Search results for: hospital setting

Authors: Carol Yue-En Ong, Angelina Hui-Min Tan, Quan Liu, Paul Chi-Lui Ho

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A public general hospital in Singapore has recently implemented an automated unit-dose machine in their inpatient dispensary, Swisslog, with the objective of reducing human error and improving patient safety. However, a concern in stability arises as tablets are removed from their original packaging (bottled loose tablets/capsules) and are repackaged into individual, clear plastic wrappers as unit doses in the system. Drugs that are light-sensitive and hygroscopic would be more susceptible to degradation as the wrapper does not offer full protection. Hence, this study was carried out to study the stability of haloperidol tablets and phenytoin capsules that are light-sensitive and hygroscopic respectively. Validated HPLC-UV assays were first established for quantification of these two compounds. The medications involved were put in the Swisslog and sampled every week for one month. The collected data was analysed and showed no degradation over time. This study also explored an alternative approach for drug stability determination-Raman spectroscopy. The advantage of Raman spectroscopy is its high time efficiency and non-destructive nature. The results suggest that drug degradation can indeed be detected using Raman microscopy, but further research is needed to establish this approach for quantification or qualification of compounds. NanoRam®, a portable Raman spectrocope was also used alongside Raman microscopy but was unsuccessful in detecting degradation in this study.

Keywords: drug stability, haloperidol, HPLC, phenytoin, raman spectroscopy, Swisslog

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Authors: Tien Hui Chiang

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Along with the predominant influence of neo-liberalism, public managerialism is viewed as a panacea for curing the institutionalized weakness caused by the monopoly of the public sector. In the name of efficiency, its outcome-led approach acquires a legitimate status and, in turn, it transforms into the discourse of performativity, reformulating the souls of individual members into the form of docile bodies who are willing to demonstrate their own ability in organizational contributions. The evaluation system and the organizational reconstruction are viewed as the crucial means for achieving this mission. Inevitably, university teachers are confined within a rigid and bureaucratic setting, in which they do not have too much latitude but are subject to the commands of senior administrators. However, the notion of duality highlights the interaction between structural constraints and agency. If the actor discovers the rules or properties of social structure, he/she is able to transform structural constraints into resources for developing creative actions, conceptualized as an agency. This study was designed for examining how duality operates within this hierarchical arrangement formed by public managerialism. Fourteen informants were interviewed from February to August 2014. The findings show that the evaluation system created the culture of neo-academicalism, addressing excellence in research and, in turn, motivating academic-oriented teachers. This correspondence provided a gateway for them to win honor, dignity, and prestige in groups. However, unlike the concept of duality, this agency was operating within the institutionalized context, regulated by structural constraint. Furthermore, complying with the rule/property of social structure was able to secure their advantages.

Keywords: public managerialism, social discourse, neo-academicalism, duality, structural constraint, agency

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Authors: Rujnan Tuna, Ayse Cil Akinci

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Work life takes up an important place in human life, and an employed person faces many stimuli from internal and external environments and is affected by them in a positive or negative way. Also, the handover process, which is the process of sharing information about the patient with other health professionals, is an important criterion to maintain patient care and enhance the quality of care provided. Handover is a key component for sustaining daily basic clinical practices and is also essential to maintain the safe patient care. This investigation followed a descriptive and correlation design in order to establish job stress and the handover efficiency of nurses and the relationship in between. The study was conducted with 192 nurses working in a public hospital in Istanbul between January and March 2017. Descriptive information form, Job Stressors Scale, and Handover Evaluation Scale were used to collect the data of the study. The data were analyzed by using IBM SPSS Statistics 22.0 statistical software. Approvals from participants, managers of institution, and ethics committee were taken for the study. As a result of the research, it was found that job stress was above the median value, and the highest score in the ‘work role conflict’ subdimension. Also, it was found that the effectiveness of the nurses' handover effectiviness was above the median value and the highest score in the ‘quality of information’ subdimension. In the study, there was a negatively weak correlation between ‘work role overload’ subdimension of Job Stressors Scale and ‘interaction and support’ subdimension of Handover Evaluation Scale. There is a need for further study in order to maintain patient safety.

Keywords: handover, job stress, nurse, patient

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Authors: Jameela Ali, Hamid A. Jalab, Loay E. George, Abdul Rahim Ahmad, Azizah Suliman, Karim Al-Jashamy

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Red blood cells (RBC) are the most common types of blood cells and are the most intensively studied in cell biology. The lack of RBCs is a condition in which the amount of hemoglobin level is lower than normal and is referred to as “anemia”. Abnormalities in RBCs will affect the exchange of oxygen. This paper presents a comparative study for various techniques for classifying the RBCs as normal, or abnormal (anemic) using WEKA. WEKA is an open source consists of different machine learning algorithms for data mining applications. The algorithm tested are Radial Basis Function neural network, Support vector machine, and K-Nearest Neighbors algorithm. Two sets of combined features were utilized for classification of blood cells images. The first set, exclusively consist of geometrical features, was used to identify whether the tested blood cell has a spherical shape or non-spherical cells. While the second set, consist mainly of textural features was used to recognize the types of the spherical cells. We have provided an evaluation based on applying these classification methods to our RBCs image dataset which were obtained from Serdang Hospital-alaysia, and measuring the accuracy of test results. The best achieved classification rates are 97%, 98%, and 79% for Support vector machines, Radial Basis Function neural network, and K-Nearest Neighbors algorithm respectively.

