Search results for: the improving

Authors: Canan Duzan

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For most language learners, mastery of the speaking skill is the proof of the mastery of the foreign language. On the other hand, the speaking skill is considered as the most difficult aspect of language learning to develop for both learners and teachers. Especially in countries like Turkey where exposure to the target language is minimum and resources and opportunities provided for language practice are scarce, teaching and learning to speak the language become a real struggle for teachers and learners alike. Data collected from students, instructors, faculty members and the business sector in needs analysis studies conducted previously at Middle East Technical University (METU) consistently revealed the need for addressing the problem of lack of confidence in speaking English. Action was taken during the design of the only EAP speaking course offered in Modern Languages Department since lack of confidence is considered to be a serious barrier for effective communication and causes learners to suffer from insecurity, uncertainty and fear. “Confidence building” served as the guiding principle in the syllabus design, nature of the tasks created for the course and the assessment procedures to help learners become more confident speakers of English. In order to see the effectiveness of the decisions made during the design phase of the course and whether students become more confident speakers upon completion of the course, a case study was carried out with 100 students at METU. A questionnaire including both Likert-Scale and open-ended items were administered to students to collect data and this data were analyzed using the SPSS program. Group interviews were also carried out to gain more insight into the effectiveness of the course in terms of building speaking confidence. This presentation will explore the specific actions taken to develop students’ confidence based on the findings of program evaluation studies and to what extent the students believe these actions to be effective in improving their confidence. The unique design of this course and strategies adopted for confidence building are highly applicable in other EAP contexts and may yield similar positive results.

Keywords: confidence, EAP, speaking, strategy

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Authors: Adawati Suhaili, Kamisah Osman, Mohd Effendi, Ewan Mohd Matore

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The global education reform has prompted Malaysia to transform the education system in Malaysia through the Malaysian Education Blueprint (MEB) 2013-2025. This transformation is aimed to achieve the top one-third rank in international assessment. The low achievement of student scientific literacy in TIMMS (Trends in International Mathematics and Science Study ) and PISA (Programme for International Student Assessment) has caused concern to the Ministry Of Education (MOE) despite various reform efforts. Therefore, an alternative action by enhancing the role of the Head of Science Panels (HoSPs) as a key change agent in catalyzing the improvement of student performance should be considered. Highlights of previous studies have shown that subject leadership is able to enhance teacher teaching quality in order to increase student learning. To lead the Science department and guide Science teachers more effectively, HoSPs need to strengthen their leadership skills. However, the issue of weaknesses in the leadership competencies of HoSPs in Malaysia has caused them to lack confidence and ability in leading the Science Department. The main objective of this study is to explore the factors that contribute to the problems faced by HoSPs at Sarawak in their leadership roles. This study used a qualitative design framework and using a semi-structured interview method for data collection. There were six informants involved in the interview consisting of lecturers, Senior Administrative Assistant Teacher and HoSPs. The findings of the study had been identified four main factors that contribute to problems in the leadership competencies of HoSPs in Sarawak, namely leadership practices, leadership structure, academic subjects and school change. The results are significant to the MOE in strengthening the leadership competencies of HoSPs in a more focus for improving the achievement of scientific literacy of students in Malaysia. This study can help improve the Hosps' leadership competencies in Malaysia.

Keywords: issues, problems, Malaysia education blueprint, leadership competencies, head of science panels

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Authors: Miroslav Dumbrovsky

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The paper deals with positive impacts of land consolidation on decreasing soil degradation with the main emphasis on soil and water conservation in the landscape. The importance of land degradation is very high because of its impact on crop productivity and many other adverse effects. Soil degradation through soil erosion is causing losses in crop productivity and quality of the environment, through decreasing quality of soil and water (especially water resources). Negative effects of conventional farming practices are increased water erosion, as well as crusting and compaction of the topsoil and subsoil. Soil erosion caused by water destructs the soil’s structure, reduces crop productivity due to deterioration in soil physical and chemical properties such as infiltration rate, water holding capacity, loss of nutrients needed for crop production, and loss of soil carbon. Recently, a new process of complex land consolidation in the Czech Republic has provided a unique opportunity for improving the quality of the environment and sustainability of the crop production by means a better soil and water conservation. The present process of the complex land consolidation is not only a reallocation of plots, but this system consists of a new layout of plots within a certain territory, aimed at establishing the integrated land-use economic units, based on the needs of individual landowners and land users. On the other hand, the interests of the general public and the environmental protection have to be solved, too. From the general point of view, a large part of the Czech landscape shall be reconstructed in the course of complex land consolidation projects. These projects will be based on new integrated soil-economic units, spatially arranged in a designed multifunctional system of soil and water conservation measures, such as path network and a territorial system of ecological stability, according to structural changes in agriculture. This new approach will be the basis of a rational economic utilization of the region which will comply with the present ecological and aesthetic demands at present.

