Search results for: organisational outcomes

Authors: Mohammad Naeem Lakanwall, Jamshid Abdul-Ghafar

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Background: Endocrinopathies are a commonly occurring entity, particularly those of the thyroid gland; however, there is a lack of scientific literature from Afghanistan, a country with very limited health care facilities and resources. To our best knowledge, this is the first study aimed to describe the frequency of occurrence and factors associated with thyroid dysfunction in the Afghan population. The aim of this study is to estimate the frequency and to identify factors associated with thyroid dysfunction among individuals coming to a tertiary care facility in Kabul, Afghanistan. Methods: A cross-sectional study was conducted from July to Sep 2018 at the Department of Clinical Pathology, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan. Blood samples were obtained, serum TSH levels were analyzed, and the patients were divided into three diagnostic categories according to their serum TSH concentrations: 1) hypothyroidism, 2) hyperthyroidism, 3) normal. Results: A total of 127 individuals were included in the final analysis. The majority of study participants (77%) were females. A large number of the participants (92%) did not have a family history of thyroid dysfunction. 74% of the participants in the study had normal TSH levels classified as normal thyroid function, (14%) had lower TSH levels, and (12%) higher TSH levels, classified as hyper and hypothyroid, respectively. Conclusions: The findings of the current study showed a high frequency of thyroid dysfunctions from a single center. Further large-scale studies are needed to find out the prevalence and document this entity for better health outcomes in the country.

Keywords: Afghanistan, factors, frequency, hypothyroid, hyperthyroid, thyroid, thyroid stimulating hormone

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Authors: C. Park, H. Lee, Y-J. Lee

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Aim: This study presents Interdisciplinary Collaborative Innovation Mechanism as a medium to enable the effective generation of innovations for sustainability challenges facing humanities. Background: Interdisciplinary approach of fusing disparate knowledge and perspectives from diverse expertise and subject areas is one of the key requirements to address the intricate nature of sustainability issues. There is a lack of rigorous empirical study of the systematic structure of interdisciplinary collaborative innovation for sustainability to date. Method: To address this research gap, the action research approach is adopted to develop the Interdisciplinary Collaborative Innovation Mechanism (ICIM) framework based on an empirical study of a total of 28 open innovation competitions in the format of MAKEathons between 2016 to 2023. First, the conceptual framework was formulated based on the literature findings, and the framework was subsequently tested and iterated. Outcomes: The findings provide the ICIM framework composed of five elements: Discipline Diversity Quadruple; Systematic Structure; Inspirational Stimuli; Supportive Collaboration Environment; and Hardware and Intellectual Support. The framework offers a discussion of the key elements when attempting to facilitate interdisciplinary collaboration for sustainability innovation. Contributions: This study contributes to two burgeoning areas of sustainable development and open innovation studies by articulating the concrete structure to bridge the gap. In practice, the framework helps facilitate effective innovation processes and positive social and environmental impact created for real-world sustainability challenges.

Keywords: action research, interdisciplinary collaboration, open innovation, problem-solving, sustainable development, sustainability challenges

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Authors: Aagesson, Ekstrand, Persson, Sallander

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A description of how a team of librarians at Linnaeus University Library in Sweden utilizes a pedagogical approach to deliver engaging digital workshops on information retrieval. The team consists of four librarians supporting three different faculties. The paper discusses the challenges faced in engaging students who may perceive information retrieval as a boring and difficult subject. The paper emphasizes the importance of motivation, inclusivity, constructive feedback, and collaborative learning in enhancing student engagement. By employing a two-librarian teaching model, maintaining a lighthearted approach, and relating information retrieval to everyday experiences, the team aimed to create an enjoyable and meaningful learning experience. The authors describe their approach to increase student engagement and learning outcomes through a three-phase workshop structure: before, during, and after the workshops. The "flipped classroom" method was used, where students were provided with pre-workshop materials, including a short film on information search and encouraged to reflect on the topic using a digital collaboration tool. During the workshops, interactive elements such as quizzes, live demonstrations, and practical training were incorporated, along with opportunities for students to ask questions and provide feedback. The paper concludes by highlighting the benefits of the flipped classroom approach and the extended learning opportunities provided by the before and after workshop phases. The authors believe that their approach offers a sustainable alternative for enhancing information retrieval knowledge among students at Linnaeus University.

Keywords: digital workshop, flipped classroom, information retrieval, interactivity, LIS practitioner, student engagement

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Authors: Awad Mohamed Elkhadir, Rajab M. Ben Yousef

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Background/Aim: Radiological technologists are medical professionals who perform diagnostic imaging tests such as X-rays, magnetic resonance imaging (MRI) scans, and computer tomography (CT) scans. Despite the recognition of image interpretation by British radiologists, it is still considered a problem in the Arab world. This study evaluates the perceptions of radiologists in the Middle East concerning the plain image interpretation of adults by radiologic technologist specialists. Methods: This is a cross-sectional study that follows a quantitative approach. A close-ended questionnaire was distributed among 103 participants who were radiologists by profession from various hospitals in Saudi Arabia and Sudan. The gathered data was then analyzed through Statistical Package for Social Sciences (SPSS). Results: The results showed that 29% recognized the Radiologic Technologist Specialist (RTS) role of writing image reports, while 61% did not. A total of 38% of participants believed that RTS image interpretation would help diagnose unreported radiographs. 47% of the sample responded that the workload and stress on radiologists would reduce by allowing reporting for RTS, while 37% did not. Lastly, 43% believe that image interpretation by RTS can be introduced into the Middle East in the future. Conclusion: The study's findings reveal that the combination of image reporting and radiography improves the care of the patients. The study's outcomes also show that the burden of the medical practitioners reduces due to image reporting of the radiographers. Further researches need to be conducted in the Arab World to obtain and measure the associated factors of the desired criteria.

