Search results for: difficulty in hospital acceptance

Authors: Rafael Muñoz, Juan Melchor, Alicia Valera, Laura Peralta, Guillermo Rus

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A torsional piezoelectric ultrasonic transducer design is proposed to measure shear moduli in soft tissue with direct access availability, using shear wave elastography technique. The measurement of shear moduli of tissues is a challenging problem, mainly derived from a) the difficulty of isolating a pure shear wave, given the interference of multiple waves of different types (P, S, even guided) emitted by the transducers and reflected in geometric boundaries, and b) the highly attenuating nature of soft tissular materials. An immediate application, overcoming these drawbacks, is the measurement of changes in cervix stiffness to estimate the gestational age at delivery. The design has been optimized using a finite element model (FEM) and a semi-analytical estimator of the probability of detection (POD) to determine a suitable geometry, materials and generated waves. The technique is based on the time of flight measurement between emitter and receiver, to infer shear wave velocity. Current research is centered in prototype testing and validation. The geometric optimization of the transducer was able to annihilate the compressional wave emission, generating a quite pure shear torsional wave. Currently, mechanical and electromagnetic coupling between emitter and receiver signals are being the research focus. Conclusions: the design overcomes the main described problems. The almost pure shear torsional wave along with the short time of flight avoids the possibility of multiple wave interference. This short propagation distance reduce the effect of attenuation, and allow the emission of very low energies assuring a good biological security for human use.

Keywords: cervix ripening, preterm birth, shear modulus, shear wave elastography, soft tissue, torsional wave

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Authors: Malgorzata Sekulowicz, Krystyna Boron-Krupinska, Paulina Morga, Blazej Cieslik

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Burnout is highly prevalent in health care employees, especially in physicians. It significantly reduces the efficiency of these employees, which can have negative consequences for both physicians and patients. Resilience and mindfulness enhancing positive emotions, leading to sustainable development and personal commitment, can have a significant impact on burnout. Therefore, the aim of this study was to determine the relationship between burnout symptoms and mindfulness and resilience among physicians. The authors conducted a cross-sectional survey study among seventy-four polish physicians. Participants filled out the following psychometric tools: the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), Five Facet Mindfulness Questionnaire (FFMQ), Areas of Work-Life Survey (AWS), International Personality Item Pool (IPIP), the Resilience Assessment Scale (SPP-25) and the Mini-COPE Inventory. The relationship between burnout and resilience and mindfulness was assessed with path analysis. Analyzing the relationship between MBI-HSS components and mindfulness, a significant negative correlation of the FFMQ score with emotional exhaustion (-0.50, p < 0.05) and depersonalization (-0.43, p < 0.05) and a positive correlation with personal accomplishment (0.50, p < 0.05) was demonstrated. Analyzing resilience, a statistically significant relationship of SPP-25 with all tested components of MBI-HSS was demonstrated: emotional exhaustion (-0.54, p < 0.05), depersonalization (-0.31, p < 0.05) and personal accomplishment (0.35, p < 0.05). In the group of medical doctors, the higher the level of mindfulness and resilience, the lower the risk of burnout. Furthermore, the more frequently used active coping strategies (planning, acceptance), the lower the risk of burnout, while the use of passive, evasive strategies increases the risk of burnout. It may be worth considering implementing mindfulness intervention to effectively manage burnout symptoms in this group.

Keywords: burnout, medical doctors, mindfulness, physicians, resilience

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Authors: A. Felimban, A. Prieto, U. Knaack, T. Klein

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This study aims to present an overview of recent research in building energy-retrofitting strategy applications and analyzing them within the context of hot arid climate regions which is in this case study represented by the Kingdom of Saudi Arabia. The main goal of this research is to do an analytical study of recent research approaches to show where the primary gap in knowledge exists and outline which possible strategies are available that can be applied in future research. Also, the paper focuses on energy retrofitting strategies at a building envelop level. The study is limited to specific measures within the hot arid climate region. Scientific articles were carefully chosen as they met the expression criteria, such as retrofitting, energy-retrofitting, hot-arid, energy efficiency, residential buildings, which helped narrow the research scope. Then the papers were explored through descriptive analysis and justified results within the Saudi context in order to draw an overview of future opportunities from the field of study for the last two decades. The conclusions of the analysis of the recent research confirmed that the field of study had a research shortage on investigating actual applications and testing of newly introduced energy efficiency applications, lack of energy cost feasibility studies and there was also a lack of public awareness. In terms of research methods, it was found that simulation software was a major instrument used in energy retrofitting application research. The main knowledge gaps that were identified included the need for certain research regarding actual application testing; energy retrofitting strategies application feasibility; the lack of research on the importance of how strategies apply first followed by the user acceptance of developed scenarios.

