Search results for: quality of experience (QoE)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13881

Search results for: quality of experience (QoE)

11391 An ICF Framework for Game-Based Experiences in Geriatric Care

Authors: Marlene Rosa, Susana Lopes

Abstract:

Board games have been used for different purposes in geriatric care, demonstrating good results for health in general. However, there is not a conceptual framework that can help professionals and researchers in this area to design intervention programs or to think about future studies in this area. The aim of this study was to provide a pilot collection of board games’ serious purposes in geriatric care, using a WHO framework for health and disability. Study cases were developed in seven geriatric residential institutions from the center region in Portugal that are included in AGILAB program. The AGILAB program is a serious game-based method to train and spread out the implementation of board games in geriatric care. Each institution provides 2-hours/week of experiences using TATI Hand Game for serious purposes and then fulfill questions about a study-case (player characteristics; explain changes in players health according to this game experience). Two independent researchers read the information and classified it according to the International Classification for Functioning and Disability (ICF) categories. Any discrepancy was solved in a consensus meeting. Results indicate an important variability in body functions and structures: specific mental functions (e.g., b140 Attention functions, b144 Memory functions), b156 Perceptual functions, b2 sensory functions and pain (e.g., b230 Hearing functions; b265 Touch function; b280 Sensation of pain), b7 neuromusculoskeletal and movement-related functions (e.g., b730 Muscle power functions; b760 Control of voluntary movement functions; b710 Mobility of joint functions). Less variability was found in activities and participation domains, such as purposeful sensory experiences (d110-d129) (e.g., d115 Listening), communication (d3), d710 basic interpersonal interactions, d920 recreation and leisure (d9200 Play; d9205 Socializing). Concluding, this framework designed from a brief gamed-based experience includes mental, perceptual, sensory, neuromusculoskeletal, and movement-related functions and participation in sensory, communication, and leisure domains. More studies, including different experiences and a high number of users, should be developed to provide a more comprehensive ICF framework for game-based experiences in geriatric care.

Keywords: board game, aging, framework, experience

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11390 Caring for a Spinal Cord Injury Patient with Diabetic Nephropathy Receiving Hospice Palliative Care

Authors: Li-Ting Kung, Hui-Zhu Chen, Hsin-Tzu Lee, Wan-Yin Hsu

Abstract:

Patients with spinal cord injury combined with diabetic nephropathy may under a lot of painful conditions due to complications related to the illness itself or treatments, such as recurrent pressure ulcers, autonomic and peripheral neuropathy, as well as dialysis, for long term. This case report illustrated the nursing experience of transferring a spine cord injure patient who received hemodialysis due to adverse lifestyle-induced diabetic nephropathy to the hospice ward. Nursing care was provided in this patient from July 25th to August 30th, 2015. The tool of 'Gordon’s 11-item functional health assessment' and clinical observation, interviews as well as physical examination were used as data collections. Based on results of health assessment as above, the patient’s health problems were identified as the following: impaired skin integrity, chronic pain, and hopeless. Besides to relieve the symptom of pain due to disease or the treatment of hemodialysis and provide wound care, the first author also played a role to assist the patient to achieve his goal of receiving the hospice palliative care. Finally, with much effort of nurses to communicate with medical teams between the surgical and hospice wards, the patient was transferred to the hospice ward to have fulfilled his last wish of having a good death. We hope this nursing experience can be applied to other similar cases in the future.

Keywords: diabetic nephropathy, hospice care, palliative care, spinal cord injury

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11389 Embracing Our Scars: Self-Harm 101

Authors: Bree Wiles

Abstract:

Self-harm is still a topic that is not talked about enough, especially with the growing concern for the safety of LGBTQIA+ youth. LGBTQIA+ youth are coming out at earlier ages, thus bringing to attention the added risks for this population. Many LGBTQIA+ youth end up engaging in some form of self-destructive behavior from dealing with the stigma and negative socialization around them. Within the LGBTQIA+ youth population, self-harm alongside depression and suicide is especially common. This disparity shows the importance of providing LGBTQIA+ youth with resources that affirm their identities. As professionals and parents, it is important to understand the types of self-harm, the average age range when it can occur, causes, populations, risk factors, and self-harm in connection with mental health and suicide. It is imperative to provide protective factors for LGBTQIA+ youth in helping to replace self-harming behaviors with positive coping strategies. Helping LGBTQIA+ youth in different contexts, including from a professional, parent, and educator perspective, allows unique ways in which each can assist an LGBTQIA+ youth who is self-harming. The stigma, shame, and many misconceptions about self-harming behaviors are discussed in depth including from the lived experience of this author and professional experiences working with queer youth. Most importantly, it is imperative to know how to approach LGBTQIA+ youth who are self-harming, including how to speak in a compassionate and empathy-based framework. Clear interventions and therapeutic techniques based on evidence-based practices on alternatives to self-harm, lived experience, and previous practices with queer youth who are self-harming are provided and discussed.

Keywords: LGBTQ+, mental health, self-harm, depression

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11388 Characterization of Fateh Sagar Wetland and Its Catchment Area at Udaipur City, (Raj.) India, Using High Resolution Data

Authors: Parul Bhalla, Sarvesh Palria

Abstract:

Wetlands are areas of land that are either temporarily or permanently covered by water. Wetlands exhibit enormous diversity according to their genesis, geographical location, water regime and chemistry, dominant plants and soil or sediment characteristics. The spatial and temporal characteristics of wetland in terms of turbidity and aquatic vegetation could serve as guiding tool, in conservation prioritization of wetlands. The aquatic vegetation in the wetland is an indicator of the trophic status of the wetland which has a bearing on the water quality, the turbidity level in any wetland is indicative of the quality of the water in it. To conserve and manage wetland resources, it is important to have inventory of wetland and its catchment. Fateh Sagar wetland in Udaipur city is the one of the important wetland for tourism industry and other economic activities in the region. Realizing the importance of the wetland, the present study has been taken up with the specific objective of delineation and characterization of Fateh Sagar wetland in terms of turbidity and aquatic vegetation, using high resolution satellite data such as Cartosat and LISS IV multi-temporal data, which will efficiently bring out the changes in water spread and quality parameters. The catchment of wetland has been also characterized for various features. The study leads in to takes necessary steps to conserve the wetland and its resources.

