Search results for: quality care

Authors: Harith Mohammed Benbouali

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The concept of sustainable development is becoming increasingly important in our society. The efforts of specialized agencies, cleverly portrayed in the media, allow a widespread environmental awareness. Far from the old environmental movement in the backward-looking nostalgia, the environment is combined with today's progress. Many areas now include these concerns in their efforts, this in order to try to reduce the negative impact of human activities on the environment. The quantitative dimension of development has given way to the quality aspect. However, this feature is not common, and the initial target was abandoned in favor of economic considerations. Specialists in the field of building and construction have constantly sought to further integrate the environmental dimension, creating a seal of high environmental quality buildings. The pursuit of well-being of neighborhood residents and the quality of buildings are also a hot topic in planning. Quality of life is considered so on, since financial concerns dominate to the detriment of the environment and the welfare of the occupants. This work concerns the development of an analytical method based on multiple indicators of objectives across the district. The quantification of indicators related to objectives allows the construction professional, the developer or the community, to quantify and compare different alternatives for development of a neighborhood. This quantification is based on the use of simulation tools and a multi-criteria aggregation.

Keywords: sustainable development, environment, district, indicators, multi-criteria analysis, evaluation

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Authors: Valentina Zhang

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While facial expression is a complex and individualized behavior, all facial emotion recognition (FER) systems known to us rely on a single facial representation and are trained on universal data. We conjecture that: (i) different facial representations can provide different, sometimes complementing views of emotions; (ii) when employed collectively in a discussion group setting, they enable more accurate emotion reading which is highly desirable in autism care and other applications context sensitive to errors. In this paper, we first study FER using pixel-based DL vs semantics-based DL in the context of deepfake videos. Our experiment indicates that while the semantics-trained model performs better with articulated facial feature changes, the pixel-trained model outperforms on subtle or rare facial expressions. Armed with these findings, we have constructed an adaptive FER system learning from both types of models for dyadic or small interacting groups and further leveraging the synthesized group emotions as the ground truth for individualized FER training. Using a collection of group conversation videos, we demonstrate that FER accuracy and personalization can benefit from such an approach.

Keywords: neurodivergence care, facial emotion recognition, deep learning, ground truth for supervised learning

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Authors: Walid Wahballah, Taher Bazan, Fawzy Eltohamy

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One of the important functions of the satellite attitude control system is to provide the required pointing accuracy and attitude stability for optical remote sensing satellites to achieve good image quality. Although offering noise reduction and increased sensitivity, time delay and integration (TDI) charge coupled devices (CCDs) utilized in high-resolution satellites (HRS) are prone to introduce large amounts of pixel smear due to the instability of the line of sight. During on-orbit imaging, as a result of the Earth’s rotation and the satellite platform instability, the moving direction of the TDI-CCD linear array and the imaging direction of the camera become different. The speed of the image moving on the image plane (focal plane) represents the image motion velocity whereas the angle between the two directions is known as the drift angle (β). The drift angle occurs due to the rotation of the earth around its axis during satellite imaging; affecting the geometric accuracy and, consequently, causing image quality degradation. Therefore, the image motion velocity vector and the drift angle are two important factors used in the assessment of the image quality of TDI-CCD based optical remote sensing satellites. A model for estimating the image motion velocity and the drift angle in HRS is derived. The six satellite attitude control parameters represented in the derived model are the (roll angle φ, pitch angle θ, yaw angle ψ, roll angular velocity φ֗, pitch angular velocity θ֗ and yaw angular velocity ψ֗ ). The influence of these attitude parameters on the image quality is analyzed by establishing a relationship between the image motion velocity vector, drift angle and the six satellite attitude parameters. The influence of the satellite attitude parameters on the image quality is assessed by the presented model in terms of modulation transfer function (MTF) in both cross- and along-track directions. Three different cases representing the effect of pointing accuracy (φ, θ, ψ) bias are considered using four different sets of pointing accuracy typical values, while the satellite attitude stability parameters are ideal. In the same manner, the influence of satellite attitude stability (φ֗, θ֗, ψ֗) on image quality is also analysed for ideal pointing accuracy parameters. The results reveal that cross-track image quality is influenced seriously by the yaw angle bias and the roll angular velocity bias, while along-track image quality is influenced only by the pitch angular velocity bias.

Keywords: high-resolution satellites, pointing accuracy, attitude stability, TDI-CCD, smear, MTF

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Authors: Mukesh Kumar, Mahendra Pal Sharma

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Depleting fossil fuel resources coupled with serious environmental degradation has led to the search for alternative resources for biodiesel production as a substitute of Petro-diesel. Currently, edible, non-edible oils and microalgal plant species are cultivated for biodiesel production. Looking at the demerits of edible and non-edible oil resources, the focus is being given to grow microalgal species having high oil productivities, less maturity time and less land requirement. Out of various microalgal species, Chlorella protothecoides is considered as the most promising species for biodiesel production owing to high oil content (58 %), faster growth rate (24–48 h) and high biomass productivity (1214 mg/l/day). The present paper reports the results of optimization of reaction parameters of transesterification process as well as the kinetics of transesterification with 97% yield of biodiesel. The measurement of fuel quality of microalgal biodiesel shows that the biodiesel exhibit very good oxidation stability (O.S) of 7 hrs, more than ASTM D6751 (3 hrs) and EN 14112 (6 hrs) specifications. The CP and PP of 0 and -3 °C are finding as per ASTM D 2500-11 and ASTM D 97-12 standards. These results show that the microalgal biodiesel does not need any enhancement in O.S & CFP and hence can be recommended to be directly used as MB100 or its blends into diesel engine operation. Further, scope is available for the production of binary blends using poor quality biodiesel for engine operation.

