Search results for: public score

Authors: Rozelle Labuschagne, Ronel Roos

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Individuals often experience a reduction in physical function, quality of life and basic activities of daily living after surgery. This is exponentially true for high-risk patients, especially the elderly and frail individuals. Not much is known about the physical function, physical activity preferences and factors associated with the six-minute walk test of elderly individuals who would undergo elective abdominal surgery in South Africa. Such information is important to design effective prehabilitation physiotherapy programs prior to elective surgery. The purpose of the study was to describe the demographic profile and physical function of elderly patients who would undergo elective surgery and to determine factors associated with their six-minute walk test distance findings. A cross-sectional descriptive study in elderly patients older than 60 years of age who would undergo elective abdominal surgery were consecutively sampled at a private hospital in Pretoria, South Africa. Participants’ demographics were collected and physical function assessed with the Functional Comorbidity Index (FCI), DeMorton Mobility Index (DEMMI), Lawton-Brody Instrumental Activities of Daily Living Scale (IADL) and six-minute walk test (6MWT). Descriptive and inferential statistics were used for data analysis with IBM SPSS 25. A p-value ≤ 0.05 were deemed statistically significant. The pilot study consisted of 12 participants (female (n=11, 91.7%), male (n=1, 8.3%) with a mean age of 65.8 (±4.5) years, body mass index of 28 (±4.2) kg.m2 with one (8.3%) participant being a current smoker and four (33.3%) participants having a smoking history. Nine (75%) participants lived independently at home and three (25%) had caregivers. Participants reported walking (n=6, 50%), stretching exercises (n=1, 8.3%), household chores & gardening (n=2, 16.7%), biking/swimming/running (n=1, 8.3%) as physical activity preferences. Physical function findings of the sample were: mean FCI score 3 (±1.1), DEMMI score 81.1 (±14.9), IADL 95 (±17.3), 6MWT 435.50 (IQR 364.75-458.50) with percentage 6MWT distance achieved 81.8% (IQR 64.4%-87.5%). A strong negative correlation was observed between 6MWT distance walked and FCI (r = -0.729, p=0.007). The majority of study participants reported incorporating some form of physical activity into their daily life as form of exercise. Most participants did not achieve their predicted 6MWT distance indicating less than optimal levels of physical function capacity. The number of comorbidities as determined by the FCI was associated with the distance that participants could walk with the 6MWT. The results of this pilot study could be used to indicate which elderly individuals would benefit most from a pre-surgical rehabilitation program. The main goal of such a program would be to improve physical function capacity as measured by the 6MWT. Surgeons could refer patients based on age and number of comorbidities, as determined by the FCI, to potentially improve surgical outcomes.

Keywords: abdominal surgery, elderly, physical function, six-minute walk test

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Authors: M. Iqbal Hossain, Azharul Islam Khan, S. M. Rafiqul Islam, Tahmeed Ahmed

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Objective: Moderate acute malnutrition (MAM) is a major cause of morbidity and mortality in under-5 children of low-income countries. Approximately 14.6% of all under-5 mortality worldwide is attributed to MAM with >3 times increased risk of death compared to well-nourished peers. Prevalence of MAM among under-5 children in Bangladesh is ~12% (~1.7 million). Providing a diet containing adequate nutrients is the mainstay of treatment of children with MAM. It is now possible to process fish into fish peptides with longer shelf-life without refrigerator, known as ‘Fish Surimi peptide’ and this could be an attractive alternative to supply fish protein in the diet of children in low-income countries like Bangladesh. We conducted this study to assess the acceptability of Fish Surimi peptide given with various foods/meals in 2-5 years old children with MAM. Design/methods: Fish Surimi peptide is broken down from white fish meat using plant-derived enzyme and the ingredient is just fish meat consisted of 20 different kinds of amino acids including nine essential amino acids. In a convenience sample of 34 children we completed the study ward of Dhaka Hospital of icddr,b in Bangladesh during November 2014 through February 2015. For each child the study was for two consecutive days: i.e. direct observation of food intake of two lunches and two suppers. In a randomly and blinded manner and cross over design an individual child received Fish Surimi peptide (5g at lunch and 5g at supper) mixed meal [e.g. 30g rice and 30g dahl (thick lentil soup) or 60g of a vegetables-lentil-rice mixed local dish known as khichuri in one day and the same meal on other day without any Fish Surimi peptide. We observed the completeness and eagerness of eating and any possible side effect (e.g. allergy, vomiting, diarrhea etc.) over these two days. Results: The mean±SD age of the enrolled children was 38.4±9.4 months, weight 11.22±1.41 kg, height 91.0±6.3 cm, and WHZ was -2.13±0.76. Their mean±SD total feeding time (minutes) for lunch was 25.4±13.6 vs. 20.6±11.1 (p=0.130) and supper was 22.3±9.7 vs. 19.7±11.2 (p=0.297), and total amount (g) of food eaten in lunch and supper was found similar 116.1±7.0 vs. 117.7±8.0 (p=3.01) in A (Fish Surimi) and B group respectively. Score in Hedonic scale by mother on test of food given to children at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) and on overall acceptance (including the texture, smell, and appearance) of food at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) for A and B group respectively. No adverse event was observed in any food group during the study period. Conclusions: Fish Surimi peptide may be a cost effective supplementary food, which should be tested by appropriately designed randomized community level intervention trial both in wasted children and stunted children.

Keywords: protein-energy malnutrition, moderate acute malnutrition, weight-for-height z-score, mid upper arm circumference, acceptability, fish surimi peptide, under-5 children

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Authors: O. Y. Yurieva, O. V. Yurieva, O. V. Kiselkina, A. V. Kamaseva

