Search results for: macroeconomic outcomes

Authors: Zoe M. G. Skalkos, Sam N. Dowland, James U. Van Dyke, Camilla. M. Whittington

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Syngnathid fishes (seahorses, pipefishes, and seadragons) are unique because embryos develop on or in the male in a specialised brooding structure. Many seahorse species are endangered or vulnerable, while others are popular in the ornamental fish trade. Seahorses are capable of nutrient provisioning (patrotrophy) of lipids during pregnancy via their fully enclosed brood pouch. Protein is vital for gene regulation and tissue growth during embryogenesis. We tested the hypothesis that protein is paternally transported to developing embryos during pregnancy in the Australian Pot-bellied seahorse, Hippocampus abdominalis. We compared the dry masses and nitrogen content in recently fertilised H. abdominalis embryos and newborns. We calculated an updated patrotrophy index, 1.34, but without a significant difference in dry mass between the two developmental stages. There was, however, a significant increase in total protein content from recently fertilised embryos to neonates. This suggests paternal protein transport is essential for H. abdominalis embryogenesis because protein yolk reserves are depleted by embryonic metabolism, and supplementation is required. This study is the first to provide evidence for paternal protein transport during pregnancy in seahorses. It furthers our understanding of the paternal influence on embryonic development in male pregnancy and how a protein-deficient diet during pregnancy may limit the allocation of resources to embryos, reducing offspring fitness. This research contributes to a deeper understanding of the fundamental reproductive biology of seahorses, which can help improve conservation and farming production outcomes.

Keywords: brood pouch, embryonic provisioning, nitrogen, parentotrophy, paternal investment, reproduction

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Authors: Inaam Nasrallah, Pascale Salameh, Abbas El-Outa, Assem Alkak, Rihab Nasr, Wafa Toufic Bawab

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Background: Hazardous Waste Management(HWM). is critical to human health outcomes and environmental protection. This study evaluated the knowledge regarding safety measures to be applied when collecting and storing waste in scientific laboratories of two universities in Lebanon.Method: A survey-based observational study was conducted in scientific laboratories of the public university and that of a private university, where a total of 309 participants were recruited.Result: The mean total knowledge score on safety measures of HWM was 9.02±4.34 (maximum attainable score, 13). Significant association (p<0.05) was found between knowledge score and job function, years of experience, educational level, professional status, work schedule, and training on proper HWM. Participants had adequate perceptions regarding the impact of HWM on health and the environment. Linear regression modeling revealed that knowledge score was significantly higher among bachelor level lab workers compared to those with doctoral degrees (p=0.043), full-time schedule workers versus part-timers (p=0.03), and among public university participants as compared to those of the private university (p<0.001).Conclusion: This study showed good knowledge concerning HWM in the scientific laboratoriesof the studied universities in Lebanon and a good awareness of the HWM on health and the environment. It highlights the importance of culture, attitude, and practice on proper HWM in the academic scientific laboratory.

Keywords: hasardous waste, safety measures, waste management, knwoledge score, scientific laboratory workers

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Authors: D. Kurt, İ. F. Barut, Z. Ü. Yümün, E. Kam

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After development of the industrial revolution, industrial plants and settlements have spread widely on the sea coasts. This concentration also brings environmental pollution in the sea. This study focuses on the Gulf of İzmir where is located in West of Turkey and it is a fascinating natural gulf of the Eastern Aegean Sea. Investigating marine current sediment is extremely important to detect pollution. Natural radionuclides’ pollution of the marine environment which is also known as a significant environmental anxiety. Ground drilling cores (the depth of each sediment is variant) were collected from the Gulf of İzmir’s four different locations which were Karşıyaka, İnciraltı, Çeşmealtı and Bayraklı. These sediment cores were put in preserving bags with weight around 1 kg, and they were dried at room temperature in a week for moisture removal. Then, they were sieved with 1 mm sieve holes, and finally these powdered samples were relocation to polyethylene Marinelli beakers of 100 ml versions. Each prepared sediment was waited to reach radioactive equilibrium between uranium and thorium for 40 days. Gamma spectrometry measurements were settled using a HPG (High- Purity Germanium) semiconductor detector. Semiconductor detectors are very good at separating power of the energy, they are easily able to differentiate peaks that are pretty close to each other. That is why, gamma spectroscopy’s usage is common for the determination of the activities of U - 238, Th - 232, Ra - 226, Cr - 137 and K - 40 in Bq kg⁻¹. In this study, the results display that the average concentrations of activities’ values are in respectively; 2.2 ± 1.5 Bq/ kg⁻¹, 0.98 ± 0.02 Bq/ kg⁻¹, 8 ± 0.96 Bq/ kg⁻¹, 0.93 ± 0.14 Bq/ kg⁻¹, and 76.05 ± 0.93 Bq/ kg⁻¹. The outcomes of the study are able to be used as a criterion for forthcoming research and the obtained data would be pragmatic for radiological mapping of the precise areas.

Keywords: gamma, Gulf of İzmir (Eastern Aegean Sea-Turkey), natural radionuclides, pollution

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Authors: A. Sathiya Susuman

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Background: The importance of maternal and child healthcare services cannot be stressed enough. These services are very important for the health and health outcomes of the mother and that of the child and in ensuring that both maternal and child deaths are prevented. The objective of the study is to inspire good quality maternal and child health care services in Swaziland. Specifically, is Swaziland on track with the 2015 Millennium Development Goals? Methods: The study used secondary data from the Swaziland Demographic and Health Survey 2006-07. This is an explorative and descriptive study which used pre-selected variables to study factors influencing the use of maternal and child healthcare services in Swaziland. Different types of examinations, such as univariate, bivariate, and multivariate statistical analysis were adopted. Results: The study findings showed a high use rate of antenatal care (97.3%) and delivery care (74.0%), and a low rate of postnatal care use (20.5%). The uptake childhood immunization is also high in the country, averaging more than 80.0%. Moreover, certain factors which were found to be influencing the use of maternal healthcare and childhood immunization include: woman’s age, parity, media exposure, maternal education, wealth status, and residence. The findings also revealed that these factors affect the use of maternal and child health differently. Conclusion: It is important to study factors related to maternal and child health uptake to inform relevant stakeholders about possible areas of improvement. Programs to educate families about the importance of maternal and child healthcare services should be implemented. Swaziland needs to work hard on child survival and maternal health care services, no doubt it is on track with the MDG 4 & 5.