Keywords: aquatic vegetation, catchment, turbidity status, wetland

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11387 Monitoring Future Climate Changes Pattern over Major Cities in Ghana Using Coupled Modeled Intercomparison Project Phase 5, Support Vector Machine, and Random Forest Modeling

Authors: Stephen Dankwa, Zheng Wenfeng, Xiaolu Li

Abstract:

Climate change is recently gaining the attention of many countries across the world. Climate change, which is also known as global warming, referring to the increasing in average surface temperature has been a concern to the Environmental Protection Agency of Ghana. Recently, Ghana has become vulnerable to the effect of the climate change as a result of the dependence of the majority of the population on agriculture. The clearing down of trees to grow crops and burning of charcoal in the country has been a contributing factor to the rise in temperature nowadays in the country as a result of releasing of carbon dioxide and greenhouse gases into the air. Recently, petroleum stations across the cities have been on fire due to this climate changes and which have position Ghana in a way not able to withstand this climate event. As a result, the significant of this research paper is to project how the rise in the average surface temperature will be like at the end of the mid-21st century when agriculture and deforestation are allowed to continue for some time in the country. This study uses the Coupled Modeled Intercomparison Project phase 5 (CMIP5) experiment RCP 8.5 model output data to monitor the future climate changes from 2041-2050, at the end of the mid-21st century over the ten (10) major cities (Accra, Bolgatanga, Cape Coast, Koforidua, Kumasi, Sekondi-Takoradi, Sunyani, Ho, Tamale, Wa) in Ghana. In the models, Support Vector Machine and Random forest, where the cities as a function of heat wave metrics (minimum temperature, maximum temperature, mean temperature, heat wave duration and number of heat waves) assisted to provide more than 50% accuracy to predict and monitor the pattern of the surface air temperature. The findings identified were that the near-surface air temperature will rise between 1°C-2°C (degrees Celsius) over the coastal cities (Accra, Cape Coast, Sekondi-Takoradi). The temperature over Kumasi, Ho and Sunyani by the end of 2050 will rise by 1°C. In Koforidua, it will rise between 1°C-2°C. The temperature will rise in Bolgatanga, Tamale and Wa by 0.5°C by 2050. This indicates how the coastal and the southern part of the country are becoming hotter compared with the north, even though the northern part is the hottest. During heat waves from 2041-2050, Bolgatanga, Tamale, and Wa will experience the highest mean daily air temperature between 34°C-36°C. Kumasi, Koforidua, and Sunyani will experience about 34°C. The coastal cities (Accra, Cape Coast, Sekondi-Takoradi) will experience below 32°C. Even though, the coastal cities will experience the lowest mean temperature, they will have the highest number of heat waves about 62. Majority of the heat waves will last between 2 to 10 days with the maximum 30 days. The surface temperature will continue to rise by the end of the mid-21st century (2041-2050) over the major cities in Ghana and so needs to be addressed to the Environmental Protection Agency in Ghana in order to mitigate this problem.

Keywords: climate changes, CMIP5, Ghana, heat waves, random forest, SVM

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11386 Effects of Packaging Method, Storage Temperature and Storage Time on the Quality Properties of Cold-Dried Beef Slices

Authors: Elif Aykın Dinçer, Mustafa Erbaş

Abstract:

The effects of packaging method (modified atmosphere packaging (MAP) and aerobic packaging (AP)), storage temperature (4 and 25°C) and storage time (0, 15, 30, 45, 60, 75 and 90 days) on the chemical, microbiological and sensory properties of cold-dried beef slices were investigated. Beef slices were dried at 10°C and 3 m/s after pasteurization with hot steam and then packaged in order to determine the effect of different storage conditions. As the storage temperature and time increased, it was determined that the amount of CO2 decreased in the MAP packed samples and that the amount of O2 decreased while the amount of CO2 increased in the AP packed samples. The water activity value of stored beef slices decreased from 0.91 to 0.88 during 90 days of storage. The pH, TBARS and NPN-M values of stored beef slices were higher in the AP packed samples and pH value increased from 5.68 to 5.93, TBARS increased from 25.25 to 60.11 μmol MDA/kg and NPN-M value increased from 4.37 to 6.66 g/100g during the 90 days of storage. It was determined that the microbiological quality of MAP packed samples was higher and the mean counts of TAMB, TPB, Micrococcus/Staphylococcus, LAB and yeast-mold were 4.10, 3.28, 3.46, 2.99 and 3.14 log cfu/g, respectively. As a result of sensory evaluation, it was found that the quality of samples packed MAP and stored at low temperature was higher and the shelf life of samples was 90 days at 4°C and 75 days at 25°C for MAP treatment, and 60 days at 4°C and 45 days at 25°C for AP treatment.

Keywords: cold drying, dried meat, packaging, storage

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11385 The Adoption and Use of Social Media as a Source of Information by Egyptian Government Journalists

Authors: Essam Mansour

Abstract:

This study purposes to explore the adoption and use of social media as a source of information by Egyptian government journalists. It applied a survey with a total of 386 journalists representing the three official newspapers of Egypt. Findings showed that 27.2% of journalists were found to not use social media, mainly males (69.7%), older than 40 years (77.7%) and mostly with a BA degree (80.4%). On the other hand, 72.8% of them were found to use these platforms who were also males (59.1%), younger than 40 years (65.9%) and mostly with a BA degree (93.2%). More than two-thirds (69.9%) were somewhat old users whose experience ranged from seven to ten years, and more than two-thirds (73.5%) have been heavily using these platforms (four to more than six hours a day. Such results confirm that a large number (95.7%) of users were found to be at least advanced users. Social media users’ home and work were the most significant places to access these platforms, which were found to be easy and useful to use. Most types of social media used were social news, media sharing and micro blogging, blogs comments and forums, social networking sites and bookmarking sites to perform tasks, such as finding information, making communication, keeping up to date, checking materials, sharing information and making discussions. A large number of users tend to accept these media platforms to be a source of information since they are accessible, linked references updated sources, accurate, promote current work, convenient, secured, credible, reliable, stabled, easily identified, copyrighted, build confident and contain filtered information. However, lack of know-how to cite sources, followed by lack of credibility of the source of news, lack of quality of information sources and lack of time were at least significant to journalists when using social media platforms.

