Search results for: level of physical activity

Authors: Nautiyal Ruchira, Nautiyal Hemant, Chaudhury Devnanda, Bhargava Surbhi, Chauhan Nidhi

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Introduction: South East Asian region contributes 2.5 million cases of malaria each year to the global burden of 300 to 500 million of which 76% is reported from India. Government of India launched a national program almost half a century ago, still malaria remains a major public health challenge. Pregnant women are more susceptible to severe malaria and its fetomaternal complications. Inadequate surveillance and under-reporting underestimates the problem. Aim: Present study aimed to analyze the clinical course and pattern of malaria during pregnancy and to study the feto-maternal outcome. Methodology: This is a prospective observational study carried out at Himalayan Institute of Medical Sciences – a tertiary care center in the sub-Himalayan state of Uttarakhand, Northern India. All the pregnant women with malaria and its complications were recruited in the study during 2009 to 2014 which included referred cases from the state of western Uttar Pradesh. A thorough history and clinical examination were carried out to assess maternal and fetal condition. Relevant investigations including haemogram, platelet count, LFT, RFT, and USG was done. Blood slides and rapid diagnostic tests were done to diagnose the type of malaria.The primary outcomes measured were the type of malaria infection, maternal complications associated with malaria, outcome of pregnancy and effect on the fetus. Results: 67 antenatal cases with malaria infection were studied. 71% patients were diagnosed with plasmodium vivax infection, 25% cases were plasmodium falciparum positive and in 3% cases mixed infection was found. 38(56%) patients were primigravida and 29(43%) were multiparous. Most of the patients had already received some treatment from their local doctors and presented with severe malaria with the complications. Thrombocytopenia was the commonest manifestation seen in 35(52%) patients, jaundice in 28%, severe anemia in 18%, and severe oligohydramnios in 10% and renal failure in 6% cases. Regarding pregnancy outcome there were 44 % preterm deliveries, 22% had IUFD and abortions in 6% cases.20% of newborn were low birth weight and 6% were IUGR. There was only one maternal death which occurred due to ARDS in falciparum malaria. Although Plasmodium vivax was the main parasite considering the severity of clinical presentation, all the patients received intensive care. As most of the patients had received chloroquine therapy hence they were treated with IV artesunate followed by oral artemesinin combination therapy. Other therapies in the form of packed RBC’s and platelet transfusions, dialysis and ventilator support were provided when required. Conclusion: Even in areas with annual parasite index (API) less than 2 like ours, malaria in pregnancy could be an alarming problem. Vivax malaria cannot be considered benign in pregnancy because of high incidence of morbidity. Prompt diagnosis and aggressive treatment can reduce morbidity and mortality significantly. Increased community level research, integrating ANC checkups with the distribution of insecticide-treated nets in areas of high endemicity, imparting education and awareness will strengthen the existing control strategies.

Keywords: severe malaria, pregnancy, plasmodium vivax, plasmodium falciparum

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Authors: Allison Herlene Du Plessis, Dalena (R.M.) Van Rooyen, Wilma Ten Ham-Baloyi, Sihaam Jardien-Baboo

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Introduction: Women die in pregnancy and childbirth for five main reasons—severe bleeding, infections, unsafe abortions, hypertensive disorders (pre-eclampsia and eclampsia), and medical complications including cardiac disease, diabetes, or HIV/AIDS complicated by pregnancy. In 2015, WHO classified sepsis as the third highest cause for maternal mortalities in the world. Chorioamnionitis is a clinical syndrome of intrauterine infection during any stage of the pregnancy and it refers to ascending bacteria from the vaginal canal up into the uterus, causing infection. While the incidence rates for chorioamnionitis are not well documented, complications related to chorioamnionitis are well documented and midwives still struggle to identify this condition in time due to its complex nature. Few diagnostic methods are available in public health services, due to escalated laboratory costs. Often the affordable biomarkers, such as C-reactive protein CRP, full blood count (FBC) and WBC, have low significance in diagnosing chorioamnionitis. A lack of screening impacts on effective and timeous management of chorioamnionitis, and early identification and management of risks could help to prevent neonatal complications and reduce the subsequent series of morbidities and healthcare costs of infants who are health foci of perinatal infections. Objective: This integrative literature review provides an overview of current best research evidence on the screening of women at risk for chorioamnionitis. Design: An integrative literature review was conducted using a systematic electronic literature search through EBSCOhost, Cochrane Online, Wiley Online, PubMed, Scopus and Google. Guidelines, research studies, and reports in English related to chorioamnionitis from 2008 up until 2020 were included in the study. Findings: After critical appraisal, 31 articles were included. More than one third (67%) of the literature included ranked on the three highest levels of evidence (Level I, II and III). Data extracted regarding screening for chorioamnionitis was synthesized into four themes, namely: screening by clinical signs and symptoms, screening by causative factors of chorioamnionitis, screening of obstetric history, and essential biomarkers to diagnose chorioamnionitis. Key conclusions: There are factors that can be used by midwives to identify women at risk for chorioamnionitis. However, there are a paucity of established sociological, epidemiological and behavioral factors to screen this population. Several biomarkers are available to diagnose chorioamnionitis. Increased Interleukin-6 in amniotic fluid is the better indicator and strongest predictor of histological chorioamnionitis, whereas the available rapid matrix-metalloproteinase-8 test requires further testing. Maternal white blood cells count (WBC) has shown poor selectivity and sensitivity, and C-reactive protein (CRP) thresholds varied among studies and are not ideal for conclusive diagnosis of subclinical chorioamnionitis. Implications for practice: Screening of women at risk for chorioamnionitis by health care providers providing care for pregnant women, including midwives, is important for diagnosis and management before complications arise, particularly in resource-constraint settings.

Keywords: chorioamnionitis, guidelines, best evidence, screening, diagnosis, pregnant women

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Authors: Tesfaye Dagne, Dagmawit Solomon, Firmaye Bogale, Yosef Gebreyohannes, Samson Mideksa, Mamuye Hadis, Desalegn Ararso, Ermias Woldie, Tsegaye Getachew, Sabit Ababor, Zelalem Kebede

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Globally, road traffic accident (RTA) is causing millions of deaths and injuries every year. It is one of the leading causes of death among people of all age groups and the problem is worse among young reproductive age group. Moreover the problem is increasing with an increasing number of vehicles. The majority of the problem happen in low and middle income countries (LMIC), even if the number of vehicles in these countries is low compared to their population. So, the objective of this paper is to summarize the best available evidence on interventions that can reduce road traffic accidents in low and middle income countries (LMIC). Method: A rapid evidence synthesis approach adapted from the SURE Rapid Response Service was applied to search, appraise and summarize the best available evidence on effective intervention in reducing road traffic injury. To answer the question under review, we searched for relevant studies from databases including PubMed, the Cochrane Library, TRANSPORT, Health system evidence, Epistemonikos, and SUPPORT summary. The following key terms were used for searching: Road traffic accident, RTA, Injury, Reduc*, Prevent*, Minimiz*, “Low and middle-income country”, LMIC. We found 18 articles through a search of different databases mentioned above. After screening for the titles and abstracts of the articles, four of them which satisfy the inclusion criteria were included in the final review. Then we appraised and graded the methodological quality of systematic reviews that are deemed to be highly relevant using AMSTAR. Finding: The identified interventions to reduce road traffic accidents were legislation and enforcement, public awareness/education, speed control/ rumble strips, road improvement, mandatory motorcycle helmet, graduated driver license, street lighting. Legislation and Enforcement: Legislation focusing on mandatory motorcycle helmet usage, banning cellular phone usage when driving, seat belt laws, decreasing the legal blood alcohol content (BAC) level from 0.06 g/L to 0.02 g/L bring the best result where enforcement is there. Public Awareness/Education: focusing on seat belt use, child restraint use, educational training in health centers and schools/universities, and public awareness with media through the distribution of videos, posters/souvenirs, and pamphlets are effective in the short run. Speed Control: through traffic calming bumps, or speed bumps, rumbled strips are effective in reducing accidents and fatality. Mandatory Motorcycle Helmet: is associated with reduction in mortality. Graduated driver’s license (GDL): reduce road traffic injury by 19%. Street lighting: is a low-cost intervention which may reduce road traffic accidents.

Keywords: evidence synthesis, injury, rapid review, reducing, road traffic accident

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Authors: Saule Mussabekova

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A number of chemical elements widely presented in the nature is seldom met in people and vice versa. This is a peculiarity of accumulation of elements in the body, and their selective use regardless of widely changed parameters of external environment. Microelemental identification of human hair and particularly dead body is a new step in the development of modern forensic medicine which needs reliable criteria while identifying the person. In the condition of technology-related pressing of large industrial cities for many years and specific for each region multiple-factor toxic effect from many industrial enterprises it’s important to assess actuality and the role of researches of human hair while assessing degree of deposition with specific pollution. Hair is highly sensitive biological indicator and allows to assess ecological situation, to perform regionalism of large territories of geological and chemical methods. Besides, monitoring of concentrations of chemical elements in the regions of Kazakhstan gives opportunity to use these data while performing forensic medical identification of dead bodies of unknown persons. Methods based on identification of chemical composition of hair with further computer processing allowed to compare received data with average values for the sex, age, and to reveal causally significant deviations. It gives an opportunity preliminary to suppose the region of residence of the person, having concentrated actions of policy for search of people who are unaccounted for. It also allows to perform purposeful legal actions for its further identification having created more optimal and strictly individual scheme of personal identity. Hair is the most suitable material for forensic researches as it has such advances as long term storage properties with no time limitations and specific equipment. Besides, quantitative analysis of micro elements is well correlated with level of pollution of the environment, reflects professional diseases and with pinpoint accuracy helps not only to diagnose region of temporary residence of the person but to establish regions of his migration as well. Peculiarities of elemental composition of human hair have been established regardless of age and sex of persons residing on definite territories of Kazakhstan. Data regarding average content of 29 chemical elements in hair of population in different regions of Kazakhstan have been systemized. Coefficients of concentration of studies elements in hair relative to average values around the region have been calculated for each region. Groups of regions with specific spectrum of elements have been emphasized; these elements are accumulated in hair in quantities exceeding average indexes. Our results have showed significant differences in concentrations of chemical elements for studies groups and showed that population of Kazakhstan is exposed to different toxic substances. It depends on emissions to atmosphere from industrial enterprises dominating in each separate region. Performed researches have showed that obtained elemental composition of human hair residing in different regions of Kazakhstan reflects technogenic spectrum of elements.