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Since the early 2000s, there are some innovative changes in the civil service in Russia due to administrative reform. Perspectives of the reform of the civil service include a fundamental change in the personnel component, increasing the level of professionalism of officials, increasing their capacity for self-organization and self-regulation. In order to achieve this, the civil service must be able to continuously change. Organizational changes have long become the subject of scientific understanding; problems of research in the field of organizational change is presented by topics focused on the study of the methodological aspects of the implementation of the changes, the specifics of changes in different types of organizations (business, government, and so on), design changes in the organization, including based on the change in organizational culture. In this case, the organizational changes in the civil service are the least studied areas; research of problems of its transformation is carried out in fragments. According to the theory of resistance of Herbert Simon, the root of the opposition and rejection of change is in the person who will resist any change, if it threatens to undermine the degree of satisfaction as a member of the organization (regardless of the reasons for this change). Thus, the condition for successful adaptation to changes in the organization is the ability of its staff to perceive innovation. As part of the problem, the study sought to identify the innovation civil servants, to determine readiness for the development of proposals for the implementation of organizational change in the public service. To identify the relationship to organizational changes case study carried out by the method of "Attitudes to organizational change" of I. Motovilina, which allowed predicting the type of resistance to changes, to reveal the contradictions and hidden results. The advantage of the method of I. Motovilina is its brevity, simplicity, the analysis of the responses to each question, the use of "overlapping" issues potentially conflicting factors. Based on the study made by the authors, it was found that respondents have a positive attitude to change more local than those that take place in reality, such as "increase opportunities for professional growth", "increase the requirements for the level of professionalism of", "the emergence of possible manifestations initiatives from below". Implemented by the authors diagnostics related to organizational changes in the public service showed the presence of specific problem areas, with roots in the lack of understanding of the importance of innovation personnel in the process of bureaucratization of innovation in public service organizations.

Keywords: innovative changes, self-organization, self-regulation, civil service

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Authors: John Zacharias, Bin Wang

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Travel comfort is increasingly seen as crucial to effecting the switch from private motorized modes to public transit. Surveys suggest that travel comfort is closely related to perceived crowding, that may involve lack of available seating, difficulty entering and exiting, jostling and other physical contacts with strangers. As found in studies on environmental stress, other factors may moderate perceptions of crowding–in this case, we hypothesize that the ambient environment may play a significant role. Travel comfort was measured by applying a structured survey to randomly selected passengers (n=369) on 3 lines of the Beijing metro on workdays. Respondents were standing with all seats occupied and with car occupancy at 14 levels. A second research assistant filmed the metro car while passengers were interviewed, to obtain the total number of passengers. Metro lines 4, 6 and 10 were selected that travel through the central city north-south, east-west and circumferentially. Respondents evaluated the following factors: crowding, noise, smell, air quality, temperature, illumination, vibration and perceived safety as they experienced them at the time of interview, and then were asked to rank these 8 factors according to their importance for their travel comfort. Evaluations were semantic differentials on a 7-point scale from highly unsatisfactory (-3) to highly satisfactory (+3). The control variables included age, sex, annual income and trip purpose. Crowding was assessed most negatively, with 41% of the scores between -3 and -2. Noise and air quality were also assessed negatively, with two-thirds of the evaluations below 0. Illumination was assessed most positively, followed by crime, vibration and temperature, all scoring at indifference (0) or slightly positive. Perception of crowding was linearly and positively related to the number of passengers in the car. Linear regression tested the impact of ambient environmental factors on perception of crowding. Noise intensity accounted for more than the actual number of individuals in the car in the perception of crowding, with smell also contributing. Other variables do not interact with the crowding variable although the evaluations are distinct. In all, only one-third of the perception of crowding (R2=.154) is explained by the number of people, with the other ambient environmental variables accounting for two-thirds of the variance (R2=.316). However, when ranking the factors by their importance to travel comfort, perceived crowding made up 69% of the first rank, followed by noise at 11%. At rank 2, smell dominates (25%), followed by noise and air quality (17%). Commuting to work induces significantly lower evaluations of travel comfort with shopping the most positive. Clearly, travel comfort is particularly important to commuters. Moreover, their perception of crowding while travelling on metro is highly conditioned by the ambient environment in the metro car. Focussing attention on the ambient environmental conditions of the metro is an effective way to address the primary concerns of travellers with overcrowding. In general, the strongly held opinions on travel comfort require more attention in the effort to induce ridership in public transit.

Keywords: ambient environment, mass rail transit, public transit, travel comfort

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Authors: Lamiaa Shehata

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The current (COVID-19) pandemic is one of the international crises, and a lot of efforts have been directed toward the improvement of efficient vaccines, however vaccine hesitancy is one of the universal menaces that make the fulfillment of society immunity very hard. The World Health Organization acknowledges vaccine hesitancy as the society’s maximum risk to people's health protection, especially in little and moderate-revenue nations. Social media is strong in observing audience behaviors and evaluating the circulation, which would supply useful data for strategy makers. It has a significant function in spreading facts during the pandemic, it could assist to boost protective manners. The objective of this study is to determine the effects of social media exposure on vaccine hesitancy. Data were collected using a survey in a form of a structured questionnaire conducted during December 2021- January 2022 using convenient sampling techniques (680) in Egypt and the United Arab Emirates. The results revealed that there was a significant relationship between the high exposure to social media and the refusal of the Covid19 vaccine also, the percentage of the refusal of the vaccine is higher in Egypt, however, UAE forced people to take the vaccine. Furthermore, public attitudes toward COVID-19 vaccination vary from gender and region. In conclusion, policymakers must adjust their policies through the use of social media to immediate actions to vaccine-related news to support vaccination approval.

Keywords: COVID-19, hesitancy, social media, vaccine

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Authors: Jennifer Wallbrown

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It’s not uncommon in the US to see news article headlines about public school teachers being scrutinized for what they are teaching or see the general public weighing in on whether or not they think certain controversial subjects should be addressed in the classroom- such as LGBTQ+ or multicultural literature. Even though this is a subject that has been written about and discussed for years, it continues to be a relevant topic in education as it continues to be a struggle to implement more diverse texts. Although it is valid for teachers to fear controversy when they attempt to create a more diverse or inclusive curriculum, it is a fight worth fighting because of the benefits students can gain from being exposed to a wide range of texts. This paper is different from others of its kind because it addresses many of the counterarguments often made to implementing LGBTQ+ or multicultural literature in secondary classrooms. It not only encourages educators to try to include more diverse texts, but it gives them the tools to address common concerns and be sound in their reasoning for choosing these texts. This can be of interest to those educators who are not English teachers because a truly diverse and inclusive curriculum would include other subjects as well- including history, art, and more. By the end of my proposed paper, readers will feel encouraged to choose more diverse and inclusive texts for their classrooms. They can also be confident that if met with opposition or controversy, as is sometimes common when implementing new texts, that they have sound arguments and reasoning for why they chose to include these texts. This reasoning is that, based on the research, studies have found there are benefits to students studying texts about those different from themselves, because it teaches them empathy and helps fight prejudice.