Keywords: K-nearest neighbors algorithm, radial basis function neural network, red blood cells, support vector machine

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Authors: A. Robbin

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In a multilingual setting like Nigeria, the success of service encounters is enhanced by the use of a language that ensures the linguistic and persuasive demands of the interlocutors. This study examined motivations for code switching as a negotiation strategy in bank-hall desk service encounters in Ìbàdàn metropolis using Myers-Scotton’s exploration on markedness in language use. The data consisted of transcribed audio recording of bank-hall service encounters, and direct observation of bank interactions in two purposively sampled commercial banks in Ìbàdàn metropolis. The data was subjected to descriptive linguistic analysis using Myers Scotton’s Markedness Model.  Findings reveal that code switching is frequently employed during different stages of service encounter: greeting, transaction and closing to fulfil relational, bargaining and referential functions. Bank staff and customers code switch to make unmarked, marked and explanatory choices. A strategy used to identify with customer’s cultural affiliation, close status gap, and appeal to begrudged customer; or as an explanatory choice with non-literate customers for ease of communication. Bankers select English to maintain customers’ perceptions of prestige which is retained or diverged from depending on their linguistic preference or ability.  Yoruba is seen as an efficient negotiation strategy with both bankers and their customers, making choices within conversation to achieve desired conversational and functional aims.

Keywords: banking, bilingualism, code-switching, markedness, service encounter

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Authors: Sumreen Hafeez

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Objective: The objective of this study is to compare the efficacy of terbinafine versus Itraconazole in the treatment of tinea corporis. Study design: The study design is a randomized controlled trial. Place and duration of study: This study was conducted at the Department of Dermatology, DHQ Hospital, Sheikhupura, during the duration of July 2023 to December 2023. Methodology: A total of 50 cases (25 in both groups) with Tinea corporis were included. Then, patients were randomly divided into two groups. In group A, patients were given terbinafine. In group B, patients were given Itraconazole. Then, the patients were followed up for 2, 4, 6, and 8 weeks. On each visit, patients were examined for complete resolution of tinea by using the total body surface area index, and they were assessed for resolution of lesions. All the data was recorded in proforma and then entered & analyzed through SPSS version 26. Results: In the terbinafine group, the mean age of the patients was 35.16 ± 8.76 years. In the itraconazole group, the mean age of the patients was 28.36 ± 10.65 years. In the terbinafine group, there were 15 (60%) males and 10 (40%) females. Meanwhile, in the itraconazole group, there were 8 (32%) males and 17 (68%) females. Moreover, in the terbinafine group, the baseline BSI score was 6.44 ± 3.19, and this score was reduced to 3.64 + 2.11 after 4 weeks of treatment. In this group, the efficacy (complete cure within 4 weeks) was achieved in 6 (24%) cases. On the other hand, in the itraconazole group, the baseline BSI score was 7.20 ± 2.99, which was reduced to 1.75 + 0.50 after 4 weeks of treatment, and the efficacy (complete cure within 4 weeks) was achieved in 13(52%) cases in this group. Conclusion: We found that itraconazole has better efficacy than terbinafine for tinea corporis. Thus, in the future, Itraconazole can be a drug of choice for such cases.

Keywords: terbinafine, Itraconazole, Tinea corporis, topical treatment, body surface area

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Authors: P. Siriarchawatana, K. Leungchavaphongse, N. Covavisaruch, K. Rojananuangnit, P. Boondaeng, N. Panyayingyong

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Glaucoma is a disease that causes visual loss in adults. Glaucoma causes damage to the optic nerve and its overall pathophysiology is still not fully understood. Vasculopathy may be one of the possible causes of nerve damage. Photographic imaging of retinal vessels by fundus camera during eye examination may complement clinical management. This paper presents an innovation for measuring central light reflex width-to-retinal vessel diameter ratio (CRR) from digital retinal photographs. Using our edge detection technique, CRRs from glaucoma and normal eyes were compared to examine differences and associations. CRRs were evaluated on fundus photographs of participants from Mettapracharak (Wat Raikhing) Hospital in Nakhon Pathom, Thailand. Fifty-five photographs from normal eyes and twenty-one photographs from glaucoma eyes were included. Participants with hypertension were excluded. In each photograph, CRRs from four retinal vessels, including arteries and veins in the inferotemporal and superotemporal regions, were quantified using edge detection technique. From our finding, mean CRRs of all four retinal arteries and veins were significantly higher in persons with glaucoma than in those without glaucoma (0.34 vs. 0.32, p < 0.05 for inferotemporal vein, 0.33 vs. 0.30, p < 0.01 for inferotemporal artery, 0.34 vs. 0.31, p < 0.01 for superotemporal vein, and 0.33 vs. 0.30, p < 0.05 for superotemporal artery). From these results, an increase in CRRs of retinal vessels, as quantitatively measured from fundus photographs, could be associated with glaucoma.

Keywords: glaucoma, retinal vessel, central light reflex, image processing, fundus photograph, edge detection

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Authors: Doriane Micaela Andeme Bikoro, Samuel Fosso Wamba, Jean Robert Kala Kamdjoug

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Currently one of the leading fields in the market of technological innovation is digital health. In developed countries, this booming innovation is experiencing an exponential speed. We understand that in developed countries, e-health could also revolutionize the practice of medicine and therefore fill the many failures observed in medical care. Everything leads to believe that future technology is oriented towards the medical sector. The aim of this work is to explore at the same time the technological resources and the potential of health care based on new technologies; it is a case study in a rural area of Southern Cameroon. Among other things, we will make a census of the shortcomings and problems encountered, and we will propose various appropriate solutions. The work methodology used here is essentially qualitative. We used two qualitative data collection techniques, direct observation, and interviews. In fact, we spent two weeks in the field observing and conducting some semi-directive interviews with some of those responsible for these health structures. This study was conducted in three health facilities in the south of the country; including two health centers and a rural hospital. Many technological failures have been identified in the day-to-day management of these health facilities and especially in the administration of health care to patients. We note major problems such as the digital divide, the lack of qualified personnel, the state of isolation of this area. This is why various proposals are made to improve the health sector in Cameroon both technologically and medically.