Keywords: soil degradation, land consolidation, soil erosion, soil conservation

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Authors: Laïd Boukraâ

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Complementary and Alternative Medicine is an inclusive term that describes treatments, therapies, and modalities that are not accepted as components of mainstream education or practice, but that are performed on patients by some practitioners. While these treatments and therapies often form part of post-graduate education, study and writing, they are generally viewed as alternatives or complementary to more universally accepted treatments. Ancient civilizations used bee products and medicinal plants, but modern civilization and ‘education’ have seriously lessened our natural instinctive ability and capability. Despite the fact that the modern Western establishment appears to like to relegate apitherapy and aromatherapy to the status of 'folklore' or 'old wives' tales', they contain a vast spread of pharmacologically-active ingredients and each one has its own unique combination and properties. They are classified in modern herbal medicine according to their spheres of action. Bee products and medicinal plants are well-known natural product for their healing properties and their increasing popularity recently as they are widely used in wound healing. Honey not only has antibacterial properties which can help as an antibacterial agent but also has chemical properties which may further help in the wound healing process. A formulation with honey as its main component was produced into a honey gel. This new formulation has enhanced texture and is more user friendly for usage as well. This new formulation would be better than other formulas as it is hundred percent consisting of natural products and has been made into a better formulation. In vitro assay, animal model study and clinical trials have shown the effectiveness of LEADERMAX for the treatment of diabetic foot, burns, leg ulcer and bed sores. This one hundred percent natural product could be the best alternative to conventional products for wound and burn management. The advantages of the formulation are: 100% natural, affordable, easy to use, strong power of absorption, dry surface on the wound making a film, will not stick to the wound bed; helps relieve wound pain, inflammation, edema and bruising while improving comfort.

Keywords: bed sore bee products, burns, diabetic foot, medicinal plants, leg ulcer, wounds

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Authors: Lourenço Bastos, Filipa Carneiro, Bruno Vale, Rita Marques Joana Silva, Ricardo Freitas, Ângelo Marques, Sara Cortez, Alberta Coelho, Pedro Parreira, Liliana Sousa, Anabela Salgueiro, Bruno Silva

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The process of flushing is considered to be an adequate technique to reduce the risk of infection during the clinical practice of venous catheterization. Nonetheless, there is still a lack of adhesion to this method, in part due to the complexity of this procedure. The project SeringaDuo aimed to develop an innovative double-chamber syringe for intravenous sequential administration of drugs and serums. This device served the purpose of improving the adherence to the practice, through the reduction of manipulations needed, which also improves patient safety, and though the promotion of flushing practice by health professionals, by simplifying this task. To assist on the development of this innovative syringe, a numerical methodology was developed and validated in order to predict the syringe’s mechanical and flow behavior during the fluids’ loading and administration phases, as well as to allow the material behavior evaluation during its production. For this, three commercial numerical simulation software was used, namely ABAQUS, ANSYS/FLUENT, and MOLDFLOW. This methodology aimed to evaluate the concepts feasibility and to optimize the geometries of the syringe’s components, creating this way an iterative process for product development based on numerical simulations, validated by the production of prototypes. Through this methodology, it was possible to achieve a final design that fulfils all the characteristics and specifications defined. This iterative process based on numerical simulations is a powerful tool for product development that allows obtaining fast and accurate results without the strict need for prototypes. An iterative process can be implemented, consisting of consecutive constructions and evaluations of new concepts, to obtain an optimized solution, which fulfils all the predefined specifications and requirements.

Keywords: Venous catheterization, flushing, syringe, numerical simulation

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Authors: Mansoureh Karimollahi, Mehriar Adrmohammadi, Mohsen Mohammadi

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Introduction: Patient satisfaction with nursing care is considered as an important indicator of the quality and effectiveness of the health care system, and improving the quality of care is not possible without paying attention to the opinions and expectations of patients. Considering that the scales for assessing satisfaction with nursing care in our country are not comprehensive and measure very few areas, therefore, in this study, psychometrically, the Persian version of the Newcastle Nursing Care Satisfaction Scale was used in patients hospitalized in the wards. Internal medicine and general surgery were discussed. Methods: This cross-sectional study was conducted on 200 patients admitted to the surgery and internal departments of hospitals affiliated to Ardabil University of Medical Sciences. The Newcastle nursing care satisfaction scale was used for the first time in Iran in comparison with the good nursing care scale from the patients' point of view to evaluate the criterion validity. The Newcastle nursing care satisfaction scale was used after translation, validity, and reliability. Results: The level of satisfaction of patients and the experience of patients with nursing care was at a favorable level, respectively, with an average of 111.8 ± 14.2 and 69.07 ± 14.8. Total CVI was estimated at 0.96 for the experience section, 0.95 for the satisfaction section, and 0.96 for the whole scale. The index (CVR) was also 0.95 for the experience section, 0.95 for the satisfaction section, and 0.95 for the whole scale. Criterion validity was also estimated using 0.725 correlation. The validity of the construct was also confirmed using the goodness of fit index (X2=1932/05, p=0.013, KMO=0.913). Convergent validity was estimated at 0.99 in the experience subscale and 0.98 in the satisfaction subscale. . The overall reliability in the experience subscale and satisfaction subscale was 94%, 92%, and 98%, respectively, which indicated the acceptable reliability of the questionnaire. Conclusion: The Persian version of the Newcastle nursing care satisfaction scale as a comprehensive tool that can be easily completed by patients and is easy to interpret, has good validity and reliability and can be used in patient care centers, in departments Surgery, and internal medicine are recommended.