Keywords: Arab world, image interpretation, radiographer, radiologist, Saudi Arabia, Sudan

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Authors: Justina Ijeoma Ezebuwa, Catherine C. Ikewuchi, Eka B. Essien, Francis C. Anacletus

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Iron deficiency anemia (IDA) is a significant problem in Nigeria, especially in children under five. Intervention options for treating anemia in under-five children have also been the subject of research. This study aims to synthesize the evidence on dietary interventions for managing iron deficiency anemia in under-five children in Nigeria. This study uses a systematic review method to collect relevant studies to answer the research questions and a narrative synthesis to analyze and synthesize the findings of this study. Cochrane, PubMed, and ScienceDirect databases were thoroughly searched, and five (5) articles were selected for this study. The results show that dietary interventions, such as daily multi-nutrient fortified dairy-based drinks, biofortified (yellow/ white) cassava rich in pro-vitamin A, iron supplementation in foods, and ready-to-use therapeutic food (RUTF) may be relevant to the management of iron deficiency anemia in under-five children in Nigeria. The study also shows that daily multi-nutrient fortified dairy-based drinks may be more effective, feasible, and culturally acceptable for managing anemia in under-5 children in Nigeria. In addition, daily multi-nutrient fortified dairy-based drinks and ready-to-use therapeutic food (RUTF) were reported to have the potential to improve the growth, cognitive development, and overall health outcomes of under-five children with iron deficiency anemia in Nigeria. Recommendations for future studies in this research area and for public health practitioners and policymakers were provided.

Keywords: dietary intervention, iron deficiency anemia, under-five children, Nigeria

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Authors: Mohd Dahlan Abdul Malek, Muhamad Idris, Adi Fahrudin, Ida Shafinaz Mohamed Kamil, Husmiati Yusuf, Edeymend Reny Japil, Wan Anor Wan Sulaiman, Lailawati Madlan, Alfred Chan, Nurfarhana Adillah Aftar, Mahirah Masdin

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This research intended to develop a valid and reliable instrument of the Satisfaction with Life Scale (SWLS) to measure satisfaction with life (SWL) constructs among public and private university students in Sabah, Malaysia, through the exploratory factor analysis (EFA) procedure. The pilot study obtained a sample of 108 students from public and private education institutions in Sabah, Malaysia, through an online survey using a self-administered questionnaire. The researchers performed the EFA procedure on SWL construct using IBM SPSS 25. The Bartletts' Test of Sphericity is highly significant (Sig. = .000). Furthermore, the sampling adequacy by Kaiser-Meyer-Olkin (KMO = 0.839) is excellent. Using the extraction method of Principal Component Analysis (PCA) with Varimax Rotation, a component of the SWL construct is extracted with an eigenvalue of 3.101. The variance explained for this component is 62.030%. The construct of SWL has Cronbach's alpha value of .817. The development scale and validation confirmed that the instrument is consistent and stable with both private and public college and university student samples. It adds a remarkable contribution to the measurement of SWLS, mainly in the context of higher education institution students. The EFA outcomes formed a configuration that extracts a component of SWL, which can be measured by the original five items established in this research. This research reveals that the SWL construct is applicable to this study.

Keywords: satisfaction, university students, measurement, scale development

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Authors: ChunYi Peng, Wei Hsuan CHeng, Shyh Kuang Ueng

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This study focuses on the application of self-organizing maps (SOM) technology in analyzing credit card transaction data, aiming to enhance the accuracy and efficiency of fraud detection. Som, as an artificial neural network, is particularly suited for pattern recognition and data classification, making it highly effective for the complex and variable nature of credit card transaction data. By analyzing transaction characteristics with SOM, the research identifies abnormal transaction patterns that could indicate potentially fraudulent activities. Moreover, this study has developed a specialized visualization tool to intuitively present the relationships between SOM analysis outcomes and transaction data, aiding financial institution personnel in quickly identifying and responding to potential fraud, thereby reducing financial losses. Additionally, the research explores the integration of SOM technology with composite intelligent system technologies (including finite state machines, fuzzy logic, and decision trees) to further improve fraud detection accuracy. This multimodal approach provides a comprehensive perspective for identifying and understanding various types of fraud within credit card transactions. In summary, by integrating SOM technology with visualization tools and composite intelligent system technologies, this research offers a more effective method of fraud detection for the financial industry, not only enhancing detection accuracy but also deepening the overall understanding of fraudulent activities.

Keywords: self-organizing map technology, fraud detection, information visualization, data analysis, composite intelligent system technologies, decision support technologies

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Authors: B. El Fadil, R. Najar

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STEM education is promoted by many scholars and curricula around the world, but it is not yet well established in the province of Quebec in Canada. In addition, effective instructional STEM activities and design methods are required to ensure that students and teachers' needs are being met. One potential method is the Engineering Design Process (EDP), a methodology that emphasizes the importance of creativity and collaboration in problem-solving strategies. This article reports on a case study that focused on using the EDP to develop instructional materials by means of making a technological artifact to teach mathematical variables and functions at the secondary level. The five iterative stages of the EDP (design, make, test, infer, and iterate) were integrated into the development of the course materials. Data was collected from different sources: pre- and post-questionnaires, as well as a working document dealing with pupils' understanding based on designing, making, testing, and simulating. Twenty-four grade seven (13 years old) students in Northern Quebec participated in the study. The findings of this study indicate that STEM activities have a positive impact not only on students' engagement in classroom activities but also on learning new mathematical concepts. Furthermore, STEM-focused activities have a significant effect on problem-solving skills development in an interdisciplinary approach. Based on the study's results, we can conclude, inter alia, that teachers should integrate STEM activities into their teaching practices to increase learning outcomes and attach more importance to STEM-focused activities to develop students' reflective thinking and hands-on skills.