Keywords: Cameroon, capacities, census, digital health, qualitative method, rural area

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Authors: Gashaw Abebaw

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Concrete usage in Ethiopia is expanding at a faster rate than before. Cement is the most important and costly ingredient in this respect. The construction industry is currently challenged by cement scarcity and stock market inflation. Scholars' trays, on the other hand, will use natural pozzolan material to substitute cement. Apart from that, Metakaolin has pozzolanic characteristics. According to the industrial mineral occurrence map, Ethiopia kaolin may be found in abundance. Some of them include Debretabor, so it is good to utilize Metakaolin as cement replacement material. In this study, the capability of Ethiopian Metakaolin as a partial substitute for cement in C-25 concrete production with 0%, 5%, 10%, 15%, and 20% replacement of PPC by MA with 0.49 percent water to cement ratio is investigated. The study examines; the chemical properties of MA, Physical properties of cement paste, workability, compressive strength, water absorption, density and sulfate attack of concrete was investigated. The chemical composition of Metakaolin was examined and the summation of SiO₂, AlO₃, and FeO₃ is 86.25% and the ash was classified class N pozzolan. The normal consistency percent of water increases as the MA replacement amount increase and both initial and final setting time rang increase as the MA replacement amount increase. On the 28th day, the compressive strength of concrete with MA replacement of 5%, 10%, and 15% exceeds the goal mean strength (33.5Mpa) with compressive strength enhancements of 2.23 %, 4.05 %, and 2.23 %, respectively. Similarly, on the 56th day, 5 %, 10%, and 15% replacement enhance concrete strength by 2.06 %, 3.06 %, and 1.2 %, respectively. The MA mixed concrete has improved significantly in terms of water absorption and sulphate attack, with a 15% replacement level. MA content Metakaolin could possibly replace cement up to 15%, according to the studies. The study's findings will help to offset cement price increases while also boosting house affordability without significantly degrading.

Keywords: metakaolin, compressive strength, sulphate attack, water absorption, N pozzolan

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Authors: Ritu Sharma

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In order to be objective, critics must examine the dynamic relationships between the author, the reader, the text, and the outside world. However, it is also crucial to recognize that because the language was created by God, meaning is ingrained in it. Meaning is located in and discovered through literature rather than being limited to the author, reader, text, or the outside world. The link between the author, the reader, and the text is crucial because literature unites an author and a reader through the use of language. Literature is a potent kind of communication, and Ethan Frome's audience is forever changed as a result of the book's language and the language its characters use. The narrative of Ethan Frome and his wife Zeena is presented in Ethan Frome. Ethan's story is told throughout the course of the book, revealed through the eyes of the narrator, an outsider passing through Starkfield, as well as through the insight that the narrator gains from the townspeople and his stay on the Frome farm. The story is set in the rural New England community of Starkfield, Massachusetts. The weather provides the ideal setting for Ethan and the narrator to get to know one another as the narrator gets preoccupied with unraveling the narrative that underlies Ethan's physical anomalies. In addition to telling a gripping tale and capturing human nature as it is, Ethan Frome uses its storyline to achieve something more significant. The book by Edith Wharton supports language. Zeena's deliberate and convincing language challenges relativity and meaninglessness. Ethan and Mattie's effort to effectively use words reflects the complexity of language, and their battle illustrates the influence that language may have if and when it is used. Ethan Frome defends the written word, the foundation upon which it is constructed, as a literary work. Communication is based on language, and as the characters respond to and get involved in disputes throughout the book, Zeena, Ethan, and Mattie, each reflects particular theories of communication that help define their uses of communication within the broader context of language.

Keywords: dynamic relationships, potent, communication, complexity

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Authors: Atefeh Esmailnejad, Mohammad Abbaszadeh Hasiri

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Coxiella burnetii is a gram-negative obligatory intracellular bacterium that causes Q fever, a significant zoonotic disease. Sheep, cattle, and goats are the most commonly reported reservoirs for the bacteria, but infected cats and dogs have also been implicated in the transmission of the disease to human. The aim of present study was to investigate the presence of antibodies against Coxiella burnetii among companion dogs in Fars province, South of Iran. A total of 181 blood samples were collected from asymptomatic dogs, mostly referred to Veterinary Hospital of Shiraz University for regular vaccination. The IgG antibody detection against Coxiella burnetii was made by indirect Enzyme-linked Immunosorbent Assay (ELISA), employing phase I and II Coxiella burnetii antigens. A logistic regression model was developed to analyze multiple risk factors associated with seropositivity. An overall seropositivity of 7.7% (n=14) was observed. Prevalence was significantly higher in adult dogs above five years (18.18 %) compared with dogs between 1 and five years (7.86 %) and less than one year (6.17%) (P=0.043). Prevalence was also higher in male dogs (11.21 %) than in female (2.7 %) (P=0.035). There were no significant differences in the prevalence of positive cases and breed, type of housing, type of food and exposure to other farm animals (P>0.05). The results of this study showed the presence of Coxiella burnetii infection among the companion dogs population in Fars province. To our knowledge, this is the first study regarding Q fever in dogs carried out in Iran. In areas like Iran, where human cases of Q fever are not common or remain unreported, the public health implications of Q fever seroprevalence in dogs are quite significant.