Keywords: psychometrics, Newcastle nursing care satisfaction scale, nursing care satisfaction, general surgery department

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Authors: Marko Spasojevic, Ying Hei Chui, Yuxiang Chen

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Increasing the level of exterior insulation in residential buildings is a popular way for improving the thermal characteristic of building enclosure and reducing heat loss. However, the layout and properties of materials composing the wall have a great effect on moisture accumulation within the wall cavity, long-term durability of a wall as well as the structural performance. A one-dimensional hygrothermal modeling has been performed to investigate moisture condensation risks and the drying capacity of standard 2×4 and 2×6 light wood-frame wall assemblies including exterior low-permeance extruded polystyrene (XPS) insulation. The analysis considered two different wall configurations whereby the rigid insulation board was placed either between Oriented Strand Board (OSB) sheathing and the stud or outboard to the structural sheathing. The thickness of the insulation varied between 0 mm and 50 mm and the analysis has been conducted for eight different locations in Canada, covering climate zone 4 through zone 8. Results show that the wall configuration with low-permeance insulation inserted between the stud and OSB sheathing accumulates more moisture within the stud cavity, compared to the assembly with the same insulation placed exterior to the sheathing. On the other hand, OSB moisture contents of the latter configuration were markedly higher. Consequently, the analysis of hygrothermal performance investigated and compared moisture accumulation in both the OSB and stud cavity. To investigate the structural performance of the wall and the effect of soft insulation layer inserted between the sheathing and framing, forty nail connection specimens were tested. Results have shown that both the connection strength and stiffness experience a significant reduction as the insulation thickness increases. These results will be compared with results from a full-scale shear wall tests in order to investigate if the capacity of shear walls with insulated sheathing would experience a similar reduction in structural capacities.

Keywords: hygrothermal analysis, insulated sheathing, moisture performance, nail joints, wood shear wall

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Authors: Po-Sheng Kuo, Che-Wei Lu, Ssu-Ching Chen

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Chlorinated ethenes (CEs) constitute a predominant contaminant in Taiwan's native polluted sites, particularly in groundwater inundated with sulfate salts that substantially impede remediation efforts. The reduction of sulfate by sulfate-reducing bacteria (SRB) impairs the dechlorination efficiency of Dehalococcoides by generating hydrogen sulfide (H₂S), resulting in incomplete chloride degradation and thereby leading to the failure of bioremediation. In order to elucidate interactions between sulfate reduction and dechlorination, this study aims to establish a co-culture system of Dehalococcoides and SRB, overcoming H₂S inhibition by employing the synthesis of ferrous sulfide (FeS), which is commonly utilized in chemical remediation due to its high reduction potential. Initially, the study demonstrates that the addition of ferrous chloride (FeCl₂) effectively removed H₂S production from SRB and enhanced the degradation of trichloroethylene to ethene. This process overcomes the inhibition caused by H₂S produced by SRB in high sulfate environments. Compared to different concentrations of ferrous dosages for the biogenic generation of FeS, the efficiency was optimized by adding FeCl₂ at an equal ratio to the concentration of sulfate in the environment. This was more effective in removing H₂S and crystal particles under 10 times smaller than those synthesized under excessive FeCl₂ dosages, addressing clogging issues in situ remediation. Finally, utilizing Taiwan's indigenous dechlorinating consortium in a simulated high sulfate-contaminated environment, the biodiversity of microbial species was analyzed to reveal a higher species richness within the FeS group, conducive to ecological stability. This study validates the potential of the co-culture system in generating biogenic FeS under sulfate and CEs co-contamination, removing sulfate-reducing products, and improving CE remediation through integrated chemical and biological remediations.

Keywords: biogenic ferrous sulfide, chlorinated ethenes, Dehalococcoides, sulfate-reducing bacteria, sulfide inhibition

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Authors: Husain Rajib, T. H. Sheikh, D. G. Jewel

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Background: Amblyopia is a frequent cause of monocular blindness in children. It can be unilateral or bilateral reduction of best corrected visual acuity associated with decrement in visual processing, accomodation, motility, spatial perception or spatial projection. Anisometropia is an important risk factor for amblyopia that develops when unequal refractive error causes the image to be blurred in the critical developmental period and central inhibition of the visual signal originating from the affected eye associated with significant visual problems including anisokonia, strabismus, and reduced stereopsis. Methods: It is a prospective hospital based study of newly diagnosed of amblyopia seen at the pediatric clinic of Chittagong Eye Infirmary & Training Complex. There were 50 anisometropic amblyopia subjects were examined & questionnaire was piloted. Included were all patients diagnosed with refractive amblyopia between 3 to 13 years, without previous amblyopia treatment, and whose parents were interested to participate in the study. Patients diagnosed with strabismic amblyopia were excluded. Patients were first corrected with the best correction for a month. When the VA in the amblyopic eye did not improve over month, then occlusion treatment was started. Occlusion was done daily for 6-8 hours (full time) together with vision therapy. The occlusion was carried out for 3 months. Results: In this study about 8% subjects had anisometropia from myopia, 18% from hyperopia, 74% from astigmatism. The initial mean visual acuity was 0.74 ± 0.39 Log MAR and after intervention of amblyopia therapy with active vision therapy mean visual acuity was 0.34 ± 0.26 Log MAR. About 94% of subjects were improving at least two lines. The depth of amblyopia associated with type of anisometropic refractive error and magnitude of Anisometropia (p<0.005). By doing this study 10% mild amblyopia, 64% moderate and 26% severe amblyopia were found. Binocular function also decreases with magnitude of Anisometropia. Conclusion: Anisometropic amblyopia is a most important factor in pediatric age group because it can lead to visual impairment. Occlusion therapy with at least one instructed hour of active visual activity practiced out of school hours was effective in anisometropic amblyopes who were diagnosed at the age of 8 years and older, and the patients complied well with the treatment.