Keywords: maternal healthcare, antenatal care, delivery care, postnatal care, child health, immunization, socio-economic and demographic factors

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Authors: Valentina Colonnello, Paolo Maria Russo

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Living kidney donation requires psychological evaluation and ongoing follow-up. A crucial aspect of this evaluation is assessing the social functioning of donors after donation. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a review of quantitative and qualitative studies on the psychological assessment of living kidney donors' social functioning. The majority of quantitative studies examining the long-term social health post-donation have primarily utilized the Short Form Health Survey (SF) and the World Health Organization Quality of Life-BREF (WHOQoL-BREF) questionnaires. These studies have indicated that donors' social functioning and relationships either remained stable post-donation or returned to pre-donation levels. In some instances, donors' social functioning even surpassed that of the general population. Qualitative studies, conducted through interviews and focus groups, have revealed donors' experiences and emotional concerns that are often overlooked in quantitative analyses. Specifically, qualitative analysis has identified two main themes: "connecting to others" and "acknowledgment and social support." Our review highlights that the majority of published quantitative studies on donors have employed measures of social functioning that may not fully capture donors' experiences and needs. It underscores the importance of further investigation in quantitative studies to assess donors' actual social health and psychological needs accurately. Overall, this review provides valuable insights into specific constructs that warrant deeper exploration in quantitative studies concerning the assessment of donors' social health and psychological well-being.

Keywords: reported outcomes, personalized medicine, individual differences, emotions, psychological assessment

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Authors: Mahfoodh Saleh Al Sabbagh, Amitabh Mishra, Anwar Al Sheyadi

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A tremendous transformation is taking place in the state of education in Sultanate of Oman. The vision 2040 for Higher Education focuses on both academic and technical sides of education aims at improving the quality of education as per higher international standards with emphasis on learning and innovation, creativity and scientific research. The objective is to achieve a proficient education system that keeps abreast of the recent development, the essentials of sustainable development and enhancing the national identity. Higher Education Institutes have contributed immensely to the growth of education in Oman, in this context; Business Organization represents the most complex social structure known today due to its dynamic nature. Employees are considered as one of the dynamic resources of the organization and through their commitment and involvement organization becomes competitive. Organization Culture can be promoted to facilitate the achievement of job satisfaction and employees commitment. The purpose of the research is to explore the impact of Higher Educational Institutions Culture on employee satisfaction, and commitment. Based on primary data, the study was conducted in Higher Education Institutions in the Sultanate of Oman. Data was collected through questionnaire consisting of 60 questions related to culture, satisfaction, and commitment. The sample consisted of 330 employees of leading Higher Education Institutes in the Sultanate of Oman. Structural Equation Modeling was carried out on the data through SPSS and AMOS. Results indicate that culture of organization is significantly related with employees’ satisfaction and commitment both in direct and indirect ways. Significant theoretical and practical implications are driven from the outcomes of the study.

Keywords: organization culture, employee satisfaction and commitment, higher education, Sultanate of Oman

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Authors: Obiakor Casmir Uchenna, Ikegbunam Peter Chierike, Ezeja Perpetual Chisom

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Irregularities have been a major feature of the Nigerian political activities since 1999. The rate at which such impunities thrive in the country has made elections grossly unacceptable among the people because the outcomes have never reflected the wish of the masses. Conscious of this, citizens have subscribed to the use of social media in exposing the ugly faces of the country’s elections which have always been against the less privileged. This study is an exploration of the relationship between exposure to social media shared video-clips and the respondents’ perception of the 2023 presidential election in Nigeria. The general objective of the study is to find out what the respondents make of the election as a result of the video-clips shared on different social media platforms showing electoral irregularities. The study adopted survey research method in studying 378 university undergraduates from NAU, COOU and Paul University selected through purposive sampling technique. The study was premised on the theoretical provision of violation of expectation theory. Findings revealed that the respondents are well exposed to different video-clips showing irregularities on the election. It was also found that the respondents have negative perception of the election. It was concluded that electoral umpire, the government in power and the security apparatus violated the respondents’ expectation from the election based on the pre-election promises made to the citizens. It was recommended among others, that Nigeria must strengthen the various institutions responsible for the conduct of elections if violence will not be made the best option for the poor masses.

