Search results for: physician factors

Authors: Asghar Arif

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Lung cancer has been recognized as one of the greatest common cancers, causing the annual mortality rate of about 1.2 million people in the world. Lung cancer is the most prevalent cancer in men and the third-most common cancer among women (after breast and digestive cancers).Recent evidences have shown the inflammatory process as one of the potential factors of cancer. Tuberculosis (TB), pneumonia, and chronic bronchitis are among the most important inflammation-inducing factors in the lungs, among which TB has a more profound role in the emergence of cancer.TB is one of the important mortality factors throughout the world, and 205,000 death cases are reported annually due to this disease. Chronic inflammation and fibrosis due to TB can induce genetic mutation and alternations. Parenchyma tissue of lung is involved in both diseases of TB and lung cancer, and continuous cough in lung cancer, morphological vascular variations, lymphocytosis processes, and generation of immune system mediators such as interleukins, are all among the factors leading to the hypothesis regarding the role of TB in lung cancer Some reports have shown that the induction of necrosis and apoptosis or TB reactivation, especially in patients with immune-deficiency, may result in increasing IL-17 and TNF_α, which will either decrease P53 activity or increase the expression of Bcl-2, decrease Bax-T, and cause the inhibition of caspase-3 expression due to decreasing the expression of mitochondria cytochrome oxidase. It has been also indicated that following the injection of BCG vaccine, the host immune system will be reinforced, and in particular, the rates of gamma interferon, nitric oxide, and interleukin-2 are increased. Therefore, CD4 + lymphocyte function will be improved, and the person will be immune against cancer.Numerous prospective studies have so far been conducted on the role of TB in lung cancer, and it seems that this disease is effective in that particular cancer.One of the main challenges of lung cancer is its correct and timely diagnosis. Unfortunately, clinical symptoms (such as continuous cough, hemoptysis, weight loss, fever, chest pain, dyspnea, and loss of appetite) and radiological images are similar in TB and lung cancer. Therefore, anti-TB drugs are routinely prescribed for the patients in the countries with high prevalence of TB, like Pakistan. Regarding the similarity in clinical symptoms and radiological findings of lung cancer, proper diagnosis is necessary for TB and respiratory infections due to nontuberculousmycobacteria (NTM). Some of the drug resistive TB cases are, in fact, lung cancer or NTM lung infections. Acid-fast staining and histological study of phlegm and bronchial washing, culturing and polymerase chain reaction TB are among the most important solutions for differential diagnosis of these diseases. Briefly, it is assumed that TB is one of the risk factors for cancer. Numerous studies have been conducted in this regard throughout the world, and it has been observed that there is a significant relationship between previous TB infection and lung cancer. However, to prove this hypothesis, further and more extensive studies are required. In addition, as the clinical symptoms and radiological findings of TB, lung cancer, and non-TB mycobacteria lung infections are similar, they can be misdiagnosed as TB.

Keywords: TB and lung cancer, TB people, TB servivers, TB and HIV aids

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Authors: Atefeh Abedini, Fatemeh Razavi, Mihan Pourabdollah Toutkaboni, Hossein Mehravaran, Arda Kiani

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In countries with the highest prevalence of tuberculosis, such as Iran, the differentiation of malignant tumors from non-malignant is very important. In this study, which was conducted for the first time among the Iranian population, the utility of the ultrasonographic morphological characteristics in patients undergoing EBUS was used to distinguish the non-malignant versus malignant lymph nodes. The morphological characteristics of lymph nodes, which consist of size, shape, vascular pattern, echogenicity, margin, coagulation necrosis sign, calcification, and central hilar structure, were obtained during Endobronchial Ultrasound-Guided Trans-Bronchial Needle Aspiration and were compared with the final pathology results. During this study period, a total of 253 lymph nodes were evaluated in 93 cases. Round shape, non-hilar vascular pattern, heterogeneous echogenicity, hyperechogenicity, distinct margin, and the presence of necrosis sign were significantly higher in malignant nodes. On the other hand, the presence of calcification and also central hilar structure were significantly higher in the benign nodes (p-value ˂ 0.05). Multivariate logistic regression showed that size>1 cm, heterogeneous echogenicity, hyperechogenicity, the presence of necrosis signs and, the absence of central hilar structure are independent predictive factors for malignancy. The accuracy of each of the aforementioned factors is 42.29 %, 71.54 %, 71.90 %, 73.51 %, and 65.61 %, respectively. Of 74 malignant lymph nodes, 100% had at least one of these independent factors. According to our results, the morphological characteristics of lymph nodes based on Endobronchial Ultrasound-Guided Trans-Bronchial Needle Aspiration can play a role in the prediction of malignancy.

Keywords: EBUS-TBNA, malignancy, nodal characteristics, pathology

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Authors: Kang Shuo-Shuo, Li Jian-Nan, Yang Shiming

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Purpose: The three-dimensional anatomical structure of the facial nerve recess and its relationship were measured by high-resolution temporal bone CT to provide imaging reference for cochlear implant operation. Materials and Methods: By analyzing the high-resolution CT of 160 cases (320 pleural ears) of the temporal bone, the following parameters were measured at the axial window niche level: 1. The distance between the facial nerve and chordae tympani nerve d1; 2. Distance between the facial nerve and circular window niche d2; 3. The relative Angle between the facial nerve and the circular window niche a; 4. Distance between the middle point of the face recess and the circular window niche d3; 5. The relative angle between the middle point of the face recess and the circular window niche b. Factors that might influence the anatomy of the facial recess were recorded, including the patient's sex, age, and anatomical variation (e.g., vestibular duct dilation, mastoid gas type, mothoid sinus advancement, jugular bulbar elevation, etc.), and the correlation between these factors and the measured facial recess parameters was analyzed. Result: The mean value of face-drum distance d1 is (3.92 ± 0.26) mm, the mean value of face-niche distance d2 is (5.95 ± 0.62) mm, the mean value of face-niche Angle a is (94.61 ± 9.04) °, and the mean value of fossa - niche distance d3 is (6.46 ± 0.63) mm. The average fossa-niche Angle b was (113.47 ± 7.83) °. Gender, age, and anterior sigmoid sinus were the three factors affecting the width of the opposite recess d1, the Angle of the opposite nerve relative to the circular window niche a, and the Angle of the facial recess relative to the circular window niche b. Conclusion: High-resolution temporal bone CT before cochlear implantation can show the important anatomical relationship of the facial nerve recess, and the measurement results have clinical reference value for the operation of cochlear implantation.