Keywords: analysis of elemental composition of hair, forensic medical research of hair, identification of unknown dead bodies, microelements

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Authors: Fei Jia, Xingjian Bai, Xiaowei Zhang, Wenjie Yan, Ruitong Dai, Xingmin Li, Jozef Kokini

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Pseudomonas aeruginosa is a Gram-negative, aerobic, opportunistic human pathogen that is present in the soil, water, and food. This microbe has been recognized as a representative food-borne spoilage bacterium that can lead to many types of infections. Considering the casualties and property loss caused by P. aeruginosa, the development of a rapid and reliable technique for the detection of P. aeruginosa is crucial. The whole-cell aptasensor, an emerging biosensor using aptamer as a capture probe to bind to the whole cell, for food-borne pathogens detection has attracted much attention due to its convenience and high sensitivity. Here, a low-field magnetic resonance imaging (LF-MRI) aptasensor for the rapid detection of P. aeruginosa was developed. The basic detection principle of the magnetic relaxation switch (MRSw) nanosensor lies on the ‘T₂-shortening’ effect of magnetic nanoparticles in NMR measurements. Briefly speaking, the transverse relaxation time (T₂) of neighboring water protons get shortened when magnetic nanoparticles are clustered due to the cross-linking upon the recognition and binding of biological targets, or simply when the concentration of the magnetic nanoparticles increased. Such shortening is related to both the state change (aggregation or dissociation) and the concentration change of magnetic nanoparticles and can be detected using NMR relaxometry or MRI scanners. In this work, two different sizes of magnetic nanoparticles, which are 10 nm (MN₁₀) and 400 nm (MN₄₀₀) in diameter, were first immobilized with anti- P. aeruginosa aptamer through 1-Ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC)/N-hydroxysuccinimide (NHS) chemistry separately, to capture and enrich the P. aeruginosa cells. When incubating with the target, a ‘sandwich’ (MN₁₀-bacteria-MN₄₀₀) complex are formed driven by the bonding of MN400 with P. aeruginosa through aptamer recognition, as well as the conjugate aggregation of MN₁₀ on the surface of P. aeruginosa. Due to the different magnetic performance of the MN₁₀ and MN₄₀₀ in the magnetic field caused by their different saturation magnetization, the MN₁₀-bacteria-MN₄₀₀ complex, as well as the unreacted MN₄₀₀ in the solution, can be quickly removed by magnetic separation, and as a result, only unreacted MN₁₀ remain in the solution. The remaining MN₁₀, which are superparamagnetic and stable in low field magnetic field, work as a signal readout for T₂ measurement. Under the optimum condition, the LF-MRI platform provides both image analysis and quantitative detection of P. aeruginosa, with the detection limit as low as 100 cfu/mL. The feasibility and specificity of the aptasensor are demonstrated in detecting real food samples and validated by using plate counting methods. Only two steps and less than 2 hours needed for the detection procedure, this robust aptasensor can detect P. aeruginosa with a wide linear range from 3.1 ×10² cfu/mL to 3.1 ×10⁷ cfu/mL, which is superior to conventional plate counting method and other molecular biology testing assay. Moreover, the aptasensor has a potential to detect other bacteria or toxins by changing suitable aptamers. Considering the excellent accuracy, feasibility, and practicality, the whole-cell aptasensor provides a promising platform for a quick, direct and accurate determination of food-borne pathogens at cell-level.

Keywords: magnetic resonance imaging, meat spoilage, P. aeruginosa, transverse relaxation time

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Authors: Shilpa Murthy, Hazlina Binti Abu Bakar, Juliet Mathew, Chandrashekhar Thummala Hlly Sreerama Reddy, Pathiyil Ravi Shankar

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Simulation is defined as a technique that replaces or expands real experiences with guided experiences that interactively imitate real-world processes or systems. Simulation enables learners to train in a safe and non-threatening environment. For decades, simulation has been considered an integral part of clinical teaching and learning strategy in medical education. The several types of simulation used in medical education and the clinical environment can be applied to several models, including full-body mannequins, task trainers, standardized simulated patients, virtual or computer-generated simulation, or Hybrid simulation that can be used to facilitate learning. Simulation allows healthcare practitioners to acquire skills and experience while taking care of patient safety. The recent COVID pandemic has also led to an increase in simulation use, as there were limitations on medical student placements in hospitals and clinics. The learning is tailored according to the educational needs of students to make the learning experience more valuable. Simulation in the pre-clinical years has challenges with resource constraints, effective curricular integration, student engagement and motivation, and evidence of educational impact, to mention a few. As instructors, we may have more reliance on the use of simulation for pre-clinical students while the students’ confidence levels and perceived competence are to be evaluated. Our research question was whether the implementation of simulation-based learning positively influences preclinical medical students' confidence levels and perceived competence. This study was done to align the teaching activities with the student’s learning experience to introduce more low-fidelity simulation-based teaching sessions for pre-clinical years and to obtain students’ input into the curriculum development as part of inclusivity. The study was carried out at International Medical University, involving pre-clinical year (Medical) students who were started with low-fidelity simulation-based medical education from their first semester and were gradually introduced to medium fidelity, too. The Student Satisfaction and Self-Confidence in Learning Scale questionnaire from the National League of Nursing was employed to collect the responses. The internal consistency reliability for the survey items was tested with Cronbach’s alpha using an Excel file. IBM SPSS for Windows version 28.0 was used to analyze the data. Spearman’s rank correlation was used to analyze the correlation between students’ satisfaction and self-confidence in learning. The significance level was set at p value less than 0.05. The results from this study have prompted the researchers to undertake a larger-scale evaluation, which is currently underway. The current results show that 70% of students agreed that the teaching methods used in the simulation were helpful and effective. The sessions are dependent on the learning materials that are provided and how the facilitators engage the students and make the session more enjoyable. The feedback provided inputs on the following areas to focus on while designing simulations for pre-clinical students. There are quality learning materials, an interactive environment, motivating content, skills and knowledge of the facilitator, and effective feedback.

Keywords: low-fidelity simulation, pre-clinical simulation, students satisfaction, self-confidence

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Authors: Laila A. H. F. Dashti, Tom Jackson, Andrew West, Lisa Jackson

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Traceability systems are important in the agri-food and halal food sectors for monitoring ingredient movements, tracking sources, and ensuring food integrity. However, designing a traceability system for the halal food supply chain is challenging due to diverse stakeholder requirements and complex needs. Existing literature on stakeholder mapping and identifying requirements for halal food supply chains is limited. To address this gap, a pilot study was conducted to identify the objectives, requirements, and recommendations of stakeholders in the Kuwaiti halal food industry. The study collected data through semi-structured interviews with an international halal food manufacturer based in Kuwait. The aim was to gain a deep understanding of stakeholders' objectives, requirements, processes, and concerns related to the design of a traceability system in the country's halal food sector. Traceability systems are being developed and tested in the agri-food and halal food sectors due to their ability to monitor ingredient movements, track sources, and detect potential issues related to food integrity. Designing a traceability system for the halal food supply chain poses significant challenges due to diverse stakeholder requirements and the complexity of their needs (including varying food ingredients, different sources, destinations, supplier processes, certifications, etc.). Achieving a halal food traceability solution tailored to stakeholders' requirements within the supply chain necessitates prior knowledge of these needs. Although attempts have been made to address design-related issues in traceability systems, literature on stakeholder mapping and identification of requirements specific to halal food supply chains is scarce. Thus, this pilot study aims to identify the objectives, requirements, and recommendations of stakeholders in the halal food industry. The paper presents insights gained from the pilot study, which utilized semi-structured interviews to collect data from a Kuwait-based international halal food manufacturer. The objective was to gain an in-depth understanding of stakeholders' objectives, requirements, processes, and concerns pertaining to the design of a traceability system in Kuwait's halal food sector. The stakeholder mapping results revealed that government entities, food manufacturers, retailers, and suppliers are key stakeholders in Kuwait's halal food supply chain. Lessons learned from this pilot study regarding requirement capture for traceability systems include the need to streamline communication, focus on communication at each level of the supply chain, leverage innovative technologies to enhance process structuring and operations and reduce halal certification costs. The findings also emphasized the limitations of existing traceability solutions, such as limited cooperation and collaboration among stakeholders, high costs of implementing traceability systems without government support, lack of clarity regarding product routes, and disrupted communication channels between stakeholders. These findings contribute to a broader research program aimed at developing a stakeholder requirements framework that utilizes "business process modelling" to establish a unified model for traceable stakeholder requirements.