Keywords: energy efficiency, energy retrofitting, hot arid, Saudi Arabia

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Authors: Martha Berg, Megan Ramaiya, Andi Schmidt, Susanna Sharma, Brandon Kohrt

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Nepali adolescents report tension and negative emotion due to perceived expectations of both academic and social achievement. These societal goals, which are internalized through early-life socialization, drive the development of self-regulatory processes such as emotion regulation. Emotion dysregulation is linked with adverse psychological outcomes such as depression, self-harm, and suicide, which are public health concerns for organizations working with Nepali adolescents. This study examined the relation among socialization, internalized cultural goals, and emotion regulation to inform interventions for reducing depression and suicide in this population. Participants included 102 students in grades 7 through 9 in a post-earthquake school setting in rural Kathmandu valley. All participants completed a tablet-based battery of quantitative measures, comprising transculturally adapted assessments of emotion regulation, depression, and self-harm/suicide ideation and behavior. Qualitative measures included two focus groups and semi-structured interviews with 22 students and 3 parents. A notable proportion of the sample reported depression symptoms in the past 2 weeks (68%), lifetime self-harm ideation (28%), and lifetime suicide attempts (13%). Students who lived with their nuclear family reported lower levels of difficulty than those who lived with more distant relatives (z=2.16, p=.03), which suggests a link between family environment and adolescent emotion regulation, potentially mediated by socialization and internalization of cultural goals. These findings call for further research into the aspects of nuclear versus extended family environments that shape the development of emotion regulation.

Keywords: adolescent mental health, emotion regulation, Nepal, socialization

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Authors: Karla Hrbackova, Anna Petr Safrankova, Jakub Hladik

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Machiavellianism as social phenomenon reveals certain methods of communication that man puts in contact with other people in both personal and working life (and work with clients). Especially at the helping-profession students is honesty, openness or low motivation for personal benefit important part of the profession. The aim of a study is to expose intercultural differences influence of Machiavellianism between Czech and Slovak university students and to determine whether these differences manifest themselves differently among students focusing on management and social profession (by helping degrees). The research involved 1120 university students from the Czech Republic and the Slovak Republic. The measurement of Machiavellianism used a test Mach IV. The test contained 20 statements divided into four central dimensions of Machiavellianism: flattery, deception and falsehood, immorality and cynicism. We found out, that Czech and Slovak's student expressed a similar attitude toward Machiavellianism as a means of manipulation in the interpersonal relationship, but this is not true in all dimensions. Czech and Slovak's students perceive differently flattery, deception and falsehood and cynicism too. In addition to specific features of cultural conditionality, we found out differences depending on the helping profession. Students focusing on managerial occupation (lower level of helping) tend towards greater acceptance of the use flattery as a means of communication than students specializing in the social profession (high-grade assisting). If they are an intercultural and interdisciplinary influences combined and effect on the perception of Machiavellianism together, then their significant importance for the perception of flattery and cynicism. The result will help us to reveal certain specific traits that students apply communication and with whom we can continue to work during their training.

Keywords: use of manipulative strategies, Machiavellianism, helping-profession students, professional training of students

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Authors: Luciano Tarantino

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Gas gangrene is a rare, severe infection with a very high mortality rate caused by Clostridium species. The infection causes a non-suppurative localized producing gas lesion from which harmful toxins that impair the inflammatory response cause vessel damage and multiple organ failure. Gas gangrene of the liver is very rare and develops suddenly, often as a complication of abdominal surgery and liver transplantation. The present paper deals with a case of gas gangrene of the liver that occurred after percutaneous MW ablation of hepatocellular carcinoma, resulting in progressive liver necrosis and multi-organ failure in spite of specific antibiotics administration. The patient was successfully treated with percutaneous Radiofrequency ablation. Case report: Female, 76 years old, Child A class cirrhosis, treated with synchronous insertion of 3 MW antennae for large HCC (5.5 cm) in the VIII segment. 24 hours after treatment, the patient was asymptomatic and left the hospital . 2 days later, she complained of fever, weakness, abdominal swelling, and pain. Abdominal US detected a 2.3 cm in size gas-containing area, eccentric within the large (7 cm) ablated area. The patient was promptly hospitalized with the diagnosis of anaerobic liver abscess and started antibiotic therapy with Imipenem/cilastatine+metronidazole+teicoplanine. On the fourth day, the patient was moved to the ICU because of dyspnea, congestive heart failure, atrial fibrillation, right pleural effusion, ascites, and renal failure. Blood tests demonstrated severe leukopenia and neutropenia, anemia, increased creatinine and blood nitrogen, high-level FDP, and high INR. Blood cultures were negative. At US, unenhanced CT, and CEUS, a progressive enlargement of the infected liver lesion was observed. Percutaneous drainage was attempted, but only drops of non-suppurative brownish material could be obtained. Pleural and peritoneal drainages gave serosanguineous muddy fluid. The Surgeon and the Anesthesiologist excluded any indication of surgical resection because of the high perioperative mortality risk. Therefore, we asked for the informed consent of the patient and her relatives to treat the gangrenous liver lesion by percutaneous Ablation. Under conscious sedation, percutaneous RFA of GG was performed by double insertion of 3 cool-tip needles (Covidien LDT, USA ) into the infected area. The procedure was well tolerated by the patient. A dramatic improvement in the patient's condition was observed in the subsequent 24 hours and thereafter. Fever and dyspnea disappeared. Normalization of blood tests, including creatinine, was observed within 4 days. Heart performance improved, 10 days after the RFA the patient left the hospital and was followed-up with weekly as an outpatient for 2 months and every two months thereafter. At 18 months follow-up, the patient is well compensated (Child-Pugh class B7), without any peritoneal or pleural effusion and without any HCC recurrence at imaging (US every 3 months, CT every 6 months). Percutaneous RFA could be a valuable therapy of focal GG of the liver in patients non-responder to antibiotics and when surgery and liver transplantation are not feasible. A fast and early indication is needed in case of rapid worsening of patient's conditions.