Keywords: engineering design process, motivation, stem, integration, variables, functions

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Authors: David J. Foran, Nhan Do, Samuel Ajjarapu, Wenjin Chen, Tahsin Kurc, Joel H. Saltz

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The large-scale data and computational requirements of investigators throughout the clinical and research communities demand an informatics infrastructure that supports both existing and new investigative and translational projects in a robust, secure environment. In some subspecialties of medicine and research, the capacity to generate data has outpaced the methods and technology used to aggregate, organize, access, and reliably retrieve this information. Leading health care centers now recognize the utility of establishing an enterprise-wide, clinical data warehouse. The primary benefits that can be realized through such efforts include cost savings, efficient tracking of outcomes, advanced clinical decision support, improved prognostic accuracy, and more reliable clinical trials matching. The overarching objective of the work presented here is the development and implementation of a flexible Intelligent Retrieval and Interrogation System (IRIS) that exploits the combined use of computational imaging, genomics, and data-mining capabilities to facilitate clinical assessments and translational research in oncology. The proposed System includes a multi-modal, Clinical & Research Data Warehouse (CRDW) that is tightly integrated with a suite of computational and machine-learning tools to provide insight into the underlying tumor characteristics that are not be apparent by human inspection alone. A key distinguishing feature of the System is a configurable Extract, Transform and Load (ETL) interface that enables it to adapt to different clinical and research data environments. This project is motivated by the growing emphasis on establishing Learning Health Systems in which cyclical hypothesis generation and evidence evaluation become integral to improving the quality of patient care. To facilitate iterative prototyping and optimization of the algorithms and workflows for the System, the team has already implemented a fully functional Warehouse that can reliably aggregate information originating from multiple data sources including EHR’s, Clinical Trial Management Systems, Tumor Registries, Biospecimen Repositories, Radiology PAC systems, Digital Pathology archives, Unstructured Clinical Documents, and Next Generation Sequencing services. The System enables physicians to systematically mine and review the molecular, genomic, image-based, and correlated clinical information about patient tumors individually or as part of large cohorts to identify patterns that may influence treatment decisions and outcomes. The CRDW core system has facilitated peer-reviewed publications and funded projects, including an NIH-sponsored collaboration to enhance the cancer registries in Georgia, Kentucky, New Jersey, and New York, with machine-learning based classifications and quantitative pathomics, feature sets. The CRDW has also resulted in a collaboration with the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC) at the U.S. Department of Veterans Affairs to develop algorithms and workflows to automate the analysis of lung adenocarcinoma. Those studies showed that combining computational nuclear signatures with traditional WHO criteria through the use of deep convolutional neural networks (CNNs) led to improved discrimination among tumor growth patterns. The team has also leveraged the Warehouse to support studies to investigate the potential of utilizing a combination of genomic and computational imaging signatures to characterize prostate cancer. The results of those studies show that integrating image biomarkers with genomic pathway scores is more strongly correlated with disease recurrence than using standard clinical markers.

Keywords: clinical data warehouse, decision support, data-mining, intelligent databases, machine-learning.

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Authors: Kevin Yeo, Christine Hall, Babinchak Tim

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BAT® [Botulism Antitoxin Heptavalent (A,B,C,D,E,F,G)-(Equine)] anti-toxin is a mixture of equine immune globulin fragments indicated for the treatment of symptomatic botulism in adult and pediatric patients. The effectiveness of BAT anti-toxin is based on efficacy studies conducted in animal models. A general explanation of the pivotal animal studies, post market surveillance and outcomes of an observational patient registry for patients treated with BAT product distributed in the USA is briefly discussed. Overall it took 20 animal studies for two well-designed and appropriately powered pivotal efficacy studies – one in which the effectiveness of BAT was assessed against all 7 serotypes in the guinea pig, and the other where efficacy is confirmed in the Rhesus macaque using Serotype A. Clinical Experience for BAT to date involves approximately 600 adult and pediatric patients with suspected botulism. In pre-licensure, patient data was recorded under the US CDC expanded access program (259 adult and pediatric patients between 10 days to 88 years of age). In post licensure, greater than 350 patients to date have received BAT and been followed up by enhanced expanded access program. The analysis of the post market surveillance data provided a unique opportunity to demonstrate clinical benefit in the field study required by the animal rule. While the animal rule is applied because human efficacy studies are not ethical or feasible, a post-marketing requirement is to conduct a study to evaluate safety and clinical benefit when circumstances arise and demonstrate the favourable benefit-risk profile that supported licensure.

Keywords: botulism, threat, clinical benefit, observational patient registry

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Authors: Jeanne Grace, Jacqueline Naiker

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Background: Longevity is increasing, accompanied by a rise in disability and chronic diseases with physical activity (PA) delaying disability, ensuring successful aging (SA) and independent living in older adults. Aim: This study aimed to determine objectively measured PA levels, health-related quality of life (HRQoL), life-space mobility, and successful aging (SA) of older adults in KwaZulu-Natal province, South Africa, as well as their mutual associations. Methods: A total of 210 older adults aged 65–92 years were purposively sampled and completed the Medical Outcomes Study 36-Item Short-Form Health Survey, the Life-Space Mobility, and Successful Aging questionnaires. PA levels were measured using an Omron Pedometer, which the participants wore for seven consecutive days. Results: The average number of steps taken per day for the seven days was 2025, with 98.6% of the entire study population classified as sedentary. The Vitality domain (one of 8 categorized) reflected the best health status (M = 59.9, SD ± 18.8), with a significant 93% of the participants indicating that they had not visited places outside their immediate neighborhood (P < 0.0005). A significant, negative association between the average number of steps taken in 7 days and all three SA variables – namely, the physical (r = –0.152, P = 0.027), sociological (r = –0.148, P = 0.032) and psychological (r = –0.176, P = 0.010), and a significant, positive association with life-space mobility (r = 0.224, P = 0.001) was noted. Conclusion: The majority of the elderly were sedentary, affecting their HRQoL, life-space mobility, and SA negatively.