Keywords: refractive error, anisometropia, amblyopia, strabismic amblyopia

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Authors: Mohammed Shaath

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Aims Technological advancements in teaching and learning have made significant improvements over the past decade and have been incorporated in institutions to aid the learner’s experience. This review aims to assess whether Technology Enhanced Learning (TEL) pedagogy is more effective at improving students’ attitude and knowledge retention in orthodontic training than traditional methods. Methodology The searches comprised Systematic Reviews (SRs) related to the comparison of TEL and traditional teaching methods from the following databases: PubMed, SCOPUS, Medline, and Embase. One researcher performed the screening, data extraction, and analysis and assessed the risk of bias and quality using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2). Kirkpatrick’s 4-level evaluation model was used to evaluate the educational values. Results A sum of 34 SRs was identified after the removal of duplications and irrelevant SRs; 4 fit the inclusion criteria. On Level 1, students showed positivity to TEL methods, although acknowledging that the harder the platforms to use, the less favourable. Nonetheless, the students still showed high levels of acceptability. Level 2 showed there is no significant overall advantage of increased knowledge when it comes to TEL methods. One SR showed that certain aspects of study within orthodontics deliver a statistical improvement with TEL. Level 3 was the least reported on. Results showed that if left without time restrictions, TEL methods may be advantageous. Level 4 shows that both methods are equally as effective, but TEL has the potential to overtake traditional methods in the future as a form of active, student-centered approach. Conclusion TEL has a high level of acceptability and potential to improve learning in orthodontics. Current reviews have potential to be improved, but the biggest aspect that needs to be addressed is the primary study, which shows a lower level of evidence and heterogeneity in their results. As it stands, the replacement of traditional methods with TEL cannot be fully supported in an evidence-based manner. The potential of TEL methods has been recognized and is already starting to show some evidence of the ability to be more effective in some aspects of learning to cater for a more technology savvy generation.

Keywords: TEL, orthodontic, teaching, traditional

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Authors: Maria Manzoor, Iram Gul, Muhammad Arshad, Jean Kallerhoff

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The potential of fungal isolates to be used in phytoremediation of widespread lead contaminated soil has been evaluated in this study. Five different fungal isolates (Trichoderma harzianum, Penicillium simplicissimum, Aspergillus flavus, Aspergillus niger and Mucor spp.) were obtained and tested for their tolerance to increasing concentration of lead (Pb) i.e. 100, 200, 300, 400 and 500 mgL-1 on PDA and PDB culture experiment. All strains were tolerant up to 500 mgL-1 following sequence; A. flavus > A. niger > Mucor spp. > P. simplicissimum > T. harzianum. Further the isolates were then monitored for possible effect on Pb solubility/mobility through soil incubation experiments and characterized for essays including pathogenicity, germination and root elongation and plant growth promoting activities including IAA (indole acetic acid), phosphorus solubilization and gibberellic acid (GA3) production. Results revealed that fungal isolates have positive effect on Pb mobility in soil and plant biomass production. Pb solubility was significantly (P> 0.05) increased in soil upon application of Mucor spp. P. simplicissimum and T. harzianum. when compared to control. Among different strains three isolates (Mucor spp., P. simplicissimum and T. harzianum) were nonpathogenic because no inhibitory effect of fungus was observed to plant growth when exposed to these strains in root shoot elongation essay. Particularly T. harzianum and P. simplicissimum showed great ability to increase root length by 1.1 and 1.3 folds and shoot length by 1.47 and 1.5 folds respectively under Pb stress (500 mgL-1). Significantly high production of IAA was observed in A. niger (26.7 μg/ml), Phosphorus solubilization was observed in T. harzianum (9.15 μg/ml) and GA3 production was observed in P. simplicissimum (11.02 μg/ml). From results it is concluded that Mucor spp., P. simplicissimum and T. harzianum have potential to increase Pb mobility and improving plant growth under highy Pb contamination, therefore can be used in microbially assisted phytoremediation of Pb contaminated soil.

Keywords: Pb tolerant fungus, Pb mobility, plant growth promoting activities, indole acetic acid (IAA)

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Authors: Zhang Dongqing

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Concern for students' mental health and the application of intelligent advanced technologies are driving changes in teaching models. The traditional teacher-centered classroom is beginning to transform into a student-centered smart interactive learning environment. Nowadays, smart classrooms are compatible with constructivist learning. This theory emphasizes the role of teachers in the teaching process as helpers and facilitators of knowledge construction, and students learn by interacting with them. The spatial design of classrooms is closely related to the teaching model and should also be developed in the direction of smart classroom design. The goal is to explore the impact of smart classroom layout on student-centered teaching environment and teacher-student interaction under the guidance of constructivist learning theory, by combining the design process and feedback analysis of the smart transformation project on the campus of Tongji University in Shanghai. During the research process, the theoretical basis of constructivist learning was consolidated through literature research and case analysis. The integration and visual field analysis of the traditional and transformed indoor floor plans were conducted using space syntax tools. Finally, questionnaire surveys and interviews were used to collect data. The main conclusions are as followed: flexible spatial layouts can promote students' learning effects and mental health; the interactivity of smart classroom layouts is different and needs to be combined with different teaching models; the public areas of teaching buildings can also improve the interactive learning atmosphere by adding discussion space. This article provides a data-based research basis for improving students' learning effects and mental health, and provides a reference for future smart classroom design.