Keywords: liver tumor ablation, interventional ultrasound, liver infection, gas gangrene, radiofrequency ablation

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Authors: Mohammed Almohammedali, David Edgar, Duncan Peter

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The aim of this exploratory research is to further understand how organisations can evaluate their activities, which generate knowledge creation, to meet changing stakeholder expectations. A Scale of Knowledge (SoK) Framework is proposed which links knowledge management and organisational activities to changing stakeholder expectations. The framework was informed by the knowledge management literature, as well as empirical work conducted via a single case study of a multi-site hospital organisation in Saudi Arabia. Eight in-depth semi-structured interviews were conducted with managers from across the organisation regarding current and future stakeholder expectations, organisational strategy/activities and knowledge management. Data were analysed using thematic analysis and a hierarchical value map technique to identify activities that can produce further knowledge and consequently impact on how stakeholder expectations are met. The SoK Framework developed may be useful to practitioners as an analytical aid to determine if current organisational activities produce organisational knowledge which helps them meet (increasingly higher levels of) stakeholder expectations. The limitations of the research and avenues for future development of the proposed framework are discussed.

Keywords: knowledge creation, knowledge management, organisational knowledge, analytical aid, stakeholders

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Authors: Jeaha Yang, Ahmed Khan, Donna L. Rodela, Mohammed A. Qaudeer

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Traditional supply chain silos still exist today due to the difficulty of establishing trust between various partners and technological barriers across industries. Companies lose opportunities and revenue and inadvertently make poor business decisions resulting in further challenges. Blockchain technology can bring a new level of transparency through sharing information with a distributed ledger in a decentralized manner that creates a basis of trust for business. Blockchain is a loosely coupled, hub-style communication network in which trading partners can work indirectly with each other for simpler integration, but they work together through the orchestration of their supply chain operations under a coherent process that is developed jointly. A Blockchain increases efficiencies, lowers costs, and improves interoperability to strengthen and automate the supply chain management process while all partners share the risk. Blockchain ledger is built to track inventory lifecycle for supply chain transparency and keeps a journal of inventory movement for real-time reconciliation. State design patterns are used to capture the life cycle (behavior) of inventory management as a state machine for a common, transparent and coherent process which creates an opportunity for trading partners to become more responsive in terms of changes or improvements in process, reconcile discrepancies, and comply with internal governance and external regulations. It enables end-to-end, inter-company visibility at the unit level for more accurate demand planning with better insight into order fulfillment and replenishment.

Keywords: supply chain management, inventory trace-ability, perpetual inventory system, inventory lifecycle, blockchain, inventory consignment, supply chain transparency, digital thread, demand planning, hyper ledger fabric

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Authors: Yazidu Saidi Mbalamula

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Free Basic Education (FBE) policy implementation in Secondary Schools has been one of thrilled undertaking both to the government and household in Tanzania. On the one hand, the government has achieved citizenry acceptance to responsibility and accountability, and on the other hand, the household has been relieved from social costs that were unbearable and deprived many Tanzanians access to basic education and secondary education in particular. Specifically, this study presents a descriptive survey conducted in two districts of Kagera region located at the northern part of Tanzania. Three objectives were pursued to identify achievements realized and challenges in the FBE implementation, and also stakeholders’ proposals were explored on how to improve FBE implementation. A sample of 91 respondents, including school managers, teachers, students, and parents, were involved in the study. Both questionnaires and interviews were used whereby the quantitative data were analyzed using Statistical Package for Social Sciences (SPSS), and content analysis was used to analyze the qualitative data. The results show that implementation of free education policy in secondary schools had far positive impact on the improvement of school management, school attendance, reduced school drop-out, reduced parents-school managers conflicts, and increased enrollment rates. Notwithstanding that, the political machinery remains instrumental to instigate policy reforms in education sector. Nevertheless, the alienating interests of politibureau, often top-down and blanketed by superficial government redness, can hardly be feasible to wield such huge programme given staggering stakeholders’ awareness of the actual requirements and unlatching resources to back up policy implementation. The study recommends that further studies on stakeholders’ conceptions on the FBE and equity of financing of basic education in Tanzania.