Keywords: fuel quality, methyl ester yield, microalgae, transesterification

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Authors: Alaa Ashraf Khaleel Abdallah

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Background: The global landscape has witnessed an alarming rise in armed conflicts, further devastating populations through enforced displacement, compromised infrastructure, and strained healthcare systems. In Sudan, the situation is particularly dire, with conflict exacerbating shortages in medical supplies and personnel, pushing the already fragile healthcare system into crisis, especially affecting surgical care. Initially, war impacts were significant in conflict zones like Khartoum, but since mid-April 2023, the entire country has descended into chaos. Weak monitoring and health information systems hinder accurate assessment of surgical care in conflict zones, leading to inadequate resource allocation, suboptimal care, and missed opportunities for global learning. This study investigates the impact of the Sudanese conflict on postoperative complications, exploring prevalence, types, outcomes, and psychological effects in conflict and safe areas. Methods: Conducted across 10 Sudanese states—5 in conflict zones such as Khartoum and West Darfur, and 5 in safer regions like River Nile and Kassala—this study analyzed data from 1,457 patients who underwent surgery post-April 2023. Data were collected using a pretested, mixed-mode questionnaire that incorporated elements from validated frameworks and tailored questions specific to the study's context. Hospital records and surgical logs were also used, with data analyzed via SPSS. Results: The overall prevalence of postoperative complications was 35.89%, with a higher rate in conflict zones (57.5%) compared to safe areas (26.4%). Surgical site infections predominated in conflict zones (24.7%) and higher than its prevalence in safe areas, and while fever was prevalent in safer regions even though much less compared to conflict areas, bleeding from surgical site was very frequent in conflict areas. Most patients recovered within two months at a rate higher in safe areas, but most of them required further medical or surgical management within the first month, but psychological impacts were more pronounced in conflict zones with 22.22% reported anxiety among injuries patients, and 20.6% experienced depression, 13.5% and 16.9% respectively, in those had surgeries for other medical conditions, compared to 0.22%anxiety rates and 8.1%for depression in safer regions. Risk factors included age, travel to conflict zones, access to care, delays, and comorbidities. Conclusion: Strengthening healthcare systems and ensuring accessible surgical care are critical in both conflict and safe areas. Specific attention must be given to addressing patient suffering and demographic shifts caused by armed conflict. Further research is needed to refine the predictive model for postoperative complications in conflict zones.

Keywords: postoperative complications, conflict zones, risk factors, surgical outcomes, Sudan

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Authors: Yoshinori Wakatake

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Many defects after the release of software packages are caused due to omissions of sufficient test items in test specifications. Poor test specifications are detected by manual review, which imposes a high human load. The prevention of omissions depends on the end-user awareness of test specification writers. If test specifications were written while envisioning the behavior of end-users, the number of omissions in test items would be greatly reduced. The paper pays attention to the point that writers who can achieve it differ from those who cannot in not only the description richness but also their gaze information. It proposes a method to estimate the degree of user-awareness of writers through the analysis of their gaze information when writing test specifications. We conduct an experiment to obtain the gaze information of a writer of the test specifications. Test specifications are automatically classified using gaze information. In this method, a Random Forest model is constructed for the classification. The classification is highly accurate. By looking at the explanatory variables which turn out to be important variables, we know behavioral features to distinguish test specifications of high quality from others. It is confirmed they are pupil diameter size and the number and the duration of blinks. The paper also investigates test specifications automatically classified with gaze information to discuss features in their writing ways in each quality level. The proposed method enables us to automatically classify test specifications. It also prevents test item omissions, because it reveals writing features that test specifications of high quality should satisfy.

Keywords: blink, eye tracking, gaze information, pupil diameter, quality improvement, specification document, user-awareness

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Authors: Danika Tynes

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Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory (Rogers, 1962). System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of telehealth (teleradiology, teledermatology, telepathology, telepsychology, and remote monitoring) using multiple logistic regression. The analyses supported relative advantage and compatibility as the strongest influencers of telehealth adoption, remote monitoring in particular. These findings help to quantitatively clarify the factors influencing the adoption of innovation and advance the ability to make recommendations on the viability of state telehealth adoption. In addition, results indicate when DoI theory is most applicable to the understanding of telehealth diffusion. Ultimately, this research may contribute to more focused allocation of scarce health care resources through consideration of existing state conditions available foster innovation.

Keywords: adoption, diffusion of innovation theory, remote monitoring, system-level indicators

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Authors: Xiaodong Li, Peng Gao, Chao-Jung Huang, Shiying Hao, Xuefeng B. Ling, Yongxia Han, Yaqi Zhang, Le Zheng, Chengyin Ye, Modi Liu, Minjie Xia, Changlin Fu, Bo Jin, Karl G. Sylvester, Eric Widen

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Predicting the risk of Pancreatic Adenocarcinoma (PA) in advance can benefit the quality of care and potentially reduce population mortality and morbidity. The aim of this study was to develop and prospectively validate a risk prediction model to identify patients at risk of new incident PA as early as 3 months before the onset of PA in a statewide, general population in Maine. The PA prediction model was developed using Deep Neural Networks, a deep learning algorithm, with a 2-year electronic-health-record (EHR) cohort. Prospective results showed that our model identified 54.35% of all inpatient episodes of PA, and 91.20% of all PA that required subsequent chemoradiotherapy, with a lead-time of up to 3 months and a true alert of 67.62%. The risk assessment tool has attained an improved discriminative ability. It can be immediately deployed to the health system to provide automatic early warnings to adults at risk of PA. It has potential to identify personalized risk factors to facilitate customized PA interventions.