Keywords: cochlear implantation, recess of facial nerve, temporal bone CT, three-dimensional measurement

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Authors: Aly Mohamed El Husseiny, Azza Ezz Abdelkader

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There is a critical thin line between freedom of choice and randomness. The distance between imagination and perception and between perception and execution varies depending on numerous factors. While in developed areas residents have the opportunity and abilities to build flexible homes, residents in developing areas create their own dwellings in informal settlements, even though none of them is comfortable at home in the long run. This paper explores three factors: What residents really need, what they do with limited flexibility, and what they do when there are no limits, as in the case of informal settlements. This paper studies alteration to residential buildings and how they connect to the changes in people’s lifecycle in all past cases. This study also examines all approaches to flexibility, focusing on a social approach. The results of this study are based on three practical studies: Interviews with residents in an informal settlement (Eshash Mahfouz in Minya in Egypt), a civil study of buildings in a middle-class district, and a survey of residents from many countries, including Egypt, and interviews with a number of them to determine residents’ needs and the extent of renovations they made or would like to make to their homes.

Keywords: flexibility, housing, freedom of choice, social, changes, residents

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Authors: Dalia Almaghaslah

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Design thinking approach; empathize, define, ideate prototype, test, implement, was used to assess outpatient experiences in two hospital pharmacies in the Asir region, Saudi Arabia. Semi-structured interviews were conducted with 40 patients. The data were analyzed using thematic analysis. The findings suggested that patients were generally satisfied with pharmaceutical services provided in both pharmacies. Pharmacists were found to have enough knowledge, good attitude, and efficient communication and counselling skills. Non-pharmacy-related factors such as cultural factors (gender segregation), long waiting times, uncomfortable waiting areas, lack of electronic prescribing, number waiting system were found to have a negative impact on patients' experiences and satisfaction. Prototypes will be used to test the effects of implementing the electronic system in Al -mahal hospital and to test changing the physical layout of the waiting area in Asir hospital.

Keywords: design thinking, hospital pharmacy, patient satisfaction, Saudi Arabia

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Authors: Lu Ren, You-Liang Fang, Yan-Gang Zhao

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In recent years, the application of BIM (Building Information Modelling) to construction schedule plan has been the focus of more and more researchers. In order to assess the reasonable level of the BIM-based construction schedule plan, that is whether the schedule can be completed on time, some researchers have introduced reliability theory to evaluate. In the process of evaluation, the uncertain factors affecting the construction schedule plan are regarded as random variables, and probability distributions of the random variables are assumed to be normal distribution, which is determined using two parameters evaluated from the mean and standard deviation of statistical data. However, in practical engineering, most of the uncertain influence factors are not normal random variables. So the evaluation results of the construction schedule plan will be unreasonable under the assumption that probability distributions of random variables submitted to the normal distribution. Therefore, in order to get a more reasonable evaluation result, it is necessary to describe the distribution of random variables more comprehensively. For this purpose, cubic normal distribution is introduced in this paper to describe the distribution of arbitrary random variables, which is determined by the first four moments (mean, standard deviation, skewness and kurtosis). In this paper, building the BIM model firstly according to the design messages of the structure and making the construction schedule plan based on BIM, then the cubic normal distribution is used to describe the distribution of the random variables due to the collecting statistical data of the random factors influencing construction schedule plan. Next the reliability analysis of the construction schedule plan based on BIM can be carried out more reasonably. Finally, the more accurate evaluation results can be given providing reference for the implementation of the actual construction schedule plan. In the last part of this paper, the more efficiency and accuracy of the proposed methodology for the reliability analysis of the construction schedule plan based on BIM are conducted through practical engineering case.

Keywords: BIM, construction schedule plan, cubic normal distribution, reliability analysis

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Authors: Wafa Al Jabri

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Background: In Middle Eastern Islamic Countries (MEICs), there is a high prevalence of genetic blood disorders (GBDs), particularly sickle cell disease and thalassemia. The GBDs are considered a major public health concern, especially with the increase in affected populations along with the associated psychological, social, and financial cost of management. Despite the availability of premarital screening services (PSS) that aim to identify the asymptomatic carriers of GBDs and provide genetic counseling to couples in order toreduce the prevalence of these diseases; yet, the success rate of PSS is very low due to religious and socio-cultural concerns. Purpose: This paper aims to highlight the factors that affect the success of PSS in MEICs. Methods: A literature review of articles located in CINAHL, PubMed, SCOPUS, and MedLinewas carried out using the following terms: “premarital screening,” “success,” “effectiveness,” and “ genetic blood disorders.” Second, a hand search of the reference lists and Google searches were conducted to find studies that did not exist in the primary database searches. Only studies which are conducted in MEICs countries and published in the last five years were included. Studies that were not published in English were excluded. Results: Fourteen articles were included in the review. The results showed that PSS in most of the MEICs was successful in achieving its objective of identifying high-risk marriages; however, the service failed to meetitsultimate goal of reducing the prevalence of GBDs. Various factors seem to hinder the success of PSS, including poor public awareness, late timing of the screening, culture and social stigma, religious beliefs, availability of prenatal diagnosis and therapeutic abortion, emotional factors, and availability of genetic counseling services. However, poor public awareness, late timing of the screening, and unavailability of adequate counseling services were the most common barriers identified. Conclusion: Overcoming the identified barriers by providing effective health education programs, offering the screening test to young adults at an earlier stage, and tailoring the genetic counseling would be crucial steps to provide a framework for an effective PSS in MEICs.