Keywords: capitation grant, CCM, free basic education, kagera, education policy

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Authors: Angelis P. Barlampas

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Theoretical background Disorders of fixation and rotation of the large intestine, result in the existence of its parts in ectopic anatomical positions. In case of symptomatology, the clinical picture is complicated by the possible symptomatology of the neighboring anatomical structures and a differential diagnostic problem arises. Target The purpose of this work is to demonstrate the difficulty of revealing the real cause of abdominal pain, in cases of anatomical variants and the decisive contribution of imaging and especially that of computed tomography. Methods A patient came to the emergency room, because of acute pain in the right hypochondrium. Clinical examination revealed tenderness in the gallbladder area and a positive Murphy's sign. An ultrasound exam depicted a normal gallbladder and the patient was referred for a CT scan. Results Flexible, unfixed ascending colon and cecum, located in the anatomical region of the right mesentery. Opacities of the surrounding peritoneal fat and a small linear concentration of fluid can be seen. There was an appendix of normal anteroposterior diameter with the presence of air in its lumen and without clear signs of inflammation. There was an impression of possible inflammatory swelling at the base of the appendix, (DD phenomenon of partial volume; e.t.c.). Linear opacities of the peritoneal fat in the region of the second loop of the duodenum. Multiple diverticula throughout the colon. Differential Diagnosis The differential diagnosis includes the following: Inflammation of the base of the appendix, diverticulitis of the cecum-ascending colon, a rare case of second duodenal loop ulcer, tuberculosis, terminal ileitis, pancreatitis, torsion of unfixed cecum-ascending colon, embolism or thrombosis of a vascular intestinal branch. Final Diagnosis There is an unfixed cecum-ascending colon, which is exhibiting diverticulitis.

Keywords: unfixed cecum-ascending colon, abdominal pain, malrotation, abdominal CT, congenital anomalies

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Authors: Walid A. Alkeridy, Arwa Aljasser, Khalid Mohammed Alayed, Saad Alsaad, Amani S. Alqahtani, Claire Ann Lim, Sultan H. Alamri, Doaa Zainhom Mekkawy, Mohammed Al-Sofiani

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Introduction: The history of publicly funded Home Health Care (HHC) service in Saudi Arabia dates back to 1991. The first HC program was launched to provide palliative home care services for patients with terminal cancer. Thereafter, more programs launched across Saudi Arabia most remarkably was launching the national program for HHC by the Ministry Of Health (MOH) in 2008. The national HHC MOH program is mainly providing long-term care home care services for over 40,000 Saudi citizens. The scope of the HHC service program provided by the Saudi MOH is quite diverse, ranging from basic nursing care to specialized care programs, e.g., home peritoneal dialysis, home ventilation, home infusion therapy, etc. Objectives: The primary aim of our study is to report the prevalence of chronic conditions among Saudi people receiving long-term HHC services. Secondary aims include identifying the predictors of mortality among individuals receiving long-term HHC services and studying the association between frailty and poor health outcomes among HHC users. Methods: We conducted a retrospective and cross-sectional data collection from participants receiving HHC services at King Saud University Medical City, Riyadh, Saudi Arabia. Data were collected from electronic health records (EHR), patient charts, and interviewing caregivers from the year 2019 to 2022. We assessed functional performance by Katz's activity of daily living and the Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). Mortality was assessed by reviewing the death certificates if patients were hospitalized through discharge status ascertainment from EHR. Results: The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. The following variables were statistically significant between deceased and alive individuals receiving HHC services; clinical frailty scale, the total number of comorbid conditions, and functional performance based on the KATZ activity of daily living scale and the BADLS. We found that the strongest predictors for mortality were pressure ulcers which had an odds ratio of 3.75 and p-value of < 0.0001, and the clinical frailty scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis. In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services. Moreover, we found a high rate of annual readmission for individuals enrolled in HHC, which requires further analysis to understand the possible contributing factors for the increased rate of hospital readmission and develop strategies to address them. Future studies should focus on designing quality improvement projects aimed at improving the quality of life for individuals receiving HHC services, especially those who have pressure ulcers at the end of life.

Keywords: homecare, Saudi, prevalence, chronic

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Authors: Hongquan Zhang

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Inspired by endogenous protein motors, researchers have constructed various synthetic DNA motors based on the specificity and predictability of Watson-Crick base pairing. However, the application of DNA motors to signal amplification and biosensing is limited because of low mobility and difficulty in real-time monitoring of the walking process. The objective of our work was to construct a new type of DNA motor termed target-triggered DNA motors that can walk for hundreds of steps in response to a single target binding event. To improve the mobility and processivity of DNA motors, we used gold nanoparticles (AuNPs) as scaffolds to build high-density, three-dimensional tracks. Hundreds of track strands are conjugated to a single AuNP. To enable DNA motors to respond to specific protein and nucleic acid targets, we adapted the binding-induced DNA assembly into the design of the target-triggered DNA motors. In response to the binding of specific target molecules, DNA motors are activated to autonomously walk along AuNP, which is powered by a nicking endonuclease or DNAzyme-catalyzed cleavage of track strands. Each moving step restores the fluorescence of a dye molecule, enabling monitoring of the operation of DNA motors in real time. The motors can translate a single binding event into the generation of hundreds of oligonucleotides from a single nanoparticle. The motors have been applied to amplify the detection of proteins and nucleic acids in test tubes and live cells. The motors were able to detect low pM concentrations of specific protein and nucleic acid targets in homogeneous solutions without the need for separation. Target-triggered DNA motors are significant for broadening applications of DNA motors to molecular sensing, cell imagining, molecular interaction monitoring, and controlled delivery and release of therapeutics.