Keywords: cancer prediction, deep learning, electronic health records, pancreatic adenocarcinoma

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Authors: Ben Cheikh Asma, Bouafia Nabiha, Ammar Asma, Ezzi Olfa, Meddeb Khaoula, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Hospital Acquired Infection (HAI) constitutes an important worldwide health problem. It was associated with high mortality rate in intensive care units (ICU). This study aimed to determine HAI mortality rate in Tunisian intensive care units and identify its risk factors. Methods: We conducted a prospective observational cohort study over a 12 months period (September 15th 2015 to September 15 th 2016) in the adult medical ICU of University Hospital-Farhat Hached (Sousse-Tunisia). All patients admitted in the ICU for more than 48 hours were included in the study. We used an anonymous standardized survey record form to collect data by a medical hygienist assisted by an intensivist. We adopted definitions of Center for Diseases Control and prevention of Atlanta to detect HAI, Kaplan Meier survival analysis and Cox proportional hazard regression to identify independent risk factor of HAI mortality. Results: Of 171 patients, 67 developed ICU-acquired infection (global incidence rate=39.2%). The mean age of patients was 59 ± 21.2 years and 60.8% were male. The most frequently identified infections were pulmonary acquired infection (ventilator associated pneumonia (VAP) and infected atelectasis with density rates 21.4 VAP/1000 days of mechanical ventilation and 9.4 infected atelectasis /1000 days of mechanical ventilation; respectively) and central venous catheter associated infection (CVC - AI) with density rate 28.4 CVC-AI / 1000 CVC-days). HAI mortality rate was 66.7% (n=44). The median survival was 20 days 3.36, 95% Confidential Interval [13.39 – 26.60]. Specific mortality rates according to infectious site were 65.5%, 36.4% and 4.5% respectively for VAP, CVC associated infection and infected atelectasis. In univariate analysis, a significant associations between mortality and cardiovascular history (p=0.04) tracheotomy (p=0.00), peripheral venous catheterization (p=0.04), VAP (p=0.04) and infected atelectasis (p=0.04) were detected. Independent risk factors for HAI mortality were VAP with Hazard Ratio = 3.14, 95% Confidential Interval [1.63 – 6.05] (p=0.001) and tracheotomy (Hazard Ratio=0.22, 95% Confidential Interval [0.10 – 0.44], p=0.000). Conclusions: In the present study, hospital acquired infection mortality rate was relatively high. We need to intensify the fight against these infections especially ventilator-associated pneumonia that is associated with higher risk of mortality in many studies. Thus, more effective infection control interventions were necessary in our hospital.

Keywords: hospital acquired infection, intensive care unit, mortality, risk factors

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Authors: Amir Moslemi, Amir movafeghi, Shahab Moradi

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One of the most important challenging factors in medical images is nominated as noise.Image denoising refers to the improvement of a digital medical image that has been infected by Additive White Gaussian Noise (AWGN). The digital medical image or video can be affected by different types of noises. They are impulse noise, Poisson noise and AWGN. Computed tomography (CT) images are subjected to low quality due to the noise. The quality of CT images is dependent on the absorbed dose to patients directly in such a way that increase in absorbed radiation, consequently absorbed dose to patients (ADP), enhances the CT images quality. In this manner, noise reduction techniques on the purpose of images quality enhancement exposing no excess radiation to patients is one the challenging problems for CT images processing. In this work, noise reduction in CT images was performed using two different directional 2 dimensional (2D) transformations; i.e., Curvelet and Contourlet and Discrete wavelet transform(DWT) thresholding methods of BayesShrink and AdaptShrink, compared to each other and we proposed a new threshold in wavelet domain for not only noise reduction but also edge retaining, consequently the proposed method retains the modified coefficients significantly that result in good visual quality. Data evaluations were accomplished by using two criterions; namely, peak signal to noise ratio (PSNR) and Structure similarity (Ssim).

Keywords: computed tomography (CT), noise reduction, curve-let, contour-let, signal to noise peak-peak ratio (PSNR), structure similarity (Ssim), absorbed dose to patient (ADP)

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Authors: Gumashta Raghvendra, Gumashta Jyotsna

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Aim and Objective of Study : The use of Horrock’s Apparatus by health care worker requires onsite mathematical calculations for estimation of ‘volume of water’ and ‘amount of bleaching powder’ necessary as per the serial number of first cup showing blue coloration after adding freshly prepared starch-iodide indicator solution. In view of the difficulties of two simultaneous calculations required to be done, the use of Horrock’s Apparatus is not routinely done by health care workers because it is impractical and inconvenient Material and Methods: Arbitrary use of bleaching powder in wells results in hyper-chlorination or hypo-chlorination of well defying the purpose of adequate chlorination or non-usage of well water due to hyper-chlorination. Keeping this in mind two nomograms have been developed, one to assess the volume of well using depth and diameter of well and the other to know the quantity of bleaching powder to b added using the number of the cup of Horrock’s apparatus which shows the colour indication. Result & Conclusion: Out of thus developed two self-speaking interlinked easy charts, first chart will facilitate bypassing requirement of formulae ‘πr2h’ for water volume (ready reckoner table with depth of water shown on ‘X’ axis and ‘diameter of well’ on ‘Y’ axis) and second chart will facilitate bypassing requirement formulae ‘2ab/455’ (where ‘a’ is for ‘serial number of cup’ and ‘b’ is for ‘water volume’, while ready reckoner table showing ‘water volume’ shown on ‘X’ axis and ‘serial number of cup’ on ‘Y’ axis). The use of these two charts will help health care worker to immediately known, by referring the two charts, about the exact requirement of bleaching powder. Thus, developed ready reckoner charts will be easy and convenient to use for ensuring prevention of water-borne diseases occurring due to hypo-chlorination, especially in rural India and other developing countries.

