Search results for: comprehensive care

Authors: Ercan Eker, Muhammer Karaman, Akif Aslan, Hakan Tanrikuluoglu

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Deficiency of institutional memory and knowledge management can result in information security breaches, loss of prestige and trustworthiness and the worst the loss of know-how and institutional knowledge. Traditional learning management within organizations is generally handled by personal efforts. That kind of struggle mostly depends on personal desire, motivation and institutional belonging. Even if an organization has highly motivated employees at a certain time, the institutional knowledge and memory life cycle will generally remain limited to these employees’ spending time in this organization. Having a learning management system in an organization can sustain the institutional memory, knowledge and know-how in the organization. Learning management systems are much more needed especially in public organizations where the job rotation is frequently seen and managers are appointed periodically. However, a learning management system should not be seen as an organizations’ website. It is a more comprehensive, interactive and user-friendly knowledge management tool for organizations. In this study, the importance of using learning management systems in the process of emerging tacit knowledge is underlined.

Keywords: knowledge management, learning management systems, tacit knowledge, institutional memory

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Authors: Sélima Baccar, Ephraim Clark

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This paper can be considered as a new perspective to analyse credit spreads. A comprehensive empirical analysis of conditional variance of credit spreads indices is performed using various GARCH models. Based on a comparison between traditional and asymmetric GARCH models with alternative functional forms of the conditional density, we intend to identify what macroeconomic and financial factors have driven daily changes in the US Dollar credit spreads in the period from January 2011 through January 2013. The results provide a strong interdependence between credit spreads and the explanatory factors related to the conditions of interest rates, the state of the stock market, the bond market liquidity and the exchange risk. The empirical findings support the use of asymmetric GARCH models. The AGARCH and GJR models outperform the traditional GARCH in credit spreads modelling. We show, also, that the leptokurtic Student-t assumption is better than the Gaussian distribution and improves the quality of the estimates, whatever the rating or maturity.

Keywords: corporate bonds, default risk, credit spreads, asymmetric garch models, student-t distribution

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Authors: Mark McGuire, Eric Shannon, John Parmigiani

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Timber harvesting increasingly involves mechanized equipment. This has increased the efficiency of harvesting, but has also introduced worker-safety concerns. One such concern arises from the use of harvesters. During operation, harvesters subject saw chain to large dynamic mechanical stresses. These stresses can, under certain conditions, cause the saw chain to fracture. The high speed of harvester saw chain can cause the resulting open chain loop to fracture a second time due to the dynamic loads placed upon it as it travels through space. If a second fracture occurs, it can result in a projectile consisting of one-to-several chain links. This projectile is referred to as a chain shot. It has speeds similar to a bullet but typically has greater mass and is a significant safety concern. Numerous examples exist of chain shots penetrating bullet-proof barriers and causing severe injury and death. Improved harvester-cab barriers can help prevent injury however a comprehensive scientific understanding of chain shot is required to consistently reduce or prevent it. Obtaining this understanding requires a test machine with the capability to cause chain shot to occur under carefully controlled conditions and accurately measure the response. Worldwide few such test machine exist. Those that do focus on validating the ability of barriers to withstand a chain shot impact rather than obtaining a scientific understanding of the chain shot event itself. The purpose of this paper is to describe the design, fabrication, and use of a test machine capable of a comprehensive scientific investigation of chain shot. The capabilities of this machine are to test all commercially-available saw chains and bars at chain tensions and speeds meeting and exceeding those typically encountered in harvester use and accurately measure the corresponding key technical parameters. The test machine was constructed inside of a standard shipping container. This provides space for both an operator station and a test chamber. In order to contain the chain shot under any possible test conditions, the test chamber was lined with a base layer of AR500 steel followed by an overlay of HDPE. To accommodate varying bar orientations and fracture-initiation sites, the entire saw chain drive unit and bar mounting system is modular and capable of being located anywhere in the test chamber. The drive unit consists of a high-speed electric motor with a flywheel. Standard Ponsse harvester head components are used to bar mounting and chain tensioning. Chain lubrication is provided by a separate peristaltic pump. Chain fracture is initiated through ISO standard 11837. Measure parameters include shaft speed, motor vibration, bearing temperatures, motor temperature, motor current draw, hydraulic fluid pressure, chain force at fracture, and high-speed camera images. Results show that the machine is capable of consistently causing chain shot. Measurement output shows fracture location and the force associated with fracture as a function of saw chain speed and tension. Use of this machine will result in a scientific understanding of chain shot and consequently improved products and greater harvester operator safety.

Keywords: chain shot, safety, testing, timber harvesters

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Authors: Rabia Qusien

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New media has emerged as a significant force in the society which connects people across the globe. Where new media brought many advantages for its users, there is a darker aspect of new technology in the form of cyberbullying. Researcher has employed survey method to reach to its targeted audience. Sample of 604 respondents was selected from one of metropolitan city of Pakistan Lahore to collect the data. Equal sample from both genders was selected to apply gender analysis. Results of this study indicate that cyber bullying is having significant psychological and educational effects. Females face more cyber bullying incidents as compared to males so they face more severe effects of cyber bullying. A comprehensive analysis of managing strategies depicts that mostly youth tries to handle this issue personally but at times they seek the support of their family and friends when they face severe issues. Due to privacy concerns females get more upset and they are more likely to seek social support from friends and family.