Keywords: premarital screening, success, effectiveness, and genetic blood disorders

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Authors: Toka Aly

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Historically, marketplaces were the most important nodes and focal points of cities, where different activities took place. Commercial streets offer more than just spaces for shopping; they also offer choices for social activities and cultural exchange. They are considered the backbone of the city’s vibrancy and vitality. Despite that, the public life in Cairo’s commercial streets has deteriorated, where the shopping activities became reliant mainly on 'planned formal places', mainly in privatized or indoor spaces like shopping malls. The main aim of this paper is to explore the key elements and tools of assessing the successfulness of commercial streets in Cairo. The methodology followed in this paper is based on a case study methodology (multiple cases) that is based on assessing and analyzing the physical and social elements in historical and contemporary commercial streets in El Muiz Street and Baghdad Street in Cairo. The data collection is based on personal observations, photographs, maps and street sections. Findings indicate that the key factors of analyzing commercial streets are factors affecting the sensory experience, factors affecting the social behavior, and general aspects that attract people. Findings also indicate that urban features have clear influence on shopping pedestrian activities in both streets. Moreover, in order for a commercial street to be successful, shopping patterns must provide people with a quality public space that can provide easy navigation and accessibility, good visual continuity, and well-designed urban features and social gathering. Outcomes of this study will be a significant endeavor in providing a good background for urban designers on analyzing and assessing successfulness of commercial streets. The study will also help in understanding the different physical and social pattern of vending activities taking place in Cairo.

Keywords: activities, commercial street, marketplace, successful, vending

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Authors: Julia Reinold, Inge Hooijen, Christoph Meng, Melissa Siegel

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This paper investigates whether or not students intend to stay in the Euregio Meuse-Rhine (EMR) after graduation taking into account the role of hard and soft locational factors, social factors as well as demographic aspects in shaping their mobility preferences. Since graduates are considered a convenient source of human capital in today’s knowledge based economy, it is crucial to understand what drives their mobility intentions in order to retain larger numbers of graduates. This is particularly true for peripheral regions, which need to compete with assumed more attractive economic centres. This paper adds a euregional perspective to the existing literature on graduate migration. Using survey data from 2015 from five higher education institutions in the EMR, this paper finds that mobility intentions are determined by students’ perceptions of the quality of life, openness and career opportunities in the euroregion. In addition, distance to the partner and other social ties such as family and friends influence migration intentions.

Keywords: Euroregion, graduate migration, highly skilled migration, human capital

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Authors: N. G. Teik Hiang, Fathyah Hashim

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This is a case of how strategic management techniques can be used to help resolving problems faced by an ageing Small and Medium Enterprise (SME). Strategic way of resolving problems had been proven to be possible in this case despite general thought that strategic management is useful mostly for large corporations. Small and Medium Enterprises (SMEs) can also use strategic management in managing their business and determining their future cause of action and strategies in order to survive in this ever competent world. Strategic orientation is the key to survival and development of small and medium enterprises. In order to adapt to the fierce market competition, ageing SMEs should improve competitiveness and operational efficiency. They must therefore establish a sense of strategic management to improve the strategic management skills, combined with its own unique characteristics, and work out practical strategies to develop core competitiveness of enterprises in the fierce market competition in order to be sustainable. In this case, internal strengths and weaknesses of an SME had been identified. Strategic internal factors and external factors had been classified and further utilized to formulate potential strategies to encounter various problems faced by the SME. These strategies had been further match to take advantages of the opportunities and to overcome the weaknesses and minimize the threats it is facing. Tan, a consultant who was given the opportunity to formulate a plan for the business started with the environmental scanning (internal and external environmental analysis), assessing strengths and weaknesses for the company, strategies generation, analysis and evaluation. He had numerous discussions with the owner of the business and the senior management in order to match the key internal and external factors to formulate alternative strategies for solving the problems that the company facing. Some of the recommendations or solutions are generated from the inspiration of the owner of the business who is a very enterprising and experience businessman.

Keywords: strategic orientation, strategic management, SME, core competitiveness, sustainable

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Authors: Arti Singh, Carolyn Jenkins, Oyedunni S. Arulogun, Mayowa O. Owolabi, Fred S. Sarfo, Bruce Ovbiagele, Enzinne Sylvia