Keywords: active life expectancy, geriatrics, nursing homes, well-being

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Authors: Shutchapol Chopvitayakun

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Internship program is a compulsory course of many undergraduate programs in Thailand. It gives opportunities to a lot of senior students as interns to practice their working skills in the real organizations and also gives chances for interns to face real-world working problems. Interns also learn how to solve those problems by direct and indirect experiences. This program in many schools is a well-structured course with a contract or agreement made with real business organizations. Moreover, this program also offers opportunities for interns to get jobs after completing it from where the internship program takes place. Interns also learn how to work as a team and how to associate with other colleagues, trainers, and superiors of each organization in term of social hierarchy, self-responsibility, and self-disciplinary. This research focuses on senior students of Suan Sunandha Rajabhat University, Thailand whose studying major is information technology program. They practiced their working skills or took internship programs in the real business sector or real operating organizations in 2015-2016. Interns are categorized in to two types: normal program and special program. For special program, students study in weekday evening from Monday to Friday or Weekend and most of them work full-time or part-time job. For normal program, students study in weekday working hours and most of them do not work. The differences of these characters and the outcomes of internship performance were studied and analyzed in this research. This work applied some statistical analytics to find out whether the internship performance of each intern type has different performances statistically or not.

Keywords: internship, intern, senior student, information technology program

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Authors: Bhavna Rajagopal, Mrinmoyi Kulkarni

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Today women experience more menstrual cycles than their ancestors did a hundred years ago, owing to early puberty, fewer pregnancies and dietary changes. Much of the research in menstruation is located in the medical domain with a focus on physical symptoms. The research in psychology is largely concerned with premenstrual syndrome (PMS), whereas the focus in sociology is on social and cultural practices relating to menstruation. Research that simultaneously studies the physical, psychological, social and cultural aspects is lacking. Therefore, in this study, an attempt has been made to identify socio-cultural, psychological and physical factors that interact to influence a woman’s experience of menstruation in the urban setting. The study included seven unmarried women in the age group of 24-30 and data was obtained through a focus group discussion. The transcript of the focus group discussion was thematically analysed. Two major themes relating to the self and social experience of menstruation emerged. Themes relating to the self included menarcheal experiences, self-perception, mood and management of menstrual hygiene and symptoms while themes relating to social experience included the construction of menstruation by family and peers, and cultural factors. Attitudes towards the menstrual cycle appeared to be primarily influenced by severity of symptoms and the resulting disruption to daily life. Outcomes of this study have indicated that future research needs to study menstruation and its impact on women’s wellbeing by adopting a socio-ecological approach and by collecting data using the whole cycle approach across a woman’s reproductive years.

Keywords: India, menstrual cycle, psychosocial approach, wellbeing

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Authors: Remon Karam Zakry Kelada

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This survey research ambitions to examine the usual of carrier quality of meals and beverage provider staffs in lodge business by way of studying the carrier fashionable of 3 pattern inns, Siam Kempinski lodge Bangkok, four Seasons lodge Chiang Mai, and Banyan Tree Phuket. as a way to locate the international provider general of food and beverage provider, triangular research, i.e. quantitative, qualitative, and survey were hired. on this research, questionnaires and in-depth interview have been used for getting the statistics on the sequences and method of services. There had been three components of modified questionnaires to degree carrier pleasant and visitor’s satisfaction inclusive of carrier facilities, attentiveness, obligation, reliability, and circumspection. This observe used pattern random sampling to derive topics with the go back fee of the questionnaires changed into 70% or 280. information have been analyzed via SPSS to find mathematics mean, SD, percent, and comparison by using t-take a look at and One-manner ANOVA. The outcomes revealed that the service first-rate of the three lodges have been in the worldwide stage that could create excessive pride to the international clients. hints for studies implementations have been to hold the area of precise carrier satisfactory, and to enhance some dimensions of service fine together with reliability. training in service fashionable, product expertise, and new generation for employees must be provided. furthermore, for you to develop the provider pleasant of the enterprise, training collaboration among inn corporation and academic institutions in food and beverage carrier should be considered.

Keywords: food and beverage staff, food poisoning, food production, hygiene knowledge BPA, health, regulations, toxicity service standard, food and beverage department, sequence of service, service method

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Authors: Asma Ahmed, Farah Khalid, Sahlah Sohail, Saira Banusokwalla, Sabiha Banu, Inaara Akbar, Safia Awan, Syed Iqbal Azam

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Background and Objectives: The level of knowledge regarding obesity as a disease condition and health-seeking behavior regarding its management is grossly lacking. We present data from our multidisciplinary obesity clinic at the large tertiary care facility in Karachi, Pakistan, to provide baseline profiles and outcomes of patients attending these clinics. Methods: 260 who attended the obesity clinic between June 2018 to March 2020 were enrolled in this study. The analysis included descriptive and ROC analysis to identify the best cut-offs of theanthropometric measurements to diagnose obesity-related comorbid conditions. Results: The majority of the studied population were women (72.3%) and employed(43.7%) with a mean age of 35.5 years. Mean BMIwas 37.4, waist circumference was 112.4 cm, visceral fat was 11.7%, and HbA1C was 6.9%. The most common comorbidities were HTN & D.M (33 &31%, respectively). The prevalence of MetS was 16.3% in patients and was slightly higher in males. Visceral fat was the main factor in predicting D.M (0.750; 95% CI: 0.665, 0.836) and MetS (0.709; 95% CI: 0.590, 0.838) compared to total body fat, waist circumference, and BMI. The risk of predicting DM &MetS for the visceral fat above 9.5% in women had the highest sensitivity (80% for D.M & 79% for MetS) and an NPV (92.75% for D.M & 95% for MetS). Conclusions: This study describes and establishes characteristics of these obese individuals, which can help inform clinical practices. These practices may involve using visceral fat for earlier identification and counseling-based interventions to prevent more severe surgical interventions down the line.