Keywords: supply chain, traceability system, halal food, stakeholders’ requirements

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Authors: Zhenyu Zhang, Hsi-Hsien Wei

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Highway network systems play a vital role in disaster response for disaster-damaged areas. Damaged bridges in such network systems can impede disaster response by disrupting transportation of rescue teams or humanitarian supplies. Therefore, emergency inspection and repair of bridges to quickly collect damage information of bridges and recover the functionality of highway networks is of paramount importance to disaster response. A widely used measure of a network’s capability to recover from disasters is resilience. To enhance highway network resilience, plenty of studies have developed various repair scheduling methods for the prioritization of bridge-repair tasks. These methods assume that repair activities are performed after the damage to a highway network is fully understood via inspection, although inspecting all bridges in a regional highway network may take days, leading to the significant delay in repairing bridges. In reality, emergency repair activities can be commenced as soon as the damage data of some bridges that are crucial to emergency response are obtained. Given that emergency bridge inspection and repair (EBIR) activities are executed simultaneously in the response phase, the real-time interactions between these activities can occur – the blockage of highways due to repair activities can affect inspection routes which in turn have an impact on emergency repair scheduling by providing real-time information on bridge damages. However, the impact of such interactions on the optimal emergency inspection routes (EIR) and emergency repair schedules (ERS) has not been discussed in prior studies. To overcome the aforementioned deficiencies, this study develops a routing and scheduling model for EBIR while accounting for real-time inspection-repair interactions to maximize highway network resilience. A stochastic, time-dependent integer program is proposed for the complex and real-time interacting EBIR problem given multiple inspection and repair teams at locations as set post-disaster. A hybrid genetic algorithm that integrates a heuristic approach into a traditional genetic algorithm to accelerate the evolution process is developed. Computational tests are performed using data from the 2008 Wenchuan earthquake, based on a regional highway network in Sichuan, China, consisting of 168 highway bridges on 36 highways connecting 25 cities/towns. The results show that the simultaneous implementation of bridge inspection and repair activities can significantly improve the highway network resilience. Moreover, the deployment of inspection and repair teams should match each other, and the network resilience will not be improved once the unilateral increase in inspection teams or repair teams exceeds a certain level. This study contributes to both knowledge and practice. First, the developed mathematical model makes it possible for capturing the impact of real-time inspection-repair interactions on inspection routing and repair scheduling and efficiently deriving optimal EIR and ERS on a large and complex highway network. Moreover, this study contributes to the organizational dimension of highway network resilience by providing optimal strategies for highway bridge management. With the decision support tool, disaster managers are able to identify the most critical bridges for disaster management and make decisions on proper inspection and repair strategies to improve highway network resilience.

Keywords: disaster management, emergency bridge inspection and repair, highway network, resilience, uncertainty

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Authors: Haresh Sharma, Jaimini Luharia

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The ecology in the Western Himalayan region transforms with the change in altitude. This change is observed in terms of topography, species of flora and fauna and the quality of the soil. The current study focuses on women of indigenous communities of Pangi Valley, which is located in the state of Himachal Pradesh, India. The valley is bifurcated into three different areas –Saichu, Hudan Bhatori, and Sural Bhatori valleys. It is one of the most remote, rugged and difficult to access tribal regions of Chamba district. The altitude of the valley ranges from 2,000 m to 6,000 m above sea level. The Pangi valley is inhabited by ‘Pangwals’ and ‘Bhots’ tribes of the Himalayas who speak their local tribal language called’ Pangwali’. The valley is cut-off from the mainland due to heavy snow and lack of proper roads during peak winters. Due to difficult geographical location, the daily lives of the people are constantly challenged, and they are most of the times deprived of benefits targeted through government programs. However, the indigenous communities earn their livelihood through livestock and forest-based produce while some of them migrate to nearby places for better work. The current study involves snowball sampling methodology for data collection along with in-depth interviews of women members of Self-Help Groups and women farmers. The findings reveal that the lives of these indigenous communities largely depend on forest-based products. So, it creates all the more significance of enhancing, maintaining, and consuming natural resources sustainably. Under such circumstances, the women of the community play a significant role of guardians in conservation and protection of the forests. They are the custodians of traditional knowledge of environment conservation practices that have been followed for many years in the region. The present study also sought to establish a relationship between some of the development initiatives undertaken by the women in the valley that stimulate sustainable mountain economy and conservation practices. These initiatives include cultivation of products like hazelnut, ‘Gucchi’ rare quality mushroom, medicinal plants exclusively found in the region, thereby promoting long term sustainable conservation of agro-biodiversity of the Western Himalayan region. The measures taken by the community women are commendable as they ensure access and distribution of natural resources as well as manage them for future generations. Apart from this, the tribal women have actively formed Self-Help Groups promoting financial inclusion through various activities that augment ownership and accountability towards the overall development of the communities. But, the results also suggest that there’s not enough recognition given to women’s role in forests conservation practices due to several local socio-political reasons. There are not enough research studies done on communities of Pangi Valley due to inaccessibility created out of lack of proper roads and other resources. Also, there emerged a need to concretize indigenous and traditional knowledge of conservation practices followed by women in the community.

Keywords: forest conservation, indigenous community women, sustainable livelihoods, sustainable development, poverty alleviation, Western Himalayas

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Authors: Jonas De Kerf, Rein De Cooman, Sara De Gieter

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For many decades, scholars have aimed to understand how work can become more meaningful by maximizing both potential and enhancing feelings of satisfaction. One of the largest contributions towards such positive psychology was made with the introduction of the concept of ‘flow,’ which refers to a condition in which people feel intense engagement and effortless action. Since then, valuable research on work-related flow has indicated that this state of mind is related to positive outcomes for both organizations (e.g., social, supportive climates) and workers (e.g., job satisfaction). Yet, scholars still do not fully comprehend how such deep involvement at work is obtained, given the notion that flow is considered a short-term, complex, and dynamic experience. Most research neglects that people who experience flow ought to be optimally challenged so that intense concentration is required. Because attention is at the core of this enjoyable state of mind, this study aims to comprehend how elements that affect workers’ cognitive functioning impact flow at work. Research on cognitive performance suggests that working on mentally demanding tasks (e.g., information processing tasks) requires workers to concentrate deeply, as a result leading to flow experiences. Based on social facilitation theory, working on such tasks in an isolated environment eases concentration. Prior research has indicated that working at home (instead of working at the office) or in a closed office (rather than in an open-plan office) impacts employees’ overall functioning in terms of concentration and productivity. Consequently, we advance such knowledge and propose an interaction by combining cognitive task characteristics and work environments among part-time teleworkers. Hence, we not only aim to shed light on the relation between cognitive tasks and flow but also provide empirical evidence that workers performing such tasks achieve the highest states of flow while working either at home or in closed offices. In July 2022, an experience-sampling study will be conducted that uses a semi-random signal schedule to understand how task and environment predictors together impact part-time teleworkers’ flow. More precisely, about 150 knowledge workers will fill in multiple surveys a day for two consecutive workweeks to report their flow experiences, cognitive tasks, and work environments. Preliminary results from a pilot study indicate that on a between level, tasks high in information processing go along with high self-reported fluent productivity (i.e., making progress). As expected, evidence was found for higher fluency in productivity for workers performing information processing tasks both at home and in a closed office, compared to those performing the same tasks at the office or in open-plan offices. This study expands the current knowledge on work-related flow by looking at a task and environmental predictors that enable workers to obtain such a peak state. While doing so, our findings suggest that practitioners should strive for ideal alignments between tasks and work locations to work with both deep involvement and gratification.

Keywords: cognitive work, office lay-out, work location, work-related flow

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Authors: O. O. Sufyani, M. E. Oraiby, S. A. Qumaiy, A. I. Alaamri, Z. M. Eisa, A. M. Hakami, M. A. Attafi, O. M. Alhassan, W. M. Elsideeg, E. M. Noureldin, Y. A. Hobani, Y. Q. Majrabi, I. A. Khardali, A. B. Maashi, A. A. Al Mane, A. H. Hakami, I. M. Alkhyat, A. A. Sahly, I. M. Attafi

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According to the Food and Agriculture Organization (FAO) Pesticides Use Database, pesticide use in agriculture in Saudi Arabia has more than doubled from 4539 tons in 2009 to 10496 tons in 2019. Among pesticides, pyrethroids is commonly used in Saudi Arabia. Pesticides may increase susceptibility to a variety of diseases, particularly among pesticide workers, due to their extensive use, indiscriminate use, and long-term exposure. Therefore, analyzing blood chemo-profiles and evaluating the detected substances as biomarkers for pyrethroid pesticide exposure may assist to identify and predicting adverse effects of exposure, which may be used for both preventative and risk assessment purposes. The purpose of this study was to (a) analyze chemo-profiling by Gas Chromatography-Mass Spectrometry (GC-MS) analysis, (b) identify the most commonly detected chemicals in a time-exposure-dependent manner using a Venn diagram, and (c) identify their associated disease among pesticide workers using analyzer tools on the Comparative Toxicogenomics Database (CTD) website, (250 healthy male volunteers (20-60 years old) who deal with pesticides in the Jazan region of Saudi Arabia (exposure intervals: 1-2, 4-6, 6-8, more than 8 years) were included in the study. A questionnaire was used to collect demographic information, the duration of pesticide exposure, and the existence of chronic conditions. Blood samples were collected for biochemistry analysis and extracted by solid-phase extraction for gas chromatography-mass spectrometry (GC-MS) analysis. Biochemistry analysis reveals no significant changes in response to the exposure period; however, an inverse association between the albumin level and the exposure interval was observed. The blood chemo-profiling was differentially expressed in an exposure time-dependent manner. This analysis identified the common chemical set associated with each group and their associated significant occupational diseases. While some of these chemicals are associated with a variety of diseases, the distinguishing feature of these chemically associated disorders is their applicability for prevention measures. The most interesting finding was the identification of several chemicals; erucic acid, pelargonic acid, alpha-linolenic acid, dibutyl phthalate, diisobutyl phthalate, dodecanol, myristic Acid, pyrene, and 8,11,14-eicosatrienoic acid, associated with pneumoconiosis, asbestosis, asthma, silicosis and berylliosis. Chemical-disease association study also found that cancer, digestive system disease, nervous system disease, and metabolic disease were the most often recognized disease categories in the common chemical set. The hierarchical clustering approach was used to compare the expression patterns and exposure intervals of the chemicals found commonly. More study is needed to validate these chemicals as early markers of pyrethroid insecticide-related occupational disease, which might assist evaluate and reducing risk. The current study contributes valuable data and recommendations to public health.