Keywords: cyber bullying, cyber victims, educational impacts, psychological impacts

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Authors: A. Anis, W. Bekheet, A. El Hakim

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Implementing a Road Safety Management System (SMS) in a crowded developing country such as Egypt is a necessity. Beginning a sustainable SMS requires a comprehensive reliable data system for all information pertinent to road crashes. In this paper, a survey for the available data in Egypt and validating it for using in an SMS in Egypt. The research provides some missing data, and refer to the unavailable data in Egypt, looking forward to the contribution of the scientific society, the authorities, and the public in solving the problem of missing or unreliable crash data. The required data for implementing an SMS in Egypt are divided into three categories; the first is available data such as fatality and injury rates and it is proven in this research that it may be inconsistent and unreliable, the second category of data is not available, but it may be estimated, an example of estimating vehicle cost is available in this research, the third is not available and can be measured case by case such as the functional and geometric properties of a facility. Some inquiries are provided in this research for the scientific society, such as how to improve the links among stakeholders of road safety in order to obtain a consistent, non-biased, and reliable data system.

Keywords: road safety management system, road crash, road fatality, road injury

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Authors: Weiyao Zhu, Bingbing Li, Yajing Liu, Zhiyong Song

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Branched-preformed particle gel (B-PPG) is a newly developed profile control and oil displacement agent for enhanced oil recovery in major oilfields. To provide a better understanding of the performance of B-PPG in high temperature reservoirs, a comprehensive experimental investigation was conducted by utilizing glass micromodel and synthetic core. The microscopic experimental results show that the B-PPG can selectively flow and plug in large pores. In terms of enhanced oil recovery, the decrease of residual oil in the margin regions (24.6%) was higher than that in the main stream (13.7%), which indicates it enlarged the sweep area. In addition, the effects of B-PPG injection concentration and injection rate on enhanced oil recovery were implemented by core flooding. The macroscopic experimental results indicate that the enhanced oil recovery increased with the increasing of injection concentration. However, the injection rate had a peak value. It is significant to get insight into the behaviors of B-PPG in reservoirs.

Keywords: branched-preformed particle gel, enhanced oil recovery, micromodel, core flooding

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Authors: Murad Almadani, Khalil Abu-Hantash, Xinyu Wang, Herbert Jelinek, Kinda Khalaf

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Gait analysis is used by healthcare professionals as a tool to gain a better understanding of the movement impairment and track progress. In most circumstances, monitoring patients in their real-life environments with low-cost equipment such as cameras and wearable sensors is more important. Inertial sensors, on the other hand, cannot provide enough information on angular dynamics. This research offers a method for tracking 2D joint coordinates using cutting-edge vision algorithms and a single RGB camera. We provide an end-to-end comprehensive deep learning pipeline for marker-less gait parameter estimation, which, to our knowledge, has never been done before. To make our pipeline function in real-time for real-world applications, we leverage the AlphaPose human posture prediction model and a deep learning transformer. We tested our approach on the well-known GPJATK dataset, which produces promising results.

Keywords: gait analysis, human pose estimation, deep learning, real time gait estimation, AlphaPose, transformer

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Authors: Anna Ghosh, Dominic Shields, Ceri McIntosh, Stephen Crank

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A 29-year-old male was a referral to the maxillofacial unit following a referral from his general dental practitioner via a routine pathway regarding a large periapical lesion on the LR4 with root resorption. The patient was asymptomatic, the LR4 vital and unrestored, and this was an incidental finding at a routine check-up. The patient's past medical history was unremarkable. Examination revealed no extra or intra-oral pathology and non-mobile teeth. No focal neurology was detected. An orthopantogram demonstrated a well-defined unilocular corticated radiolucency associated with the LR4. The root appeared shortened with the radiolucency between the root and a radio-opacity, possibly representing the displacement of the apical tip of the tooth. It was recommended that the referring general practitioner should proceed with orthograde root canal therapy, after which time exploration, enucleation, and retrograde root filling of the LR4 would be carried out by a maxillofacial unit. The patient was reviewed six months later where, due to the COVID-19 pandemic, the patient had been unable to access general dental services for the root canal treatment. He was still entirely asymptomatic. A one-year review was planned in the hope this would allow time for the orthograde root canal therapy to be completed. At this review, the orthograde root canal therapy had still not been completed. Interestingly, a repeat orthopantogram revealed a significant reduction in size with good bony infill and a significant reduction in the size of the lesion. Due to the ongoing delays with primary care dental therapy, the patient was subsequently internally referred to the restorative dentistry department for care. The patient was seen again by oral and maxillo-facial surgery in mid-2022 where he still reports this tooth as asymptomatic with no focal neurology. The patient's history was fully reviewed, and noted that 15 years previously, the patient underwent open reduction and internal fixation of a left angle of mandible fracture. Temporary IMF involving IMF screws and fixation wires were employed to maintain occlusion during plating and subsequently removed post-operatively. It is proposed that the radiolucency was, as a result of the IMF screw placement, penetrating the LR4 root resulting in resorption of the tooth root and development of a radiolucency. This case highlights the importance of careful screw size and physical site location, and placement of IMF screws, as there can be permeant damage to a patient’s dentition.