Keywords: Coxiella burnetii, dog, Iran, Q fever

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Authors: Hanna Faron, Wojciech Marcinkowski, Daniel Prusak

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The aim of this article is to familiarize with the activity of AGH Racing scientific circle, pertaining to the international project -Formula Student, giving the opportunity to young engineers from all around the world to validate their talent and knowledge in the real world conditions, under the pressure of time, and the design requirements. Every year, the team begins the process of building a race car from the formation of human resources. In case of the public sector, to which public universities can be included, the scientific circles represent the structure uniting students with the common interests and level of determination. Due to the scientific nature of the project which simulates the market conditions, they have a chance to verify previously acquired knowledge in practice. High level of the innovation and competitiveness of participating in the project Formula Student teams, requires an intelligent organizational system, which is characterized by a high dynamics. It is connected with the necessity of separation of duties, setting priorities, selecting optimal solutions which is often a compromise between the available technology and a limited budget. Proper selection of the adequate guidelines in the design phase allows an efficient transition to the implementation stage, which is process-oriented implementation of the project. Four dynamic and three static competitions are the main verification and evaluation of year-round work and effort put into the process of building a race car. Acquired feedback flowing during the race is a very important part while monitoring the effectiveness of AGH Racing scientific circle, as well as the main criterion while determining long-term goals and all the necessary improvements in the team.

Keywords: SAE, formula student, race car, public sector, automotive industry

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Authors: M. Yosra, A. Mohamed, T. Sami

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Over the past few years, mobile communication technologies have seen significant evolution. This fact promoted the implementation of many systems in a multi-technological setting. From one system to another, the Quality of Service (QoS) provided to mobile consumers gets better. The growing number of normalized standards extends the available services for each consumer, moreover, most of the available radio frequencies have already been allocated, such as 3G, Wifi, Wimax, and LTE. A study by the Federal Communications Commission (FCC) found that certain frequency bands are partially occupied in particular locations and times. So, the idea of Cognitive Radio (CR) is to share the spectrum between a primary user (PU) and a secondary user (SU). The main objective of this spectrum management is to achieve a maximum rate of exploitation of the radio spectrum. In general, the CR can greatly improve the quality of service (QoS) and improve the reliability of the link. The problem will reside in the possibility of proposing a technique to improve the reliability of the wireless link by using the CR with some routing protocols. However, users declared that the links were unreliable and that it was an incompatibility with QoS. In our case, we choose the QoS parameter "bandwidth" to perform a supervised classification. In this paper, we propose a comparative study between some routing protocols, taking into account the variation of different technologies on the existing spectral bandwidth like 3G, WIFI, WIMAX, and LTE. Due to the simulation results, we observe that LTE has significantly higher availability bandwidth compared with other technologies. The performance of the OLSR protocol is better than other on-demand routing protocols (DSR, AODV and DSDV), in LTE technology because of the proper receiving of packets, less packet drop and the throughput. Numerous simulations of routing protocols have been made using simulators such as NS3.

Keywords: cognitive radio, multi technology, network simulator (NS3), routing protocol

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Authors: Sara Ataei, Molouk Hadjibabaie, Shirinsadat Badri, Amirhossein Moslehi, Iman Karimzadeh, Ardeshir Ghavamzadeh

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Purpose: To assess the pattern and probable risk factors for moderate and major drug–drug interactions in a referral hematology-oncology ward in Iran. Methods: All patients admitted to hematology–oncology ward of Dr. Shariati Hospital during a 6-month period and received at least two anti-cancer or non-anti-cancer medications simultaneously were included. All being scheduled anti-cancer and non-anti-cancer medications both prescribed and administered during ward stay were considered for drug–drug interaction screening by Lexi-Interact On- Desktop software. Results: One hundred and eighty-five drug–drug interactions with moderate or major severity were detected from 83 patients. Most of drug–drug interactions (69.73 %) were classified as pharmacokinetics. Fluconazole (25.95 %) was the most commonly offending medication in drug–drug interactions. Interaction of sulfamethoxazole-trimethoprim with fluconazole was the most common drug–drug interaction (27.27 %). Vincristine with imatinib was the only identified interaction between two anti-cancer agents. The number of administered medications during ward stay was considered as an independent risk factor for developing a drug–drug interaction. Conclusions: Potential moderate or major drug–drug interactions occur frequently in patients with hematological malignancies or related diseases. Performing larger standard studies are required to assess the real clinical and economical effects of drug–drug interactions on patients with hematological and non-hematological malignancies.

Keywords: drug–drug interactions, hematology–oncology ward, hematological malignancies

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Authors: Yunfan Jiang

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In response to an identified gap in available treatment programmes for high-risk offenders with multiple criminogenic needs and guided by emerging literature in the field of correctional rehabilitation, Singapore Prison Service (SPS) developed the Integrated Criminogenic Programme (ICP) in 2012. This evidence-informed psychological programme was designed to address all seven dynamic criminogenic needs (from the Central 8) of high-risk offenders by applying concepts from rehabilitation and psychological theories such as Risk-Need-Responsivity, Good Lives Model, narrative identity, and motivational interviewing. This programme also encompasses a 6-month community maintenance component for the purpose of providing structured step-down support in the aftercare setting. These sessions provide participants the opportunity for knowledge reinforcement and application of skills attained in-care. A quantitative evaluation of the ICP showed that the intervention group had statistically significant improvements across time in most self-report measures of criminal attitudes, substance use attitudes, and psychosocial functioning. This was congruent with qualitative data from participants saying that the ICP had the most impact on their criminal thinking patterns and management of behaviours in high-risk situations. Results from the comparison group showed no difference in their criminal attitudes, even though they reported statistically significant improvements across time in their substance use attitudes and some self-report measures of psychosocial functioning. The programme’s efficacy was also apparent in the lower rates of recidivism and relapse within 12 months for the intervention group. The management of staff issues arising from the development and implementation of an innovative high-intensity psychological programme such as the ICP will also be discussed.