Keywords: education, diverse, inclusive, multicultural, lgbtq+, pedagogy

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Authors: Piotr Tylec, Alicja Dudek, Grzegorz Torbicz, Magdalena Mizera, Natalia Gajewska, Michael Su, Tanawat Vongsurbchart, Tomasz Stefura, Magdalena Pisarska, Mateusz Rubinkiewicz, Piotr Malczak, Piotr Major, Michal Pedziwiatr

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Introduction: Quality of life after bariatric surgery is an important factor when evaluating the final result of the treatment. Considering the vast surgical options, we tried to globally compare available methods in terms of quality of following the surgery. The aim of the study is to compare the quality of life a year after bariatric intervention using network meta-analysis methods. Material and Methods: We performed a systematic review according to PRISMA guidelines with Bayesian network meta-analysis. Inclusion criteria were: studies comparing at least two methods of weight loss treatment of which at least one is surgical, assessment of the quality of life one year after surgery by validated questionnaires. Primary outcomes were quality of life one year after bariatric procedure. The following aspects of quality of life were analyzed: physical, emotional, general health, vitality, role physical, social, mental, and bodily pain. All questionnaires were standardized and pooled to a single scale. Lifestyle intervention was considered as a referenced point. Results: An initial reference search yielded 5636 articles. 18 studies were evaluated. In comparison of total score of quality of life, we observed that laparoscopic sleeve gastrectomy (LSG) (median (M): 3.606, Credible Interval 97.5% (CrI): 1.039; 6.191), laparoscopic Roux en-Y gastric by-pass (LRYGB) (M: 4.973, CrI: 2.627; 7.317) and open Roux en-Y gastric by-pass (RYGB) (M: 9.735, CrI: 6.708; 12.760) had better results than other bariatric intervention in relation to lifestyle interventions. In the analysis of the physical aspects of quality of life, we notice better results in LSG (M: 3.348, CrI: 0.548; 6.147) and in LRYGB procedure (M: 5.070, CrI: 2.896; 7.208) than control intervention, and worst results in open RYGB (M: -9.212, CrI: -11.610; -6.844). Analyzing emotional aspects, we found better results than control intervention in LSG, in LRYGB, in open RYGB, and laparoscopic gastric plication. In general health better results were in LSG (M: 9.144, CrI: 4.704; 13.470), in LRYGB (M: 6.451, CrI: 10.240; 13.830) and in single-anastomosis gastric by-pass (M: 8.671, CrI: 1.986; 15.310), and worst results in open RYGB (M: -4.048, CrI: -7.984; -0.305). In social and vital aspects of quality of life, better results were observed in LSG and LRYGB than control intervention. We did not find any differences between bariatric interventions in physical role, mental and bodily aspects of quality of life. Conclusion: The network meta-analysis revealed that better quality of life in total score one year after bariatric interventions were after LSG, LRYGB, open RYGB. In physical and general health aspects worst quality of life was in open RYGB procedure. Other interventions did not significantly affect the quality of life after a year compared to dietary intervention.

Keywords: bariatric surgery, network meta-analysis, quality of life, one year follow-up

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Authors: Paawani Tewari, Oishik Dasgupta

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Cinema and politics have often intertwined in India. Movies have become a mainstream method of communication with audiences and voters subliminally and directly. Indian film industry on average produces over a thousand films in a year, and during the election year of 2019, India witnessed the release of several highly political movies. Movies such as Uri: The Surgical Strike, Accidental Prime Minister, and PM Modi, et cetera, which are the sample of this study have tried to depict an ideal character of political stalwart leaders with the plausibility to inspire and aiming to change ideological orientations of viewers and the potent voters. This study tries to understand the major links between nationalism, its representation, and its manifestation in Indian cinema and how it is instrumental in shaping the character and orientations of its citizens towards nation, nationalism, and nationhood. Our work aims to highlight how nationalistic assumptions that are swaddled in the Hindi movies released during January 2019 – May 2019 affect the political mood of the nation and, in totality, the democratic system. The authors also try to throw light on how films being a powerful tool, are now being used to shape ideas, brainwashing and swaying opinions for political mileage. Hence it becomes essential for us to explore the dynamics between the quintessential definitions of what nationalism is for a common man in India versus of what has been represented in cinema, especially during the time of the elections.

Keywords: political governance and political analysis, political and public administration, election, public choice

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Authors: Daniela Pisu

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The paper deals with the issue of territorial inequalities focused on the gap of the marginalization of inland areas with respect to the centrality of urban centers as they are subjected to an almost unstoppable demographic hemorrhage in a context marked by the tendency to depopulation such as the Sardinian territory, to which are added further and intense phenomena of de-anthropization. The research question is aimed at exploring the functionality of the interventions envisaged by the Piano Nazionale Ripresa Resilienza for the reduction of territorial imbalances in these areas to the extent that it is possible to identify policy strategies aimed at increasing the relational expertise of citizenship, functional to the consolidation of results in a long-term perspective. In order to answer this question, the qualitative case study on the Municipality of Ulàssai (province of Nuoro) is highlighted as the only winner on the island, with the Pilot Project ‘Where nature meets art’, intended for the cultural and social regeneration of small towns. The main findings, which emerged from the analysis of institutional sources and secondary data, highlight the socio-demographic fragility of the territory in the face of the active institutional commitment to make Ulàssai a smart community, starting from the enhancement of natural resources and the artistic heritage of fellow citizen Maria Lai. The findings drawn from the inspections and focus groups with the youth population present the aforementioned project as a generative opportunity for both the economic and social fabric, leveraging the public debates of the living labs, where the process of public communication becomes the main vector for the exercise of the rights of participatory democracy. The qualitative lunge leads to the conclusion that the repercussions envisaged by the PNRR in internal areas will be able to show their self-sustainable effect through colloquial administrations such as that of Ulàssai, capable of seeing in the interactive paradigm of public communication that natural process with which to reduce that historical sense of extraneousness attributed to the institution-citizenship relationship.

