ground patches. Assessment of spatial and temporal variations of these life-forms patterns under climate change is of high ecological priority. Here we report on one of the first attempts to discriminate between images of three Mediterranean life-forms patterns at three densities. The development of an extensive database of orthophoto images representing these 9 pattern categories was instrumental for training and testing pre-trained and newly-trained DL models utilizing DenseNet architecture. Both models demonstrated the advantages of using Deep Learning approaches over existing spectral and spatial (pattern or texture) algorithmic methods in differentiation 9 life-form spatial mixtures categories.

Keywords: texture classification, deep learning, desert fringe ecosystems, climate change

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13886 Concrete Mix Design Using Neural Network

Authors: Rama Shanker, Anil Kumar Sachan

Abstract:

Basic ingredients of concrete are cement, fine aggregate, coarse aggregate and water. To produce a concrete of certain specific properties, optimum proportion of these ingredients are mixed. The important factors which govern the mix design are grade of concrete, type of cement and size, shape and grading of aggregates. Concrete mix design method is based on experimentally evolved empirical relationship between the factors in the choice of mix design. Basic draw backs of this method are that it does not produce desired strength, calculations are cumbersome and a number of tables are to be referred for arriving at trial mix proportion moreover, the variation in attainment of desired strength is uncertain below the target strength and may even fail. To solve this problem, a lot of cubes of standard grades were prepared and attained 28 days strength determined for different combination of cement, fine aggregate, coarse aggregate and water. An artificial neural network (ANN) was prepared using these data. The input of ANN were grade of concrete, type of cement, size, shape and grading of aggregates and output were proportions of various ingredients. With the help of these inputs and outputs, ANN was trained using feed forward back proportion model. Finally trained ANN was validated, it was seen that it gave the result with/ error of maximum 4 to 5%. Hence, specific type of concrete can be prepared from given material properties and proportions of these materials can be quickly evaluated using the proposed ANN.

Keywords: aggregate proportions, artificial neural network, concrete grade, concrete mix design

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13885 The Effect of Psychosocial, Behavioral and Disease Specific Characteristics on Health-Related Quality of Life after Primary Surgery for Colorectal Cancer: A Cross Sectional Study of a Regional Australian Population

Authors: Lakmali Anthony, Madeline Gillies

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Background: Colorectal cancer (CRC) is usually managed with surgical resection. Many of the outcomes traditionally used to define successful operative management, such as resection margin, do not adequately reflect patients’ experience. Patient-reported outcomes (PRO), such as Health-Related Quality of life (HRQoL), provide a means by which the impact of surgery for cancer can be reported in a patient-centered way. HRQoL has previously been shown to be impacted by psychosocial, behavioral and disease-specific characteristics. This exploratory cross-sectional study aims to; (1) describe postoperative HRQoL in patients who underwent primary resection in a regional Australian hospital; (2) describe the prevalence of anxiety, depression and clinically significant fear of cancer recurrence (FCR) in this population; and (3) identify demographic, psychosocial, disease and treatment factors associated with poorer self-reported HRQoL. Methods: Consecutive patients who had resection of colorectal cancer in a single regional Australian hospital between 2015 and 2022 were eligible. Participants were asked to complete a survey instrument designed to assess HRQoL, as well as validated instruments that assess several other psychosocial PROs hypothesized to be associated with HRQoL; emotional distress, fear of cancer recurrence, social support, dispositional optimism, body image and spirituality. Demographic and disease-specific data were also collected via medical record review. Results: Forty-six patients completed the survey. Clinically significant levels of fear of recurrence as well as emotional distress, were present in this group. Many domains of HRQoL were significantly worse than an Australian reference population for CRC. Demographic and disease factors associated with poor HRQoL included smoking and ongoing adjuvant systemic therapy. The primary operation was not associated with HRQoL; however, the operative approach (laparoscopic vs. open) was associated with HRQoL for these patients. All psychosocial factors measured were associated with HRQoL, including cancer worry, emotional distress, body image and dispositional optimism. Conclusion: HRQoL is an important outcome in surgery for both research and clinical practice. This study provides an overview of the quality of life in a regional Australian population of postoperative colorectal cancer patients and the factors that affect it. Understanding HRQoL and awareness of patients particularly vulnerable to poor outcomes should be used to aid the informed consent and shared decision-making process between surgeon and patient.

Keywords: surgery, colorectal, cancer, PRO, HRQoL

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