Keywords: biosensing, DNA motors, gold nanoparticles, signal amplification

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

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

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

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Authors: Shohra Qaderi

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

Keywords: afghanistan, acute renal failure, child, mortality

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Authors: Rai Mansoor Imtiaz

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Guardians in hybrid regimes fragment opposition parties and ban their political leaders, and disenfranchise their voters' political participation. When guardians in hybrid regimes are so powerful that they remain decisive on electoral politics of states, and have powers to ban political parties and their leadership, then "why do political parties backed by those powerful guardians lose elections" and "how do anti-establishment parties make electoral inroads at the local and national levels." These two questions are interrelated with the key research question of my research "why do people vote for political parties rejected by powerful guardians in establishmentarian democracies." Furthermore, this research question is important to be explored for two reasons. First, existing literature only reflects the electoral victories of opposition parties or defeats of military-sponsored parties (see Thailand and Turkey) but remains silent on political change that led the anti-military parties to win the elections. Second, why is it a case that people belonging to the countries where militaries remain popular among the public (see Turkey and Pakistan) have started putting their trust in anti-establishment politicians who criticise the military against their intervention in politics? For instance, in Pakistan, where commenting against the military is meant to comment against the state –– an anti-military narrative is getting popular support. The conceptual framework of hybrid states in this research relies on the concept of a 'reserved domain/tutelary body' (guardians of hybrid states). However, this research makes a case that hybrid states are not consolidated separate political entities but rather vacillated states that fluctuate between democratic and authoritarian practices. This paper, therefore, uses the term establishmentarian democracy as a subtype of the hybrid regime, which is more consolidated than a hybrid democracy.

Keywords: Guardians, Hybrid Regimes, Voters, Elections, Democracy, South Asia

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Authors: Hsi-Chuan Wang, Hongxi Yin

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Compactness has been proposed as a type of sustainable urban form globally. However, the meanings and the measurements might diverse in regarding to the varying interpretation; moreover, since compactness was proposed to eliminate auto culture and urban sprawl in the developed countries, voices have emerged asking to rethink the suitability of compactness in the developing countries – based upon such understanding, Quality of Life (QOL) has been suggested as a good way to show the overall benefit of compactness. In regarding to such background, two subjects were targeted for discussion in this paper: (I) the meaning and feasibility of compactness between the developing and developed countries, and (II) the interaction between compactness and QOL. This paper argues that compactness should not be considered a universal principle for cities of all kind, but rather an ideal concept for urban designer and planner to consider throughout local practices. It firstly reviewed the benefits of both compactness and sprawl to uncover the features behind these urban forms, and later addressed the meaning and difficulty of adopting compactness in both the developing and developed countries. Secondly, arguing compactness to be positioned as a ‘process’ along the transition from the developing countries to the developed ones, this paper applied both cross-sectional and longitudinal analysis to uncover (I) the relationship between compactness and QOL in regarding to 30 American cities and (II) the impact of ‘becoming compact’ on QOL in regarding to 8 identified American Urbanized Areas (UZAs). The findings indicated that higher compactness could link to lower QOL among the compact cities, but with higher QOL among the sprawl cities. In addition, based upon the comparison between 2000 and 2010 on 8 UZAs, their QOL have escalated during the transition from the sprawl areas into the compact ones, but the extent of improvement in QOL could differ greatly among areas. In regarding to our findings, compact development should be proposed as a general guideline leading the contemporary sprawl cities in transition with sustainable urbanism; however, to prevent the externalities from damaging QOL with over-compactness, the compact policy should be flexible to adjust a long-term roadmap for sustainable development.

Keywords: compactness, quality of life, sprawl, sustainable urbanism

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Authors: Ammarah Irum, Muhammad Ali Tahir

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Document-level sentiment analysis in Urdu is a challenging Natural Language Processing (NLP) task due to the difficulty of working with lengthy texts in a language with constrained resources. Deep learning models, which are complex neural network architectures, are well-suited to text-based applications in addition to data formats like audio, image, and video. To investigate the potential of deep learning for Urdu sentiment analysis, we implemented five different deep learning models, including Bidirectional Long Short Term Memory (BiLSTM), Convolutional Neural Network (CNN), Convolutional Neural Network with Bidirectional Long Short Term Memory (CNN-BiLSTM), and Bidirectional Encoder Representation from Transformer (BERT). In this study, we developed a hybrid deep learning model called BiLSTM-Single Layer Multi Filter Convolutional Neural Network (BiLSTM-SLMFCNN) by fusing BiLSTM and CNN architecture. The proposed and baseline techniques are applied on Urdu Customer Support data set and IMDB Urdu movie review data set by using pre-trained Urdu word embedding that are suitable for sentiment analysis at the document level. Results of these techniques are evaluated and our proposed model outperforms all other deep learning techniques for Urdu sentiment analysis. BiLSTM-SLMFCNN outperformed the baseline deep learning models and achieved 83%, 79%, 83% and 94% accuracy on small, medium and large sized IMDB Urdu movie review data set and Urdu Customer Support data set respectively.