Keywords: social media, social networking sites, newspapers, journalists, Egypt

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11384 Close-Reading Works of Art and the Ideal of Naïveté: Elements of an Anti-Cartesian Approach to Humanistic Liberal Education

Authors: Peter Hajnal

Abstract:

The need to combine serious training in disciplinary/scholarly approaches to problems of general significance with an educational experience that engages students with these very same problems on a personal level is one of the key challenges facing modern liberal education in the West. The typical approach to synthesizing these two goals, one highly abstract, the other elusively practical, proceeds by invoking ideals traditionally associated with Enlightenment and 19th century “humanism”. These ideas are in turn rooted in an approach to reality codified by Cartesianism and the rise of modern science. Articulating this connection of the modern humanist tradition with Cartesianism allows for demonstrating how the central problem of modern liberal education is rooted in the strict separation of knowledge and personal experience inherent in the dualism of Descartes. The question about the shape of contemporary liberal education is, therefore, the same as asking whether an anti-Cartesian version of liberal education is possible at all. Although the formulation of a general answer to this question is a tall order (whether in abstract or practical terms), and might take different forms (nota bene in Eastern and Western contexts), a key inspiration may be provided by a certain shift of attitude towards the Cartesian conception of the relationship of knowledge and experience required by discussion based close-reading of works of visual art. Taking the work of Stanley Cavell as its central inspiration, my paper argues that this shift of attitude in question is best described as a form of “second naïveté”, and that it provides a useful model of conceptualizing in more concrete terms the appeal for such a “second naïveté” expressed in recent writings on the role of various disciplines in organizing learning by philosophers of such diverse backgrounds and interests as Hilary Putnam and Bruno Latour. The adoption of naïveté so identified as an educational ideal may be seen as a key instrument in thinking of the educational context as itself a medium of synthesis of the contemplative and the practical. Moreover, it is helpful in overcoming the bad dilemma of ideological vs. conservative approaches to liberal education, as well as in correcting a certain commonly held false view of the historical roots of liberal education in the Renaissance, which turns out to offer much more of a sui generis approach to practice rather than represent a mere precursor to the Cartesian conception.

Keywords: liberal arts, philosophy, education, Descartes, naivete

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11383 Farmers’ Use of Indigenous Knowledge System (IKS) for Selected Arable Crops Production in Ondo State

Authors: A. M. Omoare, E. O. Fakoya

Abstract:

This study sought to determine the use of indigenous knowledge for selected arable crops production in Ondo Sate. A multistage sampling method was used and 112 arable crops farmers were systematically selected. Data were analyzed using both descriptive and inferential statistics. The results showed that majority of the sampled farmers were male (75.90%) About 75% were married with children. Large proportion of them (62.61%) were within the ages of 30-49 years. Most of them have spent about 10 years in farming (58.92%). The highest raw scores of use of indigenous knowledge were found in planting on mound in yam production, use of native medicine and scare-crow method in controlling birds in rice production, timely planting of locally developed resistant varieties in cassava production and soaking of maize seeds in water to determine their viability with raw scores of 313, 310, 305, 303, and 300 respectively, while the lowest raw scores was obtained in use of bell method in controlling birds in rice production with raw scores of 210. The findings established that proverbs (59.8%) and taboos (55.36%) were the most commonly used media in transmitting indigenous knowledge by arable crop farmers. The multiple regression analysis result revealed that age of the farmers and farming experience had a significant relationship with the use of indigenous knowledge of the farmers which gave R2=0.83 for semi-log function form of equation which is the land equation. The policy implication is that indigenous knowledge should provide a basis for designing modern technologies to enhance sustainable agricultural development.

Keywords: Arable Crop Production, extent of use, indigenous knowledge, farming experience

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11382 Pedagogical Practices of a Teacher in Students' Experience Tellings: A Conversation Analytic Study

Authors: Derya Duran, Christine Jacknick

Abstract:

This study explores post-task reflections in an English as a Medium of Instruction (EMI) setting, and it specifically focuses on how a teacher performs pedagogical practices such as reformulating, extending and evaluating following students’ spontaneous experience tellings in EMI classrooms. The data consist of 30 hours of video recordings from two EMI content classes, which were recorded for an academic term at a university in Turkey. The course, Guidance, is offered to fourth year undergraduate students as a compulsory course in the Department of Educational Sciences. The participants (n=78) study at the Faculty of Education, majoring in different educational departments (i.e., Computer Education and Instructional Technology, Elementary Education, Foreign Language Education). Using conversation analysis, we demonstrate that the teacher employs a variety of interactional resources to elicit (i.e., asking specific questions) and also provides (i.e., giving scientific information) as much content as possible, which also sheds light on the institutional fingerprints of the current research context. The study contributes to the existing research by unpacking articulation of personal experiences and cultivation of collaborativeness in classroom interaction. Moreover, describing the dialogic nature of these specific occasions, the study demonstrates how teacher and students address learning tasks together (collectivity), how they orient to each other turns interactionally (reciprocity), and how they keep the pedagogical focus in mind (purposefulness).

Keywords: conversation analysis, English as a medium of instruction, higher education, post-task reflections

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11381 Optimizing Coal Yard Management Using Discrete Event Simulation

Authors: Iqbal Felani

Abstract:

A Coal-Fired Power Plant has some integrated facilities to handle coal from three separated coal yards to eight units power plant’s bunker. But nowadays the facilities are not reliable enough for supporting the system. Management planned to invest some facilities to increase the reliability. They also had a plan to make single spesification of coal used all of the units, called Single Quality Coal (SQC). This simulation would compare before and after improvement with two scenarios i.e First In First Out (FIFO) and Last In First Out (LIFO). Some parameters like stay time, reorder point and safety stock is determined by the simulation. Discrete event simulation based software, Flexsim 5.0, is used to help the simulation. Based on the simulation, Single Quality Coal with FIFO scenario has the shortest staytime with 8.38 days.

Keywords: Coal Yard Management, Discrete event simulation First In First Out, Last In First Out.