Keywords: occupational, toxicology, chemo-profiling, pesticide, pyrethroid, GC-MS

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Authors: Natàlia Garcia Soler, Timothy Moss

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Despite the multiple benefits of sustainable urban drainage, as demonstrated in numerous case studies across the world, urban rainwater harvesting techniques are generally restricted to isolated model projects. The leap from niche to mainstream has, in most cities, proved an elusive goal. Why policies promoting rainwater harvesting are limited in their widespread implementation has seldom been subjected to systematic analysis. Much of the literature on the policy, planning and institutional contexts of these techniques focus either on their potential benefits or on project design, but very rarely on a critical-constructive analysis of past experiences of implementation. Moreover, the vast majority of these contributions are restricted to single-case studies. There is a dearth of knowledge with respect to, firstly, policy implementation processes and, secondly, multi-case analysis. Insights from both, the authors argue, are essential to inform more effective rainwater harvesting in cities in the future. This paper presents preliminary findings from a research project on rainwater harvesting in cities from a social science perspective that is funded by the Swedish Research Foundation (Formas). This project – UrbanRain – is examining the challenges and opportunities of mainstreaming rainwater harvesting in three European cities. The paper addresses two research questions: firstly, what lessons can be learned on suitable policy incentives and planning instruments for rainwater harvesting from a meta-analysis of the relevant international literature and, secondly, how far these lessons are reflected in a study of past and ongoing rainwater harvesting projects in a European forerunner city. This two-tier approach frames the structure of the paper. We present, first, the results of the literature analysis on policy and planning issues of urban rainwater harvesting. Here, we analyze quantitatively and qualitatively the literature of the past 15 years on this topic in terms of thematic focus, issues addressed and key findings and draw conclusions on research gaps, highlighting the need for more studies on implementation factors, actor interests, institutional adaptation and multi-level governance. In a second step we focus in on the experiences of rainwater harvesting in Berlin and present the results of a mapping exercise on a wide variety of projects implemented there over the last 30 years. Here, we develop a typology to characterize the rainwater harvesting projects in terms of policy issues (what problems and goals are targeted), project design (which kind of solutions are envisaged), project implementation (how and when they were implemented), location (whether they are in new or existing urban developments) and actors (which stakeholders are involved and how), paying particular attention to the shifting institutional framework in Berlin. Mapping and categorizing these projects is based on a combination of document analysis and expert interviews. The paper concludes by synthesizing the findings, identifying how far the goals, governance structures and instruments applied in the Berlin projects studied reflect the findings emerging from the meta-analysis of the international literature on policy and planning issues of rainwater harvesting and what implications these findings have for mainstreaming such techniques in future practice.

Keywords: institutional framework, planning, policy, project implementation, urban rainwater management

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Authors: Dan Kanmegne

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Africa will become the most populated continent by the end of the century, with around 4 billion inhabitants. Food security and climate changes will become continental issues since agricultural practices depend on climate but also contribute to global emissions and land degradation. Agroforestry has been identified as a cost-efficient and reliable strategy to address these two issues. It is defined as the integrated management of trees and crops/animals in the same land unit. Agroforestry provides benefits in terms of goods (fruits, medicine, wood, etc.) and services (windbreaks, fertility, etc.), and is acknowledged to have a great potential for carbon sequestration; therefore it can be integrated into reduction mechanisms of carbon emissions. Particularly in sub-Saharan Africa, the constraint stands in the lack of information about both areas under agroforestry and the characterization (composition, structure, and management) of each agroforestry system at the country level. This study describes and quantifies “what is where?”, earliest to the quantification of carbon stock in different systems. Remote sensing (RS) is the most efficient approach to map such a dynamic technology as agroforestry since it gives relatively adequate and consistent information over a large area at nearly no cost. RS data fulfill the good practice guidelines of the Intergovernmental Panel On Climate Change (IPCC) that is to be used in carbon estimation. Satellite data are getting more and more accessible, and the archives are growing exponentially. To retrieve useful information to support decision-making out of this large amount of data, satellite data needs to be organized so to ensure fast processing, quick accessibility, and ease of use. A new solution is a data cube, which can be understood as a multi-dimensional stack (space, time, data type) of spatially aligned pixels and used for efficient access and analysis. A data cube for Burkina Faso has been set up from the cooperation project between the international service provider WASCAL and Germany, which provides an accessible exploitation architecture of multi-temporal satellite data. The aim of this study is to map and characterize agroforestry systems using the Burkina Faso earth observation data cube. The approach in its initial stage is based on an unsupervised image classification of a normalized difference vegetation index (NDVI) time series from 2010 to 2018, to stratify the country based on the vegetation. Fifteen strata were identified, and four samples per location were randomly assigned to define the sampling units. For safety reasons, the northern part will not be part of the fieldwork. A total of 52 locations will be visited by the end of the dry season in February-March 2020. The field campaigns will consist of identifying and describing different agroforestry systems and qualitative interviews. A multi-temporal supervised image classification will be done with a random forest algorithm, and the field data will be used for both training the algorithm and accuracy assessment. The expected outputs are (i) map(s) of agroforestry dynamics, (ii) characteristics of different systems (main species, management, area, etc.); (iii) assessment report of Burkina Faso data cube.

Keywords: agroforestry systems, Burkina Faso, earth observation data cube, multi-temporal image classification

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Authors: Jara Kaye S. Villanueva, M. Rosario Concepcion O. Ang

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For the past few years, Philippines has depended most of its energy source on oil, coal, and fossil fuel. According to the Department of Energy (DOE), the dominance of coal in the energy mix will continue until the year 2020. The expanding energy needs in the country have led to increasing efforts to promote and develop renewable energy. This research is a part of the government initiative in preparation for renewable energy development and expansion in the country. The Philippine Renewable Energy Resource Mapping from Light Detection and Ranging (LiDAR) Surveys is a three-year government project which aims to assess and quantify the renewable energy potential of the country and to put them into usable maps. This study focuses on the site suitability analysis of the four renewable energy sources – biomass (coconut, corn, rice, and sugarcane), hydro, solar, and wind energy. The site assessment is a key component in determining and assessing the most suitable locations for the construction of renewable energy power plants. This method maximizes the use of both the technical methods in resource assessment, as well as taking into account the environmental, social, and accessibility aspect in identifying potential sites by utilizing and integrating two different methods: the Multi-Criteria Decision Analysis (MCDA) method and Geographic Information System (GIS) tools. For the MCDA, Analytical Hierarchy Processing (AHP) is employed to determine the parameters needed for the suitability analysis. To structure these site suitability parameters, various experts from different fields were consulted – scientists, policy makers, environmentalists, and industrialists. The need to have a well-represented group of people to consult with is relevant to avoid bias in the output parameter of hierarchy levels and weight matrices. AHP pairwise matrix computation is utilized to derive weights per level out of the expert’s gathered feedback. Whereas from the threshold values derived from related literature, international studies, and government laws, the output values were then consulted with energy specialists from the DOE. Geospatial analysis using GIS tools translate this decision support outputs into visual maps. Particularly, this study uses Euclidean distance to compute for the distance values of each parameter, Fuzzy Membership algorithm which normalizes the output from the Euclidean Distance, and the Weighted Overlay tool for the aggregation of the layers. Using the Natural Breaks algorithm, the suitability ratings of each of the map are classified into 5 discrete categories of suitability index: (1) not suitable (2) least suitable, (3) suitable, (4) moderately suitable, and (5) highly suitable. In this method, the classes are grouped based on the best groups similar values wherein each subdivision are set from the rest based on the big difference in boundary values. Results show that in the entire Philippine area of responsibility, biomass has the highest suitability rating with rice as the most suitable at 75.76% suitability percentage, whereas wind has the least suitability percentage with score 10.28%. Solar and Hydro fall in the middle of the two, with suitability values 28.77% and 21.27%.

Keywords: site suitability, biomass energy, hydro energy, solar energy, wind energy, GIS

Procedia PDF Downloads 137

Authors: Bissonnette Jean-François, Dossa Fabrice

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The project focuses on analyzing the spatial and temporal evolution of mangrove forest ecosystems near the city of Douala, Cameroon, in response to increasing human and environmental pressures. The selected study area, located in the Wouri River estuary, has a unique combination of economic importance, and ecological prominence. The study included valuable insights by conducting semi-structured interviews with resource operators and local officials. The thorough analysis of socio-economic data, farmer surveys, and satellite-derived information was carried out utilizing quantitative approaches in Excel and SPSS. Simultaneously, qualitative data was subjected to rigorous classification and correlation with other sources. The use of ArcGIS and CorelDraw facilitated the visual representation of the gradual changes seen in various land cover classifications. The research reveals complex processes that characterize mangrove ecosystems on Manoka and Cape Cameroon Islands. The lack of regulations in urbanization and the continuous growth of infrastructure have led to a significant increase in land conversion, causing negative impacts on natural landscapes and forests. The repeated instances of flooding and coastal erosion have further shaped landscape alterations, fostering the proliferation of water and mudflat areas. The unregulated use of mangrove resources is a significant factor in the degradation of these ecosystems. Activities including the use of wood for smoking and fishing, together with the coastal pollution resulting from the absence of waste collection, have had a significant influence. In addition, forest operators contribute to the degradation of vegetation, hence exacerbating the harmful impact of invasive species on the ecosystem. Strategic interventions are necessary to guarantee the sustainable management of these ecosystems. The proposals include advocating for sustainable wood exploitation techniques, using appropriate techniques, along with regeneration, and enforcing rules to prevent wood overexploitation. By implementing these measures, the ecological balance can be preserved, safeguarding the long-term viability of these precious ecosystems. On a conceptual level, this paper uses the framework developed by Elinor Ostrom and her colleagues to investigate the consequences of open access resources, where local actors have not been able to enforce measures to prevent overexploitation of mangrove wood resources. Governmental authorities have demonstrated limited capacity to enforce sustainable management of wood resources and have not been able to establish effective relationships with local fishing communities and with communities involved in the purchase of wood. As a result, wood resources in the mangrove areas remain largely accessible, while authorities do not monitor wood volumes extracted nor methods of exploitation. There have only been limited and punctual attempts at forest restoration with no significant consequence on mangrove forests dynamics.