Keywords: spatial layout, smart classroom, space syntax, renovation, educational environment

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Authors: Tomasz Zarebski

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A very important element of the education system is its evaluation procedure. Each education system should be systematically evaluated and improved. Among the criteria subject to evaluation, attention should be paid to the following: structure of the study programme, implementation of the study programme, admission to studies, verification of learning outcomes achievement by students, giving credit for individual semesters and years, and awarding diplomas, competence, experience, qualifications and the number of staff providing education, staff development, and in-service training, education infrastructure, cooperation with social and economic stakeholders on the development, conditions for and methods of improving the internationalisation of education provided as part of the degree programme, supporting learning, social, academic or professional development of students and their entry on the labour market, public access to information about the study programme and quality assurance policy. Concerning the assessment process and the individual assessment indicators, the participation of students in these processes is essential. The purpose of this paper is to analyse the rules of student participation in accreditation processes on the example of individual countries in Europe. The rules of students' participation in the work of accreditation committees and their influence on the final grade of the committee were analysed. Most of the higher education institutions follow similar rules for accreditation. The general model gives the individual institution freedom to organize its own quality assurance, as long as the system lives up to the criteria for quality and relevance laid down in the particular provisions. This point also applies to students. The regulations of the following countries were examined in the legal-comparative aspect: Poland (Polish Accreditation Committee), Denmark (The Danish Accreditation Institution), France (High Council for the Evaluation of Research and Higher Education), Germany (Agency for Quality Assurance through Accreditation of Study Programmes) and Italy (National Agency for the Evaluation of Universities and Research Institutes).

Keywords: accreditation, student, study programme, quality assurance in higher education

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Authors: Akram Abi, Clarissa Müller, Hans-Joachim Jördening

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Laminaribiose is a beta-1,3-glycoside which is used in the medical field for the treatment of dermatitis and also can be used as a building block for new pharmaceutics. The conventional process of laminaribiose production is the uneconomical process of hydrolysis of laminarin extracted from natural polysaccharides of plant origin. A more economical approach however is attainable by enzymatically synthesis of laminaribiose via a reverse phosphorylase reaction catalyzed by laminaribiose phosphorylase (LP) from Euglena gracilis. Different cultivation methods of Euglena gracilis and the effect on LP production have been investigated. Buffered/unbuffered heterotrophic and mixotrophic cultivations of Euglena gracilis has been carried out. Changes of biomass and LP production, glucose level and pH, cell count and shape has been monitored in the course of time. The results obtained from experiments each in three repetitions, show that in the heterotrophic cultivation of Euglena gracilis not only more biomass is produced compared to mixotrophic cultivation, but also higher specific protein concentration is achieved. Furthermore, the LP activity test showed that the protein extracted from heterotrophically cultured cells has a higher LP activity. It was also observed that the cells develop in a distinctive different shape between these two cultures and have different length to width ratios. Taking the heterotrophic culture as the more efficient cultivation method in LP production, another comparative experiment between buffered and unbuffered heterothrophic culture was carried out that showed the unbuffered culture has advantages over the other one in respect of both LP production and resulting activity. A hetrotrophic cultivation of Euglena gracilis in a 5L bioreactor with controlled operating conditions showed a distinctive improvement of all the aspects of culture compared to the shaking flask cultivations. Biomass production was improved from 5 to more than 8 g/l (dry weight) which resulted in a specific protein concentration of 45 g/l in the heterotrophic cultivation in the bioreactor. In further attempts to improve LP production, different purification methods were tested and each method was checks through an activity assay. A laminaribiose yield of 35% was achieved which was by far the highest amount amongst different methods tested.

Keywords: euglena gracilis, heterotrophic culture, laminaribiose production, mixotrophic culture

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Authors: Imran Dayan, Ashiqul Khan

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Internal corporate fraud, which is fraud carried out by internal stakeholders of a company, affects the well-being of the organisation just like its external counterpart. Even if such an act is carried out for the short-term benefit of a corporation, the act is ultimately harmful to the entity in the long run. Internal fraud is often carried out by relying upon aberrations from usual business processes. Business processes are the lifeblood of a company in modern managerial context. Such processes are developed and fine-tuned over time as a corporation grows through its life stages. Modern corporations have embraced technological innovations into their business processes, and Enterprise Resource Planning (ERP) systems being at the heart of such business processes is a testimony to that. Since ERP systems record a huge amount of data in their event logs, the logs are a treasure trove for anyone trying to detect any sort of fraudulent activities hidden within the day-to-day business operations and processes. This research utilises the ERP systems in place within corporations to assess the likelihood of prospective internal fraud through developing a framework for measuring the risks of fraud through Process Mining techniques and hence finds risky designs and loose ends within these business processes. This framework helps not only in identifying existing cases of fraud in the records of the event log, but also signals the overall riskiness of certain business processes, and hence draws attention for carrying out a redesign of such processes to reduce the chance of future internal fraud while improving internal control within the organisation. The research adds value by applying the concepts of Process Mining into the analysis of data from modern day applications of business process records, which is the ERP event logs, and develops a framework that should be useful to internal stakeholders for strengthening internal control as well as provide external auditors with a tool of use in case of suspicion. The research proves its usefulness through a few case studies conducted with respect to big corporations with complex business processes and an ERP in place.