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11380 The Effects of Architectural Anatomy on Improving the Quality of Place Identity: Case Study of Shiraz Opera Hall

Authors: Hamid Reza Zeraatpisheh, Shamsoddin Hashemi, Farshad Negintaji

Abstract:

This study has examined the effects of the architectural anatomy of opera hall on improving the quality of place identity. By measuring the effects of place identity on the inner aspects of human which are influenced by the physical and social environments it has investigated the results of a balance between internal and external environment. To assess the anatomical effects of urban landscape, two components of subjective landscape including perception and diversity and the component of objective landscape including form and order have been measured. The current survey is descriptive and the statistical population has been Shiraz which is a city in Iran. To analyze the data the SPSS software has been used. The results have been investigated in two levels of descriptive and inferential statistics. In the inferential statistics, Pearson correlation coefficient has been used to evaluate the research hypotheses. The results of this study indicate that between the dimensions of landscape, the component of the subjective landscape has the highest impact on the place identity and in the second place, an objective landscape has the impact on the place identity. Anatomical effects have an important role on improving the quality of place identity of Shiraz citizens and in order to enhance the place identity in the urban landscape it is also required that they will be inspired and operated.

Keywords: architectural anatomy, identity, place identity, urban landscape, perception

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11379 Water Accessibility at Household Levels in Zambia: A Case Study of Fitobaula Settlement

Authors: Emmanuel Sachikumba, Micheal Msoni, Westone Mafuleka

Abstract:

Zambia has a good climate with favourable rainfall pattern; this provides sufficient recharge for the surface and groundwater resources. In spite of the sufficient surface and ground water resources, accessibility to water at household levels is problematic both in quality and quantity. The study examined water accessibility as well as water quality at the household level. The research looked at the sources of water for the households and considered the complications of accessibility to water and the available opportunities therein. The investigation involved fifty households and the data was collected by the use of questionnaires (to assess accessibility) and laboratory tests (for ascertaining water quality). In addition to this, government departments such as the health, agriculture, forestry and education as well as the municipal council were interviewed on the topic under study. The study was descriptive in nature where clustered sampling procedures using simple random methods were utilised to select the households which were to participate in the study. The key findings were that; accessibility to water household levels is still a challenge in the settlement as most of the point sources (shallow wells, the stream and the river) were found to be contaminated. In addition to this, it was found that there was no direct relationship between the economic performance of a household and the accessibility to water. The study also observed that there were opportunities for the people in the settlement as they were increasingly getting into the education system, and adult literacy was being encouraged in the settlement. Furthermore, the settlement has groundwater resources which indicate that there can be sufficient water provision for the settlers.

Keywords: accessibility, household, water, settlement

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11378 Barriers and Facilitators of Physical Activity among Adults and Older Adults from Black and Minority Ethnic Groups in the UK: A Meta-Ethnographic Study

Authors: Janet Ige, Paul Pilkington, Selena Gray, Jane Powell

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Older adults from socially disadvantaged groups and Black and Minority Ethnic (BME) groups experience a higher burden of physical inactivity. Physical inactivity among BME groups is associated with the disproportionately higher level of health inequalities. People from minority ethnic groups encounter more barriers to physical activity. However, this is not often reported. There is very limited review-level evidence on the barriers and facilitators of physical activity among older adults from BME groups in the UK. This study aims to answer the following research question: what are the barriers and facilitators of physical activity participation among adults and older adults from BME background in the UK? To address this, we conducted a review of qualitative studies investigating the barriers and opportunities for physical activity among of BME adults and older adults in the UK. Method: This study is nested in an interpretive paradigm of meta-ethnography. A structured search for published literature was conducted on 6 electronic databases (MEDLINE, PsychINFO, Cumulative Index to Nursing & Allied Health Literature, Applied Social Sciences Index and Abstracts, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine) from January 2007 to July 2017. Hand searching of the reference list of publications was performed in addition to a search conducted on Google Scholar to identify grey literature. Studies were eligible provided they employed any qualitative method and included participants identified as being BME, aged 50 and above, living in any community within the UK. In total, 1036 studies were identified from the structured search for literature, 718 studies were screened by titles after duplicates were removed. On applying the inclusion and exclusion criteria, a final selection of 10 studies was considered eligible for synthesis. Quality assessment was performed using the Critical Appraisal Skills Programme tool. Logic maps were used to show the relationship between factors that impact on physical activity participation among adults and older adults Result: Six key themes emerged from the data: awareness of the links between physical activity and health, interaction, and engagement with health professionals, cultural expectations and social responsibilities, appropriate environment, religious fatalism and practical challenges. Findings also showed that the barriers and facilitators of physical activity exist at the individual, community, and socio-economic, cultural and environmental level. There was a substantial gap in research among Black African groups. Findings from the review also informed the design of an ongoing survey investigating the experience and attitude of adults from Somali backgrounds towards physical activity in the UK. Conclusion: Identifying the barriers and facilitators of physical activity among BME groups is a crucial step in addressing the widening inequality gap. Findings from this study highlight the importance of engaging local BME residents in the design of exercise facilities within the community. This will ensure that cultural and social concerns are recognized and properly addressed.

Keywords: BME, UK, meta-ethnographic, adults

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11377 COVID-19: The Dark Side of an Unprecedented Social Isolation in the Elderly

Authors: L. Paulino Ferreira, M. Gomes Neto, M. Duarte, S. Serra

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Objectives: COVID-19 pandemic has caused older adults to experience a degree of social isolation and loneliness that is unprecedented. Our aim is to review state of the art regarding the consequences of social isolation due to COVID-19 in elderly people. Methods: The authors conducted a search on Medscape and PubMed with the keywords mentioned below, and the most relevant articles were selected. Results: Social isolation leads many elderlies to experience loneliness, anxiety, depression, alcohol abuse, and feelings of abandonment with a perception of being a burden on society. Thus, social isolation has increased the risk for suicide in older people. It is also noteworthy that the exacerbation of psychiatric disorders (such as depression, anxiety, and post-traumatic stress disorder) without correct treatment and follow-up also increases suicide risk. Loneliness is also associated with accelerated cognitive deterioration and dementia. Besides that, during social isolation, it could be more difficult for older people to get medication as well as proper health care. It is also noticed an increase in the risk of falls, poor nutrition, and lack of exercise. All this contributes to weakening elderlies’ immune systems leading to a higher risk of developing infections, cardiovascular events, and cancer, increasing hospitalization and morbimortality. Conclusion: Social isolation in the elderly has a significant impact on physical and mental health, as well as morbimortality and hospitalizations due to non-COVID causes. Nevertheless, further studies will be needed to assess the real dimension of the effects of social isolation due to COVID-19.