Keywords: Mangroves, forest management, governance, open access resources, Cameroon

Procedia PDF Downloads 46

Authors: Rachel S. Chang, Samuel P. Massion, Alan Z. Grusky, Heather A. Ridinger

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Introduction Health advocacy is defined as activities that improve access to care, utilize resources, address health disparities, and influence health policy. Advocacy is increasingly being recognized as a critical component of a physician’s role, as understanding social determinants of health and improving patient care are important aspects within the American Medical Association’s Health Systems Science framework. However, despite this growing prominence, educational interventions that address advocacy topics are limited and variable across medical school curricula. Furthermore, few recent studies have evaluated attitudes toward health advocacy among physicians-in-training in the United States. This study examines medical student attitudes towards health advocacy, along with perceived knowledge, ability, and current level of engagement with health advocacy during their clerkships. Methods This study employed a cross-sectional survey design using a single anonymous, self-report questionnaire to all second-year medical students at Vanderbilt University School of Medicine (n=96) in December 2020 during clerkship rotations. The survey had 27 items with 5-point Likert scale (15), multiple choice (11), and free response questions (1). Descriptive statistics and thematic analysis were utilized to analyze responses. The study was approved by the Vanderbilt University Institutional Review Board. Results There was an 88% response rate among second-year clerkship medical students. A majority (83%) agreed that formal training in health advocacy should be a mandatory part of the medical student curriculum Likewise, 83% of respondents felt that acting as a health advocate or patients should be part of their role as a clerkship student. However, a minority (25%) felt adequately prepared. While 72% of respondents felt able to identify a psychosocial need, 18% felt confident navigating the healthcare system and only 9% felt able to connect a patient to a psychosocial resource to fill that gap. 44% of respondents regularly contributed to conversations with their medical teams when discussing patients’ social needs, such as housing insecurity, financial insecurity, or legal needs. On average, respondents reported successfully connecting patients to psychosocial resources 1-2 times per 8-week clerkship block. Barriers to participating in health advocacy included perceived time constraints, lack of awareness of resources, lower emphasis among medical teams, and scarce involvement with social work teams. Conclusions In this single-institutional study, second-year medical students on clerkships recognize the importance of advocating for patients and support advocacy training within their medical school curriculum. However, their perceived lack of ability to navigate the healthcare system and connect patients to psychosocial resources, result in students feeling unprepared to advocate as effectively as they hoped during their clerkship rotations. Our results support the ongoing need to equip medical students with training and resources necessary for them to effectively act as advocates for patients.

Keywords: clerkships, medical students, patient advocacy, social medicine

Procedia PDF Downloads 121

Authors: Daniel Rowe, Christopher R. Vogel, Richard H. J. Willden

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The University of Oxford’s recirculating water flume is a combined wave and current test tank with a 1 m depth, 1.1 m width, and 10 m long working section, and is capable of flow speeds up to 1 ms−1 . This study documents the hydrodynamic characteristics of the facility in preparation for experimental testing of horizontal axis tidal stream turbine models. The turbine to be tested has a rotor diameter of 0.6 m and is a modified version of one of two model-scale turbines tested in previous experimental campaigns. An Acoustic Doppler Velocimeter (ADV) was used to measure the flow at high temporal resolution at various locations throughout the flume, enabling the spatial uniformity and turbulence flow parameters to be investigated. The mean velocity profiles exhibited high levels of spatial uniformity at the design speed of the flume, 0.6 ms−1 , with variations in the three-dimensional velocity components on the order of ±1% at the 95% confidence level, along with a modest streamwise acceleration through the measurement domain, a target 5 m working section of the flume. A high degree of uniformity was also apparent for the turbulence intensity, with values ranging between 1-2% across the intended swept area of the turbine rotor. The integral scales of turbulence exhibited a far higher degree of variation throughout the water column, particularly in the streamwise and vertical scales. This behaviour is believed to be due to the high signal noise content leading to decorrelation in the sampling records. To achieve more realistic levels of vertical velocity shear in the flume, a simple procedure to practically generate target vertical shear profiles in open-channel flows is described. Here, the authors arranged a series of non-uniformly spaced parallel bars placed across the width of the flume and normal to the onset flow. By adjusting the resistance grading across the height of the working section, the downstream profiles could be modified accordingly, characterised by changes in the velocity profile power law exponent, 1/n. Considering the significant temporal variation in a tidal channel, the choice of the exponent denominator, n = 6 and n = 9, effectively provides an achievable range around the much-cited value of n = 7 observed at many tidal sites. The resulting flow profiles, which we intend to use in future turbine tests, have been characterised in detail. The results indicate non-uniform vertical shear across the survey area and reveal substantial corner flows, arising from the differential shear between the target vertical and cross-stream shear profiles throughout the measurement domain. In vertically sheared flow, the rotor-equivalent turbulence intensity ranges between 3.0-3.8% throughout the measurement domain for both bar arrangements, while the streamwise integral length scale grows from a characteristic dimension on the order of the bar width, similar to the flow downstream of a turbulence-generating grid. The experimental tests are well-defined and repeatable and serve as a reference for other researchers who wish to undertake similar investigations.

Keywords: acoustic doppler Velocimeter, experimental hydrodynamics, open-channel flow, shear profiles, tidal stream turbines

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Authors: Sofia Dokuka, Liz Lockhart, Alex Furman

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Organizational hierarchy, traditionally composed of individual contributors, middle management, and executives, is enhanced by the understanding of informal social roles. These roles, identified with organizational network analysis (ONA), might have an important effect on organizational functioning. In this paper, we identify three social roles – influencers, bridges, and soloists, and provide empirical analysis based on real-world organizational networks. Influencers are employees with broad networks and whose contacts also have rich networks. Influence is calculated using PageRank, initially proposed for measuring website importance, but now applied in various network settings, including social networks. Influencers, having high PageRank, become key players in shaping opinions and behaviors within an organization. Bridges serve as links between loosely connected groups within the organization. Bridges are identified using betweenness and Burt’s constraint. Betweenness quantifies a node's control over information flows by evaluating its role in the control over the shortest paths within the network. Burt's constraint measures the extent of interconnection among an individual's contacts. A high constraint value suggests fewer structural holes and lesser control over information flows, whereas a low value suggests the contrary. Soloists are individuals with fewer than 5 stable social contacts, potentially facing challenges due to reduced social interaction and hypothetical lack of feedback and communication. We considered social roles in the analysis of real-world organizations (N=1,060). Based on data from digital traces (Slack, corporate email and calendar) we reconstructed an organizational communication network and identified influencers, bridges and soloists. We also collected employee engagement data through an online survey. Among the top-5% of influencers, 10% are members of the Executive Team. 56% of the Executive Team members are part of the top influencers group. The same proportion of top influencers (10%) is individual contributors, accounting for just 0.6% of all individual contributors in the company. The majority of influencers (80%) are at the middle management level. Out of all middle managers, 19% hold the role of influencers. However, individual contributors represent a small proportion of influencers, and having information about these individuals who hold influential roles can be crucial for management in identifying high-potential talents. Among the bridges, 4% are members of the Executive Team, 16% are individual contributors, and 80% are middle management. Predominantly middle management acts as a bridge. Bridge positions of some members of the executive team might indicate potential micromanagement on the leader's part. Recognizing the individuals serving as bridges in an organization uncovers potential communication problems. The majority of soloists are individual contributors (96%), and 4% of soloists are from middle management. These managers might face communication difficulties. We found an association between being an influencer and attitude toward a company's direction. There is a statistically significant 20% higher perception that the company is headed in the right direction among influencers compared to non-influencers (p < 0.05, Mann-Whitney test). Taken together, we demonstrate that considering social roles in the company might indicate both positive and negative aspects of organizational functioning that should be considered in data-driven decision-making.

Keywords: organizational network analysis, social roles, influencer, bridge, soloist

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Authors: Luis Castiella, Mariano Rueda, Catalina Palacio

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The world’s rapid urbanisation represents an excellent opportunity to implement initiatives that are oriented towards a country’s general development. However, this phenomenon has created considerable pressure on current urban models, pushing them nearer to a crisis. As a result, several factors usually associated with underdevelopment have been steadily rising. Moreover, actions taken by public authorities have not been able to keep up with the speed of urbanisation, which has impeded them from meeting the demands of society, responding with reactionary policies instead of with coordinated, organised efforts. In contrast, the concept of a Smart City which emerged around two decades ago, in principle, represents a city that utilises innovative technologies to remedy the everyday issues of the citizen, empowering them with the newest available technology and information. This concept has come to adopt a wider meaning, including human and social capital, as well as productivity, economic growth, quality of life, environment and participative governance. These developments have also disrupted the management of institutions such as academia, which have become key in generating scientific advancements that can solve pressing problems, and in forming a specialised class that is able to follow up on these breakthroughs. In this light, the Ministry of Modernisation of the Argentinian Nation has created a model that is rooted in the concept of a ‘Smart City’. This effort considered all the dimensions that are at play in an urban environment, with careful monitoring of each sub-dimensions in order to establish the government’s priorities and improving the effectiveness of its operations. In an attempt to ameliorate the overall efficiency of the country’s economic and social development, these focused initiatives have also encouraged citizen participation and the cooperation of the private sector: replacing short-sighted policies with some that are coherent and organised. This process was developed gradually. The first stage consisted in building the model’s structure; the second, at applying the method created on specific case studies and verifying that the mechanisms used respected the desired technical and social aspects. Finally, the third stage consists in the repetition and subsequent comparison of this experiment in order to measure the effects on the ‘treatment group’ over time. The first trial was conducted on 717 municipalities and evaluated the dimension of Governance. Results showed that levels of governmental maturity varied sharply with relation to size: cities with less than 150.000 people had a strikingly lower level of governmental maturity than cities with more than 150.000 people. With the help of this analysis, some important trends and target population were made apparent, which enabled the public administration to focus its efforts and increase its probability of being successful. It also permitted to cut costs, time, and create a dynamic framework in tune with the population’s demands, improving quality of life with sustained efforts to develop social and economic conditions within the territorial structure.