Keywords: urdu sentiment analysis, deep learning, natural language processing, opinion mining, low-resource language

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Authors: Aliyaa Zaidan, Rayan Bahabri

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The twenty-first century revealed an accelerating change and intensifying complexity of communication technology. Online social networking engines have gained astounding recognition worldwide. The influence of those social media platforms on dentistry and dental students is not well established. Therefore, this study aimed to evaluate the impact of using social media on professional and profile level among dental students in Saudi Arabia. A cross-sectional study developed via online questionnaire concerning on social media usage and its effect on professional and profile level of dental students and dental interns from several universities in Saudi Arabia. A total of 296 dental students and dental interns in Saudi Arabia responded to the questionnaire. Ninety-eight percent of the participants usually use the social media on a regular basis. Most social media sites used among the participants were Snapchat, Instagram, and YouTube by 85%, 81%, 77% respectively. Forty-one percent of the participants agreed that using social media in the dental field is a necessity nowadays. Thirty-eight percent of participants agreed that using social media is an easy way to gain a reliable knowledge, while 43% agreed that social media will improve the quality of healthcare. Furthermore, 65% of the students deemed using social media for academic purposes will improve their performance. Fifty-five percent of the respondents often use social media tools to obtain information about subject or procedures related to the dental field. Regarding profile reputation of dental students, 40% of the respondents agreed that their profile information published on social networking websites, could be used by others to judge their level of professionalism. Male and female dental students both agreed that their reputation would be adversely affected by 37%,63%, respectively, if their social networking activity were viewed by members of the public. The discrepancy among student levels reveals that social media profile positively influence the acceptance to postgraduate programs (P= 0.01).

Keywords: dental students, professional, reputation, social media

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Authors: C. F. Jones Couto

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The implementation of quality Physical Education (PE) inspires and instils lasting healthy behavioural patterns, hence have the potential as an educational tool to teach values in today’s society. The goal of PE should be to contribute to the acceptance of the infinite qualities of South Africa’s (RSA) diversity and to claim RSA’s diversity as a source of strength that forms a universal bond of a common set of values. There is a global change in the interaction of children with their environment; their lives are shaped by forces that do not necessarily assist them in learning and applying values. In most countries today, the responsibility for developing values is assigned to schools in formal teaching settings. Values-based education offers an investment in individual and societal improvement through attendance to a values framework. The aim of this qualitative research is to develop a PE programme aligned with the current South African curriculum, enriched with values of Olympism and Ubuntuism, and to present PE teacher training workshops (TTW). Participatory action research will be used as the basis of how data will be collected, analysed, and presented on an ongoing, cyclical basis. PE teachers from different schools in the Tshwane District of RSA will participate as they can best inform the research questions and enhance the understanding of the phenomenon under study. The outcomes of using PE as a tool to teach values can propose recommendations to the Department of Basic Education of RSA to improve and implement a quality PE curriculum that is applicable to practice and that will optimize the chances of meeting the South African National Curriculum Statement standards. A PE programme with the aim of holistic development, based on the values of Olympism and Ubuntuism, can strive to ensure that the values set out in RSA’s constitution are part of PE organization, planning, and teaching at each South African school.

Keywords: olympism, physical education, teacher training, ubuntuism, values-based education

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

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

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

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Authors: Md. Rezaul Karim, Md. Ashikur Rahman, Dewan Mahmud Mim

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Scarcity of potable water as the result of rapid climate change and saltwater intrusion in groundwater has been a major problem in the coastal regions over the world. In equinoctial countries like Bangladesh, where sunlight is available for more than 10 hours a day, Solar Distillation provides a promising sustainable way for safe drinking water supply in coastal poor households with negligible major cost and difficulty of construction and maintenance. In this paper, two passive type solar stills- a Conventional Single Slope Solar still (CSS) and a Pyramid Solar Sill (PSS) is used and relationship is established between distill water output corresponding to four different factors- temperature, solar intensity, relative humidity and wind speed for Gazipur, Bangladesh. Comparison is analyzed between the two different still outputs for nine months period (January- September) and efficiency is calculated. Later a thermal mathematical model is developed and the distilled water output for Khulna, Bangladesh is computed. Again, difference between the output of the two cities- Gazipur and Khulna is demonstrated and finally an economic analysis is prepared. The distillation output has a positive correlation with temperature and solar intensity, inverse relation with relative humidity and wind speed has nugatory consequence. The maximum output of Conventional Solar Still is obtained 3.8 L/m2/day and Pyramid still is 4.3 L/m2/day for Gazipur and almost 15% more efficiency is found for Pyramid still. Productivity in Khulna is found almost 20% more than Gazipur. Based on economic analysis, taking 10 BDT, per liter, the net profit, benefit cost ratio, payback period all indicates that both stills are feasible but pyramid still is more feasible than Conventional Still. Finally, for a 3-4 member family, area of 4 m2 is suggested for Conventional Still and 3m2 for Pyramid Solar Still.