Keywords: enterprise resource planning, fraud risk framework, internal corporate fraud, process mining

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Authors: Melba Sheila D'Souza, Anandhi Amirtharaj, Shreedevi Balachandran

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Background: Type 2 diabetes has a significant impact on individuals’ health and well-being. Glycemic control may influence self-efficacy and self-care behaviors, and reduce the risk of complications among adults with type 2 diabetes. Type 2 diabetes has substantial morbidity and mortality and 60% of adults’ poor self-care. Glycemic control is associated with reported self-efficacy and self-care behavior. Adults with type 2 diabetes with less information were less likely to take diabetes self-care. Aim: To examine the relationship between glycemic control, demographic factors, clinical factors on self-efficacy, self-care behaviors among Omani adults with type 2 diabetes. Methods: A correlational, descriptive study was used. Omani adults with type 2 diabetes (n=140) were recruited from a public hospital in Oman. The data were collected during January-March 2015. Ethical approval was given by the college research and ethics committee, College of Nursing, and the Hospital, Sultan Qaboos University Data was collected on self-efficacy, self-care behaviors and glycemic control. The study was approved by the Institution Ethics and Research Committee. Bivariate and multivariate analyses were conducted. Results: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating ‘uncontrolled or poor HbA1c of > 8%’ (65%). Variance of self-care behavior (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. Adults with type 2 diabetes with poor glycemic control were more likely to have poor self-efficacy and poor self-care behaviors. Conclusion: This study confirms that self-efficacy model on outcome predicts self-efficacy and self-care behavior. Higher understanding of diabetes, prevention of normal daily activities, higher ability to fit diabetes life in a positive manner and high patient-physician communication were significant with self-efficacy and self-care behaviors. Hence, glycemic control has a high effect on improving self-care behaviors like diet, exercise, medication, foot care and self-efficacy among type 2 diabetes. Implications: Using these findings to improve self-efficacy, individualized self-care management is recommended for better self-efficacy and self-care behaviors among adults with type 2 diabetes.

Keywords: self-efficacy, self-care behaviors, self-care management, glycemic control, type 2 diabetes, nurse

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Authors: Hajar Zarei, AliAkbar Zarenejadatashgah, Vuk Uskoković, Hiroshi Watabe

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The reactive oxygen species (ROS) generated by radiation in nuclear diagnostic imaging and radiotherapy could damage the structure of the proteins in noncancerous cells surrounding the tumor. The critical factor in many age-related diseases, such as Alzheimer, Parkinson, or Huntington diseases, is the oxidation of proteins by the ROS as molecular triggers of the given pathologies. Our studies by spectroscopic experiments showed doses close to therapeutic ones (1 to 5 Gy) could lead to changes of secondary and tertiary structures in BSA protein macromolecule as a protein model as well as the aggregation of polypeptide chain but without the fragmentation. For this reason, we investigated the radioprotective effects of natural (vitamin C and E) and synthetic materials (CNPs and FIOMPs) on the structural changes in BSA protein induced by gamma irradiation at a therapeutic dose (3Gy). In the presence of both vitamins and synthetic materials, the spectroscopic studies revealed that irradiated BSA was protected from the structural changes caused by ROS, according to in vitro research. The radioprotective property of CNPs and FIOMPs arises from enzyme mimetic activities (catalase, superoxide dismutase, and peroxidase) and their antioxidant capability against hydroxyl radicals. In the case of FIOMPs, a porous structure also leads to increased ROS recombination with each other in the same radiolytic track and subsequently decreased encounters with BSA. The hydrophilicity of vitamin C resulted in the major scavenging of ROS in the solvent, whereas hydrophobic vitamin E localized on the nonpolar patches of the BSA surface, where it did not only neutralize them thanks to the moderate BSA binding constant but also formed a barrier for diffusing ROS. To the best of our knowledge, there has been a persistent lack of studies investigating the radioactive effect of mentioned materials on proteins. Therefore, the results of our studies can open a new widow for application of these common dietary ingredients and new synthetic NPs in improving the safety of radiotherapy.

Keywords: reactive oxygen species, spectroscopy, bovine serum albumin, gamma radiation, radioprotection

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Authors: Stavroula Stavropoulou-Tatla, Danyal Awal, Mohammad Ayaz Hossain

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The first wave of the COVID-19 pandemic saw several countries issue guidance postponing all non-urgent diagnostic evaluations and operations, leading to an estimated backlog of 28 million cases worldwide and over 4 million in the UK alone. In an attempt to regulate the resumption of elective surgical activity, the National Institute for Health and Care Excellence (NICE) introduced the ‘COVID-19 rapid guideline [NG179]’. This project aimed to increase healthcare staff knowledge of the aforementioned guideline to a targeted score of 100% in the disseminated questionnaire within 3 months at the Royal Free Hospital. A standardized online questionnaire was used to assess the knowledge of surgical and medical staff at baseline and following each 4-week-long Plan-Study-Do-Act (PDSA) cycle. During PDSA1, the A4 visual summary accompanying the guideline was visibly placed in all relevant clinical areas and the full guideline was distributed to the staff in charge together with a short briefing on the salient points. PDSA2 involved brief small-group teaching sessions. A total of 218 responses was collected. Mean percentage scores increased significantly from 51±19% at baseline to 81±16% after PDSA1 (t=10.32, p<0.0001) and further to 93±8% after PDSA2 (t=4.9, p<0.0001), with 54% of participants achieving a perfect score. In conclusion, the targeted distribution of guideline printouts and visual aids, combined with small-group teaching sessions, were simple and effective ways of educating healthcare staff about the new standards of elective surgical care at the time of COVID-19. This could facilitate the safe restoration of surgical activity, which is critical in order to mitigate the far-reaching consequences of surgical delays on an unprecedented scale during a time of great crisis and uncertainty.