Keywords: composite index, comprehensive model, smart cities, strategic framework

Procedia PDF Downloads 165

Authors: Mirain Rhys, Kevin Smith

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In 2017, the Welsh Government introduced an ambitious, new strategy to increase the number of Welsh speakers in Wales to 1 million by 2050. The Welsh education system is a vitally important feature of this strategy. All children attending state schools in Wales learn Welsh as a second language until the age of 16 and are assessed at General Certificate of Secondary Education (GCSE) level. In 2013, a review of Welsh second language instruction in Key Stages 3 and 4 was completed. The report identified considerable gaps in teachers’ preparation and training for teaching Welsh; poor Welsh language ethos at many schools; and a general lack of resources to support the instruction of Welsh. Recommendations were made across a number of dimensions including curriculum content, pedagogical practice, and teacher assessment, training, and resources. With a new national curriculum currently in development, this study builds on this review and provides unprecedented detail into pupils’ and teachers’ perceptions of Welsh language instruction. The current research built on data taken from an existing capacity building research project on Welsh education, the Wales multi-cohort study (WMS). Quantitative data taken from WMS surveys with over 1200 pupils in schools in Wales indicated that Welsh language lessons were the least enjoyable subject among pupils. The current research aimed to unpick pupil experiences in order to add to the policy development context. To achieve this, forty-four pupils and four teachers in three schools from the larger WMS sample participated in focus groups. Participants from years 9, 11 and 13 who had indicated positive, negative and neutral attitudes towards the Welsh language in a previous WMS survey were selected. Questions were based on previous research exploring issues including, but not limited to pedagogy, policy, assessment, engagement and (teacher) training. A thematic analysis of the focus group recordings revealed that the majority of participants held positive views around keeping the language alive but did not want to take on responsibility for its maintenance. These views were almost entirely based on their experiences of learning Welsh at school, especially in relation to their perceived lack of choice and opinions around particular lesson strategies and assessment. Analysis of teacher interviews highlighted a distinct lack of resources (materials and staff alike) compared to modern foreign languages, which had a negative impact on student motivation and attitudes. Both staff and students indicated a need for more practical, oral language instruction which could lead to Welsh being used outside the classroom. The data corroborate many of the review’s previous findings, but what makes this research distinctive is the way in which pupils poignantly address generally misguided aims for Welsh language instruction, poor pedagogical practice and a general disconnect between Welsh instruction and its daily use in their lives. These findings emphasize the complexity of incorporating the educational sector in strategies for Welsh language maintenance and the complications arising from pedagogical training, support, and resources, as well as teacher and pupil perceptions of, and attitudes towards, teaching and learning Welsh.

Keywords: bilingual education, language maintenance, language revitalisation, minority languages, Wales

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Authors: Karen Koellner, Nanette Seago, Jennifer Jacobs, Helen Garnier

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Although studies of teacher professional development (PD) are prevalent, surprisingly most have only produced incremental shifts in teachers’ learning and their impact on students. There is a critical need to understand what teachers take up and use in their classroom practice after attending PD and why we often do not see greater changes in learning and practice. This paper is based on a mixed methods efficacy study of the Learning and Teaching Geometry (LTG) video-based mathematics professional development materials. The extent to which the materials produce a beneficial impact on teachers’ mathematics knowledge, classroom practices, and their students’ knowledge in the domain of geometry through a group-randomized experimental design are considered. Included is a close-up examination of a small group of teachers to better understand their interpretations of the workshops and their classroom uptake. The participants included 103 secondary mathematics teachers serving grades 6-12 from two US states in different regions. Randomization was conducted at the school level, with 23 schools and 49 teachers assigned to the treatment group and 18 schools and 54 teachers assigned to the comparison group. The case study examination included twelve treatment teachers. PD workshops for treatment teachers began in Summer 2016. Nine full days of professional development were offered to teachers, beginning with the one-week institute (Summer 2016) and four days of PD throughout the academic year. The same facilitator-led all of the workshops, after completing a facilitator preparation process that included a multi-faceted assessment of fidelity. The overall impact of the LTG PD program was assessed from multiple sources: two teacher content assessments, two PD embedded assessments, pre-post-post videotaped classroom observations, and student assessments. Additional data were collected from the case study teachers including additional videotaped classroom observations and interviews. Repeated measures ANOVA analyses were used to detect patterns of change in the treatment teachers’ content knowledge before and after completion of the LTG PD, relative to the comparison group. No significant effects were found across the two groups of teachers on the two teacher content assessments. Teachers were rated on the quality of their mathematics instruction captured in videotaped classroom observations using the Math in Common Observation Protocol. On average, teachers who attended the LTG PD intervention improved their ability to engage students in mathematical reasoning and to provide accurate, coherent, and well-justified mathematical content. In addition, the LTG PD intervention and instruction that engaged students in mathematical practices both positively and significantly predicted greater student knowledge gains. Teacher knowledge was not a significant predictor. Twelve treatment teachers self-selected to serve as case study teachers to provide additional videotapes in which they felt they were using something from the PD they learned and experienced. Project staff analyzed the videos, compared them to previous videos and interviewed the teachers regarding their uptake of the PD related to content knowledge, pedagogical knowledge and resources used. The full paper will include the case study of Ana to illustrate the factors involved in what teachers take up and use from participating in the LTG PD.

Keywords: geometry, mathematics professional development, pedagogical content knowledge, teacher learning

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Authors: Ewa Bednorz, Marek Polrolniczak, Bartosz Czernecki, Arkadiusz Marek Tomczyk

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This study is meant as a contribution to the research of the upwelling phenomenon, which is one of the most pronounced examples of the sea-atmosphere coupling. The aim is to confirm the atmospheric forcing of the sea waters circulation and sea surface temperature along the variously oriented Baltic Sea coasts and to find out macroscale and regional circulation patterns triggering upwelling along different sections of this relatively small and semi-closed sea basin. The mean daily sea surface temperature data from the summer seasons (June–August) of the years 1982–2017 made the basis for the detection of upwelling cases. For the atmospheric part of the analysis, monthly indices of the Northern Hemisphere macroscale circulation patterns were used. Besides, in order to identify the local direction of airflow, the daily zonal and meridional regional circulation indices were constructed and introduced to the analysis. Finally, daily regional circulation patterns over the Baltic Sea region were distinguished by applying the principal component analysis to the gridded mean daily sea level pressure data. Within the Baltic Sea, upwelling is the most frequent along the zonally oriented northern coast of the Gulf of Finland, southern coasts of Sweden, and along the middle part of the western Gulf of Bothnia coast. Among the macroscale circulation patterns, the Scandinavian type (SCAND), with a primary circulation center located over Scandinavia, has the strongest impact on the horizontal flow of surface sea waters in the Baltic Sea, which triggers upwelling. An anticyclone center over Scandinavia in the positive phase of SCAND enhances the eastern airflow, which increases upwelling frequency along southeastern Baltic coasts. It was proved in the study that the zonal circulation has a stronger impact on upwelling occurrence than the meridional one, and it could increase/decrease a chance of upwelling formation by more than 70% in some coastal sections. Positive and negative phases of six distinguished regional daily circulation patterns made 12 different synoptic situations which were analyzed in the terms of their influence on the upwelling formation. Each of them revealed some impact on the frequency of upwelling in some coastal section of the Baltic Sea; however, two kinds of synoptic situations seemed to have the strongest influence, namely, the first kind representing pressure patterns enhancing the zonal flow and the second kind representing synoptic patterns with a cyclone/anticyclone centers over southern Scandinavia. Upwelling occurrence appeared to be particularly strongly reliant on the atmospheric conditions in some specific coastal sections, namely: the Gulf of Finland, the south eastern Baltic coasts (Polish and Latvian-Lithuanian section), and the western part of the Gulf of Bothnia. Concluding, it can be stated that atmospheric conditions strongly control the occurrence of upwelling within the Baltic Sea basin. Both local and macroscale circulation patterns expressed by the location of the pressure centers influence the frequency of this phenomenon; however, the impact strength varies, depending on the coastal region. Acknowledgment: This research was funded by the National Science Centre, Poland, grant number 2016/21/B/ST10/01440.

Keywords: Baltic Sea, circulation patterns, coastal upwelling, synoptic conditions

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Authors: Lourenco Camnahas, Eileen Willis, Greg Fisher, Jessie Gunson, Pascale Dettwiller, Charlene Thornton

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Stock-out of pharmaceuticals is a common issue at all level of health services in Timor-Leste, a small post-conflict country. This lead to the research questions: what are the current methods used to quantify pharmaceutical supplies; what factors contribute to the on-going pharmaceutical stock-out? The study examined factors that influence the pharmaceutical supply chain system. Methodology: Privett and Goncalvez dependency model has been adopted for the design of the qualitative interviews. The model examines pharmaceutical supply chain management at three management levels: management of individual pharmaceutical items, health facilities, and health systems. The interviews were conducted in order to collect information on inventory management, logistics management information system (LMIS) and the provision of pharmaceuticals. Andersen' behavioural model for healthcare utilization also informed the interview schedule, specifically factors linked to environment (healthcare system and external environment) and the population (enabling factors). Forty health professionals (bureaucrats, clinicians) and six senior officers from a United Nations Agency, a global multilateral agency and a local non-governmental organization were interviewed on their perceptions of factors (healthcare system/supply chain and wider environment) impacting on stock out. Additionally, policy documents for the entire healthcare system, along with population data were collected. Findings: An analysis using Pozzebon’s critical interpretation identified a range of difficulties within the system from poor coordination to failure to adhere to policy guidelines along with major difficulties with inventory management, quantification, forecasting, and budgetary constraints. Weak logistics management information system, lack of capacity in inventory management, monitoring and supervision are additional organizational factors that also contributed to the issue. There were various methods of quantification of pharmaceuticals applied in the government sector, and non-governmental organizations. Lack of reliable data is one of the major problems in the pharmaceutical provision. Global Fund has the best quantification methods fed by consumption data and malaria cases. There are other issues that worsen stock-out: political intervention, work ethic and basic infrastructure such as unreliable internet connectivity. Major issues impacting on pharmaceutical quantification have been identified. However, current data collection identified limitations within the Andersen model; specifically, a failure to take account of predictors in the healthcare system and the environment (culture/politics/social. The next step is to (a) compare models used by three non-governmental agencies with the government model; (b) to run the Andersen explanatory model for pharmaceutical expenditure for 2 to 5 drug items used by these three development partners in order to see how it correlates with the present model in terms of quantification and forecasting the needs; (c) to repeat objectives (a) and (b) using the government model; (d) to draw a conclusion about the strength.