Keywords: facial trauma, inter-maxillary fixation, mandibular radiolucency, oral and maxillo-facial surgery

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Authors: Djehich Mohamed Yousri

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In recent years, the world has witnessed a phenomenon of displacement that is unprecedented in history. The number of refugees has reached record levels, due to wars, persecution, many conflicts and repression in a number of countries. The interest of United Nations bodies and international and regional organizations in the issue of refugees has increased, as they have defined a refugee and thus Determining who is entitled to this legal protection, and the 1951 Convention for the Protection of Refugees defines rights for refugee protection and sets obligations that they must perform. The institutional mechanisms for refugee protection are represented in the various agencies that take care of refugee affairs. At the forefront of these agencies is the United Nations High Commissioner for Refugees, as well as the various efforts provided by the International Committee of the Red Cross and the United Nations Relief and Works Agency for Palestine Refugees in the Middle East (UNRWA).

Keywords: protection, refugees, international, persecution, legal

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Authors: Ghada Mohammed, Mohamed Abdel Salam, Passent Tantawi

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The study aimed to investigate the impact of motives and barriers for Egyptian users to use Airbnb as a platform of peer-to-peer accommodation instead of hotels on overall attitude towards Airbnb. A sequential mixed-methods approach was adopted to this study and it proposed a comprehensive research model adapted from both literature and results of qualitative phase and then tested via an online questionnaire. The findings revealed that, motives, price, home benefits, privacy, and online reviews significantly explained overall attitude towards Airbnb, while the main barriers were respectively: perceived risk and distrust in which they can predict the overall attitude. While from the subjective norms, only social influence can predict behavioral intention to use Airbnb. The study may serve as a practical reference for practitioners as well as researchers when developing programs and strategies to manage Airbnb consumers' needs and decision process. Some of the main conclusions drawn from this study are that variety was one of the major things that users like about Airbnb and the most important motives are the functional ones like price rather than the experiential ones like authenticity.

Keywords: airbnb, barriers, disruptive innovation, motives, sharing economy

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Authors: Wisam Ismail, Chole Wright, Elizabeth Baker, Cathy Tait, Mohamed Salhab, Richard Linforth

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Background: Post-mastectomy breast reconstruction is an important treatment option for women with breast cancer with psychosocial, emotional and quality of life benefits. Despite this, Asian patients are one-fifth as likely as Caucasian patients to undergo reconstruction after mastectomy. Aim: This study aimed to assess the difference in breast reconstruction rates between Asian and Caucasian patients treated at Bradford Teaching Hospitals between May 2011 – December 2015.The long-term goal is to equip healthcare professionals to improve breast cancer treatment outcome by increasing breast reconstruction rates in this sub-population. Methods: All patients undergoing mastectomy were identified using a prospectively collected departmental database. Further data was obtained via retrospective electronic case note review. Bradford city population is about 530.000 by the end of 2015, with 67.44% of the city's population was White ethnic groups and 26.83% Asian Ethnic Groups (UK population consensus). The majority of Asian population speaks Urdu, hence an Urdu speaking breast care nurse was appointed to facilitate communications and deliver a better understanding of the reconstruction options and pathways. Statistical analysis was undertaken using the SAS program. Patients were stratified by age, self-reported ethnicity, axillary surgery and reconstruction. Relative odds were calculated using univariate and multivariate logistic regression analyses with adjustment for known confounders. An Urdu speaking breast care nurse was employed throughout this period to facilitate communication and patient decision making. Results: 506 patients underwent Mastectomy over 5 years. 72 (14%) Asian v. 434 (85%) Caucasian. Overall median age is 64 years (SD1.1). Asian median age is 62 (SD0.9), versus Caucasian 65 (SD1.2). Total axillary clearance rate was 30% (42% Asian v.30% Caucasian). Overall reconstruction rate was 126 patients (28.9%).Only 6 of 72 Asian patients (<1%) underwent breast reconstruction versus 121of 434 Caucasian (28%) (p < 0.04), Odds ratio 0.68, (95% confidence interval 0.57-0.79). Conclusions: There is a significant difference in post-mastectomy reconstruction rates between Asian and Caucasian patients. This difference is likely to be multi-factorial. Higher rates of axillary clearance in Asian patients might suggest later disease presentation and/or higher rates of subsequent adjuvant therapy, both of which, can impact on the suitability of breast reconstruction. Strategies aimed at reducing racial disparities in breast reconstruction should include symptom awareness to enable earlier presentation and facilitated communication to ensure informed decision-making.