Keywords: apparatus, bleaching, chlorination, Horrock’s, nomogram

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Authors: Ririn Marinasari, S. Pi

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Hampal (Hampala macrolepidota) is one of Citarum river indigenous fishes that still find in Jatiluhur dam. IUCN at 2013 said that hampal listed on redlist species category, this species was rare in Jatiluhur dam. This species more and more decreasing because change of habitats characteristic such as water quality and fishing effort. This study aims to determine and identify the influence of fishing effort and the quality of water on the productivity of fish resources hampal (Hampala macrolepidota) in Jatiluhur. The study was conducted from October to November 2013. Zones of research include lacustrine zone, transition and Riverin. Hampal fish productivity value computed by Hampal’s CPUE values. The results showed that fish MSY hampal obtained from surplus production model of Schaefer is equal to 0.2045 tons / quarterly. In the years 2011-2012 have occurred over fishing in 2013 while still under fishing. Total catches have exceeded the MSY during the year 2011 and the third quarterly of 2012 tons of fish that exceed 0.2045 hampal. The rate of utilization of fish resources hampal is equal to 80% of MSY or equal to the allowable catch (Total Allowable Catch) for fish in Jatiluhur hampal based Schaefer surplus production theory. Fishing effort, water quality parameters such as DO, turbidity and negatively correlated sulfide as H2S, while the temperature and pH positively correlated to productivity or unit catches fish hampal efforts in quarterly time series in the period 2011-2013. Shows that the higher fishing effort, DO, turbidity and sulfide in H2S and diminishing the temperature and pH of the productivity decreases. Variables that affect the productivity of fishing hampal only H2S only factor beta coefficient -0.834 which indicates a negative effect. It can be caused by H2S levels are toxic and have already exceeded the quality standard, while for other water quality parameters are still below the maximum standards allowed in the waters. Result of the study can be a reference of fishing regulation for hampal conservation in Jatiluhur dam.

Keywords: effort, hampal, productivity, water quality

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Authors: Valentina Obradović, Josip Mesić, Maja Ergović Ravančić, Kamila Mijowska, Brankica Svitlica

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French oak and American oak barrels are most famous all over the world, but barrels of different origin can also be used for obtaining high quality wines. The aim of this research was to compare the influence of different Slavonian (Croatian) and French oak barrels on the quality of Chardonnay wine. Grapes were grown in Croatian wine growing region of Kutjevo in 2015. Chardonnay wines were tested for basic oenological parameters (alcohol, extract, reducing sugar, SO2, acidity), total polyphenols content (Folin-Ciocalteu method), antioxidant activity (ABTS and DPPH method) and color density. Sensory evaluation was performed by students of viticulture/oenology. Samples produced by classical fermentation and ageing in French oak barrels, had better results for polyphenols and sensory evaluation (especially low toasting level) than samples in Slavonian barrels. All tested samples were scored as a “quality” or “premium quality” wines. Sur lie method of fermentation and ageing in Slavonian oak barrel had very good extraction of polyphenols and high antioxidant activity with the usage of authentic yeasts, while commercial yeast strain resulted in worse chemical and sensory parameters.

Keywords: chardonnay, French oak, Slavonian oak, sur lie

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Authors: Medalson Ronghang, Pranjal Barman, Heemantajeet Medhi

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Bank filtration (BF) being a natural method of abstracting surface water from the river or lake via sub-surface. It can be intensively used and operated under various operating conditions for sustainability. Field investigations were carried out at various location of Kokrajhar (Assam) and Srinagar (Uttarakhand) to assess the ground water and their bank filtration wells to compare and characterized the quality. Results obtained from the analysis of the data suggest that major water quality parameter were much below the drinking water standard of BIS 10500 (2012). However, the iron concentration was found to be more than permissible limit in more than 50% of the sampled hand pump; the concentration ranged between 0.33-3.50 mg/L with acidic in nature (5.4 to 7.4) in Kokrajhar and high nitrate in Srinagar. But the abstracted water from the RBF wells has attenuated water quality with no iron concentration in Kokrajhar. The aquifers and riverbed material collected along the bank of Rivers Gaurang and Alaknanda were sieved and classified as coarse silt to medium gravel. The hydraulic conductivity was estimated in the range 5×10⁻³ to 1.4×10⁻²- 3.09×10⁻⁴-1.29 ×10⁻³ for Kokrajhar and Srinagar respectively suggesting a good permeability of the aquifer. The maximum safe yield of the well was estimated to be in the range of 4000 to 7500 L/min. This paper aims at demonstrating bank filtration method as an alternative to mineralized groundwater for drinking water.