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Background: Stroke, the leading cause of adult-onset disability and the second leading cause of death, is a major public health concern particularly pertinent in Sub-Saharan Africa (SSA), where nearly 80% of all global stroke mortalities occur. The Stroke Investigative Research and Education Network (SIREN) seeks to comprehensively characterize the genomic, sociocultural, economic, and behavioral risk factors for stroke and to build effective teams for research to address and decrease the burden of stroke and other non communicable diseases in SSA. One of the first steps to address this goal was to effectively engage the communities that suffer the high burden of disease in SSA. This study describes how the SIREN project engaged six sites in Ghana and Nigeria over the past three years, describing the community engagement activities that have arisen since inception. Aim: The aim of community engagement (CE) within SIREN is to elucidate information about knowledge, attitudes, beliefs, and practices (KABP) about stroke and its risk factors from individuals of African ancestry in SSA, and to educate the community about stroke and ways to decrease disabilities and deaths from stroke using socioculturally appropriate messaging and messengers. Methods: Community Advisory Board (CABs), Focus Group Discussions (FGDs) and community outreach programs. Results: 27 FGDs with 168 participants including community heads, religious leaders, health professionals and individuals with stroke among others, were conducted, and over 60 CE outreaches have been conducted within the SIREN performance sites. Over 5,900 individuals have received education on cardiovascular risk factors and about 5,000 have been screened for cardiovascular risk factors during the outreaches. FGDs and outreach programs indicate that knowledge of stroke, as well as risk factors and follow-up evidence-based care is limited and often late. Other findings include: 1) Most recognize hypertension as a major risk factor for stroke. 2) About 50% report that stroke is hereditary and about 20% do not know organs affected by stroke. 3) More than 95% willing to participate in genetic testing research and about 85% willing to pay for testing and recommend the test to others. 4) Almost all indicated that genetic testing could help health providers better treat stroke and help scientists better understand the causes of stroke. The CABs provided stakeholder input into SIREN activities and facilitated collaborations among investigators, community members and stakeholders. Conclusion: The CE core within SIREN is a first-of-its kind public outreach engagement initiative to evaluate and address perceptions about stroke and genomics by patients, caregivers, and local leaders in SSA and has implications as a model for assessment in other high-stroke risk populations. SIREN’s CE program uses best practices to build capacity for community-engaged research, accelerate integration of research findings into practice and strengthen dynamic community-academic partnerships within our communities. CE has had several major successes over the past three years including our multi-site collaboration examining the KABP about stroke (symptoms, risk factors, burden) and genetic testing across SSA.

Keywords: community advisory board, community engagement, focus groups, outreach, SSA, stroke

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Authors: Bin Su

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This study focuses on the impact of school building design factors on winter extra energy consumption which mainly includes space heating, water heating and other appliances related to winter indoor thermal conditions. A number of Auckland schools were randomly selected for the study which introduces a method of using real monthly energy consumption data for a year to calculate winter extra energy data of school buildings. The study seeks to identify the relationships between winter extra energy data related to school building design data related to the main architectural features, building envelope and elements of the sample schools. The relationships can be used to estimate the approximate saving in winter extra energy consumption which would result from a changed design datum for future school development, and identify any major energy-efficient design problems. The relationships are also valuable for developing passive design guides for school energy efficiency.

Keywords: building energy efficiency, building thermal design, building thermal performance, school building design

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Authors: Lovorka Galetic, Zeljko Vukelic

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The advanced concepts of strategic and innovation management in the sphere of company dynamic and innovation capabilities, and achieving their mutual alignment and a synergy effect, are important elements in business today. This paper analyses the theory and empirically investigates the influence of a company’s dynamic capabilities on its innovation capabilities. A new multidimensional model of dynamic capabilities is presented, consisting of five factors appropriate to real time requirements, while innovation capabilities are considered pursuant to the official OECD and Eurostat standards. After examination of dynamic and innovation capabilities indicated their theoretical links, the empirical study testing the model and examining the influence of a company’s dynamic capabilities on its innovation capabilities showed significant results. In the study, a research model was posed to relate company dynamic and innovation capabilities. One side of the model features the variables that are the determinants of dynamic capabilities defined through their factors, while the other side features the determinants of innovation capabilities pursuant to the official standards. With regard to the research model, five hypotheses were set. The study was performed in late 2014 on a representative sample of large and very large Croatian enterprises with a minimum of 250 employees. The research instrument was a questionnaire administered to company top management. For both variables, the position of the company was tested in comparison to industry competitors, on a fivepoint scale. In order to test the hypotheses, correlation tests were performed to determine whether there is a correlation between each individual factor of company dynamic capabilities with the existence of its innovation capabilities, in line with the research model. The results indicate a strong correlation between a company’s possession of dynamic capabilities in terms of their factors, due to the new multi-dimensional model presented in this paper, with its possession of innovation capabilities. Based on the results, all five hypotheses were accepted. Ultimately, it was concluded that there is a strong association between the dynamic and innovation capabilities of a company. 

Keywords: dynamic capabilities, innovation capabilities, competitive advantage, business results

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Authors: Estela Díaz

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This article aims to make three contributions. First, build on the literature on ethical decision-making literature by exploring factors that influence the intention of adopting veganism. Second, study the superiority of extended models of the Theory of Planned Behavior (TPB) for understanding the process involved in forming the intention of adopting veganism. Third, analyze the moderating effect of gender on TPB given that attitudes and behavior towards animals are gender-sensitive. No study, to our knowledge, has examined these questions. Veganism is not a diet but a political and moral stand that exclude, for moral reasons, the use of animals. Although there is a growing interest in studying veganism, it continues being overlooked in empirical research, especially within the domain of social psychology. TPB has been widely used to study a broad range of human behaviors, including moral issues. Nonetheless, TPB has rarely been applied to examine ethical decisions about animals and, even less, to veganism. Hence, the validity of TPB in predicting the intention of adopting veganism remains unanswered. A total of 476 non-vegan Spanish university students (55.6% female; the mean age was 23.26 years, SD= 6.1) responded to online and pencil-and-paper self-reported questionnaire based on previous studies. TPB extended models incorporated two background factors: ‘general attitudes towards humanlike-attributes ascribed to animals’ (AHA) (capacity for reason/emotions/suffer, moral consideration, and affect-towards-animals); and ‘general attitudes towards 11 uses of animals’ (AUA). SPSS 22 and SmartPLS 3.0 were used for statistical analyses. This study constructed a second-order reflective-formative model and took the multi-group analysis (MGA) approach to study gender effects. Six models of TPB (the standard and five competing) were tested. No a priori hypotheses were formulated. The results gave partial support to TPB. Attitudes (ATTV) (β = .207, p < .001), subjective norms (SNV) (β = .323, p < .001), and perceived control behavior (PCB) (β = .149, p < .001) had a significant direct effect on intentions (INTV). This model accounted for 27,9% of the variance in intention (R2Adj = .275) and had a small predictive relevance (Q2 = .261). However, findings from this study reveal that contrary to what TPB generally proposes, the effect of the background factors on intentions was not fully mediated by the proximal constructs of intentions. For instance, in the final model (Model#6), both factors had significant multiple indirect effect on INTV (β = .074, 95% C = .030, .126 [AHA:INTV]; β = .101, 95% C = .055, .155 [AUA:INTV]) and significant direct effect on INTV (β = .175, p < .001 [AHA:INTV]; β = .100, p = .003 [AUA:INTV]). Furthermore, the addition of direct paths from background factors to intentions improved the explained variance in intention (R2 = .324; R2Adj = .317) and the predictive relevance (Q2 = .300) over the base-model. This supports existing literature on the superiority of enhanced TPB models to predict ethical issues; which suggests that moral behavior may add additional complexity to decision-making. Regarding gender effect, MGA showed that gender only moderated the influence of AHA on ATTV (e.g., βWomen−βMen = .296, p < .001 [Model #6]). However, other observed gender differences (e.g. the explained variance of the model for intentions were always higher for men that for women, for instance, R2Women = .298; R2Men = .394 [Model #6]) deserve further considerations, especially for developing more effective communication strategies.