Keywords: solar distillation, household water supply, saline zones, Bangladesh

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Authors: Pratistha Shrestha

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

Keywords: acrochordons, diabetes mellitus, obesity, skin tags

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Authors: Rajapaksha J. S. R. L., Rajapaksha R. G. D. T., Ranawaka A. U. R., Rangalla R. D. M. P., Ranwala R. D. E. B., Chandratilake M. N.

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Introduction: Lesbian, gay, bisexual, and transgender (LGBT) patients experience discrimination, insensitivity, and ignorance about LGBT-specific health needs among healthcare providers. Developing the correct attitudes among medical students towards LGBT may help provide them with optimal healthcare. Objectives: This study aimed at assessing the attitudes of medical students towards the LBGT community. Methodology: A cross-sectional descriptive study was among all the medical students in the Faculty of Medicine, University of Kelaniya, Sri Lanka, using a validated online questionnaire. The questionnaire focused on eight areas. The data were descriptively analyzed, and the demographic groups were compared. Results: 358 students completed the survey. The response rate was 34.26%. Their attitudes on traditional gender roles and comfortability in interacting with LGBT people were moderate, and they disagreed with negative LGBT social beliefs. They knew less about the origin of sexuality/gender of LGBT. Although they accepted LGBT as a part of diversity, they discouraged normalizing the social practices of LGBT people. Their acceptance and association of LGBT were moderately positive. A minority has encountered LGBT in close social circles, and the majority of them were batch-mates. Although males’ knowledge about the origin of LGBT was higher, they favoured traditional gender roles more. The religious groups showed no differences. The favourability of attitudes towards LGBT reflected respondents’ political ideology. Conclusion: Although medical students’ knowledge on the sexuality/gender basis of LGBT is poor, they have moderately favourable attitudes towards them. They accept LGBT as a part of social diversity but not their social practices. Poor knowledge, lack of encounters, cultural influences, and political ideology may have influenced their attitudes.

Keywords: medical students, attitude, LGBT, diversity

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Authors: Nilda San Miguel, Elymar Pascual

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The main focus of this study is exploring the effective approaches in teaching Mathematics that is being applied in public schools, s.y. 2018-2019. This research was written as connected output to the district-wide School Learning Action Cell (DISLAC) on Math teaching approaches which was recently conducted in Victoria, Laguna. Fifty-four math teachers coming from 17 schools in Victoria became the respondents of this study. Qualitative method of doing research was applied. Teachers’ responses to the following concerns were gathered, analyzed and interpreted: (1) evaluation of the recently conducted DISLAC, (2) status of the use of different approaches, (3) perception on the effective use of approaches, (4) preference of approach to explore in classroom sessions, (5) factors affecting the choice of approach, (6) difficulties encountered, (7) and perceived benefit to learners. Results showed that the conduct of DISLAC was very highly satisfactory (mean 4.41). Teachers looked at collaborative approach as very highly effective (mean 4.74). Fifty-two percent of the teachers is using collaborative approach, 17% constructivist, 11% integrative, 11% inquiry-based, and 9% reflective. Reflective approach was chosen to be explored by most of the respondents (29%) in future sessions. The difficulties encountered by teachers in using the different approaches are: (1) learners’ difficulty in following instructions, (2) lack of focus, (3) lack of willingness and cooperation, (4) teachers’ lack of mastery in using different approaches, and (5) lack of time of doing visual aids because of time mismanagement. Teachers deemed the use of various teaching approaches can help the learners to have (1) mastery of competency, (2) increased communication, (3) improved confidence, (4) facility in comprehension, and (5) better academic output. The result obtained from this study can be used as an input for SLACs. Recommendations at the end of the study were given to school/district heads and future researchers.

Keywords: approaches, collaborative, constructivism, inquiry-based, integrative, reflective

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Authors: Banu Pradheepa Kamarajan, Muthusamy Ananthasubramanian

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

Keywords: biofilm, nanopillars, Pseudomonas aeruginosa, survival rate

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Authors: Hasmadi Mamat, Noorfarahzilah Masri

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The search for lesser known and underutilized crops, many of which are potentially valuable as human and animal foods has been the focus of research in recent years. Tarap (Artocarpus odoratisimmus) is one of the most delicious tropical fruit and can be found extensively in Borneo, particularly in Sabah and Sarawak. This study was conducted in order to determine the proximate composition, mineral contents as well as to study the effect of the seed flour on the quality of bread produced. Tarap seed powder (TSP) was incorporated (up to 20%) with wheat flour and used to produce bread. The moisture content, ash, protein, fat, ash, carbohydrates, and dietary fiber were measured using AOAC methods while the mineral content was determined using AAS. The effect of substitution of wheat flour with Tarap seed flour on the quality of dough and bread was investigated using various techniques. Farinograph tests were applied to determine the effect of seaweed powder on the rheological properties of wheat flour dough, while texture profile analysis (TPA) was used to measure the textural properties of the final product. Besides that sensory evaluations were also conducted. On a dry weight basis, the TSP was composed of 12.50% moisture, 8.78% protein, 15.60% fat, 1.17% ash, 49.65% carbohydrate and 12.30% of crude fiber. The highest mineral found were Mg, followed by K, Ca, Fe and Na respectively. Farinograh results found that as TSP percentage increased, dough consistency, water absorption capacity and development time of dough decreased. Sensory analysis results showed that bread with 10% of TSP was the most accepted by panelists where the highest acceptability score were found for aroma, taste, colour, crumb texture as well as overall acceptance. The breads with more than 10% of TSP obtained lower acceptability score in most of attributes tested.