Keywords: evaluation, forensic psychology, intervention programme, offender rehabilitation

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Authors: Yi-Fung Lin, Pei-Chen Tsai

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Background: The hospital healthcare team provides 24-hour patient care, and therefore shift-work is inevitable in the nursing field. There is an increased awareness that shift-work affecting circadian rhythms may cause various health problems, especially in poor sleep quality, which may harm the quality of life. Purposes: The purpose of this study was to investigate the influences of demographic characteristics on nurses’ sleep quality and quality of life and the relationship between these predictors of nurses’ quality of life. Methods: A cross-sectional, descriptive correlational study was conducted with purposive sampling of 520 female nurses in a medical center in north Taiwan from July to September 2014. Data were collected with structured questionnaires using Psychometric Evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and the World Health Organization Quality of Life (WHOQOL-BREF). Outcomes: The main results include: 1) Irregular menstruation, non-regular exercisers, and more daily caffeine consumption have negative impacts on sleep quality. 2) Younger age, fewer children, low education level, low annual income, irregular menstruation, pain during menstrual cycles, non-regular exercisers, constipation, and poor sleep quality all contribute negative impacts on the quality of life. 3) The odds ratio of sleep disturbance between 12-hour shifts and 8-hour shifts was 2.26, but there was no significant difference regarding their quality of life scores. Conclusion: This study showed that there is a strong correlation between oncology nurses’ sleep quality and quality of life. Sleep quality is a significant predictor of quality of life in oncology nurses.

Keywords: oncology nurses, sleep quality, quality of life, shift-work

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Authors: Pornwipa Daoduong, Jairak Loysongkroa, Napaphan Viriyautsahakul, Wachira Pengjuntr

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Obesity is on of serious health problem in many countries including Thailand where the prevalence of childhood obesity has increased from 8.8 % in 2014 to 9.5 % in 2015 and 12.9 % in 2016. The Ministry of Public Health’s objective is to reduce prevalence of childhood Obesity to 10% or lower in 2017, by implementing the measure in relation to nutrition, physical activity (PA) and environment in 6,405 targeted school with proportion of school children with obesity is higher than 10 %. Smart Kids Coacher (SKC)” is a new innovative intervention created by Department of Health and consists of 252 regional and provincial officers. The SKC aims to train the super trainers about food and nutrition.PA and emotional control through implementing three learning activities including 1) Food for Fun is about Nutrition flag, Nutrition label, food portion and Nutrition surveillance; 2) Fun for Fit includes intermediated- and advanced level workouts within 60 minutes such as kangaroo dance, Chair stretching; and 3) Control emotional is about to prevent probability of access to unhealthy food, to ensure for having meal in appropriate time, and to recruit peers and family member to increase awareness among target groups. Apart from providing SKC lesson for 3,828 officers at district level, a number of students (2,176) as role model are selected through implementing “Smart Kids Leader: (SKL)”.Consequently. The SKC lowers proportion of childhood obesity from 17% in 2012 to 12.9% in 2016. Further, the SKC coverage should be expanded to other setting. Policy maker should be aware of the important of reduction of the prevalence of childhood obesity, and it’s related risk. Network and Collaboration between stakeholders are essential as well as an improvement of holistic intervention and knowledge “NuPETHS” for kids in the future.

Keywords: childhood obesity, model, obesity, smart kids coacher

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Authors: Threera Intarareaung

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This research aims to study guidelines of organizing the Wat Sai Museum of Local Boats, of Ruam Sai Pattana Community 789, Kradangnga sub-district, Bang Khon Tee district, Samut Songkram province. The procedures are to seek for potentials and problems within the community to properly organize the said museum. The research contains methodology of qualitative by studying from the population from Ruam Sai Pattana 789, a community that located within the area of the museum. The sample contains 40 persons. The procedures are in-depth interview, observation, focus group by discussing ideas, problems and the importance of the museum. After that, the information received is synthesized and analyzed. The result finds that the local temple requires setting up the boat museum. However, there are several factors that limit the possibility which are the museum manager, resources, exhibition and service and knowledge management. These factors reflect mutual potentials and problems that lead us to seek the best solutions to set up the local boat museum. In conclusion, there are 4 issues regarding the management. First, the knowledge management should be conducted to indicate the purposes of the museum. Second, exhibition and service should be categorized. In addition, the serviced should be assisted by local guides. Third, the museum should employ staffs to correspond to other entities such as related authorities. Fourth is regarding location and condition of the building. This is considered as a major factor that needs discussion from different parties. However, the condition of the existing resource is proper. All the information is collected by field trip and interview the locals and person of interest. Therefore, the idea is inconsistent with the community’s requirement that can proceed to real practice.

Keywords: museum, boat museum, heritage tourism, conservation lifestyle

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Authors: Ahmed Ali Torad

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Background: Breast feeding maintains the maternal fetal immunological link, favours the transmission of immune-competence from the mother to her infant and is considered an important contributory factor to the neo natal immune defense system. Purpose: This study was conducted to investigate the effect of relaxation techniques on immunological properties of breast milk. Subjects and Methods: Thirty breast feeding mothers with a single, mature infant without any complications participated in the study. Subjects will be recruited from outpatient clinic of obstetric department of El Kasr El-Aini university hospital in Cairo. Mothers were randomly divided into two equal groups using coin toss method: Group (A) (relaxation training group) (experimental group): It will be composed of 15 women who received relaxation training program in addition to breast feeding and nutritional advices and Group (B) (control group): It will be composed of 15 women who received breast feeding and nutritional advices only. Results: The results showed that mean mother’s age was 28.4 ± 3.68 and 28.07 ± 4.09 for group A and B respectively, there were statistically significant differences between pre and post values regarding cortisol level, IgA level, leucocyte count and infant’s weight and height and there is only statistically significant differences between both groups regarding post values of all immunological variables (cortisol – IgA – leucocyte count). Conclusion: We could conclude that there is a statistically significant effect of relaxation techniques on immunological properties of breast milk.