Keywords: COVID-19, elective surgery, NICE guidelines, quality improvement

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Authors: Yuechao Lei, Lei Zhang

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The interface shear between asphalt overlay and existing rigid airport pavements occurs due to differences in the mechanical properties of materials subjected to aircraft loading. Interlayer contact influences the mechanical characteristics of the asphalt overlay directly. However, the effective interlayer relative displacement obtained accurately using existing displacement sensors of the loading apparatus remains challenging. This study aims to utilize digital image correlation technology to enhance the accuracy of interfacial contact parameters by obtaining effective interlayer relative displacements. Composite structure specimens were prepared, and fixtures for interlayer shear tests were designed and fabricated. Subsequently, a digital image recognition scheme for required markers was designed and optimized. Effective interlayer relative displacement values were obtained through image recognition and calculation of surface markers on specimens. Finite element simulations validated the mechanical response of composite specimens with interlayer shearing. Results indicated that an optimized marking approach using the wall mending agent for surface application and color coding enhanced the image recognition quality of marking points on the specimen surface. Further image extraction provided effective interlayer relative displacement values during interlayer shear, thereby improving the accuracy of interface contact parameters. For composite structure specimens utilizing Styrene-Butadiene-Styrene (SBS) modified asphalt as the tack coat, the corresponding maximum interlayer shear stress strength was 0.6 MPa, and fracture energy was 2917 J/m2. This research provides valuable insights for investigating the impact of interlayer contact in composite pavement structures on the mechanical characteristics of asphalt overlay.

Keywords: interlayer contact, effective relative displacement, digital image correlation technology, composite pavement structure, asphalt overlay

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Authors: Maryam Radan, Fereshteh Nejad Dehbashi, Vahid Bayati, Mahin Dianat, Seyyed Ali Mard, Zahra Mansouri

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Pulmonary emphysema is a pathological respiratory condition identified by alveolar destruction which leads to limitation of airflow and diminished lung function. A substantial body of evidence suggests that mesenchymal stem cells (MSCs) have the ability to induce tissue repair primarily through a paracrine effect. In this study, we aimed to determine the efficacy of Intratracheal adipose-derived mesenchymal stem cells (ADSCs) therapy in comparison to this approach with that of Intravenous (Systemic) therapy. Fifty adult male Sprague–Dawley rats weighing between 180 and 200 g were used in this experiment. The animals were randomized to Control groups (Intratracheal or Intravenous vehicle), Elastase group (intratracheal administration of porcine pancreatic elastase; 25 U/kg on day 0 and day 10th), Elastase+Intratracheal ADSCs therapy (1x107 Cells, on day 28) and Elastase+Systemic ADSCs therapy (1x107 Cells, on day 28). The rats which not subjected to any treatment, considered as the control. All rats were sacrificed 3 weeks later. Morphometric findings in lung tissues (Mean linear intercept) confirmed the establishment of the emphysema model via alveolar disruption. Contrarily, ADSCs administration partially restored alveolar architecture. These results were associated with improving arterial oxygenation, reducing lung edema, and decreasing lung inflammation with higher significant effects in the Intratracheal therapy route. These results documented that the efficacy of intratracheal ADSCs was comparable with intravenous ADSCs therapy. Accordingly, the obtained data suggested that intratracheal delivery of ADSCs would enhance lung repair in pulmonary emphysema. Moreover, this method provides benefits over a systemic administration, such as the reduction of cell number and the low risk to engraft other organs.

Keywords: mesenchymal stem cell, emphysema, Intratracheal, systemic

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Authors: Abdul Rashid, Varsha Rokade

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Service Quality within retail units is pivotal for satisfying customers and retaining them. This study on customer perception towards Service Quality variables in Retail aims to identify the dimensions and their impact on customers. An analytical study of the different retail service quality variables was done to understand the relationship between them. The study tries exploring the factors that attract the customers towards the organised and unorganised retail stores in the capital city of Madhya Pradesh, India. As organised retailers are seen as offering similar products in the outlets, improving service quality is seen as critical to ensuring competitive advantage over unorganised retailers. Data were collected through a structured questionnaire on a five-point Likert scale from existing walk-in customers of selected organised and unorganised retail stores in Bhopal City of Madhya Pradesh, India. The data was then analysed by factor analysis using (SPSS) Statistical Package for the Social Sciences especially Percentage analysis, ANOVA and Chi-Square. This study tries to find interrelationship between various Retail Service Quality dimensions, which will help the retailers to identify the steps needed to improve the overall quality of service. Thus, the findings of the study prove to be helpful in understanding the service quality variables which should be considered by organised and unorganised retail stores in Capital city of Madhya Pradesh, India.Also, findings of this empirical research reiterate the point of view that dimensions of Service Quality in Retail play an important role in enhancing customer satisfaction – a sector with high growth potential and tremendous opportunities in rapidly growing economies like India’s. With the introduction of FDI in multi-brand retailing, a large number of international retail players are expected to enter the Indian market, this intern will bring more competition in the retail sector. For benchmarking themselves with global standards, the Indian retailers will have to improve their service quality.