Keywords: Riverbank filtration, mineralization, water quality, groundwater

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Authors: Gülcan Taşkıran, Ayla Bayık Temel

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Background: Florence Nightingale, the modern founder of the nursing, is most famous for her role as a nurse. But not so much known about her contributions as a mathematician and statistician. Aim: In this conceptual article it is aimed to examine Florence Nightingale's statistics education, how she used her passion for statistics and applied statistical data in nursing care and her scientific contributions to statistical science. Design: Literature review method was used in the study. The databases of Istanbul University Library Search Engine, Turkish Medical Directory, Thesis Scanning Center of Higher Education Council, PubMed, Google Scholar, EBSCO Host, Web of Science were scanned to reach the studies. The keywords 'statistics' and 'Florence Nightingale' have been used in Turkish and English while being screened. As a result of the screening, totally 41 studies were examined from the national and international literature. Results: Florence Nightingale has interested in mathematics and statistics at her early ages and has received various training in these subjects. Lessons learned by Nightingale in a cultured family environment, her talent in mathematics and numbers, and her religious beliefs played a crucial role in the direction of the statistics. She was influenced by Quetelet's ideas in the formation of the statistical philosophy and received support from William Farr in her statistical studies. During the Crimean War, she applied statistical knowledge to nursing care, developed many statistical methods and graphics, so that she made revolutionary reforms in the health field. Conclusions: Nightingale's interest in statistics, her broad vision, the statistical ideas fused with religious beliefs, the innovative graphics she has developed and the extraordinary statistical projects that she carried out has been influential on the basis of her professional achievements. Florence Nightingale has also become a model for women in statistics. Today, using and teaching of statistics and research in nursing care practices and education programs continues with the light she gave.

Keywords: Crimean war, Florence Nightingale, nursing, statistics

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Authors: Raeda F. Abualrub, Amani Abdulnabi

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Aim: The aims of this study were to (a) examine the levels of nurses' political efficacy and involvement in health policy; and (b) explore the relationships between political efficacy, involvement in health policy, and participants’ background variables. Background: Nurses as citizens and health care providers have the right to express their opinions and beliefs in regard to issues that are concerned with the health care system or the public health domain. Methods: A descriptive, cross-sectional design using was utilized. A self-administered questionnaire (Political Efficacy Scale & Involvement in Health Policy Scale) was completed by a convenience sample of 302 nurses. Results: The results of this study showed low levels of involvement in health policy and political efficacy and a positive weak correlation between political efficacy and involvement in health policy. The perceived level of political efficacy was associated positively with nurses’ age and experience. Conclusions: Nurse administrators and managers may empower, support, and encourage nurses to enhance their involvement in health policy. Implications for Nursing Management: The findings have implications for nursing leaders and administrators to design appropriate strategies to enhance nurses’ involvement in health policy development.

Keywords: health policy, Jordan, nurses, political efficacy

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Authors: Deinzel R. Uezono, Vivien Fe F. Fadrilan-Camacho, Bianca Margarita L. Medina, Antonio Domingo R. Reario, Trisha M. Salcedo, Luke Wesley P. Borromeo

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The environment of health care workers is considered one of the most hazardous settings due to the nature of their work. In developing countries especially, the Philippines, this continues to be overlooked in terms of programs and services on occupational health and safety (OHS). One possible reason for this is the existing information gap on OHS which limits data comparability and impairs effective monitoring and assessment of interventions. To address this gap, there is a need to determine the current conditions of Filipino health care workers in their workplace. This descriptive cross-sectional study assessed the occupational health and safety conditions of health care workers in barangay health centers in a selected city in Metro Manila, Philippines by: (1) determining the hazards present in the workplace; (2) determining the most common self-reported medical problems; and (3) describing the elements of an OHS system based on the six building blocks of health system. Assessment was done through walkthrough survey, self-administered questionnaire, and key informant interview. Data analysis was done using Epi Info 7 and NVivo 11. Results revealed different health hazards present in the workplace particularly biological hazards (exposure to sick patients and infectious specimens), physical hazards (inadequate space and/or lighting), chemical hazards (toxic reagents and flammable chemicals), and ergonomic hazards (activities requiring repetitive motion and awkward posture). Additionally, safety hazards (improper capping of syringe and lack of fire safety provisions) were also observed. Meanwhile, the most commonly self-reported chronic diseases among health care workers (N=336) were hypertension (20.24%, n=68) and diabetes (12.50%, n=42). Top commonly self-reported symptoms were colds (66.07%, n=222), coughs (63.10%, n=212), headache (55.65%, n=187), and muscle pain (50.60%, n=170) while other diseases were influenza (16.96%, n=57) and UTI (15.48%, n=52). In terms of the elements of the OHS system, a general policy on occupational health and safety was found to be lacking and in effect, an absence of health and safety committee overseeing the implementing and monitoring of the policy. No separate budget specific for OHS programs and services was also found to be a limitation. As a result, no OHS personnel and trainings/seminar were identified. No established information system for OHS was in place. In conclusion, health and safety hazards were observed to be present across the barangay health centers visited in a selected city in Metro Manila. Medical conditions identified as most commonly self-reported were hypertension and diabetes for chronic diseases; colds, coughs, headache, and muscle pain for medical symptoms; and influenza and UTI for other diseases. As for the elements of the occupational health and safety system, there was a lack in the general components of the six building blocks of the health system.

Keywords: health hazards, occupational health and safety, occupational health and safety system, safety hazards

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Authors: Gatot Ciptadi, Mudawamah, R. P. Putra, S. Wahjuningsih, A. M. Munazaroh

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The success rate of Artificial Insemination (AI) application, particularly in the field at the farmer level is highly dependent on the quality of the sperms one post thawing. The objective of this research was to determine the effect of freezing method (-1oC/ minute) using Mr. Frosty system with commercial diluents on the post-thawing quality of Boer goat semen. Method use is experimental design with the completely randomized design (CRD) with 4 treatments of commercial diluter percentage (v/v). Freezing semen was cryopreserved in 2 main final temperatures of –45 oC (Freezer) and –196 oC (liquid nitrogen). Result showed that different commercial diluter is influenced on viability motility and abnormalities of Boer semen. Pre-freezing qualities of viability, motilities and abnormalities was 88.67+4.16 %, 66.33 +1.53 % and 4.67+ 0.57 % respectively. Meanwhile, post-thawing qualities is considered as good as standard qualities at least more than 40 % (51.0+6.5%). The percentage of commercial diluents were influenced highly significant (P<0.01).The best diluents ration is 1:4 (v/v) for both final sperms stocked. However freezing sperm conserved in -196 oC is better than –45 oC (i.e. motility 39.3.94 % vs. 51.0 + 6.5 %). It was concluded that Mr. frosty system was considered as the feasible method for freezing semen in the reason for practical purposes.