Keywords: social labs, smart community, depopulation, Sardinia, Piano Nazionale di Ripresa e Resilienza

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Authors: Sadeem Aljamaan, Reem Hariri, Rahaf Alghamdi, Batool Alotaibi, Batool Alsenan, Lama Althunayyan, Areej Alnemer

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The aim of this study is to correlate between radiological findings and histopathological results in regard to the breast imaging-reporting and data system scores, size of breast masses, molecular subtypes and suspicious radiological features, as well as to assess the concordance rate in histological grade between core biopsy and surgical excision among breast cancer patients, followed by analyzing the change of concordance rate in relation to neoadjuvant chemotherapy in a Saudi population. A retrospective review was conducted over 6-year period (2017-2022) on all breast core biopsies of women preceded by radiological investigation. Chi-squared test (χ2) was performed on qualitative data, the Mann-Whitney test for quantitative non-parametric variables, and the Kappa test for grade agreement. A total of 641 cases were included. Ultrasound, mammography, and magnetic resonance imaging demonstrated diagnostic accuracies of 85%, 77.9% and 86.9%; respectively. magnetic resonance imaging manifested the highest sensitivity (72.2%), and the lowest was for ultrasound (61%). Concordance in tumor size with final excisions was best in magnetic resonance imaging, while mammography demonstrated a higher tendency of overestimation (41.9%), and ultrasound showed the highest underestimation (67.7%). The association between basal-like molecular subtypes and the breast imaging-reporting and data system score 5 classifications was statistically significant only for magnetic resonance imaging (p=0.04). Luminal subtypes demonstrated a significantly higher percentage of speculation in mammography. Breast imaging-reporting and data system score 4 manifested a substantial number of benign pathologies in all the 3 modalities. A fair concordance rate (k= 0.212 & 0.379) was demonstrated between excision and the preceding core biopsy grading with and without neoadjuvant therapy, respectively. The results demonstrated a down-grading in cases post-neoadjuvant therapy. In cases who did not receive neoadjuvant therapy, underestimation of tumor grade in biopsy was evident. In summary, magnetic resonance imaging had the highest sensitivity, specificity, positive predictive value and accuracy of both diagnosis and estimation of tumor size. Mammography demonstrated better sensitivity than ultrasound and had the highest negative predictive value, but ultrasound had better specificity, positive predictive value and accuracy. Therefore, the combination of different modalities is advantageous. The concordance rate of core biopsy grading with excision was not impacted by neoadjuvant therapy.

Keywords: breast cancer, mammography, MRI, neoadjuvant, pathology, US

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Authors: D. Garg, S. Luthra, A. Haleem

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Due to growing concern about environmental and social consequences throughout the world, a need has been felt to incorporate sustainability concepts in conventional manufacturing. This paper is an attempt to identify and evaluate drivers in implementing sustainable manufacturing in Indian context. Nine possible drivers for successful implementation of sustainable manufacturing have been identified from extensive review. Further, Decision Making Trial and Evaluation Laboratory (DEMATEL) approach has been utilized to evaluate and categorize these identified drivers for implementing sustainable manufacturing in to the cause and effect groups. Five drivers (Societal Pressure and Public Concerns; Regulations and Government Policies; Top Management Involvement, Commitment and Support; Effective Strategies and Activities towards Socially Responsible Manufacturing and Market Trends) have been categorized into the cause group and four drivers (Holistic View in Manufacturing Systems; Supplier Participation; Building Sustainable culture in Organization; and Corporate Image and Benefits) have been categorized into the effect group. “Societal Pressure and Public Concerns” has been found the most critical driver and “Corporate Image and Benefits” as least critical or the most easily influenced driver to implementing sustainable manufacturing in Indian context. This paper may surely help practitioners in better understanding of these drivers and their priorities towards effective implementation of sustainable manufacturing.

Keywords: drivers, decision making trial and evaluation laboratory (DEMATEL), India, sustainable manufacturing

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Authors: Nnadi Ezekiel Oluwaseun Ejiofor

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This research investigates the effects of poor cost estimation, material cost variations, and payment punctuality on the financial health and execution of construction projects in Nigeria. To achieve the objectives of the study, a quantitative research approach was employed, and data was gathered through an online survey of 74 construction industry professionals consisting of quantity surveyors, contractors, and other professionals. The study surveyed input on cost estimation errors, price fluctuations, and payment delays, among other factors. The responses of the respondents were analyzed using a five-point Likert scale and the Relative Importance Index (RII). The findings demonstrated that the errors in cost estimating in the Bill of Quantity (BOQ) have a high degree of negative impact on the reputation and image of the participants in the projects. The greatest effect was experienced on the likelihood of obtaining future endeavors for contractors (mean value = 3.42), followed by the likelihood of obtaining new commissions by quantity surveyors (mean value = 3.40). The level of inaccuracy in costing that undershoots exposes them to risks was most serious in terms of easement of construction and effects of shortage of funds to pursue bankruptcy (hence fears of mean value = 3.78). There was also considerable financial damage as a result of cost underestimation, whereby contractors suffered the worst loss in profit (mean value = 3.88). Every expense comes with its own peculiar risk and uncertainty. Pressure on the cost of materials and every other expense attributed to the building and completion of a structure adds risks to the performance figures of a project. The greatest weight (mean importance score = 4.92) was attributed to issues like market inflation in building materials, while the second greatest weight (mean importance score = 4.76) was due to increased transportation charges. On the other hand, delays in payments arising from issues of the clients like poor availability of funds (RII=0.71) and contracting issues such as disagreements on the valuation of works done (RII=0.72) or other reasons were also found to lead to project delays and additional costs. The results affirm the importance of proper cost estimation on the health of organization finances and project risks and finishes within set time limits. As for the suggestions, it is proposed to progress on the methods of costing, engender better communications with the stakeholders, and manage the delays by way of contracting and financial control. This study enhances the existing literature on construction project management by suggesting ways to deal with adverse cost inaccuracies and availability of materials due to delays in payments which, if addressed, would greatly improve the economic performance of the construction business.