Keywords: obesity, metabolic syndrome, tertiary care facility, BMI, waist circumference, visceral fat

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Authors: Erhong Sun, Xuchun Ye

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Technophobia, namely the fear or dislike of modern advanced technologies, plays a central role in age-related digital divides and is considered a new risk factor for older adults, which can affect the daily lives of people through low adherence to digital living. Indeed, there is considerable heterogeneity in the group of older adults who feel technophobia. Therefore, the aim of this study was to identify different technophobia typologies of older people and to examine their associations with the subjective age factor. A sample of 704 retired elderly over the age of 55 was recruited in China. Technophobia and subjective age were assessed with a questionnaire, respectively. Latent profile analysis was used to identify technophobia subgroups, using three dimensions including techno-anxiety, techno-paranoia, and privacy concerns as indicators. The association between the identified technophobia subgroups and subjective age was explored. In summary, four different technophobia typologies were identified among older adults in China. Combined with an investigation of personal background characteristics and subjective age, it draws a more nuanced image of the technophobia phenome among older adults in China. First, not all older adults suffer from technophobia, with about half of the elderly subjects belonging to the profiles of “Low-technophobia” and “Medium-technophobia.” Second, privacy concern plays an important role in the classification of technophobia among older adults. Third, subjective age might be a protective factor for technophobia in older adults. Although the causal direction between identified technophobia typologies and subjective age remains uncertain, our suggests that future interventions should better focus on subjective age by breaking the age stereotype of technology to reduce the negative effect of technophobia on older. Future development of this research will involve extensive investigation of the detailed impact of technophobia in senior populations, measurement of the negative outcomes, as well as formulation of innovative educational and clinical pathways.

Keywords: technophobia, older adults, latent profile analysis, subjective age

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Authors: Beng Zhen Yeow

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In most work that involves children, the voice of the children is often not heard. This is ironic since a lot of discussions might involve their welfare and safety. It might seem natural that the professionals should hear from them about what they wish for instead of deciding what is best for them. However, this, unfortunately, might be more the exception than the norm in most case and hence in many instances, children are merely 'subjects' in conversations about safety instead of active participants in the construction or creation of safety in the family. There might be many reasons why it does not happen in our work. Firstly, professionals have learnt how to 'socialise' into their professional roles and hence in the process become 'un-childlike'. Secondly, there is also a lack of professional training with regards to how to talk with children. Finally, there might be also a lack of concrete tools and techniques that are developed to facilitate the process. In this paper, the case study method is used to show how the idea of safety could be concretised and discussed with children and their family members, and hence making them active participants and co-creators of their own safety. Specific skills and techniques are highlighted through the case study. In this case, there was improvement in outcomes like no repeated offence or abuse. In addition, children were also able to advocate for their own safety after six months of intervention and how the family members were able to explicitly say what they can do to improve safety. The professionals in the safety network reported significant improvements. On top of that, the abused child who was removed due to child protection concerns, had verbalized observations of change in mother’s parenting abilities, and has requested for home leave to begin due to ownership of safety planning and having confidence to co-create safety for her siblings and herself together with the professionals in the safety network. Children becoming active participants in the co-creation of safety not only serve the purpose in allowing them to own a 'voice' but at the same time, give them greater confidence to protect themselves at home and in other contexts outside of home.

Keywords: partnering for safety, collaborative social work, family and systemic psychotherapy, child protection

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Authors: Haaris Khan, Farhad Udwadia

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South Asians are the fastest-growing immigrant population in Canada and are 3-4 times more likely to develop diabetes. In a primary care setting, language barriers continue to persist as a prominent obstacle when delivering crucial health information. Given the abundance of languages in the South Asian community and the varying levels of English fluency, there is compelling evidence that these language barriers can adversely impact health outcomes. The microvascular and macrovascular complications of poor diabetic management are well established and universally recognized. However, these are often difficult concepts to grasp for even individuals fluent in English. In order to lessen the burden of language barriers, we developed a comprehensive guide in various languages that discuss the complications and screening guidelines for diabetic and prediabetic patients. The guide is presented in the form of a pamphlet, with an electronic version being constructed as well, that provides basic information on diabetic retinopathy, neuropathy and nephropathy as well as the screening recommendations. We also conducted a review of the literature around the topic and incorporated our findings into our project. Our goal is for primary care physicians to have this resource and to be able to provide the link or pamphlet to patients in need. Our presentation also provides a comprehensive overview of some of the other barriers that individuals in the South Asian community face when seeking care. Given the staggering number of individuals in the South Asian community with diabetes and the morbidity and mortality associated with diabetes and its complications, effective community-specific strategies are needed to mitigate the potential consequences of poor diabetes management.