Keywords: relaxation, breast, milk, immunology, lactation

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Authors: Stephanie Cheng, Benjamin Poh, Vivyan Tay, Sachin Mathur

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Aim: Diabetes mellitus (DM) is a worldwide pandemic affecting 500 million people. It is known to be associated with increased susceptibility to soft tissue infections (STI). Despite being a major public health burden, the literature relating the effects of DM and the presentation, severity and healing of STIs in general surgical patients remain limited. Methods: We conducted a retrospective review of all patients admitted with STI in a tertiary teaching hospital over a 12-month period. Patient demographics and surgical outcomes were collected and analyzed. Results: During the study period, 1059 patients were admitted for STIs, of which 936 (88%) required surgical intervention. Diabetic patients were presented with a higher body-mass index (BMI) (28 vs 26), larger abscess size (24 vs 14 cm²) and a longer length of stay (LOS)(4.4 days vs 2.9 days). They also underwent a higher proportion of wide debridement as well as application of negative pressure wound therapy (NPWT) (42% vs 35%). More diabetic patients underwent subsequent re-operation within the same sitting (8 vs 4). There were no differences in re-admission rates within 30 days nor subsequent abscess formation in those followed for 6 months. Conclusion: The incidence of STIs among DM patients represents a significant disease burden; surgeons should consider intensive patient counseling and partnering with primary care providers in order to help reduce the incidence of future STI admissions based on lifestyle modification and glucose control.

Keywords: general surgery, emergency general surgery, acute care surgery, soft tissue infections, diabetes mellitus

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Authors: Sajjad Esmaeili Aghdam

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Economics typically conceptualizes individual behavior as the consequence of external states, for example, budgets and prices (or respective beliefs) and choices. As the main goal, we focus on the influence of a range of Behavioral Economics factors on Strategies of Digital Marketing, evaluation of strategies and deformation of it into highly prospective marketing strategies. The different forms of behavioral prospects all lead to the succeeding two main results. First, the steadiness of the economic dynamics in a currency union be contingent fatefully on the level of economic incorporation. More economic incorporation leads to more steady economic dynamics. Electronic word-of-mouth (eWOM) is “all casual communications focused at consumers through Internet-based technology connected to the usage or characteristics of specific properties and services or their venders.” eWOM can take many methods, the most significant one being online analyses. Writing this paper, 72 articles have been gathered, focusing on the title and the aim of the article from research search engines like Google Scholar, Web of Science, and PubMed. Recent research in strategic management and marketing proposes that markets should not be viewed as a given and deterministic setting, exogenous to the firm. Instead, firms are progressively abstracted as dynamic inventors of market prospects. The use of new technologies touches all spheres of the modern lifestyle. Social and economic life becomes unbearable without fast, applicable, first-class and fitting material. Psychology and economics (together known as behavioral economics) are two protruding disciplines underlying many theories in marketing. The wide marketing works papers consumers’ none balanced behavior even though behavioral biases might not continuously be steadily called or officially labeled.

Keywords: behavioral economics, digital marketing, marketing strategy, high impact strategies

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Authors: Astika Swastirani

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Chronological age estimation can be done by looking at the stage of growth and development of teeth from orthopantomogram and mandibular remodeling from lateral cephalogram. Mandibular morphological changes associated with the size and remodeling during growth is a strong indicator of age estimation. These changes can be observed with lateral cephalogram. Objective: To prove the difference between chronological age and age estimation using orthopantomogram (dental age) and lateral cephalogram (skeletal age). Methods: Sample consisted of 100 medical records, 100 orthopantomograms digital and 100 lateral cephalograms digital belongs to 50 male and 50 female of Airlangga University hospital of dentistry. Orthopantomogram were matched with London atlas and lateral cephalograms were observed by digital tracing. The difference of dental age and skeletal age was analyzed by pair t –test. Result: Result of the pair t-test between chronological age and dental age in male (p-value 0.002, p<0.05), in female (p-value 0.605, p>0.05). Result of pair t-test between the chronological age and skeletal age (variable length Condylion-Gonion, Gonion-Gnathion, Condylion-Gnathion in male (p-value 0.000, p<0.05) in female (variable Condylion-Gonion length (p-value 0.000, Condylion-Gnathion length (p-value 0,040) and Gonion-Gnathion length (p-value 0.493). Conclusion: Orthopantomogram with London atlas and lateral cephalograms with Gonion- Gnathion variable can be used for age estimation in female. Orthopantomogram with London atlas and lateral cephalograms with Condylion-Gonion variable, Gonion-Gnathion variable and Condylion-Gnathion can not be used for age estimation in male.

Keywords: age estimation, chronological age, dental age, skeletal age

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Authors: Sara Mohammad Atef Sabaika

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Background: The development of factor VIII (FVIII) inhibitor and hemophilic arthropathy in patients with hemophilia A (PWHA) are a great challenge for hemophilia care. Both genetic and environmental factors led to complications in PWHA. The development of inhibitory antibodies is usually induced by the immune response. Tumor necrosis factor α (TNF-α), one of the cytokines, might contribute to its polymorphism. Aim: Study the association between tumor necrosis alpha level and genotypes in pediatric patients with hemophilia A and its relation to inhibitor development and joint status. Methods: A cross-sectional study was conducted among a sufficient number of PWHA attending the Pediatric Hematology and Oncology Unit, Pediatric department in Menoufia University hospital. The clinical parameters, FVIII, FVIII inhibitor, and serum TNF-α level were assessed. The genotyping of −380G > A TNF-α gene polymorphism was performed using real time polymerase chain reaction. Results: Among the 50 PWHA, 28 (56%) were identified as severe PWHA. The FVIII inhibitor was identified in 6/28 (21.5%) of severe PWHA. There was a significant correlation between serum TNF-α level and the development of inhibitor (p = 0:043). There was significant correlation between polymorphisms of −380G > A TNF-α gene and hemophilic arthropathy development (p = 0:645). Conclusion: The prevalence of FVIII inhibitor in severe PWHA in Menoufia was 21.5%. The frequency of replacement therapy is a risk factor for inhibitor development. Serum TNF-α level and its gene polymorphism might be used to predict inhibitor development and joint status in pediatric patients with hemophilia A.