Keywords: cost estimation, construction project management, material price fluctuations, payment delays, financial impact

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Authors: Liaquat Ali, Khurshid Natasha

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Low resource countries are not usually equipped with the organizational tools to implement health care for chronic diseases, and thus, providing effective diabetes care in such countries is a challenging task. Diabetic Association of Bangladesh (BADAS in Bengali acronym) has created a stimulating example to meet this challenge. Starting its journey in 1956 with 39 patients in a small tin shed clinic BADAS, and its affiliated associations now operate 90 hospitals and health centres all over the country. Together, these facilities provide integrated health care to about 1.5 million registered diabetic patients which constitute about 20% of the estimated diabetic population in the country. BADAS has also become a pioneer in health manpower generation in Bangladesh. Along with its affiliates, it now runs 3 Medical Colleges (to generate graduate physicians), 2 Nursing Institutes, and 2 Postgraduate Institutes which conduct 25 postgraduate courses (under the University of Dhaka) in various basic, clinical and public health disciplines. BADAS gives great emphasis on research, which encompasses basic, clinical as well as public health areas. BADAS is an ideal example of public-private partnership in health as most of its infrastructure has been created through government support but it is almost self-reliant in managing its revenue budget which approached approximately 40 million US dollar during 2010. BADAS raises resources by providing high-quality services to the people, both diabetic and non-diabetic. At the same time, BADAS has developed a cross financing model, to support diabetic patients in general and poor diabetic patients (identified through a social welfare network) in particular, through redistribution of the resources. Along with financial sustainability BADAS ensure organizational sustainability through a process of decentralization, community ownership, and democratic management. Presently a large scale pilot project (named as a Health Care Development Project or HCDP) is under implementation under BADAS umbrella with an objective to transform the diabetes care model to a health care model in general. It is expected to create further evidence on providing sustainable (with social safety net) health care delivery for diabetes, and other chronic illnesses as an integral part of general health care delivery in a resource constrained setting.

Keywords: Bangladesh, self sustain, health care, constrain

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Authors: Andres Calderon

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In order to avoid detection and punishment, cartels have recruited the help of third parties to organize, execute and disguise the anticompetitive practices cartel members have agreed upon. These third parties may take the form of consultancy firms, guilds or professional advisors that do not perform an economic activity in the market where the collusion takes place. This paper takes a look into how national competition authorities and national legislators have dealt with the emergence of the cartels’ facilitators in Latin America. Following the practice of other jurisdictions such as United States (Toys R' Us, Apple), European Union (AC Treuhand), United Kingdom (Replica Kits, Hasbro) and Spain (Urban, Snap-On), some countries (e.g. Argentina, Chile) in Latin America have started to conduct investigations and find antitrust liability in cartels’ facilitators for helping others to violate their national competition laws. Some countries (e.g. Peru and Colombia) have also amended their legislation to amplify the subjective scope of application in order to include cartels’ facilitators. The Latin American case is one of special relevance because public officials are often prone to promote or indulge agreements between competitors in sectors of political interest. A broad definition of cartels’ facilitator, consequently, could lead to the prosecution of punishment of public officials that may hinder the competitive process.

Keywords: anticompetitive practices, cartel, collusion, competition, facilitator, hub and spoke

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Authors: Josephine Eghonghon Ahiante, Barry Hanyane

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To give effect to the constitutional rights of gender equality, the South African government instituted various legislative policy frameworks and legislations to equalise the public service. Nonetheless, gender inequality in senior management positions remains a rift in government institutions, particularly the local sphere of government. The methodology for gathering and analysing data for this study was based on both primary and secondary data sources, namely literature review, qualitative and quantitative data collection and analysis, triangulation, and inductive and deductive thematic analysis. The study found that misogynist tendencies which are manifest in organisational culture suffocate the good intentions of government in ensuring social justices, leadership diversity, and women equality. It also demonstrates that traditional gender role expectation still informs the ground in which senior management positions are allocated, men perceive women as non-leadership fit and discriminate against them during recruitment, selection, and promotion into high positions. The analyses from the study portray that, while government legislation and framework has been instrumental in the leadership acceleration of women, much more has to be done to deconstruct internalised leadership stereotypes on women's gender roles and leadership requirements. The study recommends that gender bias training intervention is needed to teach public employees on management excellence.

Keywords: gender, leadership, misogyny, orgnisational cultural, patriachy

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Authors: J. Wozniak-Holecka, T. Holecki, P. Romaniuk

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Spa facilities are being perceived as the ways of healing treatment in Poland and are guaranteed within the public financing. The universal health insurance (National Health Fund, NFZ), and the disability prevention programme held by Social Insurance Institution (ZUS) are the main sources of financing spa facilities. The dominant public payer of spa services is the NFZ. The Social Insurance Institution covers the cost of health treatment realized in spa facilities as medical rehabilitation, in the field of disability prevention. Health services delivered in the spa resorts are characterized by complexity, and the combination of various methods, typical for health prevention, education, balneotherapy, and physiotherapy. Healing with natural methods, believed to enhance the therapeutic effect, is also involved in health spa treatment. Regardless of the type of facility, each form of spa treatment includes health promotion, health education, prevention at all levels, including rehabilitation. The aim of the study was to determine the optimal organization of health education process. Its efficiency strongly depends on the type of service provider and the funding institution (NFZ vs ZUS). It results from the use of different measures of the effectiveness, the quality and the evaluation of the process being assessed by funding institutions. The methods of the study include a comparative and descriptive quantitative and qualitative analysis. In the empirical part, a questionnaire had been developed. It was then distributed among spa personnel, responsible directly for the health promotion, and among patients who are beneficiaries of health services in spa centers. The quantitative part of the study was based on interviews carried with the use of the online survey (CAWI: Computer-Assisted Web Interview), telephone survey (CATI: Computer-Assisted Telephone Interview) and a conventional questionnaire (PAPI: Paper over Pencil Interview). As a result of the conducted research, it was found that the effectiveness of health education activities in spa resort facilities in Poland is higher when the services are organized using structured tools for managerial control. This applies to formalized procedures implemented by one of the dominant payers covering costs of services (ZUS) and involves the application of health education as one of the mandatory elements of treatment, subjected to the process of control during the course of spa therapy and evaluation after it is completed.

Keywords: effectiveness, health education, public health system, spa treatment

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Authors: Naushad Mamode Khan

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The Com-Poisson (CMP) model is one of the most popular discrete generalized linear models (GLMS) that handles both equi-, over- and under-dispersed data. In longitudinal context, an integer-valued autoregressive (INAR(1)) process that incorporates covariate specification has been developed to model longitudinal CMP counts. However, the joint likelihood CMP function is difficult to specify and thus restricts the likelihood based estimating methodology. The joint generalized quasilikelihood approach (GQL-I) was instead considered but is rather computationally intensive and may not even estimate the regression effects due to a complex and frequently ill conditioned covariance structure. This paper proposes a new GQL approach for estimating the regression parameters (GQLIII) that are based on a single score vector representation. The performance of GQL-III is compared with GQL-I and separate marginal GQLs (GQL-II) through some simulation experiments and is proved to yield equally efficient estimates as GQL-I and is far more computationally stable.