Keywords: veganism, Theory of Planned Behavior, background factors, gender moderation

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Authors: Greeshma Sharma, Sushil Chandra, Vijander Singh, Alok Prakash Mittal

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Navigational ability requires spatial representation, planning, and memory. It covers three interdependent domains, i.e. cognitive and perceptual factors, neural information processing, and variability in brain microstructure. Many attempts have been made to see the role of spatial representation in the navigational ability, and the individual differences have been identified in the neural substrate. But, there is also a need to address the influence of planning, memory on navigational ability. The present study aims to evaluate relations of aforementioned factors in the navigational ability. Total 30 participants volunteered in the study of a virtual shopping complex and subsequently were classified into good and bad navigators based on their performances. The result showed that planning ability was the most correlated factor for the navigational ability and also the discriminating factor between the good and bad navigators. There was also found the correlations between spatial memory recall and navigational ability. However, non-verbal episodic memory and spatial memory recall were also found to be correlated with the learning variable. This study attempts to identify differences between people with more and less navigational ability on the basis of planning and memory.

Keywords: memory, planning navigational ability, virtual reality

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Authors: Paul Holmes, Mike N. G.

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Foundation-year doctors face increased stress, pressure and uncertainty when starting new rotations throughout their first years of work. This research questionnaire resulted in an induction cheat sheet and induction video that enhanced the Junior doctor's understanding of how to work effectively within the plastic surgery department at NHS Tayside. The objectives and goals were to improve the transition between cohorts of junior doctors in ward 26 at Ninewells Hospital. Before this quality improvement project, the induction pack was 74 pages long and over eight years old. With the support of consultant Mike Ng a new up-to-date induction was created. This involved a questionnaire and cheat sheet being developed. The questionnaire covered clerking, venipuncture, ward pharmacy, theatres, admissions, specialties on the ward, the cardiac arrest trolley, clinical emergencies, discharges and escalation. This audit has three completed cycles between August 2022 and August 2023. The cheat sheet developed a concise two-page A4 document designed for doctors to be able to reference easily and understand the essentials. The document format is a table containing ward layout; specialty; location; physician associate, shift patterns; ward rounds; handover location and time; hours coverage; senior escalation; nights; daytime duties, meetings/MDTs/board meetings, important bleeps and codes; department guidelines; boarders; referrals and patient stream; pharmacy; absences; rota coordinator; annual leave; top tips. The induction video is a 10-minute in-depth explanation of all aspects of the ward. The video explores in more depth the contents of the cheat sheet. This alternative visual format familiarizes the junior doctor with all aspects of the ward. These were provided to all foundation year 1 and 2 doctors on ward 26 at Ninewells Hospital at NHS Tayside Scotland. This work has since been adopted by the General Surgery Department, which extends to six further wards and has improved the effective handing over of the junior doctor’s role between cohorts. There is potential to further expand the cheat sheet to other departments as the concise document takes around 30 minutes to complete by a doctor who is currently on that ward. The time spent filling out the form provides vital information to the incoming junior doctors, which has a significant possibility to improve patient care.

Keywords: induction, junior doctor, handover, plastic surgery

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Authors: Ye Jiang

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To examine how the relationships among multiple institutional logics vary over time and the factors that may impact this process, we conducted a 15-year in-depth longitudinal case study of a Higher Education Institution to examine its exploration in college student management. By employing constructive grounded theory, we developed a four-stage process model comprising separation, formalization, selective bridging, and embeddedness that showed how two contradictory logics become complementary, and finally become a new hybridized logic. We argue that selective bridging is an important step in changing inter-logic relations. We also found that ambidextrous leadership and situational sensemaking are two key factors that drive this process. Our contribution to the literature is threefold. First, we enhance the literature on the changing relationships among multiple institutional logics and our findings advance the understanding of relationships between multiple logics through a dynamic view. While most studies have tended to assume that the relationship among logics is static and persistently in a contentious state, we contend that the relationships among multiple institutional logics can change over time. Competitive logics can become complementary, and a new hybridized logic can emerge therefrom. The four-stage logic hybridization process model offers insights on the logic hybridization process, which is underexplored in the literature. Second, our research reveals that selective bridging is important in making conflicting logics compatible, and thus constitutes a key step in creating new hybridized logic dynamics. Our findings suggest that the relations between multiple logics are manageable and can thus be manipulated for organizational innovation. Finally, the factors influencing the variations in inter-logic relations enrich the understanding of the antecedents of these dynamics.