Keywords: sperm quality, goat, viability, diluteR

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Authors: K. Y. Chen, H. Chua, C. W. Kan

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In this study, we will analyze Germany’s environmental situation such as water and air quality and review its environmental policy. In addition, we will collect the yearly environmental data as well as information concerning public environmental investment. Based on the data collect, we try to find out the relationship between public environmental investment and sustainable development in Germany. In addition, after comparing the trend of environmental quality and situation of environmental policy and investment, we may have some conclusions and learnable aspects to refer to. Based upon the data collected, it was revealed that Germany has established a well-developed institutionalization of environmental education. And the ecological culture at school is dynamic and continuous renewal. The booming of green markets in Germany is a very successful experience for learning. The green market not only creates a number of job opportunities, but also helps the government to improve and protect the environment. Acknowledgement: Authors would like to thank the financial support from the Hong Kong Polytechnic University for this work.

Keywords: Germany, public environmental investment, environment quality, sustainable development

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Authors: Mansoor Soomro

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The evolution of power electronic equipment has been pivotal in making industrial processes productive, efficient and safe. Despite its attractive features, it has been due to nonlinear loads which make it vulnerable to power quality conditions. Harmonics is one of the power quality problem in which the harmonic frequency is integral multiple of supply frequency. Therefore, the supply voltage and supply frequency do not last within their tolerable limits. As a result, distorted current and voltage waveform may appear. Attributes of low power quality confirm that an electrical device or equipment is likely to malfunction, fail promptly or unable to operate under all applied conditions. The electrical power system is designed for delivering power reliably, namely maximizing power availability to customers. However, power quality events are largely untracked, and as a result, can take out a process as many as 20 to 30 times a year, costing utilities, customers and suppliers of load equipment, a loss of millions of dollars. The ill effects of current harmonics reduce system efficiency, cause overheating of connected equipment, result increase in electrical power and air conditioning costs. With the passage of time and the rapid growth of power electronic converters has highlighted the damages of current harmonics in the electrical power system. Therefore, it has become essential to address the bad influence of current harmonics while planning any suitable changes in the electrical installations. In this paper, an effort has been made to mitigate the effects of dominant 3rd order current harmonics. Passive filtering technique with six pulse multiplication converter has been employed to mitigate them. Since, the standards of power quality are to maintain the supply voltage and supply current within certain prescribed standard limits. For this purpose, the obtained results are validated as per specifications of IEEE 519-1992 and IEEE 519-2014 performance standards.

Keywords: current harmonics, power quality, passive filters, power electronic converters

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Authors: M. Medrano, M. D. M. S., L. Younes, M. D.

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Introduction: Incidence of tibial hemimelia is 1:1,000,000. Due to pre-existing case studies and literature, there is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia, but an underlying cause is generally unknown. This presentation aims to discuss a rare, congenital lower limb deficiency observed in a patient in order to identify potential prenatal risk factors and future considerations for the patient’s well-being. Observation: A newborn female child, born full term via spontaneous vaginal delivery after induction of labor to unaffected and non-consanguineous parents. The prenatal course was notable for limited and disjointed prenatal care as well as maternal tobacco and marijuana use, anemia of pregnancy, and inadequate weight gain. Prenatal imaging showed lower extremity deformity with the inability to visualize tibia and bilateral clubfeet in the setting of Intrauterine Growth Restriction (IUGR). The patient presented with right equino varus deformity of the foot and right knee joint deformity. Radiological imaging showed the absence of the right tibia and varus angulation of the right foot with dislocation of the tibiotalar joint. Normal femur with lateral and mild anterior displacement of a wide fibula (Weber Type VIIa). Due to the absence of the patient’s tibia and knee extensor mechanism, the patient was not a candidate for reconstructive surgery and ultimately underwent successful right knee disarticulation. Discussion and Conclusion: By utilizing a retrospective chart review of this case, possible risk factors in prenatal care may be identified and add to existing knowledge on etiology. Hopefully, a cause can be clearly identified in the future and, thus, addressed in the prenatal period. In addition, we can investigate the patient’s well-being and adjustment post-operatively to support outpatient management of an uncommon anomaly.

Keywords: Tibial hemimelia, prenatal care, pediatric orthopedics, congenital deformity

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Authors: Dejan Tanikić, Jelena Đoković, Saša Kalinović, Miodrag Manić, Saša Ranđelović

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This paper deals with measuring and modelling of the quality of the machined surface of the metal machining process. The average surface roughness (R_a) which represents the quality of the machined part was measured during the dry turning of the AISI 4140 steel. A large number of factors with the unknown relations among them influences this parameter, and that is why mathematical modelling is extremely complicated. Different values of cutting speed, feed rate, depth of cut (cutting regime) and workpiece hardness causes different surface roughness values. Modelling with soft computing techniques may be very useful in such cases. This paper presents the usage of the fuzzy logic-based system for determining metal machining process parameter in order to find the proper values of cutting regimes.