Keywords: aesthetic, Asian, breast, reconstruction

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Authors: Mohsin Talib Mohammed, Zahid A. Khan, Arshad N. Siddiquee

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The wide use of titanium (Ti) materials in medicine gives impetus to a search for development new techniques with elevated properties such as strength, corrosion resistance and Young's modulus close to that of bone tissue. This article presents the most recent state of the art on the use of equal channel angular pressing (ECAP) technique in evolving mechanical characteristics of the ultrafine-grained bio-grade Ti materials. Over past few decades, research activities in this area have grown enormously and have produced interesting results, including achieving the combination of conflicting properties that are desirable for biomedical applications by severe plastic deformation (SPD) processing. A comprehensive review of the most recent work in this area is systematically presented. The challenges in processing ultrafine-grained Ti materials are identified and discussed. An overview of the biomedical Ti alloys processed with ECAP technique is given in this review, along with a summary of their effect on the important mechanical properties that can be achieved by SPD processing. The paper also offers insights in the mechanisms underlying SPD.

Keywords: mechanical properties, ECAP, titanium, biomedical applications

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Authors: M. Illias Kanchan

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The death of a woman during pregnancy and childbirth is not only a health issue, but also a matter of social injustice. This study makes an attempt to explore the association between maternal death and associated factors in West Bengal using the approaches of facility-based and community-based maternal death review. Bivariate and binary logistic regression analysis have been performed to understand the causes and circumstances of maternal deaths in West Bengal. Delay in seeking care was the major contributor in maternal deaths, near about one-third women died due to this factor. The most common cause of maternal death is found to be hypertensive disorders of pregnancy or eclampsia. We believe that these deaths can be averted by reducing hypertensive disorders of pregnancy or eclampsia.

Keywords: maternal death, facility-based, community-based, review, west Bengal, eclampsia

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Authors: Loizos A. Hadjivasiliou, May Chehab

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Confronted with the human tragedy unfolding in the Mediterranean during the 2011-2016 period, the European Union introduced for the first time the “hotspot approach”, the establishment of facilities for initial reception, identification registration, and fingerprinting of asylum seekers and migrants arriving in the EU by sea, at the frontline Member States. However, the lack of a comprehensive collective policy on migration management and border security left the Mediterranean Member States, mainly Italy, Greece, and Cyprus, struggling to overcome these challenges. The current study sheds light on the implementation of the hotspot approach as the frontispiece of the European response to the migration challenges, which, limited to the operational and financial support of the hosting member states, leads to heterogeneous burden-sharing. Within this framework, it highlights the fact that the implementation of the hotspots as a panacea carries the risk of transforming the Mediterranean member states into giant hotspots with unpredictable consequences for the future of the Schengen area.

Keywords: asylum, burden sharing, hotspots, migration management policy, Schengen area

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Authors: Blessing Olamide Taiwo, Andrew Palangio, Chirag Savaliya, Jenil Patel

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Oversized material resulting from blasting presents a notable drawback in the transportation of run-off-mine material due to increased expenses associated with handling, decreased efficiency in loading, and greater wear on digging equipment. Its irregular size and weight demand additional resources and time for secondary breakage, impacting overall productivity and profitability. This paper addresses the limitations of interpreting image analysis software results and applying them to the assessment of blast-generated oversized materials. This comprehensive guide utilizes both ortho mosaic and digital photos to provide critical approaches for optimizing fragmentation analysis and improving decision-making in mining operations. It briefly covers post-blast assessment, blast block heat map interpretation, and material loading decision-making recommendations.

Keywords: blast result assessment, WipFrag, oversize identification, orthomosaic images, production optimization

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Authors: Melissa Beck Wells

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This study examines the complex factors affecting teacher retention across states, focusing on the roles of salaries, educational policies, and professional development. Despite efforts to reduce teacher turnover, it remains a significant challenge, impacting the quality of education and student outcomes. Analysis of data from the National Education Association, the ‘Raise the Bar’ initiative, and the Education Commission of the States reveals a minimal negative correlation between teacher salaries and retention, indicating that salary alone does not determine retention. Additionally, thematic analysis of educational policies and development programs highlights effective strategies for addressing retention challenges. The research emphasizes the need for holistic support systems, including mentorship and professional growth opportunities, to improve retention. These findings urge policymakers and educational leaders to develop comprehensive strategies to maintain a qualified teaching workforce and enhance educational quality and equity nationwide.

Keywords: teacher retention, salary levels, educational policies, professional development, teacher turnover

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Authors: Tao Feng, Fei Xing, Ye Lu, Jun Li Fang

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NDN is a kind of future Internet architecture. Due to the NDN design introduces four privacy challenges,Many research institutions began to care about the privacy issues of naming data network(NDN).In this paper, we are in view of the major NDN’s privacy issues to investigate privacy protection,then put forwards more effectively anonymous transfer policy for NDN.Firstly,based on mutual anonymity communication for MP2P networks,we propose NDN mutual anonymity protocol.Secondly,we add interest package authentication mechanism in the protocol and encrypt the coding coefficient, security of this protocol is improved by this way.Finally, we proof the proposed anonymous transfer protocol security and anonymity.