Keywords: social media shared video-clips, exposure, irregularities, elections, audience perception, outcome

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Authors: Khaled Alshamari

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Synthesized partially phosphorylated polyvinyl phosphate derivative (PPVP) was functionalized to extract Zirconium (IV) from Egyptian zircon sand. The specifications for the PPVP composite were approved effectively via different techniques, namely, FT-IR, XPS, BET, EDX, TGA, HNMR, C-NMR, GC-MS, XRD and ICP-OES analyses, which demonstrated a satisfactory synthesis of PPVP and zircon dissolution from Egyptian zircon sand. Factors controlling parameters, such as pH values, shaking time, initial zirconium concentration, PPVP dose, nitrate ions concentration, co-ions, temperature and eluting agents, have been optimized. At 25 ◦C, pH 0, 20 min shaking, 0.05 mol/L zirconium ions and 0.5 mol/L nitrate ions, PPVP has an exciting preservation potential of 195 mg/g, equivalent to 390 mg/L zirconium ions. From the extraction–distribution isotherm, the practical outcomes of Langmuir’s modeling are better than the Freundlich model, with a theoretical value of 196.07 mg/g, which is more in line with the experimental results of 195 mg/g. The zirconium ions adsorption onto the PPVP composite follows the pseudo-second-order kinetics with a theoretical capacity value of 204.08 mg/g. According to thermodynamic potential, the extraction process was expected to be an exothermic, spontaneous and beneficial extraction at low temperatures. The thermodynamic parameters ∆S (−0.03 kJ/mol), ∆H (−12.22 kJ/mol) and ∆G were also considered. As the temperature grows, ∆G values increase from −2.948 kJ/mol at 298 K to −1.941 kJ/mol at 338 K. Zirconium ions may be eluted from the working loaded PPVP by 0.025M HNO₃, with a 99% efficiency rate. It was found that zirconium ions revealed good separation factors towards some co-ions such as Hf⁴+ (28.82), Fe³+ (10.64), Ti⁴+ (28.82), V⁵+ (86.46) and U⁶+ (68.17). A successful alkali fusion technique with NaOH flux followed by the extraction with PPVP is used to obtain a high-purity zirconia concentrate with a zircon content of 72.77 % and a purity of 98.29%. As a result of this, the improved factors could finally be used.

Keywords: zirconium extraction, partially phosphorylated polyvinyl phosphate (PPVP), acidic medium, zircon

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Authors: Kamel Abd Elaziz Mohamed, Ahmed Yehia Mousa, Ahmed Samir ElSawy, Adel Mohamed Saleem

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Introduction: Critically ill patients frequently require tracheostomy to simplify long term air way management. While tracheostomy indications have remained unchanged, the timing of elective tracheostomy for the ventilated patient has been questioned. Aim of the work: This study was performed to compare the differences between early and late percutaneous dilatational tracheostomy (PDT) regarding, mechanical ventilation duration (MVD), length of ICU stay, length of hospital stay, incidence of ventilator associated pneumonia and hospital outcome. Patients and methods: Forty patients who met the inclusion criteria were randomly divided into early PDT who had the tracheostomy within the first 10 days of mechanical ventilation (MV) and the late PDT who had the tracheostomy after 10 days of MV. On admission, demographic data and Acute Physiology and Chronic ill Health II and GCS were collected. The duration of mechanical ventilation, ICU length of stay (LOS) and hospital LOS were all calculated. Results: Total of 40 patients were randomized to either early PDT (n= 20) or late PDT (n= 20). There were no significant differences between both groups regarding demographic data or the scores: APACHE II (22.75± 7 vs 24.35 ± 8) and GCS (6.10 ±2 vs 7.10 ± 2.71). An early PDT showed fewer complications vs late procedure, however it was insignificant. There were significant differences between the two groups regarding mean (MVD) which was shorter in early PDT than the late PDT group (32.2± 10.5) vs (20.6 ± 13 days; p= 0.004). Mean ICU stay was shorter in early PDT than late PDT (21 .0± 513.4) vs (40.15 ±12.7 days; p 6 0.001). Mean hospital stay was shorter in early PDT than late PDT (34.60± 18.37) vs (55.60± 25.73 days; p=0.005). Patients with early PDT suffered less sepsis and VAP than late PDT, there was no difference regarding the mortality rate between the two groups. Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

Keywords: intensive care unit, early PDT, late PDT, intubation

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Authors: Hamidoddin Yousefi, Ahmad Nikbakht

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The Sistan Plain, situated in the Balochistan region of southeastern Iran, is renowned for its arid climatic conditions and prevailing winds that persist for approximately 120 days annually. The region faces multiple challenges, including drought susceptibility, exacerbated by wind erosion, temperature fluctuations, and the influence of policies implemented by neighboring Afghanistan and Iran. This study focuses on investigating the characteristics of jet streams within the Sistan Plain and their implications for global climate change. Various models are employed to analyze convective mass fluxes, horizontal moisture transport, temporal variance, and the calculation of radiation convective equilibrium within the atmosphere. Key considerations encompass the distribution of relative humidity, dry air, and absolute humidity. Moreover, the research aims to predict the interplay between jet streams and human activities, particularly regarding their environmental impacts and water scarcity. The investigation encompasses both local and global environmental consequences, drawing upon historical climate change data and comprehensive field research. The anticipated outcomes of this study hold substantial potential for mitigating global climate change and its associated environmental ramifications. By comprehending the dynamics of jet streams and their interconnections with human activities, effective strategies can be formulated to address water scarcity and minimize environmental degradation.

Keywords: Sistani plain, Baluchistan, Hamoun lake, climate change, jet streams, environmental impact, water scarcity, mitigation

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Authors: Mehrdad Akbarzadeh, Afsaneh Abrisham