Keywords: social isolation, COVID-19, elderly, mental health

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11376 Teachers as Agents of Change in Diverse Classrooms: An Overview of the Literature

Authors: Anna Sanczyk

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Diverse students may experience different forms of discrimination. Some of the oppression students experience in schools are racism, sexism, classism, or homophobia that may affect their achievement, and teachers need to make sure they create inclusive, equitable classroom environments. The broader literature on social change in education shows that teachers who challenge oppression and want to promote equitable and transformative education face institutional, social, and political constraints. This paper discusses research on teachers’ work to create socially just and culturally inclusive classrooms and schools. The practical contribution of this literature review is that it provides a comprehensive compilation of the studies presenting teachers’ roles and efforts in affecting social change. The examination of the research on social change in education points to the urgency of teachers addressing the needs of marginalized students and resisting systemic oppression in schools. The implications of this literature review relate to the concerns that schools should provide greater advocacy for marginalized students in diverse learning contexts, and teacher education programs should prepare teachers to be active advocates for diverse students. The literature review has the potential to inform educators to enhance educational equity and improve the learning environment. This literature review illustrates teachers as agents of change in diverse classrooms and contributes to understanding various ways of taking action towards fostering more equitable and transformative education in today’s schools.

Keywords: agents of change, diversity, opression, social change

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11375 The Importance of Visual Communication in Artificial Intelligence

Authors: Manjitsingh Rajput

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Visual communication plays an important role in artificial intelligence (AI) because it enables machines to understand and interpret visual information, similar to how humans do. This abstract explores the importance of visual communication in AI and emphasizes the importance of various applications such as computer vision, object emphasis recognition, image classification and autonomous systems. In going deeper, with deep learning techniques and neural networks that modify visual understanding, In addition to AI programming, the abstract discusses challenges facing visual interfaces for AI, such as data scarcity, domain optimization, and interpretability. Visual communication and other approaches, such as natural language processing and speech recognition, have also been explored. Overall, this abstract highlights the critical role that visual communication plays in advancing AI capabilities and enabling machines to perceive and understand the world around them. The abstract also explores the integration of visual communication with other modalities like natural language processing and speech recognition, emphasizing the critical role of visual communication in AI capabilities. This methodology explores the importance of visual communication in AI development and implementation, highlighting its potential to enhance the effectiveness and accessibility of AI systems. It provides a comprehensive approach to integrating visual elements into AI systems, making them more user-friendly and efficient. In conclusion, Visual communication is crucial in AI systems for object recognition, facial analysis, and augmented reality, but challenges like data quality, interpretability, and ethics must be addressed. Visual communication enhances user experience, decision-making, accessibility, and collaboration. Developers can integrate visual elements for efficient and accessible AI systems.

Keywords: visual communication AI, computer vision, visual aid in communication, essence of visual communication.

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11374 Evaluation of Practicality of On-Demand Bus Using Actual Taxi-Use Data through Exhaustive Simulations

Authors: Jun-ichi Ochiai, Itsuki Noda, Ryo Kanamori, Keiji Hirata, Hitoshi Matsubara, Hideyuki Nakashima

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We conducted exhaustive simulations for data assimilation and evaluation of service quality for various setting in a new shared transportation system, called SAVS. Computational social simulation is a key technology to design recent social services like SAVS as new transportation service. One open issue in SAVS was to determine the service scale through the social simulation. Using our exhaustive simulation framework, OACIS, we did data-assimilation and evaluation of effects of SAVS based on actual tax-use data at Tajimi city, Japan. Finally, we get the conditions to realize the new service in a reasonable service quality.

Keywords: on-demand bus sytem, social simulation, data assimilation, exhaustive simulation

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11373 The Performance of Natural Light by Roof Systems in Cultural Buildings

Authors: Ana Paula Esteves, Diego S. Caetano, Louise L. B. Lomardo

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This paper presents an approach to the performance of the natural lighting, when the use of appropriated solar lighting systems on the roof is applied in cultural buildings such as museums and foundations. The roofs, as a part of contact between the building and the external environment, require special attention in projects that aim at energy efficiency, being an important element for the capture of natural light in greater quantity, but also for being the most important point of generation of photovoltaic solar energy, even semitransparent, allowing the partial passage of light. Transparent elements in roofs, as well as superior protection of the building, can also play other roles, such as: meeting the needs of natural light for the accomplishment of the internal tasks, attending to the visual comfort; to bring benefits to the human perception and about the interior experience in a building. When these resources are well dimensioned, they also contribute to the energy efficiency and consequent character of sustainability of the building. Therefore, when properly designed and executed, a roof light system can bring higher quality natural light to the interior of the building, which is related to the human health and well-being dimension. Furthermore, it can meet the technologic, economic and environmental yearnings, making possible the more efficient use of that primordial resource, which is the light of the Sun. The article presents the analysis of buildings that used zenith light systems in search of better lighting performance in museums and foundations: the Solomon R. Guggenheim Museum in the United States, the Iberê Camargo Foundation in Brazil, the Museum of Fine Arts in Castellón in Spain and the Pinacoteca of São Paulo.