Keywords: longitudinal, com-Poisson, ill-conditioned, INAR(1), GLMS, GQL

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Authors: Stephanie Giordano, Rosa Plasencia

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In the USA, in 2013, public service systems such as Medicaid, aging, and disability systems undertook an effort to measure the quality of service delivery by examining the experiences and outcomes of those receiving public services. The goal of this effort was to develop a survey to measure the experiences and outcomes of those receiving public services, with the goal of measuring system performance for quality improvement. The performance indicators were developed through with input from directors of state aging and disability service systems, along with experts and stakeholders in the field across the United States. This effort, National Core Indicators –Aging and Disabilities (NCI-AD), grew out of National Core Indicators –Intellectual and Developmental Disabilities, an effort to measure developmental disability (DD) systems across the States. The survey tool and administration protocol underwent multiple rounds of testing and revision between 2013 and 2015. The measures in the final tool – called the Adult Consumer Survey (ACS) – emphasize not just important indicators of healthcare access and personal safety but also includes indicators of system quality based on person-centered outcomes. These measures indicate whether service systems support older adults and people with disabilities to live where they want, maintain relationships and engage in their communities and have choice and control in their everyday lives. Launched in 2015, the NCI-AD Adult Consumer Survey is now used in 23 states in the US. Surveys are conducted by NCI-AD trained surveyors via direct conversation with a person receiving public long-term services and supports (LTSS). Until 2020, surveys were only conducted in person. However, after a pilot to test the reliability of videoconference and telephone survey modes, these modes were adopted as an acceptable practice. The nature of the survey is that of a “guided conversation” survey administration allows for surveyor to use wording and terminology that is best understand by the person surveyed. The survey includes a subset of questions that may be answered by a proxy respondent who knows the person well if the person is receiving services in unable to provide valid responses on their own. Surveyors undergo a standardized training on survey administration to ensure the fidelity of survey administration. In addition to the main survey section, a Background Information section collects data on personal and service-related characteristics of the person receiving services; these data are typically collected through state administrative record. This information is helps provide greater context around the characteristics of people receiving services. It has also been used in conjunction with outcomes measures to look at disparity (including by race and ethnicity, gender, disability, and living arrangements). These measures of quality are critical for public service delivery systems to understand the unique needs of the population of older adults and improving the lives of older adults as well as people with disabilities. Participating states may use these data to identify areas for quality improvement within their service delivery systems, to advocate for specific policy change, and to better understand the experiences of specific populations of people served.

Keywords: quality of life, long term services and supports, person-centered practices, aging and disability research, survey methodology

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Authors: Yayra Dzakadzie

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The descriptive cross-sectional survey study assessed dishonest academic intention, mediating academic goals, and attitude relationship with academic dishonesty among university undergraduate students in Ghana. The target population for this study was all the final-year undergraduate students enrolled full-time in Ghanaian public universities. One thousand two hundred (1,200) undergraduate students participated in the study. Multistage sampling was used to select the sample for the study. A structured questionnaire was used to collect the needed data to test hypotheses. Structural Equation Modelling (PLS-SEM) was used for the analyses. The results revealed that academic goals and attitudes had direct and indirect effects on academic dishonesty behaviour. Also, academic intention was statistically a significant mediator in the relationship that academic goals and attitude have with academic dishonesty. It was concluded that when academic goals are high, it compels individual students to try new strategies, and when academic goals are low, the students would like to “cut corners” to meet expectations. It was also concluded that when the attitude towards academic dishonesty is low, students are more unlikely to form an intention to be academically dishonest. It is recommended that lecturers should make their students aware of the goals that need to be attained in their courses and provide them with feedback on goal progress. Students should set their proximal goals and enhance their commitment so that they avoid putting things off. Enforcement of rules and regulations against academic dishonesty must be fully adhered to since students’ positive attitudes can result in high intention, which would lead to academic dishonesty behaviour.

Keywords: intention, academic goals, attitude, academic dishonesty, public university

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Authors: Tibor Koltay

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Among varied new literacies, information literacy is not only the best-known one but displays numerous models and frameworks. Nonetheless, there is still a lack of its complex theoretical model that could be applied to information literacy education in public (K12) education, which often makes use of constructivist approaches. This paper aims to present the main features of such a model. To develop a complex model, the literature and practice of phenomenographic and sociocultural theories, as well as discourse analytical approaches to information literacy, have been reviewed. Besides these constructivist and expressive based educational approaches, the new model is intended to include the innovation of coupling them with a cognitive model that takes developing informational and operational knowledge into account. The convergences between different literacies (information literacy, media literacy, media and information literacy, and data literacy) were taken into account, as well. The model will also make use of a three-country survey that examined secondary school teachers’ attitudes to information literacy. The results of this survey show that only a part of the respondents feel properly prepared to teach information literacy courses, and think that they can teach information literacy skills by themselves, while they see a librarian as an expert in educating information literacy. The use of the resulting model is not restricted to enhancing theory. It is meant to raise the level of awareness about information literacy and related literacies, and the next phase of the model’s development will be a pilot study that verifies the usefulness of the methodology for practical information literacy education in selected Hungarian secondary schools.

Keywords: communication, data literacy, discourse analysis, information literacy education, media and information literacy media literacy, phenomenography, public education, sociocultural theory

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Authors: Yutaro Kyuma, Sung-Jun Yoo, Kazuhide Ito

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A commuter bus remains important as a means to network public transportation between railway stations and terminals within cities. In some cases, the boarding time becomes longer, and the boarding rate tends to be higher corresponding to the development of urban cities. The interior environmental quality, e.g. temperature and air quality, in a commuter bus is relatively heterogeneous and complex compared to that of an indoor environment in buildings due to several factors: solar radiative heat – which comes from large-area windows –, inadequate ventilation rate caused by high density of commuters, and metabolic heat generation from travelers themselves. In addition to this, under conditions where many passengers ride in the enclosed space, contact and airborne infectious risk have attracted considerable attention in terms of public health. From this point of view, it is essential to develop the prediction method for assessment of interior environmental quality and infection risk in commuter bus cabins. In this study, we developed a numerical commuter bus model integrated with computer simulated persons to reproduce realistic indoor environment conditions with high occupancy during commuting. Here, computer simulated persons were newly designed considering different types of geometries, e.g., standing position, seating position, and individual differences. Here we conducted coupled computational fluid dynamics (CFD) analysis with radiative heat transfer analysis under steady state condition. Distributions of heterogeneous air flow patterns, temperature, and moisture surrounding the human body under some different ventilation system were analyzed by using CFD technique, and skin surface temperature distributions were analyzed using thermoregulation model that integrated into computer simulated person. Through these analyses, we discussed the interior environmental quality in specific commuter bus cabins. Further, inhaled air quality of each passenger was also analyzed. This study may have possibility to design the ventilation system in bus for improving thermal comfort of occupants.