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Introduction: Critical thinking skills are crucial for nurses, particularly those working in neonatal care, where quick and informed decision-making is essential. This study aims to evaluate the effectiveness of critical thinking skills on job performance among neonatal nurses. Methods: A cross-sectional study was conducted with 450 neonatal nurses from a hospital in Mashhad. Participants were assessed using the Critical Thinking Questionnaire (CThQ) to measure their critical thinking abilities across various subscales, including Analyzing, Evaluating, Creating, Remembering, Understanding, and Applying. Additionally, a custom Job Performance Checklist completed by supervising nurses, was used to evaluate job performance across several dimensions. Data were collected and analyzed using SPSS V.23. Correlation analysis was conducted to determine the relationship between critical thinking skills and job performance. Results: The mean age of the nurses was 33.46 ± 14.2 years, with 79.15% being female. The nurses demonstrated high proficiency in critical thinking, with notable scores in the Creating (23.98 ± 4.8), Applying (17.35 ± 3.2), and Evaluating (16.67 ± 3.4) subscales. The results indicate a significant positive correlation between several critical thinking subscales and job performance. The Creating subscale exhibited the strongest correlation (R = 0.79, p < 0.001), followed by Overall CThQ (R = 0.68, p = 0.039) and Evaluating (R = 0.67, p = 0.041). Analyzing (R = 0.45, p = 0.013) and Understanding (R = 0.41, p = 0.015) also showed significant correlations with job performance. Remembering (R = 0.29, p = 0.061) and Applying (R = 0.43, p = 0.057) were not significantly correlated with job performance. Conclusion: The findings indicate that critical thinking skills, especially in creating and evaluating, are strongly associated with job performance in neonatal nurses. Enhancing these skills through targeted training programs could improve job performance, particularly in decision-making and time management. This study underscores the importance of critical thinking in neonatal care and its impact on nursing efficacy and patient outcomes.

Keywords: critical thinking, job performance, neonatal nurses, healthcare quality

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Authors: Widad Kouachi, Nacera Benmouhoub

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Background: Erector spinae plane block (ESP) and thoracic paravertebral block (PVB) are two widely used regional anesthesia techniques in breast cancer surgery. Both techniques aim to improve postoperative pain management and reduce opioid consumption. However, comparative data on their efficacy in oncologic breast surgery remains limited. Objectives: This study aims to compare the efficacy of ESP and PVB in postoperative pain control, patient satisfaction, and opioid consumption in breast cancer surgery. Methods: A randomized, double-blind trial was conducted involving 100 patients undergoing oncologic breast surgery. Patients were randomly assigned to two groups: 50 received ESP, and 50 received PVB. Postoperative pain scores (at rest and during movement), opioid consumption, patient satisfaction, and hospital length of stay were recorded and analyzed. Results: Both ESP and PVB provided effective postoperative analgesia. No significant difference in pain scores was observed between the two groups within the first 24 hours. However, ESP showed a notable advantage in managing chronic postoperative pain at the 6-month follow-up. Opioid consumption was lower in both groups compared to patients without a block. No significant differences in complication rates or hospital stay were noted between the groups. Conclusion: ESP and PVB offer comparable efficacy for immediate postoperative pain control in breast cancer surgery. Nevertheless, ESP may have a superior role in managing long-term pain. Further research is needed to explore the mechanisms behind the observed differences in chronic pain outcomes.

Keywords: pain assessment, brest surgery, bpv block, ESP block

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Authors: Venkataraman Sankaranarayanan, Sougata Ray

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While extant research has examined many aspects of differential corporate environmental outcomes and behavior, a holistic and integrated view of heterogeneity in corporate environment sustainability (CES) practices remains a puzzle to be fully unraveled – its extent and nature, its relationship to macro or micro level influences, or strategic orientations. Such a perspective would be meaningful for the field given notable strides in CES practices and the corporate social responsibility agenda over the last two decades, in the backdrop of altered global socio-political sensitivities and technological advances. To partly address this gap, this exploratory research adopted a content analysis approach to code patterns in the sustainability disclosures of the 160 largest global firms spread over 8 years. The sample of firms spanned seven industries, nine countries and three continents thereby presenting data rich and diverse enough in several dimensions to be representative of global heterogeneity in CES practices. Through a factor analysis of the coded data, four strategic CES orientations were extracted through the analysis, that effectively straddles most of the variation observed in current CES practices – one that seeks to reduce environmental damage on account of the firm’s operations, another that prioritizes minimalism, a third that focuses on broader ecological status quo, and a final one that champions the ‘business of green’, extending the CES agenda beyond the firm’s boundaries. These environment sustainability strategy orientations are further examined to elicit prominent patterns and explore plausible antecedents.

Keywords: corporate social responsibility, corporate sustainability, environmental management, heterogeneity, strategic orientation

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Authors: Farhad Eizakshiri

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The potential for groupthink to explain the issues contributing to deterioration of decision-making ability within the unitary team and so to cause poor outcomes attracted a great deal of attention from a variety of disciplines, including psychology, social and organizational studies, political science, and others. Yet what remains unclear is how and why the team members’ strivings for unanimity and cohesion override their motivation to realistically appraise alternative courses of action. In this paper, the findings of a sequential explanatory mixed-methods research containing an experiment with thirty groups of three persons each and interviews with all experimental groups to investigate this issue is reported. The experiment sought to examine how individuals aggregate their views in order to reach a consensual group decision concerning the completion time of a task. The results indicated that groups made better estimates when they had no interaction between members in comparison with the situation that groups collectively agreed on time estimates. To understand the reasons, the qualitative data and informal observations collected during the task were analyzed through conversation analysis, thus leading to four reasons that caused teams to neglect divergent viewpoints and reduce the number of ideas being considered. Reasons found were the concurrence-seeking tendency, pressure on dissenters, self-censorship, and the illusion of invulnerability. It is suggested that understanding the dynamics behind the aforementioned reasons of groupthink will help project teams to avoid making premature group decisions by enhancing careful evaluation of available information and analysis of available decision alternatives and choices.