Keywords: natural lighting, roof lighting systems, natural lighting in museums, comfort lighting

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11372 Development of Automated Quality Management System for the Management of Heat Networks

Authors: Nigina Toktasynova, Sholpan Sagyndykova, Zhanat Kenzhebayeva, Maksat Kalimoldayev, Mariya Ishimova, Irbulat Utepbergenov

Abstract:

Any business needs a stable operation and continuous improvement, therefore it is necessary to constantly interact with the environment, to analyze the work of the enterprise in terms of employees, executives and consumers, as well as to correct any inconsistencies of certain types of processes and their aggregate. In the case of heat supply organizations, in addition to suppliers, local legislation must be considered which often is the main regulator of pricing of services. In this case, the process approach used to build a functional organizational structure in these types of businesses in Kazakhstan is a challenge not only in the implementation, but also in ways of analyzing the employee's salary. To solve these problems, we investigated the management system of heating enterprise, including strategic planning based on the balanced scorecard (BSC), quality management in accordance with the standards of the Quality Management System (QMS) ISO 9001 and analysis of the system based on expert judgment using fuzzy inference. To carry out our work we used the theory of fuzzy sets, the QMS in accordance with ISO 9001, BSC according to the method of Kaplan and Norton, method of construction of business processes according to the notation IDEF0, theory of modeling using Matlab software simulation tools and graphical programming LabVIEW. The results of the work are as follows: We determined possibilities of improving the management of heat-supply plant-based on QMS; after the justification and adaptation of software tool it has been used to automate a series of functions for the management and reduction of resources and for the maintenance of the system up to date; an application for the analysis of the QMS based on fuzzy inference has been created with novel organization of communication software with the application enabling the analysis of relevant data of enterprise management system.

Keywords: balanced scorecard, heat supply, quality management system, the theory of fuzzy sets

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11371 Effect of Permeability on Glass Fiber Reinforced Plastic Laminate Produced by Vacuum Assisted Resin Transfer Molding Process

Authors: Nagri Sateesh, Kundavarapu Vengalrao, Kopparthi Phaneendra Kumar

Abstract:

Vacuum assisted resin transfer molding (VARTM) is one of the manufacturing technique that is viable for production of fiber reinforced polymer composite components suitable for aerospace, marine and commercial applications. However, the repeatable quality of the product can be achieved by critically fixing the process parameters such as Vacuum Pressure (VP) and permeability of the preform. The present investigation is aimed at studying the effect of permeability for production of Glass Fiber Reinforced Plastic (GFRP) components with consistent quality. The VARTM mould is made with an acrylic transparent top cover to observe and record the resin flow pattern. Six layers of randomly placed glass fiber under five different vacuum pressures VP1 = 0.013, VP2 = 0.026, VP3 = 0.039, VP4 = 0.053 and VP5 = 0.066 MPa were studied. The laminates produced by this process under the above mentioned conditions were characterized with ASTM D procedures so as to study the effect of these process parameters on the quality of the laminate. Moreover, as mentioned there is a considerable effect of permeability on the impact strength and the void content in the laminates under different vacuum pressures. SEM analysis of the impact tested fractured GFRP composites showed the bonding of fiber and matrix.

Keywords: permeability, vacuum assisted resin transfer molding (VARTM), ASTM D standards, SEM

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11370 Lamb Fleece Quality as an Indicator of Endoparasitism

Authors: Maria Christine Rizzon Cintra, Tâmara Duarte Borges, Cristina Santos Sotomaior

Abstract:

Lamb’s fleece quality can be influenced by many factors, including welfare, stress, nutritional imbalance and presence of ectoparasites. The association of fleece quality and endoparasitism, until now, was not well solved. The present study was undertaken to evaluate if a fleece visual score could predict lamb parasitosis with the focus on gastrointestinal parasites. Fleece quality was scored based on a combination of cleanliness and wool cover, using a three-point scale (1-3). Score 1: fleece shows no sign of dirt or contamination, and had sufficient fleece for the breed and time of year with whole body coverage; Score 2: fleece was little damp or wet, with coat contaminated by small patches of mud or dung and some areas of fleece loose, but no shed or bald patches of no more than 10cm in diameter; Score 3: fleece filthy, very wet with coated in mud or dug, and loose fleece with shed areas of pulls with bald patches greater than 10cm, some areas may be trailing. All fleece quality scores (FQS) were assessed with lamb restrained to ensure close inspection and were done along lamb back and considered just one side of the body. To confirm the gastrointestinal parasites and animal’s anemia, faecal egg counts (FEC) and hematocrit were done for each animal. Lambs were also weighed. All these measurements were done every 15-days, beginning at 60-days until 150-days of life, using 48 animals crossed Texel x Ile de France. For statistics analysis, it was used Stratigraphic Program (4.1. version), and all significant differences between FQS, weight gain, age, hematocrit, and FEC were assessed using analysis of variance following by Duncan test, and the correlation was done by Pearson test at P<0.05. Results showed that animals scored as ‘3’ in FQS had a lower hematocrit and a higher FEC (p<0.05) than animals scored as ‘1’ (hematocrit: 26, 24, 23 and FEC 2107, 2962, 4626 respectively for 1, 2 and 3 FQS). There were correlations between FQS and FEC (r = 0.16), FQS and hematocrit (r = -0.33) an FQS and weight gain (r = -0.20) indicating that worst FQS animals (score 3) had greater gastrointestinal parasites’ infection, were more anemic and had lower weight gain than animals scored as ‘1’ or ‘2’ for FQS. Concerning the lamb´s age, animals that received score ‘3’ in FQS, maintained gastrointestinal parasites’ infection over the time (P<0.05). It was concluded that FQS could be an important indicator to be included in the selective treatment for control verminosis in lambs.

Keywords: fleece, gastrointestinal parasites, sheep, welfare

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11369 An Approach to Specify Software Requirements in Semantic Form

Authors: Deepa Vijay, Chellammal Surianarayanan, Gopinath Ganapathy

Abstract:

Requirements of a software project serve as a guideline for the entire project team which enable the team towards producing the right outcome. As requirements are the key in deciding the success of the project, it should be specified in an unambiguous manner. Also, the requirements should be complete and consistent. It should be interpreted in the same way by the entire software project team as the customer interprets. Specifying requirements in textual manner is common in software development. This leads to poor understanding of the requirements which results in more errors and degraded quality. There are some literatures which focus on semantic way of specifying functional requirement which ensure the consistency and completeness of requirements. Alternately in the work, a method is proposed to map the syntactic requirements with corresponding semantics in the form of ontologies. This improves the understanding of requirements, prevents errors and improves quality.