Keywords: hemophilic arthropathy, TNF alpha., patients witb hemophilia A PWHA, inhibitor

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Authors: Aparna Datta, Mahabub Alam

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Animal welfare is comparatively new area of research in Bangladesh and welfare concern for animal is increasing day by day. The study was conducted to investigate the animal welfare violations during treatment at different level of hospitals in Bangladesh and India. This study was conducted between January and May, 2017. The recorded data (N=180) were categorized into eight major types of violation like - delay in starting treatment, non-specific treatment, surgery without anesthesia, use of unsterilized needle, rough and painful handling, fearful approach, multiple pricking during injection and use of blunt needle. Categorized groups were analyzed according to different hospitals like Upazila Veterinary Hospitals, Bangladesh (UVHs), SAQ-Teaching Veterinary Hospital, Bangladesh (SAQTVH) and Veterinary College and Research Institute, India (VCRI). Among all hospitals, violation during treatment more frequently occurred in UVH. Among all violations, surgery without anesthesia was only found in UVH (80%) and it was belong to considerable number of cases (80%). In the view of other major violations like - non-specific treatment was 69% in UVHs, 13% in SAQTVH and 5% in VCRI. Use of unsterilized instruments during treatment was also higher in UVHs (65%) than SAQTVH (5%) and VCRI (1%). But delay in starting treatment varied insignificantly and it was 26-42% across the different levels of hospitals. Although multiple pricking during injection was found 30% cases in UVH, but statistical variations with other level of hospitals were unnoticed (p>0.05). The findings of this study will help to take necessary steps to control violation against animal welfare during treatment. A comprehensive study considering all levels of hospitals including field treatment is also recommended to find out the welfare violations during treatment.

Keywords: animal welfare, treatment, veterinary hospitals, violations

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Authors: Munir Ashraf, Shagufta Riaz

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Personal protective equipment (PPE) and bioactive textiles are highly important for the health care of front line hospital workers, patients, and the general population to be safe from highly infectious diseases. This was even more critical in the wake of COVID-19 outbreak. Most of the medical textiles are inactive against various viruses and bacteria, hence there is a need to wash them frequently to avoid the spread of microorganisms. According to survey conducted by the world health organization, more than 500 million people get infected from hospitals, and more than 13 million died due to these hospitals’ acquired deadly diseases. The market available PPE are though effective against the penetration of pathogens and to kill bacteria but, they are not breathable and active against different viruses. Therefore, there was a great need to develop textiles that are not only effective against bacteria, fungi, and viruses but also are comfortable to the medical personnel and patients. In the present study, waterproof breathable, and biologically active textiles were developed using antiviral and antibacterial nanomaterials. These nanomaterials like TiO₂, ZnO, Cu, and Ag were immobilized at the surface of cotton fabric by using different silane coupling agents and electroless deposition that they retained their functionality even after 30 industrial laundering cycles. Afterwards, the treated fabrics were coated with a waterproof breathable film to prevent the permeation of liquid droplets, any particle or microorganisms greater than 80 nm. The developed cotton fabric was highly active against bacteria and viruses. The good durability of nanomaterials at the cotton surface after several industrial washing cycles makes this fabric an ideal candidate for bioactive textiles used in the medical field.

Keywords: antibacterial, antiviral, cotton, durable

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Authors: Lista Andriyati, Nurpudji A Taslim

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The human immunodeficiency virus (HIV) patients have potential nutritional and metabolic problems. HIV is a virus that attacks cells T helper and impairs the function of immune cells. Infected individuals gradually become immunodeficient, results in increased susceptibility to a wide range of infections such as tuberculosis (TB). Malnutrition has destructive effects on the immune system and host defense mechanisms. Effective and proper nutritional therapies are important to improve medical outcomes and quality of life, which is associated with functional improvement. A case of 38-years old man admitted to hospital with loss of consciousness and was diagnosed HIV infection and relapse lung TB with severe malnutrition, fever, oral candidiasis, anemia (6.3 g/dL), severe hypoalbuminemia (1.9 g/dL), severe hypokalemia (2.2 mmol/L), immune depletion (1085 /µL) and elevated liver enzyme (ALT 1198/AST 375 U/L). Nutritional intervention by giving 2300 kcal of energy, protein 2 g/IBW/day, carbohydrate 350 g, fat 104 g through enteral and parenteral nutrition. Supplementations administered are zinc, vitamin A, vitamin B1, vitamin B6, vitamin B12, vitamin C, vitamin D, and snakehead fish extract high content of protein albumin (Pujimin®). After 46 days, there are clinical and metabolic improvement in Hb (6.3 to 11.2 g/dL), potassium (2.2 to 3.4 mmol/L), albumin (1.9 to 2.3 g/dL), ALT 1198 to 47/AST 375 to 68 U/L) and improved awareness. In conclusion, nutritional therapy in HIV infection with adequate macronutrients and micronutrients fulfillment and immunonutrition is very important to avoid cachexia and to improve nutritional status and immune disfunction.