Keywords: groupthink, group decision, cohesiveness, project teams, mixed-methods research

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Authors: Suliman Al Balawi

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Food waste is a significant problem in the Kingdom of Saudi Arabia (KSA). About SR13 billion worth of food is wasted per year in the KSA. From moral, social, and economic perspectives, it is essential to reduce the wastage of food. Although studies have identified the amount of food waste in the KSA, there is a lack of research on why people in the KSA waste food; thus, it is difficult to design efficient intervention programs to reduce food waste. This research investigates the key factors that influence the food waste behavior of the people of the KSA. A food waste behavior model is proposed in this study that has moral disengagement at the center of the model. Following a literature survey, it is hypothesised that religiosity, hedonic value, frugality, and trait cynicism are the antecedents of moral disengagement that are likely to impact the food waste behavior of the people of the KSA. The study further posits that an intervention strategy in the form of a social marketing campaign that focuses on lowering the level of moral disengagement could reduce the food waste behavior of the people of the KSA. This study will apply a pre-test/post-test experimental design (control group). A random sampling method will be used to select participants from the (employees of a chosen firm) in the KSA. The social marketing campaign will be run for six months through the Corporate Social Responsibility Department of the Company, and to analyse the experimental data, structural equation modeling (SEM) will be used. The outcomes of the study will demonstrate the effectiveness of a social marketing campaign for improving the food waste behavior of the people of the KSA and will ultimately lay the foundation for designing efficient intervention programs in the future. This study will contribute to the knowledge on food waste behavior by testing a newly proposed food waste behavior model in the KSA.

Keywords: food waste, social marketing, Saudi Arabia, moral disengagement

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Authors: Noor Azlina Mohamed Yunus, Baharom Abd Rahman, Abdul Kadir Othman, Narehan Hassan, Rohana Mat Som, Ibhrahim Zakaria

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Customer satisfaction and customer loyalty are the most important outcomes of marketing in which both elements serve various stages of consumer buying behavior. Excellent service quality has become a major corporate goal as more companies gradually struggle for quality for their products and services. Therefore, the main purpose of this study is to investigate the influence of service quality on customer satisfaction and customer loyalty at one telecommunication company in Malaysia which is Telekom Malaysia. The scope of this research is to evaluate satisfaction on the products or services at TMpoint Bukit Raja, Malaysia. The data are gathered through the distribution of questionnaires to a total of 306 respondents who visited and used the products or services. By using correlation and multiple regression analyses, the result revealed that there was a positive and significant relationship between service quality and customer satisfaction. The most influential factor on customer satisfaction was empathy followed by reliability, assurance and tangibles. However, there was no significant influence between responsiveness and customer satisfaction. The result also showed there was a positive and significant relationship between service quality and customer loyalty. The most influential factor on customer loyalty was assurance followed by reliability and tangibles. TMpoint Bukit Raja is recommended to device excellent strategies to satisfy customers’ needs and to adopt action-oriented approach by focusing on what the customers wanted. It is also recommended that similar study can be carried out in other industries using different methodologies such as longitudinal method, enlarge the sample size and use a qualitative approach.

Keywords: customer satisfaction, customer loyalty, service quality, telecommunication company

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Authors: Nathen A. Spitz, Dennis Martin Kivlighan III, Arwa Aburizik

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Background and Purpose: Presently, there is a paucity of naturalistic studies that directly compare the effectiveness of psychotherapy versus concurrent psychotherapy and psychiatric care for the treatment of depression and anxiety in cancer patients. Informed by previous clinical trials examining the efficacy of concurrent approaches, this study sought to test the hypothesis that a combined approach would result in the greatest reduction of depression and anxiety symptoms. Methods: Data for this study consisted of 433 adult cancer patients, with 252 receiving only psychotherapy and 181 receiving concurrent psychotherapy and psychiatric care at the University of Iowa Hospitals and Clinics. Longitudinal PHQ9 and GAD7 data were analyzed between both groups using latent growth curve analyses. Results: After controlling for treatment length and provider effects, results indicated that concurrent care was more effective than psychotherapy alone for depressive symptoms (γ₁₂ = -0.12, p = .037). Specifically, the simple slope for concurrent care was -0.25 (p = .022), and the simple slope for psychotherapy alone was -0.13 (p = .006), suggesting that patients receiving concurrent care experienced a greater reduction in depressive symptoms compared to patients receiving psychotherapy alone. In contrast, there were no significant differences between psychotherapy alone and concurrent psychotherapy and psychiatric care in the reduction of anxious symptoms. Conclusions: Overall, as both psychotherapy and psychiatric care may address unique aspects of mental health conditions, in addition to potentially providing synergetic support to each other, a combinatorial approach to mental healthcare for cancer patients may improve outcomes.

Keywords: psychiatry, psychology, psycho-oncology, combined care, psychotherapy, behavioral psychology

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Authors: Hassan Ibrahim

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The prevalence of hyperacusis, an auditory condition characterized by heightened sensitivity to sounds, continues to rise, posing challenges for effective diagnosis and intervention. It is believed that this work deepens will deepens the understanding of hyperacusis etiology by employing graph theory as a novel analytical framework. We constructed a comprehensive graph wherein nodes represent various factors associated with hyperacusis, including aging, head or neck trauma, infection/virus, depression, migraines, ear infection, anxiety, and other potential contributors. Relationships between factors are modeled as edges, allowing us to visualize and quantify the interactions within the etiological landscape of hyperacusis. it employ the concept of the metric dimension of a connected graph to identify key nodes (landmarks) that serve as critical influencers in the interconnected web of hyperacusis causes. This approach offers a unique perspective on the relative importance and centrality of different factors, shedding light on the complex interplay between physiological, psychological, and environmental determinants. Visualization techniques were also employed to enhance the interpretation and facilitate the identification of the central nodes. This research contributes to the growing body of knowledge surrounding hyperacusis by offering a network-centric perspective on its multifaceted causes. The outcomes hold the potential to inform clinical practices, guiding healthcare professionals in prioritizing interventions and personalized treatment plans based on the identified landmarks within the etiological network. Through the integration of graph theory into hyperacusis research, the complexity of this auditory condition was unraveled and pave the way for more effective approaches to its management.