Keywords: functional requirement, ontology, requirements management, semantics

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11368 Impact Assessment of Phosphogypsum on the Groundwater of Sfax-Agareb Aquifer, in Southeast of Tunisia

Authors: Samira Melki, Moncef Gueddari

Abstract:

In Tunisia, solid wastes storage continue to be uncontrolled. It is eliminated by land raising without any protection measurement against water table and soil contamination. Several industries are located in Sfax area, especially those of the Tunisian Chemical Group (TCG) for the enrichment and transformation of phosphate. The activity of the TCG focuses primarily on the production of chemical fertilizers and phosphoric acid, by transforming natural phosphates. This production generates gaseous emissions, liquid discharges and huge amounts of phosphogypsum (PG) stored directly on the soil surface. Groundwater samples were collected from Tunisian Chemical Group (TCG) site, to assess the effects of phosphogypsum leatchate on groundwater quality. The measurements of various physicochemical parameters including heavy metals (Al, Fe, Zn and F) and stable isotopes of the water molecule (¹⁸O, ²H) were determined in groundwater samples and are reported. The moderately high concentrations of SO₄⁼, Ortho-P, NH₄⁺ Al and F⁻ in groundwater particularly near to the phosphogypsum storage site, likely indicate that groundwater quality is being significantly affected by leachate percolation. The effect of distance of the piezometers from the pollution source was also investigated. The isotopic data of water molecule, showed that the waters of the Sfax-Agreb aquifer amount to recent-evaporation induced rainfall.

Keywords: phosphogypsum leatchate, groundwater quality, pollution, stable isotopes, Sfax-Agareb, Tunisia

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11367 Dermoscopy Compliance: Improving Melanoma Detection Pathways Through Quality Improvement

Authors: Max Butler

Abstract:

Melanoma accounts for 80% of skin cancer-related deaths globally. The poor prognosis and increasing incidence of melanoma impose a significant burden on global healthcare systems. Early detection, precise diagnosis, and preventative strategies are critical to improving patient outcomes. Dermoscopy is the gold standard for specialist assessments of pigmented skin lesions, as it can differentiate between benign and malignant growths with greater accuracy than visual inspection. In the United Kingdom, guidelines from the National Institute of Clinical Excellence (NICE) state dermoscopy should be used in all specialist assessments of pigmented skin lesions. Compliance with this guideline is low, resulting in missed and delayed melanoma diagnoses. To address this problem, a quality improvement project was initiated at Buckinghamshire Healthcare Trust (BHT) within the plastic surgery department. The target group was a trainee and consultant plastic surgeons conducting outpatient skin cancer clinics. Analysis of clinic documentation over a one-month period found that only 62% (38/61) of patients referred with pigmented skin lesions were examined using dermoscopy. To increase dermoscopy rates, teaching was delivered to the department highlighting national guidelines and the evidence base for dermoscopic examination. In addition, clinic paperwork was redesigned to include a text box for dermoscopic examination. Reauditing after the intervention found a significant increase in dermoscopy rates (52/61, p = 0.014). In conclusion, implementing a quality improvement project with targeted teaching and documentation template templates successfully increased dermoscopy rates. This is a promising step toward improving early melanoma detection and patient outcomes.

Keywords: melanoma, dermoscopy, plastic surgery, quality improvement

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11366 Effects of Medication Reminder Innovation on Adherence and the Quality of Medicine

Authors: Suparpit von Bormann, Winai Sayorwan, Sirichai Channim, Sararat Rungruangkhanarak, Premchai Suksamran, Piyaporn Srisuk, Piyatida Phosri

Abstract:

The best medicine will not work if the patient does not take them. There are several methods developed to help patients to be adherent to medicine. However, non-adherent rate still high: 24% in physically ill and 42% in mentally ill patients. Moreover, patients might feel less confident when carrying medicine around. Normal medicine box has no alarm; whereas the one with alarm is not handy and might be left at home. Therefore, Medication Reminder (MR) was invented. MR is a medicine pocket that has an alarm clock to remind the patient when it is the time to take medicine. It also has a small light indicating the medicine the patient has to take. This pocket is attached within a purse or wallet because most people forget medicine but do not forget to take their money. This research was conducted to develop innovation assisting patients to take their medicine on time. Samples were 24 volunteers who went out to work every day. Uncoated tablets, coated tablets, and capsules were filled in three types of containers: MR, plastic bag with ziplock, and normal plastic box. Each volunteer carried three types of containers everywhere during day time. After three days, medicines were tested for physical quality (appearance, odor, color, hardness, and weight) in laboratory. Medication adherence and satisfaction questionnaires were completed by participants. The results showed that MR showed significant improvement in participants’ adherence than plastic bag with ziplock, and normal plastic box at p < .001 (x̄(SD) = 11.16(0.75), 7.83(0.98), 8.83(1.32), respectively). Based on the quality test, MR and normal plastic box significantly better protected medicine than plastic bag with zip lock at p < .001 (x̄(SD) = 4(0.00), 4(0.00), 2.5(0.54), respectively). Most participants were satisfied with the innovation in highest level (4.50 out of 5). MR has a potential to improve adherent rates of participants and therefore to be an innovation that helps reducing the cost of treatment due to non-adherence. MR also has a potential in commercial aspect due to its effects in preserving quality of medicine. MR can be integrated with local products such as silk purse that can increase income for local people.

Keywords: medication, reminder, adherence, satisfaction

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11365 Urban Metis Women’s Identity and Experiences with Health Services in Toronto, Ontario

Authors: Renee Monchalin

Abstract:

Métis peoples, while comprising over a third of the total Indigenous population in Canada, experience major gaps in health services that accommodate their cultural identities. This is problematic given Métis peoples experience severe disparities in health determinants and outcomes compared to the non-Indigenous Canadian population. At the same time, Métis are unlikely to engage in health services that do not value their cultural identities, often utilizing mainstream options. Given these contexts, this research aims to fill the culturally-safe health care gap for Métis peoples in Canada. It does this by engaging 56 urban Métis women who participated in a longitudinal cohort study, Our Health Counts (OHC) Toronto. Traditionally, Métis women were central to the health and well-being of their communities. However, due to decades of colonial legislation and forced land displacement, female narratives have been silenced, and Métis identities have been fractured. This has resulted in having direct implications on Métis people’s current health and access to health services. Solutions to filling the Métis health service gap may lie in the all too often unacknowledged or missing voices of Métis women. Through a conversational method, this research will explore urban Métis women’s perspectives on identity and their experiences with health services in Toronto. The goal of this research is to learn from urban Métis women on steps towards filling the health service gap. This research is currently in the data collection stage. Preliminary findings from the conversations will be disseminated. Policy recommendations for health service providers will be provided to better accommodate Métis people.