Keywords: NDN, mutual anonymity, anonymous routing, network coding, authentication mechanism

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Authors: E. V. Fakhrutdinova, K. R. Maksimova, P. B. Chursin

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At the present stage of the society progress the health care is an integral part of both the economic system and social, while in the second case the medicine is a major component of a number of basic and necessary social programs. Since the foundation of the health system are highly qualified health professionals, it is logical proposition that increase of doctor`s professionalism improves the effectiveness of the system as a whole. Professionalism of the doctor is a collection of many components, essential role played by such personal-psychological factors as honesty, willingness and desire to help people, and motivation. A number of researchers consider motivation as an expression of basic human needs that have passed through the “filter” which is a worldview and values learned in the process of socialization by the individual, to commit certain actions designed to achieve the expected result. From this point of view a number of researchers propose the following classification of highly skilled employee’s needs: 1. the need for confirmation the competence (setting goals that meet the professionalism and receipt of positive emotions in their decision), 2. The need for independence (the ability to make their own choices in contentious situations arising in the process carry out specialist functions), 3. The need for ownership (in the case of health care workers, to the profession and accordingly, high in the eyes of the public status of the doctor). Nevertheless, it is important to understand that in a market economy a significant motivator for physicians (both legal and natural persons) is to maximize its own profits. In the case of health professionals duality motivational structure creates an additional contrast, as in the public mind the image of the ideal physician; usually a altruistically minded person thinking is not primarily about their own benefit, and to assist others. In this context, the question of the real motivation of health workers deserves special attention. The survey conducted by the American researcher Harrison Terni for the magazine "Med Tech" in 2010 revealed the opinion of more than 200 medical students starting courses, and the primary motivation in a profession choice is "desire to help people", only 15% said that they want become a doctor, "to earn a lot". From the point of view of most of the classical theories of motivation this trend can be called positive, as intangible incentives are more effective. However, it is likely that over time the opinion of the respondents may change in the direction of mercantile motives. Thus, it is logical to assume that well-designed system of motivation of doctor`s labor should be based on motivational foundations laid during training in higher education.

Keywords: motivation, quality of working life, health system, personal-psychological factors, motivational structure

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Authors: Priyesh Kumar Singh, S. K. Sharma, Sanjay Verma, C. Samuel

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Supplier Relationship Management (SRM), is strategic planning and managing of all interactions with suppliers to maximize its value. Its application varies from construction industries to healthcare system and investment banks to aviation industries. Several buyer-supplier relationship models, as well as supplier selection and evaluation strategies, have been documented by many academicians and researchers. In this paper, through a comprehensive literature review of over 30 published papers, different theoretical models, empirical data and conclusions were analysed relating to SRM to find its role in establishing better supplier relationships. These journal articles were searched by using the keyword “supplier relationship management,” in databases of Mendeley Library, ProQuest, EBSCO and Google Scholar. This paper reviews the academic literature on different relationship models, supplier evaluation, and selection strategies to discuss its implications in different situations. It also describes the dominant factors responsible for buyer-supplier relationships such trust and power. Finally, conclusions have been drawn which can be validated by various researchers and can help practitioners in industries.

Keywords: supplier relationship management, supplier performance, supplier evaluation, supplier selection strategies

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Authors: Huimin Liu, Li Xiang, Yue Liu, Jing Wang

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Background: As one of typical case for the developing countries who are stepping into the aging times globally, more and more older people in China might face the problem of which they could not maintain normal life due to the functional disability. While the government take efforts to build long-term care system and further carry out related policies for the core concept, there is still lack of strong evidence to evaluating the profile of disability states in the elderly population and its transition rate. It has been proved that disability is a dynamic condition of the person rather than irreversible so it means possible to intervene timely on them who might be in a risk of severe disability. Objective: The aim of this study was to depict the picture of the disability transferring status of the older people in China, and then find out individual characteristics that change the state of disability to provide theory basis for disability prevention and early intervention among elderly people. Methods: Data for this study came from the 2011 baseline survey and the 2013 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS). Normal ADL function, 1~2 ADLs disability,3 or above ADLs disability and death were defined from state 1 to state 4. Multi-state Markov model was applied and the four-state homogeneous model with discrete states and discrete times from two visits follow-up data was constructed to explore factors for various progressive stages. We modeled the effect of explanatory variables on the rates of transition by using a proportional intensities model with covariate, such as gender. Result: In the total sample, state 2 constituent ratio is nearly about 17.0%, while state 3 proportion is blow the former, accounting for 8.5%. Moreover, ADL disability statistics difference is not obvious between two years. About half of the state 2 in 2011 improved to become normal in 2013 even though they get elder. However, state 3 transferred into the proportion of death increased obviously, closed to the proportion back to state 2 or normal functions. From the estimated intensities, we see the older people are eleven times as likely to develop at 1~2 ADLs disability than dying. After disability onset (state 2), progression to state 3 is 30% more likely than recovery. Once in state 3, a mean of 0.76 years is spent before death or recovery. In this model, a typical person in state 2 has a probability of 0.5 of disability-free one year from now while the moderate disabled or above has a probability of 0.14 being dead. Conclusion: On the long-term care cost considerations, preventive programs for delay the disability progression of the elderly could be adopted based on the current disabled state and main factors of each stage. And in general terms, those focusing elderly individuals who are moderate or above disabled should go first.