Keywords: diabetes, patient education, ophthalmology, vascular surgery

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Authors: Marjan Mahdavi-Roshan, Arsalan Salari, Mahbobeh Gholipour

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Hypertension is one of the important reasons of morbidity and mortality in countries, including Iran. It has been shown that hypertension is a consequence of the interaction of genetics and environment. Nutrients have important roles in the controlling of blood pressure. We assessed dietary habit and anthropometric status in patients with hypertension in the north of Iran, and that have special dietary habit and according to their culture. This study was conducted on 127 patients with newly recognized hypertension and the 120 normotensive participants. Anthropometric status was measured and demographic characteristics, and medical condition were collected by valid questionnaires and dietary habit assessment was assessed with 3-day food recall (two weekdays and one weekend). The mean age of participants was 58 ± 6.7 years. The mean level of energy intake, saturated fat, vitamin D, potassium, zinc, dietary fiber, vitamin C, calcium, phosphorus, copper and magnesium was significantly lower in the hypertensive group compared to the control (p < 0.05). After adjusting for energy intake, positive association was observe between hypertension and some dietary nutrients including; Cholesterol [OR: 1.1, P: 0.001, B: 0.06], fiber [OR: 1.6, P: 0.001, B: 1.8], vitamin D [OR: 2.6, P: 0.006, B: 0.9] and zinc [OR: 1.4, P: 0.006, B: 0.3] intake. Logistic regression analysis showed that there was not significant association between hypertension, weight and waist circumference. In our study, the mean intake of some nutrients was lower in the hypertensive individuals compared to the normotensive individual. Health training about suitable dietary habits and easier access to vitamin D supplementation in patients with hypertension are cost-effective tools to improve outcomes in Iran.

Keywords: hypertension, north of Iran, dietary intake, weight

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Authors: Binish Ahmed

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Corporate Social Responsibility (CSR) is regarded as voluntary behaviors that contribute to the social welfare based on the concept of sustainable development. The corporations should not only stress on their economic and business outcomes but also pay attention to their effect on the society and environment. It could attract investors and customers, as well as maintain a positive interaction with the government. In spite of the broad diffusion, and its potential significance to employees' perspective, CSR is now examined and has built-in Organizational Behavior (OB), and Human Resource Management (HRM) look into the broad structure of relationship between employees' perspective, work attitudes and behavior to improve the research on CSR. The purpose of this research is to investigate the impact of employees’ perception of CSR on work attitudes and behaviors of employees. A conceptual framework is proposed, based on the literature and practices. The research would conduct the primary data survey of convenient sampling from the employees and managers-using detailed questionnaire- to address the following questions. The survey of 180 respondents of age greater than 20 having at least six-month experience from companies based in Karachi are source of data. The application of professional empirical models for data analysis and interpretation are source to draw the conclusion. 1. What are the dynamics of CSR in an organization? Why is it important to have a CSR department? What sort of business approach are CSR activities practiced? Do CSR activities improve the quality of life of workplace? And, how it linked with welfare of society? 2. How the positive job attitude and behavior does encourage the employees about the perception of CSR? How is it linked with the job satisfaction? What is the relationship between employees’ perception of CSR and job satisfaction?

Keywords: corporate social responsibility, job satisfaction, organizational commitment, work behaviors

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Authors: Yemane Hailu Fissuh, Zhongzhan Zhang

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An estimating equation technique is an alternative method of the widely used maximum likelihood methods, which enables us to ease some complexity due to the complex characteristics of time-varying covariates. In the situations, when both the time-varying covariates and left-truncation are considered in the model, the maximum likelihood estimation procedures become much more burdensome and complex. To ease the complexity, in this study, the modified estimating equations those have been given high attention and considerations in many researchers under semiparametric transformation model was proposed. The purpose of this article was to develop the modified estimating equation under flexible and general class of semiparametric transformation models for left-truncated and right censored survival data with time-varying covariates. Besides the commonly applied Cox proportional hazards model, such kind of problems can be also analyzed with a general class of semiparametric transformation models to estimate the effect of treatment given possibly time-varying covariates on the survival time. The consistency and asymptotic properties of the estimators were intuitively derived via the expectation-maximization (EM) algorithm. The characteristics of the estimators in the finite sample performance for the proposed model were illustrated via simulation studies and Stanford heart transplant real data examples. To sum up the study, the bias for covariates has been adjusted by estimating density function for the truncation time variable. Then the effect of possibly time-varying covariates was evaluated in some special semiparametric transformation models.

Keywords: EM algorithm, estimating equation, semiparametric transformation models, time-to-event outcomes, time varying covariate

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Authors: Zahra Asgharpour, Eric Renteria, Sebastian De Boodt

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There is a growing trend towards personalization of medical care, as evidenced by the emphasis on outcomes based medicine, the latest developments in CT and MR imaging and personalized treatment in a variety of surgical disciplines. 3D Printing has been introduced and applied in the medical field since 2000. The first applications were in the field of dental implants and custom prosthetics. According to recent publications, 3D printing in the medical field has been used in a wide range of applications which can be organized into several categories including implants, prosthetics, anatomical models and tissue bioprinting. Some of these categories are still in their infancy stage of the concept of proof while others are in application phase such as the design and manufacturing of customized implants and prosthesis. The approach of 3D printing in this category has been successfully used in the health care sector to make both standard and complex implants within a reasonable amount of time. In this study, some of the clinical applications of 3D printing in design and manufacturing of a patient-specific hip implant would be explained. In cases where patients have complex bone geometries or are undergoing a complex revision on hip replacement, the traditional surgical methods are not efficient, and hence these patients require patient-specific approaches. There are major advantages in using this new technology for medical applications, however, in order to get this technology widely accepted in medical device industry, there is a need for gaining more acceptance from the medical device regulatory offices. This is a challenge that is moving onward and will help the technology find its way at the end as an accepted manufacturing method for medical device industry in an international scale. The discussion will conclude with some examples describing the future directions of 3D Medical Printing.