Keywords: inventory management, pharmaceutical forecasting and quantification, pharmaceutical stock-out, pharmaceutical supply chain management

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Authors: Amir Shouri, Fereshteh Tabe

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Master planning and urban infrastructure’s thoughtful and sequential design strategies will play the major role in reducing the damages of natural disasters, war and or social/population related conflicts for cities. Defensive strategies have been revised during the history of mankind after having damages from natural depressions, war experiences and terrorist attacks on cities. Lessons learnt from Earthquakes, from 2 world war casualties in 20th century and terrorist activities of all times. Particularly, after Hurricane Sandy of New York in 2012 and September 11th attack on New York’s World Trade Centre (WTC) in 21st century, there have been series of serious collaborations between law making authorities, urban planners and architects and defence related organizations to firstly, getting prepared and/or prevent such activities and secondly, reduce the human loss and economic damages to minimum. This study will work on developing a model of planning for New York City, where its citizens will get minimum impacts in threat-full time with minimum economic damages to the city after the stress is passed. The main discussion in this proposal will focus on pre-hazard, hazard-time and post-hazard transformative policies and strategies that will reduce the “Life casualties” and will ease “Economic Recovery” in post-hazard conditions. This proposal is going to scrutinize that one of the key solutions in this path might be focusing on all overlaying possibilities on architectural platforms of three fundamental infrastructures, the transportation, the power related sources and defensive abilities on a dynamic-transformative framework that will provide maximum safety, high level of flexibility and fastest action-reaction opportunities in stressful periods of time. “Planning Fore Stress” is going to be done in an analytical, qualitative and quantitative work frame, where it will study cases from all over the world. Technology, Organic Design, Materiality, Urban forms, city politics and sustainability will be discussed in deferent cases in international scale. From the modern strategies of Copenhagen for living friendly with nature to traditional approaches of Indonesian old urban planning patterns, the “Iron Dome” of Israel to “Tunnels” in Gaza, from “Ultra-high-performance quartz-infused concrete” of Iran to peaceful and nature-friendly strategies of Switzerland, from “Urban Geopolitics” in cities, war and terrorism to “Design of Sustainable Cities” in the world, will all be studied with references and detailed look to analysis of each case in order to propose the most resourceful, practical and realistic solutions to questions on “New City Divisions”, “New City Planning and social activities” and “New Strategic Architecture for Safe Cities”. This study is a developed version of a proposal that was announced as winner at MoMA in 2013 in call for ideas for Rockaway after Sandy Hurricane took place.

Keywords: urban scale, city safety, natural disaster, war and terrorism, city divisions, architecture for safe cities

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Authors: Jarrod Haar, David Brougham

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The present study explores the links between supporting employee well-being and the potential benefits to employee performance. We focus on employee innovative work behaviors (IWBs), which have three stages: (1) development, (2) adoption, and (3) implementation of new ideas and work methods. We explore the role of organizational support focusing on employee well-being via High-Performance Work Systems (HPWS). HPWS are HR practices that are designed to enhance employees’ skills, commitment, and ultimately, productivity. HPWS influence employee performance through building their skills, knowledge, and abilities and there is meta-analytic support for firm-level HPWS influencing firm performance, but less attention towards employee outcomes, especially innovation. We explore HPWS-wellbeing being offered (e.g., EAPs, well-being App, etc.) to capture organizational commitment to employee well-being. Under social exchange theory, workers should reciprocate their firm's offering of HPWS-wellbeing with greater efforts towards IWBs. Further, we explore playful work design as a mediator, which represents employees proactively creating work conditions that foster enjoyment/challenge but don’t require any design change to the job itself. We suggest HPWS-wellbeing can encourage employees to become more playful, and ultimately more innovative. Finally, beyond direct effects, we examine whether these relations are similar by gender and ultimately test a moderated mediation model. Using N=1135 New Zealand employees, we established measures with confirmatory factor analysis (CFA), and all measures had good psychometric properties (α>.80). We controlled for age, tenure, education, and hours worked and analyzed data using the PROCESS macro (version 4.2) specifically model 8 (moderated mediation). We analyzed overall IWB, and then again across the three stages. Overall, we find HPWS-wellbeing is significantly related to overall IWBs and the three stages (development, adoption, and implementation) individually. Similarly, HPWS-wellbeing shapes playful work design and playful work design predicts overall IWBs and the three stages individually. It only partially mediates the effects of HPWS-wellbeing, which retains a significant indirect effect. Moderation effects are supported, with males reporting a more significant effect from HPWS-wellbeing on playful work design but not IWB (or any of the three stages) than females. Females report higher playful work design when HPWS-wellbeing is low, but the effects are reversed when HPWS-wellbeing is high (males higher). Thus, males respond stronger under social exchange theory from HPWS-wellbeing, at least towards expressing playful work design. Finally, evidence of moderated mediation effects is found on overall IWBs and the three stages. Males report a significant indirect effect from HPWS-wellbeing on IWB (through playful work design), while female employees report no significant indirect effect. The benefits of playful work design fully account for their IWBs. The models account for small amounts of variance towards playful work design (12%) but larger for IWBs (26%). The study highlights a gap in the literature on HPWS-wellbeing and provides empirical evidence of their importance towards worker innovation. Further, gendered effects suggest these benefits might not be equal. The findings provide useful insights for organizations around how providing HR practices that support employee well-being are important, although how they work for different genders needs further exploration.

Keywords: human resource practices, wellbeing, innovation, playful work design

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Authors: Maisam Rafiee, Chikashi Deguchi, Akio Odake, Minoru Matsui, Takanori Sata

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Cities in Afghanistan have been rapidly urbanized; however, many parts of these cities have been developed with no detailed land use plan or infrastructure. In other words, they have been informally developed without any government leadership. The new government started the In-situ Upgrading Project in Kabul to upgrade roads, the water supply network system, and the surface water drainage system on the existing street layout in 2002, with the financial support of international agencies. This project is an appropriate emergency improvement for living life, but not an essential improvement of living conditions and infrastructure problems because the life expectancies of the improved facilities are as short as 10–15 years, and residents cannot obtain land tenure in the unplanned areas. The Land Readjustment System (LRS) conducted in Japan has good advantages that rearrange irregularly shaped land lots and develop the infrastructure effectively. This study investigates the effects of the In-situ Upgrading Project on private investment, land prices, and residents’ satisfaction with projects in Kart-e-Char, where properties are registered, and in Afshar-e-Silo Lot 1, where properties are unregistered. These projects are located 5 km and 7 km from the CBD area of Kabul, respectively. This study discusses whether LRS should be applied to the unplanned area based on the questionnaire and interview responses of experts experienced in the In-situ Upgrading Project who have knowledge of LRS. The analysis results reveal that, in Kart-e-Char, a lot of private investment has been made in the construction of medium-rise (five- to nine-story) buildings for commercial and residential purposes. Land values have also incrementally increased since the project, and residents are commonly satisfied with the road pavement, drainage systems, and water supplies, but dissatisfied with the poor delivery of electricity as well as the lack of public facilities (e.g., parks and sport facilities). In Afshar-e-Silo Lot 1, basic infrastructures like paved roads and surface water drainage systems have improved from the project. After the project, a few four- and five-story residential buildings were built with very low-level private investments, but significant increases in land prices were not evident. The residents are satisfied with the contribution ratio, drainage system, and small increase in land price, but there is still no drinking water supply system or tenure security; moreover, there are substandard paved roads and a lack of public facilities, such as parks, sport facilities, mosques, and schools. The results of the questionnaire and interviews with the four engineers highlight the problems that remain to be solved in the unplanned areas if LRS is applied—namely, land use differences, types and conditions of the infrastructure still to be installed by the project, and time spent for positive consensus building among the residents, given the project’s budget limitation.