Keywords: tarap seed, proximate analysis, bread, sensory evaluation

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Authors: Nasrudin Andi Mappaware, Muh. Wirawan Harahap, Erlin Syahril, Farah Ekawati Mulyadi

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Cesarean section procedures are currently increasing, both for medical indications and without medical indications, better known as caesarean section on request. Cesarean section by self-request raises many dilemmas from the doctor's side regarding medical issues, professionalism, and bioethics. We report the case of a 27-year-old woman G1P0A0 gravid 38 weeks admitted to the hospital for a planned cesarean section on request for the reason that she could not tolerate pain and requested on a date that corresponded to the date and month of her mother's birth. Currently, there is no medical indication for a cesarean section. Anesthesia during cesarean section at self-request without medical indications is a dilemma for anesthesiologists considering the risks and complications of anesthesia for both the fetus and the mother. Cesarean section delivery without medical indications is still justified and does not conflict with ethics and professionalism. Because it fulfills the principle of autonomy which states that patients have the right to themselves. However, this medical procedure is still considered no safer and riskier even though medical technology has developed rapidly. The trend in increasing the number of cesarean sections is influenced by patient reasons such as: not being able to tolerate pain, trust factors and worry about damage to the birth canal.

Keywords: anesthesia, bioethics, medical, self-request, professionalism

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Authors: Fatemeh Daneshvartarigh

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New technologies and applications have radically altered construction techniques in recent years. In order to anticipate how the building will act, perform, and appear, these technologies encompass a wide range of visualization, simulation, and analytic tools. These new technologies and applications have a considerable impact on completing construction projects in today's (architecture, engineering and construction)AEC industries. The rate of changes in BIM-related topics is different worldwide, and it depends on many factors, e.g., the national policies of each country. Therefore, there is a need for comprehensive research focused on a specific area with common characteristics. Therefore, one of the necessary measures to increase the use of this new approach is to examine the challenges and obstacles facing it. In this research, based on the Delphi method, at first, the background and related literature are reviewed. Then, using the knowledge obtained from the literature, a primary questionnaire is generated and filled by experts who are selected using snowball sampling. It covered the experts' attitudes towards implementing BIM in renovation projects and their view of the benefits and obstacles in this regard. By analyzing the primary questionnaire, the second group of experts is selected among the participants to be interviewed. The results are analyzed using Theme analysis. Six themes, including Management support, staff resistance, client willingness, Cost of software and implementation, the difficulty of implementation, and other reasons, are obtained. Then a final questionnaire is generated from the themes and filled by the same group of experts. The result is analyzed by the Fuzzy Delphi method, showing the exact ranking of the obtained themes. The final results show that management support, staff resistance, and client willingness are the most critical barrier to BIM usage in renovation projects.

Keywords: building information modeling, BIM, BIM implementation, BIM barriers, BIM in renovation

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

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

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

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Authors: Shahram Nowrouzieh, Abbas Rezaei Asl, Mohamad Ali Jafari

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Cotton, as a strategic crop, plays an important role in providing human food and clothing need, because of its oil, protein, and fiber. Iran has been one of the largest cotton producers in the world in the past, but unfortunately, for economic reasons, its production is reduced now. One of the ways to reduce the cost of cotton production is to expand the mechanization of cotton harvesting. Iranian farmers do not accept the function of cotton harvesters. One reason for this lack of acceptance of cotton harvesting machines is the number of field losses on these machines. So, the majority of cotton fields are harvested by hand. Although the correct setting of the harvesting machine is very important in the cotton losses, the morphological properties of the cotton plant also affect the performance of cotton harvesters. In this study, the effect of some cotton morphological properties such as the height of the cotton plant, number, and length of sympodial and monopodial branches, boll dimensions, boll weight, number of carpels and bracts angle were evaluated on the performance of cotton picker. In this research, the efficiency of John Deere 9920 spindle Cotton picker is investigated on five different Iranian cotton cultivars. The results indicate that there was a significant difference between the five cultivars in terms of machine harvest efficiency. Golestan cultivar showed the best cotton harvester performance with an average of 87.6% of total harvestable seed cotton and Khorshid cultivar had the least cotton harvester performance. The principal component analysis showed that, at 50.76% probability, the cotton picker efficiency is affected by the bracts angle positively and by boll dimensions, the number of carpels and the height of cotton plants negatively. The seed cotton remains (in the plant and on the ground) after harvester in PCA scatter plot were in the same zone with boll dimensions and several carpels.

Keywords: cotton, bract, harvester, carpel

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