Keywords: CT/MRI, image processing, 3D printing, medical devices, patient specific implants

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Authors: Tafadzwa Shumba, Rose C. Nyatondo, Regret Sunge

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This research analyses the impact of budget deficits on the economic performance of Zimbabwe. The study employs the autoregressive distributed lag (ARDL) confines testing method to co-integration and long-run estimation using time series data from 1980-2018. The Augmented Dick Fuller (ADF) and the Granger approach were used to testing for stationarity and causality among the factors. Co-integration test results affirm a long term association between GDP development rate and descriptive factors. Causality test results show a unidirectional connection between budget shortfall to GDP development and bi-directional causality amid debt and budget deficit. This study also found unidirectional causality from debt to GDP growth rate. ARDL estimates indicate a significantly positive long term and significantly negative short term impact of budget shortfall on GDP. This suggests that budget deficits have a short-run growth retarding effect and a long-run growth-inducing effect. The long-run results follow the Keynesian theory that posits that fiscal deficits result in an increase in GDP growth. Short-run outcomes follow the neoclassical theory. In light of these findings, the government is recommended to minimize financing of recurrent expenditure using a budget deficit. To achieve sustainable growth and development, the government needs to spend an absorbable budget deficit focusing on capital projects such as the development of human capital and infrastructure.

Keywords: ARDL, budget deficit, economic performance, long run

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Authors: Peng Chun-Yi, Chen Wei-Hsuan, Ueng Shyh-Kuang

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This study focuses on the application of self-organizing maps (SOM) technology in analyzing credit card transaction data, aiming to enhance the accuracy and efficiency of fraud detection. Som, as an artificial neural network, is particularly suited for pattern recognition and data classification, making it highly effective for the complex and variable nature of credit card transaction data. By analyzing transaction characteristics with SOM, the research identifies abnormal transaction patterns that could indicate potentially fraudulent activities. Moreover, this study has developed a specialized visualization tool to intuitively present the relationships between SOM analysis outcomes and transaction data, aiding financial institution personnel in quickly identifying and responding to potential fraud, thereby reducing financial losses. Additionally, the research explores the integration of SOM technology with composite intelligent system technologies (including finite state machines, fuzzy logic, and decision trees) to further improve fraud detection accuracy. This multimodal approach provides a comprehensive perspective for identifying and understanding various types of fraud within credit card transactions. In summary, by integrating SOM technology with visualization tools and composite intelligent system technologies, this research offers a more effective method of fraud detection for the financial industry, not only enhancing detection accuracy but also deepening the overall understanding of fraudulent activities.

Keywords: self-organizing map technology, fraud detection, information visualization, data analysis, composite intelligent system technologies, decision support technologies

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Authors: Nilanchali Singh, Alka Kriplani, Reeta Mahey, Garima Kachhawa

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Objective: Resection of larger uterine septa does improve obstetric performance but whether smaller septa need resection and their impact on obstetric outcome is not clear. We wanted to evaluate the role of septal resection of septa of various sizes in obstetric performance. Methods: This retrospective cohort study comprised of 107 patients with uterine septum. The patients were categorized on the basis of extent of uterine septum into four groups: a) Subsepta (< 1/3rd), b) Septum > 1/3 to ½, c) Septum>1/2 to whole uterine cervix, d) Septum traversing whole of uterine cavity and cervix. Out of these 107 patients, 74 could be contacted telephonically and outcomes recorded. Sensitivity and specificity of investigative modalities were calculated. Results: Infertility was seen in maximum number of cases in complete septa (100%), whereas abortions were seen more commonly, in subsepta (18%). MRI had maximum sensitivity and positive predictive value, followed by hysteron-salpingography. Tubal block, fibroid, endometriosis, pelvic adhesions, ovarian pathologies were seen in some but no definite association of these pathologies was seen with any subgroup of septa. Almost five-year follow-up was recorded in all the subgroups. Significant reduction in infertility was seen in all septal subgroup (p=0.046, 0.032 & 0.05) patients except in subsepta (< 1/3rd uterine cavity) after septum resection. Abortions were significantly reduced (p=0.048) in third subgroup (i.e. septum > ½ to upto internal os) after hysteroscopic septum resection. Take home baby rate was 33% in subsepta and around 50% in the remaining subgroups of septa. Conclusions: Septal resection improves obstetric performance in patients with uterine septa of various sizes. Whether septal resection improves obstetric performance in patients with subsepta or very small septa, is controversial. Larger studies addressing this issue need to be planned.

Keywords: septal resection, obstetric outcome, infertility, septum size

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Authors: Lakmali Anthony, Madeline Gillies

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Purpose: Decreasing mortality has led to increased focus on patient-reported outcomes such as quality of life (QoL) in breast cancer. Breast cancer patients often have decreased QoL even after treatment is complete. This systematic review of the literature aims to identify psychosocial factors associated with decreased QoL in post-treatment breast cancer patients. Methodology: This systematic review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The search was conducted in MEDLINE, EMBASE, and PsychINFO using MeSH headings. The two authors screened studies for relevance and extracted data. Results: Seventeen studies were identified, including 3,150 total participants (mean = 197) with a mean age of 51.9 years. There was substantial heterogeneity in measures of QoL. The most common was the European Organisation for Research and Treatment of Cancer QLQ-C30 (n=7, 41.1%). Most studies (n=12, 70.5%) found that emotional distress correlated with poor QoL, while 3 found no significant association. The most common measure of emotional distress was the Hospital Anxiety and Depression Scale (n=12, 70.5%). Other psychosocial factors associated with QoL were unmet needs, problematic social support, and negative affect. Clinicopathologic determinants included mastectomy without reconstruction, stage IV disease, and adjuvant chemotherapy. Conclusion: This systematic review provides a summary of the psychosocial determinants of poor QoL in post-treatment breast cancer patients, as well as the most commonly reported measures of these. An understanding of these potentially modifiable determinants of poor outcome is pivotal to the provision of quality, patient-centred care in surgical oncology.