Keywords: computational fluid dynamics, CFD, computer simulated person, CSP, contaminant, indoor environment, public health, ventilation

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Authors: Raghav Lakhotia, Sameer Ganu, Anshul Goel, Abhishek Kumar

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In the age and times where women’s empowerment is a significant topic of discussion, we aim to analyze the potential gender diversity influence on box office revenues. The following research is carried out by collecting data from 400 Hollywood movies between the years 2014-2017 and performing regression analysis to find a correlation between the presence of female characters in movies and their return on investment (ROI). The paper finds that there is a positive relationship between the performance of the movies (its ROI) and the gender diversity i.e. the more the number of female characters, the higher the revenue generated. Another factor such as Number of Votes also has a direct impact on the revenue of the movie. The research not only takes into consideration the mere presence of women on screen but also the exchange of at least one dialogue among themselves, which is presented by the Bechdel Score of the movie.

Keywords: Bechdel, diversity, Hollywood, return on investment

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Authors: Amrutha Jayan

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The cities are attractors of the human population, offering opportunities for economic activities for different linguistic, cultural, and ethnic groups. The urban form and design of the city impact the life of these people. Social and cultural exclusions result in spatial segregation and gentrification. The spaces provided in cities must be inclusive for all these communities for them to feel part of the city and contribute to society. Intercultural urbanism is a theory and practice of city building, planning, and design of urban spaces and architectures that are cognizant of the social impact of the built environment. The postulate acknowledges cultural differences and opportunities for cultural exchange. Literature on intercultural urbanism, culture and space, spatial justice, and cultural inclusion are analyzed to identify parameters contributing to intercultural placemaking. A qualitative study on Mattancherry shows how the precinct has sustained throughout the years with different communities living together within a radius of 5 km, creating a diverse and vibrant environment. The research identifies the urban elements that contribute to intercultural interactions and maintain the synergy between these communities. The public spaces, porous edges, built-form, streets, and accessibility contribute to chance encounters and intercultural interactivity. The research seeks to find the factors that contribute to intercultural placemaking.

Keywords: intercultural urbanism, cultural inclusion, spatial justice, public space

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Authors: Mohsen Noroozi, Maryam Khalili

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Creating cities, objects and spaces that are economically, environmentally and socially sustainable and which meet the challenge of social interaction and generation change will be one of the biggest tasks of designers. Social sustainability is about how individuals, communities and societies live with each other and set out to achieve the objectives of development model which they have chosen for themselves. Urban lightning as one of the most important elements of urban furniture that people constantly interact with it in public spaces; can be a significant object for designers. Using intelligence by internet of things for urban lighting makes it more interactive in public environments. It can encourage individuals to carry out appropriate behaviors and provides them the social awareness through new interactions. The greatest strength of this technology is its strong impact on many aspects of everyday life and users' behaviors. The analytical phase of the research is based on a multiple method survey strategy. Smart lighting proposed in this paper is an urban lighting designed on results obtained from a collective point of view about the social sustainability. In this paper, referring to behavioral design methods, the social behaviors of the people has been studied. Data show that people demands for a deeper experience of social participation, safety perception and energy saving with the meaningful use of interactive and colourful lighting effects. By using intelligent technology, some suggestions are provided in the field of future lighting to consider the new forms of social sustainability.

Keywords: behavior pattern, internet of things, social sustainability, urban lighting

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Authors: Mark Morgan, Christine Li, Shuangyu Xu, Jenny McCarty

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The National Wild and Scenic Rivers System was created by the U.S. Congress in 1968 (Public Law 90-542; 16 U.S.C. 1271 et seq.) to preserve outstanding natural, cultural, and recreational values of some U.S. rivers in a free-flowing condition for the enjoyment of present and future generations. This Act is notable for safeguarding the special character of these rivers while supporting management action that encourages public participation for co-creating river protection goals and strategies. This is not an easy task. To meet the challenges of modern ecosystem management, federal resource agencies must address many legal, environmental, economic, political, and social issues. The U.S. Forest Service manages a 44-mile section of the Eleven Point National Scenic River (EPR) in southern Missouri, mainly for outdoor recreation purposes. About half of the acreage is in private lands, while the remainder flows through the Mark Twain National Forest. Private land along the river is managed by scenic easements to ensure protection of scenic values and natural resources, without public access. A portion of the EPR lies adjacent to a 16,500-acre tract known as the Irish Wilderness. The spring-fed river has steep bluffs, deep pools, clear water, and a slow current, making it an ideal setting for outdoor enthusiasts. A 10-month visitor study was conducted at five access points along the EPR during 2019 so the US Forest Service could update their river management plan. A mail-back survey was administered to 560 on-site visitors, yielding a response rate of 53%. Although different types of visitors use the EPR, boating and fishing were the predominant forms of outdoor recreation. Some river use was from locals, but other visitors came from farther away. Formulating unbiased policies for outdoor recreation is difficult because managers must assign relative values to recreational activities and travel distance. Because policymaking is a subjective process, management decisions can affect user groups in different ways (i.e., boaters vs. fishers; proximate vs. distal visitors), as seen through a GIS analysis.