Keywords: auditory condition, connected graph, hyperacusis, metric dimension

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Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

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Bile spillage occurs frequently during laparoscopic cholecystectomy yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact, might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visits, with subsequent readmission and additional procedures. While some authors found no increase in SSI following bile spillage (BS) compared to non-bile spillage cases, others found bile spillage to be associated with SSI. Therefore we sought to examine whether bile spillage is indeed associated with an increased risk of postoperative wound infections after laparoscopic cholecystectomy. I hypothesize that patients who experience BS during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing Laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per CDC-defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non-bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and was absent in the rest i.e.92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in nonbile spillage cases, SSI was found in 8 cases (8.7%). However, it was statistically not significant (p-value>0.05). Eleven (92%) cases were superficial SSI and one was an organ-space infection. No mortality or 30-day readmission. Spillage of Gallbladder content does not lead to an increase in SSIs. However as the rate of SSI is still higher, Surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage thorough peritoneal irrigation with normal saline should be done.

Keywords: organ space infection, Laparoscopic cholecystectomy, biliary spillage, surgical site infection

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Authors: Francesca Carta, Giovanna Linfante, Laura Agneni, Debora Radicchia, Camilla Micheletta, Angelo Del Cimmuto

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Overtaking competence mismatches and fostering career pathways congruent with the individual skills profile would significantly contribute to fighting unemployment. The aim of this paper is to examine the usefulness and efficiency of qualitative tools in supporting and improving the quality of caseworkers’ activities during the jobseekers’ profile analysis and career guidance process. The selected target groups are long-term and middle term unemployed, job seekers, young people at the end of the vocational training pathway and unemployed woman with social disadvantages. The experimentation is conducted in Italy at public employment services in 2017. In the framework of Italian labour market reform, the experimentation represents the first step to develop a customized qualitative model profiling; the final general object is to improve the public employment services quality. The experimentation tests the transferability of an OECD self-assessment competences tool in the Italian public employment services. On one hand, the first analysis results will indicate the user’s perception concerning the tool’s application and their different competence levels (literacy, numeracy, problem solving, career interest, subjective well-being and health, behavioural competencies) with reference to the specific target. On the other hand, the experimentation outcomes will show caseworkers understanding regarding the tool’s usability and efficiency for career guidance and reskilling and upskilling programs.

Keywords: career guidance, evaluation competences, reskilling pathway, unemployment

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Authors: Milad Abbasi

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Carbon fiber-reinforced polymer (CFRP) composite structures are increasingly being utilized in the automotive industry due to their lightweight and specific energy absorption capabilities. Although it is impossible to predict composite mechanical properties directly using theoretical methods, various research has been conducted so far in the literature for accurate simulation of CFRP structures' energy-absorbing behavior. In this research, axial compression experiments were carried out on hand lay-up unidirectional CFRP composite tubes. The fabrication method allowed the authors to extract the material properties of the CFRPs using ASTM D3039, D3410, and D3518 standards. A neural network machine learning algorithm was then utilized to build a robust prediction model to forecast the axial compressive properties of CFRP tubes while reducing high-cost experimental efforts. The predicted results have been compared with the experimental outcomes in terms of load-carrying capacity and energy absorption capability. The results showed high accuracy and precision in the prediction of the energy-absorption capacity of the CFRP tubes. This research also demonstrates the effectiveness and challenges of machine learning techniques in the robust simulation of composites' energy-absorption behavior. Interestingly, the proposed method considerably condensed numerical and experimental efforts in the simulation and calibration of CFRP composite tubes subjected to compressive loading.

Keywords: CFRP composite tubes, energy absorption, crushing behavior, machine learning, neural network

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Authors: Laurence C. Hanes, Robert J. Stone

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Video games have reached a point of huge commercial success as well as wide familiarity with audiences both young and old. Much attention and research have also been directed towards serious games and their potential learning affordances. It is little surprise that the field of virtual heritage has taken a keen interest in using serious games to present cultural heritage information to users, with applications ranging from museums and cultural heritage institutions, to academia and research, to schools and education. Many researchers have already documented their efforts to develop and distribute virtual heritage serious games. Although attempts have been made to create classifications of the different types of virtual heritage games (somewhat akin to the idea of game genres), no formal taxonomy has yet been produced to define the different types of cultural heritage and historical information that can be presented through these games at a content level, and how the information can be manifested within the game. This study proposes such a taxonomy. First the informational content is categorized as heritage or historical, then further divided into tangible, intangible, natural, and analytical. Next, the characteristics of the manifestation within the game are covered. The means of manifestation, level of demonstration, tone, and focus are all defined and explained. Finally, the potential learning outcomes of the content are discussed. A demonstration of the taxonomy is then given by describing the informational content and corresponding manifestations within several examples of virtual heritage serious games as well as commercial games. It is anticipated that this taxonomy will help designers of virtual heritage serious games to think about and clearly define the information they are presenting through their games, and how they are presenting it. Another result of the taxonomy is that it will enable us to frame cultural heritage and historical information presented in commercial games with a critical lens, especially where there may not be explicit learning objectives. Finally, the results will also enable us to identify shared informational content and learning objectives between any virtual heritage serious and/or commercial games.