Keywords: in-situ upgrading, Kabul city, land readjustment, land value, planned area, private investment, residents' satisfaction, unplanned area

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Authors: Naresh Kumar, Savita Kumari, Naresh Kochhar

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The objective of the study was to assess the role of mineralogy and subsurface structure on water quality of Tosham, Malani Igneous Suite (MIS), Western Rajasthan, India. MIS is the largest (55,000 km2) A-type, anorogenic and high heat producing acid magmatism in the peninsular India and owes its origin to hot spot tectonics. Apart from agricultural and industrial wastes, geogenic activities cause fluctuations in quality parameters of water resources. Twenty water samples (20) selected from Tosham and surrounding areas were analyzed for As, Pb, B, Al, Zn, Fe, Ni using Inductive coupled plasma emission and F by Ion Chromatography. The concentration of As, Pb, B, Ni and F was above the stipulated level specified by BIS (Bureau of Indian Standards IS-10500, 2012). The concentration of As and Pb in surrounding areas of Tosham ranged from 1.2 to 4.1 mg/l and from 0.59 to 0.9 mg/l respectively which is higher than limits of 0.05mg/l (As) and 0.01 mg/l (Pb). Excess trace metal accumulation in water is toxic to humans and adversely affects the central nervous system, kidneys, gastrointestinal tract, skin and cause mental confusion. Groundwater quality is defined by nature of rock formation, mineral water reaction, physiography, soils, environment, recharge and discharge conditions of the area. Fluoride content in groundwater is due to the solubility of fluoride-bearing minerals like fluorite, cryolite, topaz, and mica, etc. Tosham is comprised of quartz mica schist, quartzite, schorl, tuff, quartz porphyry and associated granites, thus, fluoride is leached out and dissolved in groundwater. In the study area, Ni concentration ranged from 0.07 to 0.5 mg/l (permissible limit 0.02 mg/l). The primary source of nickel in drinking water is leached out nickel from ore-bearing rocks. Higher concentration of As is found in some igneous rocks specifically containing minerals as arsenopyrite (AsFeS), realgar (AsS) and orpiment (As2S3). MIS consists of granite (hypersolvus and subsolvus), rhyolite, dacite, trachyte, andesite, pyroclasts, basalt, gabbro and dolerite which increased the trace elements concentration in groundwater. Nakora, a part of MIS rocks has high concentration of trace and rare earth elements (Ni, Rb, Pb, Sr, Y, Zr, Th, U, La, Ce, Nd, Eu and Yb) which percolates the Ni and Pb to groundwater by weathering, contacts and joints/fractures in rocks. Additionally, geological setting of MIS also causes dissolution of trace elements in water resources beneath the surface. NE–SW tectonic lineament, radial pattern of dykes and volcanic vent at Nakora created a way for leaching of these elements to groundwater. Rain water quality might be altered by major minerals constituents of host Tosham rocks during its percolation through the rock fracture, joints before becoming the integral part of groundwater aquifer. The weathering process like hydration, hydrolysis and solution might be the cause of change in water chemistry of particular area. These studies suggest that geological relation of soil-water horizon with MIS rocks via mineralogical variations, structures and tectonic setting affects the water quality of the studied area.

Keywords: geochemistry, groundwater, malani igneous suite, tosham

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Authors: Shpetim Rezniqi

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Financial Policies in the process of global crisis the current crisis has swept the world with special emphasis, most developed countries, those countries which have most gross -product world and you have a high level of living.Even those who are not experts can describe the consequences of the crisis to see the reality that is seen, but how far will it go this crisis is impossible to predict. Even the biggest experts have conjecture and large divergence, but agree on one thing: - The devastating effects of this crisis will be more severe than ever before and can not be predicted.Long time, the world was dominated economic theory of free market laws. With the belief that the market is the regulator of all economic problems. The market, as river water will flow to find the best and will find the necessary solution best. Therefore much less state market barriers, less state intervention and market itself is an economic self-regulation. Free market economy became the model of global economic development and progress, it transcends national barriers and became the law of the development of the entire world economy. Globalization and global market freedom were principles of development and international cooperation. All international organizations like the World Bank, states powerful economic, development and cooperation principles laid free market economy and the elimination of state intervention. The less state intervention much more freedom of action was this market- leading international principle. We live in an era of financial tragic. Financial markets and banking in particular economies are in a state of thy good, US stock markets fell about 40%, in other words, this time, was one of the darkest moments 5 since 1920. Prior to her rank can only "collapse" of the stock of Wall Street in 1929, technological collapse of 2000, the crisis of 1973 after the Yom Kippur war, while the price of oil quadrupled and famous collapse of 1937 / '38, when Europe was beginning World war II In 2000, even though it seems like the end of the world was the corner, the world economy survived almost intact. Of course, that was small recessions in the United States, Europe, or Japan. Much more difficult the situation was at crisis 30s, or 70s, however, succeeded the world. Regarding the recent financial crisis, it has all the signs to be much sharper and with more consequences. The decline in stock prices is more a byproduct of what is really happening. Financial markets began dance of death with the credit crisis, which came as a result of the large increase in real estate prices and household debt. It is these last two phenomena can be matched very well with the gains of the '20s, a period during which people spent fists as if there was no tomorrow. All is not away from the mouth of the word recession, that fact no longer a sudden and abrupt. But as much as the financial markets melt, the greater is the risk of a problematic economy for years to come. Thus, for example, the banking crisis in Japan proved to be much more severe than initially expected, partly because the assets which were based more loans had, especially the land that falling in value. The price of land in Japan is about 15 years that continues to fall. (ADRI Nurellari-Published in the newspaper "Classifieds"). At this moment, it is still difficult to çmosh to what extent the crisis has affected the economy and what would be the consequences of the crisis. What we know is that many banks will need more time to reduce the award of credit, but banks have this primary function, this means huge loss.

Keywords: globalisation, finance, crisis, recomandation, bank, credits

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Authors: Raptis Sotirios

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Health and social care (HSc) services planning and scheduling are facing unprecedented challenges due to the pandemic pressure and also suffer from unplanned spending that is negatively impacted by the global financial crisis. Data-driven can help to improve policies, plan and design services provision schedules using algorithms assist healthcare managers’ to face unexpected demands using fewer resources. The paper discusses services packing using statistical significance tests and machine learning (ML) to evaluate demands similarity and coupling. This is achieved by predicting the range of the demand (class) using ML methods such as CART, random forests (RF), and logistic regression (LGR). The significance tests Chi-Squared test and Student test are used on data over a 39 years span for which HSc services data exist for services delivered in Scotland. The demands are probabilistically associated through statistical hypotheses that assume that the target service’s demands are statistically dependent on other demands as a NULL hypothesis. This linkage can be confirmed or not by the data. Complementarily, ML methods are used to linearly predict the above target demands from the statistically found associations and extend the linear dependence of the target’s demand to independent demands forming, thus groups of services. Statistical tests confirm ML couplings making the prediction also statistically meaningful and prove that a target service can be matched reliably to other services, and ML shows these indicated relationships can also be linear ones. Zero paddings were used for missing years records and illustrated better such relationships both for limited years and in the entire span offering long term data visualizations while limited years groups explained how well patients numbers can be related in short periods or can change over time as opposed to behaviors across more years. The prediction performance of the associations is measured using Receiver Operating Characteristic(ROC) AUC and ACC metrics as well as the statistical tests, Chi-Squared and Student. Co-plots and comparison tables for RF, CART, and LGR as well as p-values and Information Exchange(IE), are provided showing the specific behavior of the ML and of the statistical tests and the behavior using different learning ratios. The impact of k-NN and cross-correlation and C-Means first groupings is also studied over limited years and the entire span. It was found that CART was generally behind RF and LGR, but in some interesting cases, LGR reached an AUC=0 falling below CART, while the ACC was as high as 0.912, showing that ML methods can be confused padding or by data irregularities or outliers. On average, 3 linear predictors were sufficient, LGR was found competing RF well, and CART followed with the same performance at higher learning ratios. Services were packed only if when significance level(p-value) of their association coefficient was more than 0.05. Social factors relationships were observed between home care services and treatment of old people, birth weights, alcoholism, drug abuse, and emergency admissions. The work found that different HSc services can be well packed as plans of limited years, across various services sectors, learning configurations, as confirmed using statistical hypotheses.

Keywords: class, cohorts, data frames, grouping, prediction, prob-ability, services

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Authors: Anna Bjällmark, Victoria Persson, Bodil Karlsson, May Bazzi

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Introduction: Interventional radiology (IR) is a continuously growing discipline that allows minimally invasive treatments of various medical conditions. The IR environment is, in several ways, comparable to the complex and accident-prone operation room (OR) environment. This implies that the IR environment may also be associated with various types of risks related to the work process and communication in the team. Patient safety is a central aspect of healthcare and involves the prevention and reduction of adverse events related to patient care. To maintain patient safety, it is crucial to build a safety culture where the staff are encouraged to report events and incidents that may have affected patient safety. It is also important to continuously evaluate the staff´s attitudes to patient safety. Despite the increasing number of IR procedures, research on the staff´s view regarding patients is lacking. Therefore, the main aim of the study was to describe and compare the IR team members' attitudes to patient safety. The secondary aim was to evaluate whether the WHO safety checklist was routinely used for IR procedures. Methods: An electronic survey was distributed to 25 interventional units in Sweden. The target population was the staff working in the IR team, i.e., physicians, radiographers, nurses, and assistant nurses. A modified version of the Safety Attitudes Questionnaire (SAQ) was used. Responses from 19 of 25 IR units (44 radiographers, 18 physicians, 5 assistant nurses, and 1 nurse) were received. The respondents rated their level of agreement for 27 items related to safety culture on a five-point Likert scale ranging from “Disagree strongly” to “Agree strongly.” Data were analyzed statistically using SPSS. The percentage of positive responses (PPR) was calculated by taking the percentage of respondents who got a scale score of 75 or higher. The respondents rated which corresponded to response options “Agree slightly” or “Agree strongly”. Thus, average scores ≥ 75% were classified as “positive” and average scores < 75% were classified as “non-positive”. Findings: The results indicated that the IR team had the highest factor scores and the highest percentages of positive responses in relation to job satisfaction (90/94%), followed by teamwork climate (85/92%). In contrast, stress recognition received the lowest ratings (54/25%). Attitudes related to these factors were relatively consistent between different professions, with only a few significant differences noted (Factor score: p=0.039 for job satisfaction, p=0.050 for working conditions. Percentage of positive responses: p=0.027 for perception of management). Radiographers tended to report slightly lower values compared to other professions for these factors (p<0.05). The respondents reported that the WHO safety checklist was not routinely used at their IR unit but acknowledged its importance for patient safety. Conclusion: This study reported high scores concerning job satisfaction and teamwork climate but lower scores concerning perception of management and stress recognition indicating that the latter are areas of improvement. Attitudes remained relatively consistent among the professions, but the radiographers reported slightly lower values in terms of job satisfaction and perception of the management. The WHO safety checklist was considered important for patient safety.

Keywords: interventional radiology, patient safety, safety attitudes questionnaire, WHO safety checklist

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