Keywords: activity selection, forest recreation, policy, travel distance

Procedia PDF Downloads 142

Authors: M. Marín-Ferrer, M. A. Hernández, T. Tollefsen, S. Vanzo, E. Nweke, P. V. Tognoli, M. De Cort

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Under the terms of Article 36 of the Euratom Treaty, European Union Member States (MSs) shall periodically communicate to the European Commission (EC) information on environmental radioactivity levels. Compilations of the information received have been published by the EC as a series of reports beginning in the early 1960s. The environmental radioactivity results received from the MSs have been introduced into the Radioactivity Environmental Monitoring database (REMdb) of the Institute for Transuranium Elements of the EC Joint Research Centre (JRC) sited in Ispra (Italy) as part of its Directorate General for Energy (DG ENER) support programme. The REMdb brings to the scientific community dealing with environmental radioactivity topics endless of research opportunities to exploit the near 200 millions of records received from MSs containing information of radioactivity levels in milk, water, air and mixed diet. The REM action was created shortly after Chernobyl crisis to support the EC in its responsibilities in providing qualified information to the European Parliament and the MSs on the levels of radioactive contamination of the various compartments of the environment (air, water, soil). Hence, the main line of REM’s activities concerns the improvement of procedures for the collection of environmental radioactivity concentrations for routine and emergency conditions, as well as making this information available to the general public. In this way, REM ensures the availability of tools for the inter-communication and access of users from the Member States and the other European countries to this information. Specific attention is given to further integrate the new MSs with the existing information exchange systems and to assist Candidate Countries in fulfilling these obligations in view of their membership of the EU. Article 36 of the EURATOM treaty requires the competent authorities of each MS to provide regularly the environmental radioactivity monitoring data resulting from their Article 35 obligations to the EC in order to keep EC informed on the levels of radioactivity in the environment (air, water, milk and mixed diet) which could affect population. The REMdb has mainly two objectives: to keep a historical record of the radiological accidents for further scientific study, and to collect the environmental radioactivity data gathered through the national environmental monitoring programs of the MSs to prepare the comprehensive annual monitoring reports (MR). The JRC continues his activity of collecting, assembling, analyzing and providing this information to public and MSs even during emergency situations. In addition, there is a growing concern with the general public about the radioactivity levels in the terrestrial and marine environment, as well about the potential risk of future nuclear accidents. To this context, a clear and transparent communication with the public is needed. EURDEP (European Radiological Data Exchange Platform) is both a standard format for radiological data and a network for the exchange of automatic monitoring data. The latest release of the format is version 2.0, which is in use since the beginning of 2002.

Keywords: environmental radioactivity, Euratom, monitoring report, REMdb

Procedia PDF Downloads 444

Authors: M. Leonora D. Guerrero

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The study attempted to uncover the most and least frequent phonological variation evident in the speech patterns of grade 1 teachers in select public elementary schools in the Philippines. It also determined the lectal description of the participants based on Tayao’s consonant charts for American and Philippine English. Descriptive method was utilized. A total of 24 grade 1 teachers participated in the study. The instrument used was word list. Each column in the word list is represented by words with the target consonant phonemes: labiodental fricatives f/ and /v/ and lingua-alveolar fricative /z/. These phonemes were in the initial, medial, and final positions, respectively. Findings of the study revealed that the most frequent variation happened when the participants read words with /z/ in the final position while the least frequent variation happened when the participants read words with /z/ in the initial position. The study likewise proved that the grade 1 teachers exhibited the segmental features of both the mesolect and basilect. Based on these results, it is suggested that teachers of English in the Philippines must aspire to manifest the features of the mesolect, if not, the acrolect since it is expected of the academicians not to be displaying the phonological features of the acrolects since this variety is only used by the 'uneducated.' This is especially so with grade 1 teachers who are often mimicked by their students who classify their speech as the 'standard.'

Keywords: consonant phonemes, lectal description, Philippine English, phonological variation

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Authors: Raif Parlakkaya, Ahmet Diken, Erkan Kara

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This paper examines the relationship between corporate governance rating and stock prices of 26 Turkish firms listed in Turkish stock exchange (Borsa Istanbul) by using panel data analysis over five-year period. The paper also investigates the stock performance of firms with governance rating with regards to the market portfolio (i.e. BIST 100 Index) both prior and after governance scoring began. The empirical results show that there is no relation between corporate governance rating and stock prices when using panel data for annual variation in both rating score and stock prices. Further analysis indicates surprising results that while the selected firms outperform the market significantly prior to rating, the same performance does not continue afterwards.

Keywords: corporate governance, stock price, performance, panel data analysis

Procedia PDF Downloads 394

Authors: Niall J. English

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Under- and post-graduate training can benefit from a more active learning style, and most particularly so in engineering. Despite this, outreach to young children in primary and secondary schools is less-developed in terms of its documented effectiveness, especially given new emphasis placed within the third level and advanced research program’s on Education and Public Engagement (EPE). Bearing this in mind, outreach and school visits form the basis to ascertain how active learning, careers stimulus and EPE initiatives for young children can inform the university sector, helping to improve future engineering-teaching standards, and enhancing both quality and practicalities of the teaching-and-learning experience. Indeed, engineering-education EPE/outreach work has been demonstrated to lead to several tangible benefits and improved outcomes, such as greater engagement and interest with science/engineering for school-children, careers awareness, enabling teachers with strong contributions to technical knowledge of engineering subjects, and providing development of general professional skills for engineering, e.g., communication and teamwork. This intervention involved active learning in ‘buzz’ groups for young children of concepts in gas engineering, observing their peer interactions to develop university-level lessons on activity learning. In addition, at the secondary level, careers-outreach efforts have led to statistical determinations of motivations towards engineering education and training, which aids in the redesign of engineering curricula for more active learning.

Keywords: outreach, education and public engagement, careers, peer interactions

Procedia PDF Downloads 122

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

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Aim: This study aims to present the Sustainability Innovation Capacity Building Framework (SICBF) to enable the wider public to achieve UN Sustainable Development Goals (UN SDGs) for a sustainable future. The intrinsically interwoven nature of sustainability requires systematic approaches to attain. However, there is a lack of an effective framework for capacity building that enables a systematic implementation approach for UN SDGs. The SICBF illustrates the six core components and their dynamics: 1. Momentum creation; 2. Exposure to diverse worldviews; 3. Serendipity/Eureka moment; 4. Creative problem solving; 5. Individual empowerment; 6. Systems thinking. Method: First, a structured literature review was used to synthesise existing sustainability competencies studies and generic innovation competencies. Secondly, the conceptual framework based on literature findings was tested with the participants' survey and interview data collected from four sets of MAKEathon events. The interview analysis and event observation data were used to further refine and validate the conceptual framework. Contributions: The scientific contribution of this study is to pave the way for SDGs specific capacity building framework that caters to the need for systematic approaches to allow the wider public aspiring to tackle the seemingly intractable sustainable development goals. The framework will aid sustainable development academics, educators, and practitioners in understanding the dynamics of how capacity building can be facilitated.

Keywords: capacity building, sustainability innovation, sustainable development, systems thinking, UN SDGs

Procedia PDF Downloads 83