Keywords: indigenous health, Metis health, urban, health service access, identity

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11364 Implementation of Autologous Adipose Graft from the Abdomen for Complete Fat Pad Loss of the Heel Following a Traumatic Open Fracture Secondary to a Motor Vehicle Accident: A Case Study

Authors: Ahmad Saad, Shuja Abbas, Breanna Marine

Abstract:

Introduction: This study explores the potential applications of autologous pedal fat pad grafting as a minimally invasive therapeutic strategy for addressing pedal fat pad loss. Without adequate shock absorbing tissue, a patient can experience functional deficits, ulcerations, loss of quality of life, and significant limitations with ambulation. This study details a novel technique involving autologous adipose grafting from the abdomen to enhance plantar fat pad thickness in a patient involved in a severe motor vehicle accident which resulted in total fat pad loss of the heel. Autologous adipose grafting (AAG) was used following adipose allografting in an effort to recreate a normal shock absorbing surface to allow return to activities of daily living and painless ambulation. Methods: A 46-year-old male sustained multiple open pedal fractures and necrosis to the heel fat pad after a motorcycle accident, which resulted in complete loss of the calcaneal fat pad. The patient underwent serial debridement’s, utilization of wound vac therapy and split thickness skin grafting to accomplish complete closure, despite complete loss of adipose to area. Patient presented with complaints of pain on ambulation, inability to bear weight on the heel, recurrent ulcerations, admitted had not been ambulating for two years. Clinical exam demonstrated complete loss of the plantar fat pad with a thin layer of epithelial tissue overlying the calcaneal bone, allowing visibility of the osseous contour of the calcaneus. Scar tissue had formed in place of the fat pad, with thickened epithelial tissue extending from the midfoot to the calcaneus. After conservative measures were exhausted, the patient opted for initial management by adipose allograft matrix (AAM) injections. Post operative X-ray imaging revealed noticeable improvement in calcaneal fat pad thickness. At 1 year follow up, the patient was able to ambulate without assistive devices. The fat pad at this point was significantly thicker than it was pre-operatively, but the thickness did not restore to pre-accident thickness. In order to compare the take of allograft versus autografting of adipose tissue, the decision to use adipose autograft through abdominal liposuction harvesting was deemed suitable. A general surgeon completed harvesting of adipose cells from the patient’s abdomen via liposuction, and a podiatric surgeon performed the AAG injection into the heel. Total of 15 cc’s of autologous adipose tissue injected to the calcaneus. Results: There was a visual increase in the calcaneal fat pad thickness both clinically and radiographically. At the 6-week follow up, imaging revealed retention of the calcaneal fat pad thickness. Three months postop, patient returned to activities of daily living and increased quality of life due to their increased ability to ambulate. Discussion: AAG is a novel treatment for pedal fat pad loss. These treatments may be viable and reproducible therapeutic choices for patients suffering from fat pad atrophy, fat pad loss, and/or plantar ulcerations. Both treatments of AAM and AAG exhibited similar therapeutic results by providing pain relief for ambulation and allowing for patients to return to their quality of life.

Keywords: podiatry, wound, adipose, allograft, autograft, wound care, limb reconstruction, injection, limb salvage

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11363 Development of a Bi-National Thyroid Cancer Clinical Quality Registry

Authors: Liane J. Ioannou, Jonathan Serpell, Joanne Dean, Cino Bendinelli, Jenny Gough, Dean Lisewski, Julie Miller, Win Meyer-Rochow, Stan Sidhu, Duncan Topliss, David Walters, John Zalcberg, Susannah Ahern

Abstract:

Background: The occurrence of thyroid cancer is increasing throughout the developed world, including Australia and New Zealand, and since the 1990s has become the fastest increasing malignancy. Following the success of a number of institutional databases that monitor outcomes after thyroid surgery, the Australian and New Zealand Endocrine Surgeons (ANZES) agreed to auspice the development of a bi-national thyroid cancer registry. Objectives: To establish a bi-national population-based clinical quality registry with the aim of monitoring and improving the quality of care provided to patients diagnosed with thyroid cancer in Australia and New Zealand. Patients and Methods: The Australian and New Zealand Thyroid Cancer Registry (ANZTCR) captures clinical data for all patients, over the age of 18 years, diagnosed with thyroid cancer, confirmed by histopathology report, that have been diagnosed, assessed or treated at a contributing hospital. Data is collected by endocrine surgeons using a web-based interface, REDCap, primarily via direct data entry. Results: A multi-disciplinary Steering Committee was formed, and with operational support from Monash University the ANZTCR was established in early 2017. The pilot phase of the registry is currently operating in Victoria, New South Wales, Queensland, Western Australia and South Australia, with over 30 sites expected to come on board across Australia and New Zealand in 2018. A modified-Delphi process was undertaken to determine the key quality indicators to be reported by the registry, and a minimum dataset was developed comprising information regarding thyroid cancer diagnosis, pathology, surgery, and 30-day follow up. Conclusion: There are very few established thyroid cancer registries internationally, yet clinical quality registries have shown valuable outcomes and patient benefits in other cancers. The establishment of the ANZTCR provides the opportunity for Australia and New Zealand to further understand the current practice in the treatment of thyroid cancer and reasons for variation in outcomes. The engagement of endocrine surgeons in supporting this initiative is crucial. While the pilot registry has a focus on early clinical outcomes, it is anticipated that future collection of longer-term outcome data particularly for patients with the poor prognostic disease will add significant further value to the registry.

Keywords: thyroid cancer, clinical registry, population health, quality improvement

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11362 Integrating Geographic Information into Diabetes Disease Management

Authors: Tsu-Yun Chiu, Tsung-Hsueh Lu, Tain-Junn Cheng

Abstract:

Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Keywords: catchment area of healthcare, chronic disease management, Geographic information system, quality of diabetes care

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