Keywords: fuzzy logic, metal machining, process modeling, surface roughness

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Authors: L. Belkhiri, L. Mouni, A. Tiri, T.S. Narany

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In the present study, the self-organizing map (SOM) clustering technique was applied to identify homogeneous clusters of hydrochemical parameters in El Milia plain, Algeria, to assess the quality of groundwater for potable and agricultural purposes. The visualization of SOM-analysis indicated that 35 groundwater samples collected in the study area were classified into three clusters, which showed progressive increase in electrical conductivity from cluster one to cluster three. Samples belonging to cluster one are mostly located in the recharge zone showing hard fresh water type, however, water type gradually changed to hard-brackish type in the discharge zone, including clusters two and three. Ionic ratio studies indicated the role of carbonate rock dissolution in increases on groundwater hardness, especially in cluster one. However, evaporation and evapotranspiration are the main processes increasing salinity in cluster two and three.

Keywords: groundwater quality, self-organizing maps, drinking water, irrigation water

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Authors: Kamran Yazdanbakhsh, Somayeh Mahmoudi

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Multiple sclerosis is the most common chronic disease of the central nervous system associated with demyelination of neurons and several demyelinated parts of the disease encompasses throughout the white matter and affects the sensory and motor function. This study compared the effectiveness of two methods of cognitive therapy and supportive-expressive therapy on the efficacy and quality of life in MS patients. This is an experimental project which has used developed group pretest - posttest and follow-up with 3 groups. The study included all patients with multiple sclerosis in 2013 that were members of the MS Society of Iran in Tehran. The sample included 45 patients with MS that were selected volunteerily of members of the MS society of Iran and randomly divided into three groups and pretest, posttest, and follow-up (three months) for the three groups had been done.The dimensions of quality of life in patients with multiple sclerosis scale, and general self-efficiency scale of Schwarzer and Jerusalem was used for collecting data. The results showed that there was a significant difference between the mean of quality of life scores at pretest, posttest, and follow-up of the experimental groups. There was no significant difference between the mean of quality of life of the experimental groups which means that both groups were effective and had the same effect. There was no significant difference between the mean of self-efficiency scores in control and experimental group in pretest, posttest and follow-up. Thus, by using cognitive and supportive-expressive group therapy we can improve quality of life in MS patients and make great strides in their mental health.

Keywords: cognitive group therapy, life style, MS, self-efficiency, supportive-expressive group therapy

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Authors: Saeedeh Eshkil, Seyedeh Farnaz Mousavi, Hamid Reza Kianifar, Seyed Java Sayyedi, Mehdi Sohrabi, Elham Bakhtiari, Morteza Mashoughi, Ezzat Khodashenas

Abstract:

Background: The effect of the SPARK physical education program on lung function in cystic fibrosis patients is not yet determined.).SPARK is Sports, play and active recreation for kids, including moving skills, aerobic games, jogging or walking, aerobic dance and jump rope. Regarding the high prevalence of cystic fibrosis and its destructive effects on the lungs, the aim of this study is to evaluate lung function and quality of life before and after undergoing the SPARK physical education program in children with cystic fibrosis. Method: In this quasi-experimental study, all patients with cystic fibrosis aged 6-18 years referred to the cystic fibrosis clinic of Dr. Sheikh Hospital were enrolled. The patients went under 12 weeks of SPARK training program (3 sessions per week, each session 45 minutes). The quality of life questionnaire ( Cystic Fibrosis Questionnaire includes self-examination, parental ) for patients with cystic fibrosis and spirometry indices (FEV1, FVC, FEV1/FVC, FEF25-75) was filled out before and after intervention for all patients. Results The mean and standard deviation of patients' age were 9.85±2.67 years, and 65% of patients were female. The FEV1 was significantly different before and after the SPARK physical education program (P=0.03), and the respiratory component of quality of life significantly increased after intervention (P=0.002). The overall score of quality of life from parents’ point of view was 2.87 ± 0.38, which increased to 2.99 ± 0.38 after the intervention. Conclusion: The SPARK training program may improve the spirometric parameters in children with cystic fibrosis. It also had a significant effect on improving the quality of life of patients, especially in the respiratory component.

Keywords: cystic fibrosis, pediatrics, SPARK motor program, spirometry

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Authors: C. Nathanailides, S. Anastasiou, A. Dimitroglou, P. Logothetis, G. Kanlis

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In the present work we reviewed historical data of the Greek Marine aquaculture industry including adoption of new methods and technological innovation. The results indicate that the industry exhibited a rapid rise in production efficiency, employment and adoption of new technologies which reduced outbreaks of diseases, reduced production risk and the price of the farmed fish. The improvements of total quality practices and technological input on the Greek Aquaculture industry include improved survival, growth and body shape of farmed fish, which resulted from development of new aquaculture feeds and the genetic selection of the bloodstock. Also improvements in the quality of the final product were achieved via technological input in the methods and technology applied during harvesting, packaging, and transportation-preservation of farmed fish ensuring high quality of the product from the fish farm to the plate of the consumers. These parameters (health management, nutrition, genetics, harvesting and post-harvesting methods and technology) changed significantly over the last twenty years and the results of these improvements are reflected in the production efficiency of the Aquaculture industry and the quality of the final product. It is concluded that the Greek aquaculture industry exhibited a rapid growth, adoption of technologies and supply was stabilized after the global financial crisis, nevertheless, the development of the Greek aquaculture industry is currently limited by international trade sanctions, credit crunch, and increased taxation and not by limited technology or resources.