Keywords: institutional theory, institutional logics, ambidextrous leadership, situational sensemaking

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Authors: Zeinab Aliyas

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Walking is known as the most common type of physical activity that helps mental and physical health of people. In the recent years, promoting walking activity in neighborhood areas and cities become as one of the important issues in terms of sustainable cities. Therefore the study aimed to investigate the influence of fear of crime and personal barriers as social and personal factor respectively on neighborhood walking. 464 questionnaires in Bandar Baru Bangi in Malaysia was distributed to collect data, and finally, 424 questionnaires were qualified to be used in the study. The Smart-PLS was used to analyze the data. The findings of the study revealed that individual barriers and fear of crime both have significant influence on the level of walking behavior in the neighborhood area. It was found that fear of crime has higher influence on walking behavior in comparison to individual factors. The finding of this study can help urban researcher and planner to know the significant influence of crime safety and individual attitudes on the level of walking activity.

Keywords: fear of crime, neighborhood walking, personal barriers, residential neighborhood

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Authors: Sina Saadati

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Multiprocessors Systems-On-Chips (MPSOCs) are used widely on modern computers to execute sophisticated software and applications. These systems include different processors for distinct aims. Most of the proposed task schedulers attempt to improve energy consumption. In some schedulers, the processor's temperature is considered to increase the system's reliability and performance. In this research, we have proposed a new method for thermal-aware task scheduling which is based on an artificial neural network (ANN). This method enables us to consider a variety of factors in the scheduling process. Some factors like ambient temperature, season (which is important for some embedded systems), speed of the processor, computing type of tasks and have a complex relationship with the final temperature of the system. This Issue can be solved using a machine learning algorithm. Another point is that our solution makes the system intelligent So that It can be adaptive. We have also shown that the computational complexity of the proposed method is cheap. As a consequence, It is also suitable for battery-powered systems.

Keywords: task scheduling, MOSOC, artificial neural network, machine learning, architecture of computers, artificial intelligence

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Authors: Wiwat Onnakklum

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Clarification is the turbidity removal process of water treatment plant. This paper was to study the factors affecting on energy consumption in order to control energy saving strategy. The factors studied were raw water turbidity in the range of 26-40 NTU and production rate in the range of 3.76-5.20 m³/sec. Clarifiers were sludge blanket and sludge recirculation clarifier. Experimental results found that the raw water turbidity was not affected significantly by energy consumption, while the production rate was affected significantly by energy consumption. Sludge blanket clarifier provided lower energy consumption than sludge recirculation clarifier about 32-37%. Subsequently, the operating pattern in production rate can be arranged to decreased energy consumption. The results showed that it can be reduced about 5.09 % of energy saving of clarification process about 754,655 Baht per year.

Keywords: sludge blanket clarifier, sludge recirculation clarifier, water treatment plant, energy

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Authors: Meity Sompie, Agnes Triasih, Wisje Ponto

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Edible coating is thin layers that act as a barrier to the external factors and protect the food products. The addition of the plasticizer to the edible coating is required to overcome film caused by extensive intermolecular forces. The potential development of pigskin with different ages as a raw material for the manufacture of edible films had not been widely publicized. This research was aimed to determine the influence of gelatin concentration and different type of plasticizer on the edible coating characteristics extracted from pigskin gelatin. This study used Completely Randomized Design (CRD) with two factors and three replicates of treatments. The first factor was consisted of pigskin gelatin concentration ( 10, 20, and 30 %) and the second factor was different type of plasticizer (glycerol, sorbitol and PEG). The results show that the interaction between the use of gelatin concentrations and type of plasticizer had significant effect (P< 0.05) on the thickness, tensile strength, elongation, water vapor transmission rate (WVTR), water content and amino acid profile of edible coating. It was concluded that the edible coating from pigskin gelatin with plasticizer gliserol had the best film characteristics, and it can be applied as an edible coating.

Keywords: edible coating, edible film, pigskin gelatin, plasticizer

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Authors: Felix Eyben, Simon Schaffrath, Markus Feldmann

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A building should maximize the potential for use through its design. Therefore, flexible use is always important when designing a steel structure. To create flexibility, steel beams with web openings are increasingly used, because these offer the advantage that cables, pipes and other technical equipment can easily be routed through without detours, allowing for more space-saving and aesthetically pleasing construction. This can also significantly reduce the height of ceiling systems. Until now, beams with web openings were not explicitly considered in the European standard. However, this is to be done with the new EN 1993-1-13, in which design rules for different opening forms are defined. In order to further develop the design concepts, beams with web openings under bending are therefore to be investigated in terms of damage mechanics as part of a German national research project aiming to optimize the verifications for steel structures based on a wider database and a validated damage prediction. For this purpose, first, fundamental factors influencing the load-bearing behavior of girders with web openings under bending load were investigated numerically without taking material damage into account. Various parameter studies were carried out for this purpose. For example, the factors under study were the opening shape, size and position as well as structural aspects as the span length, arrangement of stiffeners and loading situation. The load-bearing behavior is evaluated using resulting load-deformation curves. These results are compared with the design rules and critically analyzed. Experimental tests are also planned based on these results. Moreover, the implementation of damage mechanics in the form of the modified Bai-Wierzbicki model was examined. After the experimental tests will have been carried out, the numerical models are validated and further influencing factors will be investigated on the basis of parametric studies.