Keywords: breast cancer, quality of life, psychosocial determinants, cancer surgery

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Authors: Levent Dumenci, Laura A. Siminoff

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Health literacy has been shown to predict a variety of health outcomes. Reliable identification of persons with limited cancer health literacy (LCHL) has been proved questionable with existing instruments using an arbitrary cut point along a continuum. The CHLT-6, however, uses a latent mixture modeling approach to identify persons with LCHL. The purpose of this study was to estimate two-week and six-month stability of identifying persons with LCHL using the CHLT-6 with a discrete latent variable approach as the underlying measurement structure. Using a test-retest design, the CHLT-6 was administered to cancer patients with two-week (N=98) and six-month (N=51) intervals. The two-week and six-month latent test-retest agreements were 89% and 88%, respectively. The chance-corrected latent agreements estimated from Dumenci’s latent kappa were 0.62 (95% CI: 0.41 – 0.82) and .47 (95% CI: 0.14 – 0.80) for the two-week and six-month intervals, respectively. High levels of latent test-retest agreement between limited and adequate categories of cancer health literacy construct, coupled with moderate to good levels of change-corrected latent agreements indicated that the CHLT-6 classification of limited versus adequate cancer health literacy is relatively stable over time. In conclusion, the measurement structure underlying the instrument allows for estimating classification errors circumventing limitations due to arbitrary approaches adopted by all other instruments. The CHLT-6 can be used to identify persons with LCHL in oncology clinics and intervention studies to accurately estimate treatment effectiveness.

Keywords: limited cancer health literacy, the CHLT-6, discrete latent variable modeling, latent agreement

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Authors: Hashim Zameer

Abstract:

Effective tourism management plays a vital role in promoting sustainability and supporting ecosystems. A common principle that has been in practice over the years is “first pollute and then clean,” indicating countries need financial resources to promote sustainability. Financial development and the tourism management both seems very important to promoting sustainable development. However, without institutional support, it is very difficult to succeed. In this context, it seems prominently significant to explore how institutional quality, tourism development, and financial development could promote sustainable development. In the past, no research explored the role of tourism development in sustainable development. Moreover, the role of financial development, natural resources, and institutional quality in sustainable development is also ignored. In this regard, this paper aims to investigate the role of tourism development, natural resources, financial development, and institutional quality in sustainable development in China. The study used time-series data from 2000–2021 and employed the Bayesian linear regression model because it is suitable for small data sets. The robustness of the findings was checked using a quantile regression approach. The results reveal that an increase in tourism expenditures stimulates the economy, creates jobs, encourages cultural exchange, and supports sustainability initiatives. Moreover, financial development and institution quality have a positive effect on sustainable development. However, reliance on natural resources can result in negative economic, social, and environmental outcomes, highlighting the need for resource diversification and management to reinforce sustainable development. These results highlight the significance of financial development, strong institutions, sustainable tourism, and careful utilization of natural resources for long-term sustainability. The study holds vital insights for policy formulation to promote sustainable tourism.

Keywords: sustainability, tourism development, financial development, institutional quality

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Authors: Meriem Bahij, Ahmed Nafidi, Boujemâa Achchab, Sílvio M. A. Gama, José A. O. Matos

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Stochastic modeling concerns the use of probability to model real-world situations in which uncertainty is present. Therefore, the purpose of stochastic modeling is to estimate the probability of outcomes within a forecast, i.e. to be able to predict what conditions or decisions might happen under different situations. In the present study, we present a model of a stochastic diffusion process based on the bi-Weibull distribution function (its trend is proportional to the bi-Weibull probability density function). In general, the Weibull distribution has the ability to assume the characteristics of many different types of distributions. This has made it very popular among engineers and quality practitioners, who have considered it the most commonly used distribution for studying problems such as modeling reliability data, accelerated life testing, and maintainability modeling and analysis. In this work, we start by obtaining the probabilistic characteristics of this model, as the explicit expression of the process, its trends, and its distribution by transforming the diffusion process in a Wiener process as shown in the Ricciaardi theorem. Then, we develop the statistical inference of this model using the maximum likelihood methodology. Finally, we analyse with simulated data the computational problems associated with the parameters, an issue of great importance in its application to real data with the use of the convergence analysis methods. Overall, the use of a stochastic model reflects only a pragmatic decision on the part of the modeler. According to the data that is available and the universe of models known to the modeler, this model represents the best currently available description of the phenomenon under consideration.

Keywords: diffusion process, discrete sampling, likelihood estimation method, simulation, stochastic diffusion process, trends functions, bi-parameters weibull density function

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Authors: Taurai T. Chikotie, Bruce W. Watson

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The manifestation of ‘new’ infectious diseases and the re-emergence of ‘old’ infectious diseases now present global problems and Southern Africa has not been spared from such calamity. Although having an organized public health system, countries in this region have failed to leverage on the proliferation in use of Information and Communication Technologies to promote effective disease surveillance. Objective: The objective of this study was to critically review and analyse the crucial variables to consider in the development and implementation of electronic disease surveillance systems in public health within the context of Southern Africa. Methodology: A critical review of literature published in English using, Google Scholar, EBSCOHOST, Science Direct, databases from the Centre for Disease Control (CDC and articles from the World Health Organisation (WHO) was undertaken. Manual reference and grey literature searches were also conducted. Results: Little has been done towards harnessing the potential of information technologies towards disease surveillance and this has been due to several challenges that include, lack of funding, lack of health informatics experts, poor supporting infrastructure, an unstable socio-political and socio-economic ecosystem in the region and archaic policies towards integration of information technologies in public health governance. Conclusion: The Southern African region stands to achieve better health outcomes if they adopt the use of e-disease surveillance systems in public health. However, the dynamics and complexities of the socio-economic, socio-political and technical variables would need addressing to ensure the successful development and implementation of e-disease surveillance systems in the region.

Keywords: critical review, disease surveillance, public health informatics, Southern Africa

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