Keywords: Markov model, elderly people, disability, transition intensity

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Authors: Rodrigo Zepeda

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Transaction cost analysis (TCA) is a way of analyzing the relative performance of different intermediaries and different trading strategies for trades undertaken in financial instruments. It is a way for an investor to determine the overall quality of execution of a particular trade, and there are many different approaches to undertaking TCA. Under the updated Markets in Financial Instruments Directive (2014/65/EU) (MiFID II), investment firms are required when executing orders, to take all sufficient steps to obtain the best possible result for their clients. This requirement for 'Best Execution' must take into account price, costs, speed, likelihood of execution and settlement, size, nature or any other consideration relevant to the execution of the order. The new regulatory compliance framework under MiFID II will now also apply across a very broad range of financial instruments. This article will provide a comprehensive technical analysis of how TCA and Best Execution will significantly change under MiFID II. It will also explain why harmonization of post-trade reporting requirements under MiFID II could potentially support the development of peer group analysis, which in turn could provide a new and highly advanced framework for TCA that could more effectively support Best Execution requirements under MiFID II. The study is significant because there are no studies that have dealt with TCA and Best Execution under MiFID II in the literature.

Keywords: transaction cost analysis, execution quality, best execution, MiFID II, financial instruments

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Authors: Haley Hrymak

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For decades drug addiction has been understood to be a health problem and not a social problem. While research has advanced to allow for a more comprehensive understanding of the factors affecting addiction, the justice system has lagged behind. Given all that is known about addiction as a health issue and the need for effective rehabilitation to prevent further involvement with crime, there is a need for a dramatic shift in order to ensure individual's human right to health is being upheld within the Canadian criminal justice system. This research employs the qualitative methodology to interview advocates who work with substance users within the Greater Vancouver area to explore best practices for representing individuals with substance abuse issues within the Canadian justice system. The research shows that treatment, not punishment, is what is needed in order for recidivism to be reduced for individuals with substance abuse issues. The creative options that advocates employ to work within the current system are intended to provide a guide for lawyers working within the current criminal justice system.

Keywords: addiction, criminal law, right to health, rehabilitation

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Authors: Muhammad Saleem

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The research paper entitled above would be a comprehensive and critical study of translations of the meanings of the Holy Qur’an. The discussion will deal with the targets & purposes of Urdu (National Language of Pakistan) translators of the meanings of the Holy Qur’an. There are more than 400 translations of the meanings of the Holy Qur’an in the Urdu Language. Muslims, non-Muslims and some organizations have made translations of the meanings of the Holy Qur’an to meet various targets. It is observed that all Urdu translators have not translated the Qur’an with a single objective and motivation; rather, some are biased and strive to discredit the Qur’an. Thus, they have made unauthentic and fabricated translations of the Qur’an. Some optimistically believe that they intend to do a service, whereas others pessimistically hold that they treacherously seek to further their rule. Some of them have been observed to be against Islam, starting their activities with spite, but after perceiving the truths of Islam and the miracle and greatness of the Holy Qur’an, they submitted to Islam, embracing it with pure hearts. Some translators made their translations of the meanings of the Holy Qur’an to serve Allah, and some of them have done their translations to earn only. All these translations vary from one to another due to style, trend, type, method and style. Some Urdu translations have been made to fulfill the lingual requirements. Some translations have been made by Muslim scholars to reduce the influence of Urdu translations of the meanings of the Holy Qur’an by Non-Muslims. The article deals with the various purposes of the translators of the meanings of the Holy Qur’an.

Keywords: Qur'an, translation, urdu, language

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Authors: Emanuela Zilli, Suana Tikvina, Davide Bonaldo, Monica Varotto, Scilla Rizzardi, Barbara Ruzzante, Raffaele Napolitano, Stefano Bevilacqua, Antonella Ruffatto

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A healthy workplace increases productivity, creativity and decreases absenteeism and turnover. It also contributes to creating a more secure work environment with fewer risks of violence. In the past 3 years, the healthcare system has suffered the psychological, economic and social consequences of the COVID-19 pandemic. On the other hand, the healthcare staff reductions determine high levels of work-related stress that are often unsustainable. The Hospital of Cittadella (in the province of Padua) has 400 beds and serves a territory of 300,000 inhabitants. The hospital itself counts 1.250 healthcare employees (healthcare professionals). This year, the Medical Board of Directors has requested additional staff; however, the economic situation of Italy can not sustain additional hires. At the same time, we have initiated projects that aim to increase well-being, decrease stress and encourage activities that promote self-care. One of the projects that the hospital has organized is the psychomotor practice. It is held by therapists and trainers who operate according to the traditional method. According to the literature, the psychomotor practice is specifically intended for the staff operating in the Intensive Care Unit, Emergency Department and Pneumology Ward. The project consisted of one session of 45 minutes a week for 3 months. This method brings focus to controlled breathing, posture, muscle work and movement that help manage stress and fatigue, creating a more mindful and sustainable lifestyle. In addition, a Qigong course was held every two weeks for 5 months. It is an ancient Chinese practice designed to optimize the energy within the body, reducing stress levels and increasing general well-being. Finally, Tibetan singing crystal bowls sessions, held by a music therapist, consisted of monthly guided meditation sessions using the sounds of the crystal bowls. Sound therapy uses the vibrations created from the crystal bowls to balance the vibrations within the body to promote relaxation. In conclusion, well-being and organizational performance are closely related to each other. It is crucial for any organization to encourage and maintain better physical and mental health of the healthcare staff as it directly affects productivity and, consequently, user satisfaction of the services provided.