Keywords: damage mechanics, finite element, steel structures, web openings

Procedia PDF Downloads 174

Authors: Lindy Valdez, Daryl Parker

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Introduction: There has been much research on academic achievement in elementary schools. Most of the research has been on school leadership. While research has focused on the role of leadership on school improvement, little research has examined what variables the top elementary schools have in common. To undertake school improvement, it is important to understand what factors the best schools share. The purpose of this study was to examine data of the “Best Elementary Schools in California,” based on academic achievement as rated by three prominent websites and determine if these schools had any common factors which were different than the statewide averages. The variables examined included access to subject matter specialists (physical education, art, and music), librarians, after school programs, class size, socioeconomic status, and diversity. The participants consisted of the top public elementary schools in California based on the websites i)https://www.niche.com/k12/search/best-schools/, ii)https://www.finder.com/best-schools-california,and iii)https://www.schooldigger.com/go/CA/schoolrank.aspx. The data for subject matter specialists (physical education, art, and music), librarians, after school programs, class size, socioeconomic status, and diversity were collected from these top schools and compared to California statewide averages. Results indicate that top public elementary schools in California have a high number of subject matter specialists that teach physical education, art, and music. These positions are on the decline in the average public elementary school in California, but the top schools have abundant access to these specialists. The physical education specialist has the highest statistically significant difference between the nationwide average and the top schools—librarians, and after school programs are also most commonly high in top public elementary schools in California. The high presence of these programs may be aiding academic achievement in less visible ways. Class size is small, socio-economic status is high, and diversity is low among top public elementary schools in California when compared to the statewide average public elementary schools in California. The single largest area of discrepancy was between physical education specialists in a top school and their state and nationwide averages. The socioeconomic status of schools and parents may be an underlining factor affecting several other variables. This affluence could explain how these schools were able to have access to subject matter specialists, after-school activities, and, therefore, more opportunities for physical activity and greater learning opportunities affecting academic achievement.

Keywords: academic achievement, elementary education, factors, schools

Procedia PDF Downloads 133

Authors: Allahyar Arabmomeni, Hojjatollah Alaei

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Background: The objectives of this study was to investigate effect of anthropometric variables and body composition on physical capabilities among male and female students. Materials and Methods: The study had a descriptive correlation method. The statistical population consisted of all students of Islamic Azad University, Khomeinishahr Branch, from 2011 to 2013, which was about 7000 students. The statistical sample included 300 male and 300 female students who were randomly selected from among university students in proportion to frequency of students in each faculty. Descriptive statistical methods, t-test and Pearson correlation coefficient were used for data analysis. Results: Results of this research showed that body size of male students in the studied variables was more than that of female students (p<0.05). Moreover, there was significant difference between all the variables based on significance level of the table. Also, the results taken from the Pearson correlation of this study's variables showed a positive relationship between height and leg and hand length and sit-up, full-ups bar and vertical jump tests (p<0/01). Besides, there was a positive correlation between hand length, sit-up, full-ups bar and vertical jump tests. As far as tests of length of legs and vertical jump were concerned, a highly positive correlation was observed between them. Additionally, results of this study indicated a significant correlation at alpha level of 0.05 between age and height of the students; but, there was a negative correlation between age, sit-up and 1600-m tests (p<0.05). Conclusion: The results of this study indicated a relationship between size of weight, height, length of hands and legs and some physical fitness tests. Therefore, it is required to consider anthropometric factors in addition to gender and age while preparing norms of physical fitness since variables of height and length of hands also affect physical fitness evaluation.

Keywords: anthropometric variables, physical fitness factors, students, body composition

Procedia PDF Downloads 392

Authors: A. S. Adegoke, O. N. Popoola

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The central purpose of management in any organization is that of coordinating the efforts of people towards the achievement of its goal. Effective and productive management is the function of leadership. Leadership plays a critical role in helping groups, organizations and societies to achieve their goals. Factors considered to make leadership to be effective are intelligence, social maturity, inner motivation and achievement drives and lastly, human relations attitudes. The factors affecting leadership style and effectiveness were examined. Also, the study examined which of the various leadership style best befits an organization and discussed the ways in which the style was determined. In order to meet the objectives of this study, different types of methods of data gathering were carried out. The methods include data from primary and secondary sources. The primary sources include personal interview, personal observation, and questionnaire while data from secondary sources were derived from various books, journal write up and other documentary records. Data were collected from respondents through questionnaire, and the field research carried out through oral interview to test each of the related hypotheses. From the data analysed it was determined that 45% strongly agreed that leadership traits are inborn not acquired and 28.3% agreed that leadership traits are inborn, while 11.7% and 10% strongly disagreed and disagreed respectively and 5% were undecided. 48.4% strongly agreed, and 43.3% agreed that environmental factors determined the appropriate style of leadership to be employed while 3.3% strongly disagreed, 1.7% disagreed and 3.3% were undecided. From the study, no single style of leadership is appropriate in any situation instead of concentrating on single leadership style; leader can vary approaches depending on forces in the leaders, characteristic of the subordinates, situational forces of the organization, lastly the expectations and behaviour of superior.

Keywords: hypothesis, leadership, management, organization

Procedia PDF Downloads 144

Authors: Keh-Wen Carin Chuang, Kuan-Chou Chen

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Our society is in a constant state of change. Technology advancements continue to affect our daily lives. How we work, communicate and entertain ourselves has changed dramatically in the past decades. As our society learns to accept and adapt to the many different technological advances that seem to inundate every part of our lives, the education institutions must migrate from traditional methods of instruction to online education in order to take full advantage of the opportunities provided by these technology advancements. There are many benefits that can be gained for university and society from offering online programs by utilizing advanced technologies. But the programs must not be implemented carelessly. The key to providing a quality online program is the issue of perceived quality, which takes into account the viewpoint of all stakeholders involved. To truly ensure the institutional quality, however, a systemic view of all factors contributing to the quality must be analyzed and linked to one another — allowing education administrators to understand how each factor contributes to the perceived quality of online education. The perceived quality of an online program will be positively reinforced only through an organizational-wide effort that focuses on managed administration, augmenting online program branding, skilled faculty, supportive alumni, student satisfaction, and effective delivery systems — each of which is vital to a quality online program. This study focuses on the concept of quality assurance in the start-up, implementation, and sustainability of online education. A case of online MBA program will be analyzed to explore the quality assurance. The difficulties in promoting online education quality is the fact that universities are complex networks of disciplinary, social, economic, and political fiefdoms, both internal and external factors to the institutions. As such, the system analysis, a systems-thinking approach, on the issue of perceived quality is ideal to investigate the factors and how each factor contributes to the perceived quality in the online education domain.