Keywords: innovation, aquaculture, total quality, management

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Authors: Suwarno, M. Helmi Prakoso

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Mineral oil is commonly used for high voltage transformer insulation. The insulation quality of mineral oil is affecting the operation process of high voltage transformer. There are many contaminations which could decrease the insulation quality of mineral oil. One of them is water. This research talks about the effect of water content on dielectric properties, physic properties, and partial discharge pattern on mineral oil. Samples were varied with 10 varieties of water content value. And then all samples were tested to measure the dielectric properties, physic properties, and partial discharge pattern. The result of this research showed that an increment of water content value would decrease the insulation quality of mineral oil.

Keywords: dielectric properties, high voltage transformer, mineral oil, water content

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Authors: Himansu, Bedanga Talukdar

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The aim of present study is to investigate the prevalence of various health outcomes and quality of life and analyzes the moderating role of social capital on health outcomes (i.e., self-rated good health (SRH), depression, functional health and quality of life) among elderly in India. Using WHO Study on Global AGEing and adults health (SAGE) data, with sample of 6559 elderly between 50 and above (Mage=61.81, SD=9.00) age were selected for analysis. Multivariate analysis accessed the prevalence of SRH, depression, functional limitation and quality of life among older adults. Logistic regression evaluates the effect of social capital along with other co-founders on SRH, depression, and functional limitation, whereas linear regression evaluates the effect of social capital with other co-founders on quality of life (QoL) among elderly. Empirical results reveal that (74%) of respondents were married, (70%) having low social action, (46%) medium sociability, (45%) low trust-solidarity, (58%) high safety, (65%) medium civic engagement and 37% reported medium psychological resources. The multivariate analysis, explains (SRH) is associated with age, female, having education, higher social action great trust, safety and greater psychological resources. Depression among elderly is greatly related to age, sex, education and higher wealth, higher sociability, having psychological resources. QoL is negatively associated with age, sex, being Muslim, whereas positive associated with higher education, currently married, civic engagement, having wealth, social action, trust and solidarity, safeness, and strong psychological resources.

Keywords: depressive symptom, functional limitation, older adults, quality of life, self rated health, social capital

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Authors: Antonio Marco Miotti, Antonella Ruffatto, Giampaola Basso, Antonio Madia, Giulia Zavatta, Emanuela Salvatico, Emanuela Zilli

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A National Action Plan to fight antimicrobial resistance was launched in Italy in 2017. In order to reduce inappropriate exposure to antibiotics and infections from multi-drug resistant bacteria, it is essential to set up a structured system of surveillance and monitoring of the implementation of National Action Plan standards, including antimicrobial consumption, with a special focus on quinolones, third generation cephalosporins and carbapenems. A quantitative estimate of antibiotic consumption (defined daily dose - DDD - consumption per 100 days of hospitalization) has been provided by the Pharmaceutical Service to the Hospital of Cittadella, ULSS 6 Euganea – Health Trust (District of Padua) for the years 2019 (before the pandemic), 2020 and 2021 for all classes of antibiotics. Multidisciplinary meetings have been organized monthly by the local Antimicrobial Stewardship Group. Between 2019 and 2021, an increase in the consumption of carbapenems in the Intensive Care Unit (from 12.2 to 18.2 DDD, + 49.2%) and a decrease in Medical wards (from 5.3 to 2.6 DDD, - 50.9%) was reported; a decrease in the consumption of quinolones in Intensive Care Unit (from 17.2 to 10.8 DDD, - 37.2%), Medical wards (from 10.5 to 6.6 DDD, - 37.1%) and Surgical wards (from 10.2 to 9.3 DDD, - 8.8%) was highlighted; an increase in the consumption of third generation cephalosporins in Medical wards (from 18.1 to 22.6 DDD, + 24,1%) was reported. Finally, after an increase in the consumption of macrolides between 2020 and 2019, in 2021, a decrease was reported in the Intensive Care Unit (DDD: 8.0 in 2019, 18.0 in 2020, 6.4 in 2021) and Medical wards (DDD: 9.0 in 2019, 13.7 in 2020, 10.9 in 2021). Constant monitoring of antimicrobial consumption and timely identifying of warning situations that may need a specific intervention are the cornerstone of Antimicrobial Stewardship programs, together with analysing data on bacterial resistance rates and infections from multi-drug resistant bacteria.

Keywords: carbapenems, quinolones, antimicrobial, stewardship

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Authors: Bih-O Lee, Hsiu-Wan Hsieh, Hsiu-Chen Liu, Mer Yu Pan

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Background: Illness perceptions are developed when people face health-threatening situations. Previous research suggests that understanding discrepancies between illness perceptions of patients and caregivers may need to improve quality of health care. Objective: This study examined the differences between illness perceptions of injured patients and those of their caregivers. Methods: Comparative study design was used. The study setting was the surgical wards of a teaching hospital in Taiwan. Participants were 127 pairs of injured patients and their caregivers. The participants completed socio-demographic data and completed the Chinese Illness Perception Questionnaire Revised-Trauma, which comprises eight subscales. Clinical data of the injured patients was obtained from medical records. Results: This study found that injured patients were more pessimistic than their caregivers about the injury. There were significant differences between patients and caregivers insofar as patients perceived more physical symptoms, scored higher in terms of reasons for their injury, had more negative emotions and experienced more consequences than caregivers. Elderly caregivers and caregivers for patients who were over 65, severely injured and admitted to an ICU perceived more negative perceptions about the injury. Conclusions: This study indicated that patients and caregivers had negative illness representations several months after injury although the intensity of their perceptions was different. The interventions should highlight the need to assist patients and caregivers after injury.

Keywords: illness representations, injury, caregivers, comparative study

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