Keywords: health promotion, healthcare workers management, Weel being and organizational performance, Psychomotor practice

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Authors: A. M. Nasr, W. R. Azzam, K. E. Ebeed

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For bored piles, careful cleaning must be used to reduce the amount of material trapped in the drilled hole; otherwise, the debris' presence might cause the soft toe effect, which would affect the axial resistance. There isn't much comprehensive research on bored piles with debris. In order to investigate the behavior of a single pile, a pile composite foundation, a two pile group, a three pile group and a four pile group investigation conducts, forty-eight numerical tests in which the debris is simulated using foam rubber.1m pile diameter and 10m length with spacing 3D and depth of foundation 1m used in this study. It is found that the existence of debris causes a reduction of bearing capacity by 64.58% and 33.23% for single pile and pile composite foundation, respectively, 23.27% and 24.24% for the number of defective piles / total number of pile =1/2 and 1 respectively for two group pile, 10.23%, 19.42% and 28.47% for the number of defective piles / total number of pile =1/3,2/3 and 1 respectively for three group pile and, this reduction increase with the increase in a number of defective piles / a total number of piles and 7.1%, 13.32%,19.02% and 26.36 for the number of defective piles / total number of pile =1/4,2/4,3/4 and 1 respectively for four group pile and decreases with an increase of number of pile duo to interaction effect.

Keywords: debris, Foundation, defective, interaction, board pile

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Authors: Heena Dabas, Anju Paul, Suman Chaurasia, Ramesh Agarwal, M. Jeeva Sankar, Anurag Bajpai, Manju Saksena

Abstract:

Background: Traumatic lumbar puncture (LP) is a common occurrence and causes substantial diagnostic ambiguity. There is paucity of data regarding its epidemiology. Objective: To assess the incidence and risk factors of traumatic LP in newborns. Design/Methods: In a prospective cohort study, all inborn neonates admitted in NICU and planned to undergo LP for a clinical indication of sepsis were included. Neonates with diagnosed intraventricular hemorrhage (IVH) of grade III and IV were excluded. The LP was done by operator - often a fellow or resident assisted by bedside nurse. The unit has policy of not routinely using any sedation/analgesia during the procedure. LP is done by 26 G and 0.5-inch-long hypodermic needle inserted in third or fourth lumbar space while the infant is in lateral position. The infants were monitored clinically and by continuous measurement of vital parameters using multipara monitor during the procedure. The occurrence of traumatic tap along with CSF parameters and other operator and assistant characteristics were recorded at the time of procedure. Traumatic tap was defined as presence of visible blood or more than 500 red blood cells on microscopic examination. Microscopic trauma was defined when CSF is not having visible blood but numerous RBCs. The institutional ethics committee approved the study protocol. A written informed consent from the parents and the health care providers involved was obtained. Neonates were followed up till discharge/death and final diagnosis was assigned along with treating team. Results: A total of 362 (21%) neonates out of 1726 born at the hospital were admitted during the study period (July 2016 to January, 2017). Among these neonates, 97 (26.7%) were suspected of sepsis. A total of 54 neonates were enrolled who met the eligibility criteria and parents consented to participate in the study. The mean (SD) birthweight was 1536 (732) grams and gestational age 32.0 (4.0) weeks. All LPs were indicated for late onset sepsis at the median (IQR) age of 12 (5-39) days. The traumatic LP occurred in 19 neonates (35.1%; 95% C.I 22.6% to 49.3%). Frank blood was observed in 7 (36.8%) and in the remaining, 12(63.1%) CSF was detected to have microscopic trauma. The preliminary risk factor analysis including birth weight, gestational age and operator/assistant and other characteristics did not demonstrate clinically relevant predictors. Conclusion: A significant number of neonates requiring lumbar puncture in our study had high incidence of traumatic tap. We were not able to identify modifiable risk factors. There is a need to understand the reasons and further reduce this issue for improving management in NICUs.

Keywords: incidence, newborn, traumatic, lumbar puncture

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Authors: Hela Ghali, Sihem Ben Fredj, Mohamed Ben Rejeb, Sawssen Layouni, Salwa Khefacha, Lamine Dhidah, Houyem Said Laatiri

Abstract:

Background: Antimicrobial resistance is a growing threat to public health and motivates to improve prevention and control programs both at international (WHO) and national levels. Despite their low pathogenicity, vancomycin-resistant enterococci (VRE) are common nosocomial pathogens in several countries. The high potential for transmission of VRE between patients and the threat to send its resistance genes to other bacteria such as staphylococcus aureus already resistant to meticilin, justify strict control measures. Indeed, in Europe, the proportion of Enterococcus faecium responsible for invasive infections, varies from 1% to 35% in 2011 and less than 5% were resistant to vancomycin. In addition, it represents the second cause of urinary tract and wound infections and the third cause of nosocomial bacteremia in the United States. The nosocomial outbreaks of VRE have been mainly described in intensive care services, hematology-oncology and haemodialysis. An epidemic of VRE has affected our hospital and the objective of this work is to describe the measures put in place. Materials/Methods: Following the alert given by the service of plastic surgery concerning a patient carrier of VRE, a team of the prevention and healthcare security service (doctor + technician) made an investigation. A review of files was conducted to draw the synoptic table and the table of cases. Results: By contacting the microbiology laboratory, we have identified four other cases of VRE and who were hospitalized in Medical resuscitation department (2 cases, one of them was transferred to the Physical rehabilitation department), and Nephrology department (2 cases). The visit has allowed to detect several malfunctions in professional practice. A crisis cell has allowed to validate, coordinate and implement control measures following the recommendations of the Technical Center of nosocomial infections. In fact, the process was to technically isolate cases in their sector of hospitalization, to restrict the use of antibiotics, to strength measures of basic hygiene, and to make a screening by rectal swab for both cases and contacts (other patients and health staff). These measures have helped to control the situation and no other case has been reported for a month. 2 new cases have been detected in the intensive care unit after a month. However, these are short-term strategies, and other measures in the medium and long term should be taken into account in order to face similar outbreaks. Conclusion: The efforts to control the outbreak were not efficient since 2 new cases have been reported after a month. Therefore, a continuous monitoring in order to detect new cases earlier is crucial to minimize the dissemination of VRE.

Keywords: hospitals, nosocomial infection, outbreak, vancomycin-resistant enterococci

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Authors: J. Waldon

Abstract:

The civil aviation industry plays a crucial role in global transportation, connecting people and goods across the world. Ensuring the safety and security of passengers, crew, and aircraft is of paramount importance. This paper aims to address the aspect of training and human factors, amongst others, necessary for enhancing civil aviation safety and security. In this context, we are focusing on the level of attention exhibited in the checking of luggage and travel credentials, with the aim to identify areas of improvement and avoid compromising security and safety at the Nsimalen Airport Yaoundé, Cameroon. We found that there is a lack of proper awareness among both travelers and some staff on the safety and security of goods and passengers. We suggest that improved training and handling, and sensitization in the form of legible billboards are important. Thus, we recommend refresher courses like this one for staff to keep abreast with the fast-changing security landscape in air transport as well as proper sensitization, including health-related issues. In conclusion, we established that the human factors, as well as the frequency of training and refresher courses, have a positive outlook on safety and security in air transport.

Keywords: safety, security, passengers, cargo

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Authors: Mohamed Adel Ahmed, Warda Youssef Morsy , Hanaa Ali El Feky

Abstract:

Background: Literature review cited that sleep is absolutely essential for surviving and reclamation of the quality of life. Critically ill patients often have poor sleep quality with prolonged sleep latency, sleep fragmentation, decreased sleep efficiency and frequent arousals. Nurses have a unique role for the early diagnosis of sleep disorders, decreasing stressors levels and providing the necessary environmental regulations to create a therapeutic ambiance. The aim of the study: to assess perceived sleep quality and identify factors affecting sleep quality among adult critically ill patients At El Manial University Hospital. Research Design: A descriptive exploratory design was utilized. Research questions: a) how do adult critically ill patients perceive sleep quality in the Critical Care Department of El Manial University Hospital? b) What are the factors affecting sleep quality among adult critically ill patients at El Manial University Hospital? Setting: selected critical and cardiac care units at El Manial University Hospital. Sample: A samples of convenience consisting of 100 adult male and female patients were included in the study. Tools of data collection: tool 1: Socio-demographic and Medical Data Sheet, tool 2: Modified St Mary's Hospital Sleep Questionnaire tool 3: Factors Affecting Sleep Quality Questionnaire among ICU Patients Results: The current study revealed that 76.0% of the studied sample had lack of sleep disturbance before hospitalization. However, 84 % had sleep disturbances during ICU stay, of these more than two-thirds (67 %) had moderate sleep disturbance. Presence of strange and bad odors, noise, having pain, fear of death and a loud voice produced by the ICU personnel had the most significant negative impact on patients’ sleep in percentage of 52.4, 50, 61.9, 45.2, 52.4, respectively. Conclusion: Sleep disturbances in the ICU are multifactorial, and ICU patients’ perceived degrees of sleep disturbance as a moderate. Recommendations: Based on findings of the present study, the following are recommended to be done by ICU nurses; create a healing ICU environment that should incorporate noise, light and temperature controls; decrease stimuli during night time hours to promote regulation of the circadian rhythm, allow usage of sleeping aids such as relaxing music, eye patches and earplugs into their daily nursing practice; cluster nursing activities and eliminate non-essential treatments during night time hours to allow uninterrupted sleep periods of at least 90 minutes to complete one sleep cycle , and minimize staff conversation, alarm noise and light during the quiet night time hours.

Keywords: sleep quality, critically ill, patients, perception

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Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen

Abstract:

Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.

Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric

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