Keywords: systems thinking, quality assurance, online education, MBA program

Procedia PDF Downloads 237

Authors: Zahzouh Zoubir

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The widespread adoption of photovoltaic panel systems for global electricity generation is a prominent trend. Algeria, demonstrating steadfast commitment to strategic development and innovative projects for harnessing solar energy, emerges as a pioneering force in the field. Heat and radiation, being fundamental factors in any solar system, are currently subject to comprehensive studies aiming to discern their genuine impact on crucial elements within photovoltaic systems. This endeavor is particularly pertinent given that solar module performance is exclusively assessed under meticulously defined Standard Test Conditions (STC). Nevertheless, when deployed outdoors, solar modules exhibit efficiencies distinct from those observed under STC due to the influence of diverse environmental factors. This discrepancy introduces ambiguity in performance determination, especially when surpassing test conditions. This article centers on the performance monitoring of an Algerian photovoltaic project, specifically the Oued El Keberite power (OKP) plant boasting a 15 megawatt capacity, situated in the town of Souk Ahras in eastern Algeria. The study elucidates the behavior of a subfield within this facility throughout the year, encompassing various conditions beyond the STC framework. To ensure the optimal efficiency of solar panels, this study integrates crucial factors, drawing on an authentic technical sheet from the measurement station of the OKP photovoltaic plant. Numerical modeling and simulation of a sub-field of the photovoltaic station were conducted using MATLAB Simulink. The findings underscore how radiation intensity and temperature, whether low or high, impact the short-circuit current, open-circuit voltage; fill factor, and overall efficiency of the photovoltaic system.

Keywords: performance monitoring, photovoltaic system, numerical modeling, radiation intensity

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Authors: Ankit Tyagi, Reet Kamal Tiwari, Naveen James

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In India, landslides are the most frequently occurring disaster in the regions of the Himalayas and the Western Ghats. The steep slopes and land use in these areas are quite apprehensive. In the recent past, many landslide hazard zonation (LHZ) works have been carried out in the Himalayas. However, the preparation of LHZ maps considering temporal factors such as seismic ground shaking, seismic amplification at surface level, and rainfall are limited. Hence this study presents a comprehensive use of the multi-criteria decision-making (MCDM) method in landslide risk assessment. In this research, we conducted both geospatial and geotechnical analysis to minimize the danger of landslides. Geospatial analysis is performed using high-resolution satellite data to produce landslide causative factors which were given weightage using the MCDM method. The geotechnical analysis includes a slope stability check, which was done to determine the potential landslide slope. The landslide risk map can provide useful information which helps people to understand the risk of living in an area.

Keywords: landslide hazard zonation, PHA, AHP, GIS

Procedia PDF Downloads 192

Authors: Amey Kulkarni, Paavan Shetty, Amol Patil, B. Rajiv

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Fuel Efficiency plays a very important role in overall performance of an automobile. In this paper study of fuel efficiency of heavy construction, compaction machine is done. The fuel Consumption trials are performed in order to obtain the consumption of fuel in performing certain set of actions by the compactor. Usually, Heavy Construction machines are put to work in locations where refilling the fuel tank is not an easy task and also the fuel is consumed at a greater rate than a passenger automobile. So it becomes important to have a fuel efficient machine for long working hours. The fuel efficiency is the most important point in determining the future scope of the product. A heavy construction compaction machine operates in five major roles. These five roles are traveling, Static working, High-frequency Low amplitude compaction, Low-frequency High amplitude compaction, low idle. Fuel consumption readings for 1950 rpm, 2000 rpm & 2350 rpm of the engine are taken by using differential fuel flow meter and are analyzed. And the optimum RPM setting which fulfills the fuel efficiency, as well as engine performance criteria, is considered. Also, other factors such as rear end gears, Intake and exhaust restriction for an engine, vehicle operating techniques, air drag, Tribological aspects, Tires are considered for increasing the fuel efficiency of the compactor. The fuel efficiency of compactor can be precisely calculated by using Differential Fuel Flow Meter. By testing the compactor at different combinations of Engine RPM and also considering other factors such as rear end gears, Intake and exhaust restriction of an engine, vehicle operating techniques, air drag, Tribological aspects, The optimum solution was obtained which lead to significant improvement in fuel efficiency of the compactor.

Keywords: differential fuel flow meter, engine RPM, fuel efficiency, heavy construction compaction machine

Procedia PDF Downloads 291

Authors: Yael Teff-Seker

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More often than not, ecosystems do not follow anthropogenic political borders. Thus, transboundary environmental protection or rehabilitation initiatives can be beneficial and at times even vital for supporting healthy ecosystems. Marine areas demand unique considerations and challenges for such initiatives, as maritime borders tend to be less defined, less fortified and less visible. In areas of recent conflict, cross-border environmental initiatives can also improve relations between states and promote peace-building efforts, in addition to their environmental benefits. The current study reviews the current literature on transboundary marine environmental protection initiatives that take place in these areas and focuses on joint initiatives in Israel-Jordan and Croatia-Slovenia. In addition to factors described in the literature such as funding and third-party involvement, findings suggest that the peripheral location of marine environmental initiatives can be beneficial for the success of such initiatives, as well as facilitating border crossing and the extent to which such initiatives advance other governmental goals. A sense of urgency, environmental or other, has also been found to be highly relevant to project success.

Keywords: environmental cooperation, environmental peacebuilding, marine environment, environmental conflict, environmental management

Procedia PDF Downloads 180