Keywords: HIV, hypoalbuminemia, malnutrition, tuberculosis

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Authors: Kusay Wheib, Alexandra Krvchenko

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Crop yields are influenced by many factors, including natural ones, such as soil and environmental characteristics of the agricultural land, as well as manmade ones, such as management applications. One of the factors that frequently affect crop yields in undulating Midwest landscapes is topography, which controls the movement of water and nutrients necessary for plant life. The main objective of this study is to examine how field topography influences performance of different management practices in undulated terrain of southwest Michigan. A total of 26 agricultural fields, ranging in size from 1.1 to 7.4 ha, from the Scale-Up at Kellogg Biological Station were included in the study. The two studied factors were crop species with three levels, i.e., corn (Zea mays L.) soybean (Glycine max L.), and wheat (Triticum aestivum L.), and management practice with three levels, i.e., conventional, low input, and organic managements. They were compared under three contrasting topographical settings, namely, summit (includes summits and shoulders), slope (includes backslopes), and depression (includes footslope and toeslope). Yield data of years 2007 through 2012 was processed, cleaned, and filtered, average yield then was calculated for each field, topographic setting, and year. Topography parameters, including terrain, slope, curvature, flow direction and wetness index were computed under ArcGIS environment for each topographic class of each field to seek their effects on yield. Results showed that topographical depressions produced greatest yields in most studied fields, while managements with chemical inputs, both low input and conventional, resulted in higher yields than the organic management.

Keywords: sustainable agriculture, precision agriculture, topography, yield

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Authors: Cheng-Yu Tsai, Wen-Te Liu, Chen-Chen Lo, Yin-Tzu Lin, Kang Lo

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Background: Driving fatigue related to inadequate or disordered sleep accounts for a major percentage of traffic accidents. Obstructive sleep apnea syndrome (OSAS) is a common respiratory disorder during sleep. However, the effects of OSAS severity on driving drowsiness remain unclear. Objective: The aim of this study is to investigate the relationship between OSAS severity and driving fatigue. Methodologies: The physical condition while driving was obtained from the questionnaires to classify the state of driving fatigue. OSAS severity was quantified as the polysomnography, and the mean hourly number of greater than 3% dips in oxygen saturation during examination in a hospital in New Taipei City (Taiwan). The severity of OSAS was diagnosed by the apnea and hypopnea index (AHI) with the American Academy of Sleep Medicine (AASM) guideline. The logistic regression model was used to examine the associations after adjusted age, gender, neck circumstance, waist circumstance, and body mass index (BMI). Results: There were 880 subjects recruited in this study, who had been done polysomnography for evaluating severity for OSAS as well as completed the driver condition questionnaire. 752 subjects were diagnosed with OSA, and 484 subjects had fatigue driving behavior in the past week. Patients diagnosed with OSAS had a 9.42-fold higher odds ratio (p < 0.01, 95% CI = 5.41 – 16.42) of driving drowsiness for cohorts with a normal degree. Conclusion: We observe the considerable correlation between OSAS and driving fatigue. For the purpose of promoting traffic safety, OSAS should be monitored and treated.

Keywords: obstructive sleep apnea syndrome, driving fatigue, polysomnography, apnea and hypopnea index

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Authors: Linda Frazer

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A pluralistic methodology focuses on promoting an understanding that an alternative juridical framework for the regulation of transnational business negotiations (TBN) between private business parties is fundamentally required. This paper deals with the evolving assessment of the doctoral research of the author which demonstrated that due to insufficient juridical tools, negotiations are commonly misunderstood within the complexity of pluralistic and conflicting legal regimes. This inadequacy causes uncertainty in the enforcement of legal remedies, leaving business parties surprised. Consequently, parties cannot sufficiently anticipate when and how legal rights and obligations are created, often counting on oral or incomplete agreements which may lead to the misinterpretation of the extent of their legal rights and obligations. This uncertainty causes threats to business parties for fear of creating unintended legal obligations or, conversely, that law will not enforce intended agreements for failure to pass the tests of contractual validity. A need to find a manner to set default standards of communications and standards of conduct to monitor our evolving global trade would aid law to provide the security, predictability and foreseeability during alternative dispute resolution required by TBN parties. The conclusion of this study includes a proposal of new trade mechanisms, termed 'Bills of Negotiations' (BON) to enhance party autonomy and promote the ability for TBN parties to self-regulate within the boundaries of law. BON will be guided by a secure juridical institutionalized setting that caters to guiding communications during TBN and resolving disputes that arise along the negotiation processes on a fast track basis.

Keywords: alternative resolution disputes, ADR, good faith, good faith, juridical security, legal regulation, trade mechanisms, transnational business negotiations

Procedia PDF Downloads 148

Authors: C. M. Nur Syazwani, M. K. Ahmad Imran, Rizal E. M. Nasir

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The study on BWB UV begins in UiTM since 2005 and three designs have been studied and published. The latest designs are Baseline-III and inspired by birds that have features and aerodynamics behaviour of cruising birds without flapping capability. The aircraft featuring planform and configuration are similar to the bird. Baseline-III has major flaws particularly in its low lift-to-drag ratio, stability and issues regarding limited controllability. New design known as Baseline-IV replaces straight, swept wing to delta wing and have a broader tail compares to the Baseline-III’s. The objective of the study is to investigate aerodynamics of Baseline-IV bird-inspired BWB aircraft. This will be achieved by theoretical calculation and wind tunnel experiments. The result shows that both theoretical and wind tunnel experiments of Baseline-IV graph of CL and CD versus alpha are quite similar to each other in term of pattern of graph slopes and values. Baseline-IV has higher lift coefficient values at wide range of angle of attack compares to Baseline-III. Baseline-IV also has higher maximum lift coefficient, higher maximum lift-to-drag and lower parasite drag. It has stable pitch moment versus lift slope but negative moment at zero lift for zero angle-of-attack tail setting. At high angle of attack, Baseline-IV does not have stability reversal as shown in Baseline-III. Baseline-IV is proven to have improvements over Baseline-III in terms of lift, lift-to-drag ratio and pitch moment stability at high angle-of-attack.

Keywords: blended wing-body, bird-inspired blended wing-body, aerodynamic, stability

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