Keywords: informational content, serious games, taxonomy, virtual heritage

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Authors: Lauren McGillivray, Michelle Torok, Alison Calear

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Suicide is the leading cause of death for Australians aged 15-24 years, with rates increasing over the past decade. As young people can be particularly vulnerable to mental health problems and suicidal behavior, they are an essential and obvious target for suicide prevention efforts. This study investigates the effectiveness of the universal mental health promotion and suicide prevention program, Youth Aware of Mental Health (YAM), to reduce suicidal ideation and attempts and increase help-seeking in young people. This trial took place in Australian schools across four regions in New South Wales that form part of LifeSpan, a larger multilevel suicide prevention research trial. The YAM program was delivered to Year 9 students in up to 78 schools over two years (from January 2017 to December 2019). All schools were invited to participate in YAM's evaluation, which included completing a student questionnaire at three time-points: baseline, 3-month post-intervention, and 6-month follow-up. The primary outcome is suicidal ideation severity. Secondary outcomes are new reports of suicide attempts, stigma towards suicide, knowledge about suicide, help-seeking intentions and behaviors, and depressive symptoms. Results from pre-post and follow-up data will be presented. These research findings are promising and will contribute to the evidence-based for YAM and suicide prevention programs in Australian schools. These findings are also expected to promote YAM's value and sustainability to be more widely delivered in Australian secondary schools.

Keywords: adolescent mental health, suicidal ideation, suicide prevention, universal program

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Authors: Hassan Ibrahim

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The prevalence of hyperacusis, an auditory condition characterized by heightened sensitivity to sounds, continues to rise, posing challenges for effective diagnosis and intervention. It is believed that this work deepens will deepens the understanding of hyperacusis etiology by employing graph theory as a novel analytical framework. it constructed a comprehensive graph wherein nodes represent various factors associated with hyperacusis, including aging, head or neck trauma, infection/virus, depression, migraines, ear infection, anxiety, and other potential contributors. Relationships between factors are modeled as edges, allowing us to visualize and quantify the interactions within the etiological landscape of hyperacusis. it employ the concept of the metric dimension of a connected graph to identify key nodes (landmarks) that serve as critical influencers in the interconnected web of hyperacusis causes. This approach offers a unique perspective on the relative importance and centrality of different factors, shedding light on the complex interplay between physiological, psychological, and environmental determinants. Visualization techniques were also employed to enhance the interpretation and facilitate the identification of the central nodes. This research contributes to the growing body of knowledge surrounding hyperacusis by offering a network-centric perspective on its multifaceted causes. The outcomes hold the potential to inform clinical practices, guiding healthcare professionals in prioritizing interventions and personalized treatment plans based on the identified landmarks within the etiological network. Through the integration of graph theory into hyperacusis research, the complexity of this auditory condition was unraveled and pave the way for more effective approaches to its management.

Keywords: auditory condition, connected graph, hyperacusis, metric dimension

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Authors: Byung Keun Yang, Jae Eun Ku, Young Seon Joo, Je Sung You, Sung Phil Chung, Hahn Shick Lee

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The purpose of this study is to review the evidence comparing the efficacy and safety between L-carnitine and extracorporeal elimination therapy in the management of acute valproic acid L-carnitine vs Extracorporeal Elimination for Acute Valproic acid Intoxication. PubMed, Embase, Cochrane library, Web of Science, KoreaMed, KMbase, and KISS were searched, using the terms carnitine and valproic acid. All studies, regardless of design, reporting efficacy or safety endpoints were included. Reference citations from identified publications were reviewed. Both English and Korean languages were included. Two authors extracted primary data elements including poisoning severity, presenting features, clinical management, and outcomes. Thirty two articles including 33 cases were identified. Poisoning severity was classified as 3 mild, 11 moderate, and 19 severe cases. Nine cases were treated with L-carnitine while 24 cases received extracorporeal therapy without L-carnitine. All patients except one expired patient treated with hemodialysis recovered clinically and no adverse effects were noted. A case report comparing two patients who ingested the same amount of valproic acid showed increased ICU stay (3 vs. 11 days) in case of delayed extracorporeal therapy. Published evidence comparing L-carnitine with extracorporeal therapy is limited. Based on the available evidence, it is reasonable to consider L-carnitine for patients with acute valproic acid overdose. In case of severe poisoning, extracorporeal therapy would also be considered in the early phase of treatment.

Keywords: carnitine, overdose, poisoning, renal dialysis, valproic acid

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Authors: Ghadeer M Alkusayer, Adelicia Yu, Pamela Orr

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Study objective: To report a case of postpartum pulmonary cryptococcal infection (CCI) in an otherwise healthy 35-year-old woman. Additionally, the cases of pulmonary cryptococcal infections either in the antepartum or the postpartum period with pregnancy outcomes, were systematically reviwed. Methods: A systematic search of Cochrane Library, MEDLINE, and EMBASE was conducted for peer-reviewed studies without date restrictions, published in English and relating to CCI during pregnancy or postpartum period. Conference press, editorials, opinion pieces and letters were excluded. Two authors independently screened citations and full-text articles, extracted data and assessed study quality. Given the heterogeneity of study designs, a narrative synthesis was conducted. Results: The search identified 128 references, of which 22 case reports and series met the inclusion criteria. This is a total of 29 women (including the current case) . The mean age of the women was 28.3 ± 12.3 years. Nine (31.03%) presented and were diagnosed in the postpartum period. Two (6.90%) of the patients were reported as immunocompromised with HIV. Four maternal deaths (13.79%) were found in this case series with one (4.3%) patient with severe neurological deficits. Four (17.4%) infant deaths were reported. Women primary presentation varied with chest pain 13 (44.82%), headache 10 (35.70%), dyspnea 19 (65.51%), or fever 12 (41.38%). Three studies reported placental pathology positive for C. neoformans. Conclusion: This case of pulmonary cryptococcal infection in the postpartum period is an important addition to the literature of this rare infection in pregnancy. The patient is not immunocompromised. The patient was successfully treated with 4 months of Fluconazole 400 mg and continued to breastfeed the healthy baby.

Keywords: pulmonary cryptococcus, pregnancy, cryptococci , postpartum

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Authors: Hiba El Assibi

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This study aims to weakly solve Kalah, a two-player board game, by developing a start-to-finish winning strategy using an optimized Minimax algorithm with Alpha-Beta Pruning. In weakly solving Kalah, our focus is on creating an optimal strategy from the game's beginning rather than analyzing every possible position. The project will explore additional enhancements like symmetry checking and code optimizations to speed up the decision-making process. This approach is expected to give insights into efficient strategy formulation in board games and potentially help create games with a fair distribution of outcomes. Furthermore, this research provides a unique perspective on human versus Artificial Intelligence decision-making in strategic games. By comparing the AI-generated optimal moves with human choices, we can explore how seemingly advantageous moves can, in the long run, be harmful, thereby offering a deeper understanding of strategic thinking and foresight in games. Moreover, this paper discusses the evaluation of our strategy against existing methods, providing insights on performance and computational efficiency. We also discuss the scalability of our approach to the game, considering different board sizes (number of pits and stones) and rules (different variations) and studying how that affects performance and complexity. The findings have potential implications for the development of AI applications in strategic game planning, enhancing our understanding of human cognitive processes in game settings, and offer insights into creating balanced and engaging game experiences.

Keywords: minimax, alpha beta pruning, transposition tables, weakly solving, game theory

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Authors: Mukisa Daphine Letisha

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Plea bargaining, a practice often associated with more developed legal systems, has emerged as a significant tool within Uganda's criminal justice system despite its absence in formal legal structures inherited from its colonial past. Initiated in 2013 with the aim of reducing case backlogs, expediting trials, and addressing prison congestion, plea bargaining reflects a pragmatic response to systemic challenges. While rooted in international statutes and domestic constitutional provisions, its implementation relies heavily on the Judicature (Plea Bargain) Rules of 2016, which outline procedural requirements and safeguards. Advocates argue that plea bargaining has yielded tangible benefits, including a reduction in case backlog and efficient allocation of resources, with notable support from judicial and prosecutorial authorities. Case examples demonstrate successful outcomes, with accused individuals benefitting from reduced sentences in exchange for guilty pleas. However, challenges persist, including procedural irregularities, inadequate statutory provisions, and concerns about coercion and imbalance of power between prosecutors and accused individuals. To enhance efficacy, recommendations focus on establishing monitoring mechanisms, stakeholder training, and public sensitization campaigns. In conclusion, while plea bargaining offers potential advantages in streamlining Uganda's criminal justice system, addressing its challenges requires careful consideration of procedural safeguards and stakeholder engagement to ensure fairness and integrity in the administration of justice.

Keywords: plea-bargaining, criminal-justice system, uganda, efficacy

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Authors: André Rui Coelho Fernandes, Mariana Rufino, Divakar Hamal, Amr Sousa, Emma Fossett, Kamalpreet Cheema

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Aim: A single patella tendon rupture is relatively uncommon, but a simultaneous bilateral event is a rare occurrence and has been scarcely reviewed in the literature. This review was carried out to analyse the existing literature on this event, with the aim of proposing a standardised approach to the diagnosis and management of this injury. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three independent reviewers conducted searches in PubMed, OvidSP for Medline and Embase, as well as Cochrane Library using the same search strategy. From a total of 183 studies, 45 were included, i.e. 90 patellas. Results: 46 patellas had a Type 1 Rupture equating to 51%, with Type 3 being the least common, with only 7 patellas sustaining this injury. The mean Insall-Salvio ratio for each knee was 1.62 (R) and 1.60 (L) Direct Primary Repair was the most common surgical technique compared to Tendon Reconstruction, with End to End and Transosseous techniques split almost equally. Brace immobilisation was preferred over cast, with a mean start to weight-bearing of 3.23 weeks post-op. Conclusions: Bilateral patellar tendon rupture is a rare injury that should be considered in patients with knee extensor mechanism disruption. The key limitation of this study was the low number of patients encompassed by the eligible literature. There is space for a higher level of evidence study, specifically regarding surgical treatment choice and methods, as well as post-operative management, which could potentially improve the outcomes in the management of this injury.

Keywords: trauma and orthopaedic surgery, bilateral patella, tendon rupture, trauma

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Authors: Rizwan Iqbal

Abstract:

Introduction: Re-TURBT has been recommended by international guidelines for patients with non-muscle invasive bladder cancer (NMIBC) who are deemed high-risk. Indications for re-TURBTs remain controversial and studies show mixed outcomes. It should be performed when the initial TURBT specimen lacks detrusor muscle, has tumor stage pT1 or G3/high-grade, or where resection is deemed incomplete. This ensures complete resection of tumors that have a high risk of recurrence as well as accurately identifying any tumors which have been upstaged. The aim of this audit was to evaluate the quality of re-TURBTs in a district general hospital. Method: Data were retrospectively collected from 31 patients who had re-TURBTs between April 2021 and September 2022. Data included baseline demographics, time from initial to re-TURBT, quality of operation note, presence of residual tumor, complications, and administration of chemotherapy within 24 hours of the initial TURBT. Data collection remains ongoing at the time of writing. Results: The mean age was 76 years old and 71.0% of patients were male. 32.3% of patients had their re-TURBT within six weeks and 32.3% had intravesical chemotherapy administered within 24 hours of the initial TURBT. 74.2% of initial TURBTs had detrusor muscle present in the specimen. 48.4% of patients had residual disease following re-TURBT. Just one patient had their pathology upstaged at re-TURBT. The use of the TURBT proforma on the operation note was variable, with 51.6% and 38.7% of surgeons using the proforma after the initial and re-TURBT. Conclusion: Re-TURBT improves bladder cancer staging and is necessary in patients who are deemed high-risk in order to identify any upstaging or recurrence of the disease.

Keywords: urology, bladder cancer, turbt, cancer

Procedia PDF Downloads 62