Keywords: organized retail, unorganised retail, retail service quality, service quality dimension

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Authors: Hazel Pettifor, Charlie Wilson, David Mccollum, Oreane Edelenbosch

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Vehicle purchase is a technology adoption decision that will strongly influence future energy and emission outcomes. Global integrated assessment models (IAMs) provide valuable insights into the medium and long terms effects of socio-economic development, technological change and climate policy. In this paper we present a unique and transparent approach for improving the behavioural representation of these models by incorporating social influence effects to more accurately represent consumer choice. This work draws together strong conceptual thinking and robust empirical evidence to introduce heterogeneous and interconnected consumers who vary in their aversion to new technologies. Focussing on vehicle choice, we conduct novel empirical research to parameterise consumer risk aversion and how this is shaped by social and cultural influences. We find robust evidence for social influence effects, and variation between countries as a function of cultural differences. We then formulate an approach to modelling social influence which is implementable in both simulation and optimisation-type models. We use two global integrated assessment models (IMAGE and MESSAGE) to analyse four scenarios that introduce social influence and cultural differences between regions. These scenarios allow us to explore the interactions between consumer preferences and social influence. We find that incorporating social influence effects into global models accelerates the early deployment of electric vehicles and stimulates more widespread deployment across adopter groups. Incorporating cultural variation leads to significant differences in deployment between culturally divergent regions such as the USA and China. Our analysis significantly extends the ability of global integrated assessment models to provide policy-relevant analysis grounded in real-world processes.

Keywords: behavioural realism, electric vehicles, social influence, vehicle choice

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Authors: C. Lanzerstorfer, M. Hinterberger

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The iron content of the ore used is crucial for the productivity and coke consumption rate in blast furnace pig iron production. Therefore, most iron ore deposits are processed in beneficiation plants to increase the iron content and remove impurities. In several comminution stages, the particle size of the ore is reduced to ensure that the iron oxides are physically liberated from the gangue. Subsequently, physical separation processes are applied to concentrate the iron ore. The fine-grained ore concentrates produced need to be transported, stored, and processed. For smooth operation of these processes, the flow properties of the material are crucial. The flowability of powders depends on several properties of the material: grain size, grain size distribution, grain shape, and moisture content of the material. The flowability of powders can be measured using ring shear testers. In this study, the influence of the moisture content on the flowability for the Krivoy Rog magnetite iron ore concentrate was investigated. Dry iron ore concentrate was mixed with varying amounts of water to produce samples with a moisture content in the range of 0.2 to 12.2%. The flowability of the samples was investigated using a Schulze ring shear tester. At all measured values of the normal stress (1.0 kPa – 20 kPa), the flowability decreased significantly from dry ore to a moisture content of approximately 3-5%. At higher moisture contents, the flowability was nearly constant, while at the maximum moisture content the flowability improved for high values of the normal stress only. The results also showed an improving flowability with increasing consolidation stress for all moisture content levels investigated. The wall friction angle of the dust with carbon steel (S235JR), and an ultra-high molecule low-pressure polyethylene (Robalon) was also investigated. The wall friction angle increased significantly from dry ore to a moisture content of approximately 3%. For higher moisture content levels, the wall friction angles were nearly constant. Generally, the wall friction angle was approximately 4° lower at the higher wall normal stress.

Keywords: iron ore concentrate, flowability, moisture content, wall friction angle

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Authors: Bianca W. O. Silva, Adriana C. M. Andrade, Gustavo C. M. Lucena, Virna M. S. Lima

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Introduction: Basic life support (BLS) involves the immediate recognition of cardiopulmonary arrest. Each year, 359.400 and 275.000 individuals with cardiac arrest are attended in emergency departments in USA and Europe. Brazilian data shows that 200.000 cardiac arrests occur every year, and half of them out of the hospital. Medical schools around the world teach BLS in the first years of the course, but studies show that there is a decline of the knowledge as the years go by, affecting the chain of survival. The objective was to analyze the knowledge of medical students about BLS and the retention of this learning throughout the course. Methods: This study included 150 students who were at the second and third year of a medical school in Salvador, Bahia, Brazil. The instrument of data collection was a structured questionnaire composed of 20 questions based on the 2015 American Heart Association guideline. The Pearson Chi-square test was used in order to study the association between previous training, sex and semester with the degree of knowledge of the students. The Kruskal-Wallis test was used to evaluate the different yields obtained between the various semesters. The number of correct answers was described by average and quartiles. Results: Regarding the degree of knowledge, 19.6% of the female students reached the optimal classification, a better outcome than the achieved by the male participants. Of those with previous training, 33.33% were classified as good and optimal, none of the students reached the optimal classification and only 2.2% of them were classified as bad (those who did not have 52.6% of correct answers). The analysis of the degree of knowledge related to each semester revealed that the 5th semester had the highest outcome: 30.5%. However, the acquaintance presented by the semesters was generally unsatisfactory, since 50% of the students, or more, demonstrated knowledge levels classified as bad or regular. When confronting the different semesters and the achieved scores, the value of p was 0.831. Conclusion: It is important to focus on the training of medical professionals that are capable of facing emergency situations, improving the systematization of care, and thereby increasing the victims' possibility of survival.

Keywords: basic life support, cardiopulmonary ressucitacion, education, medical students

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Authors: María Jesús Luengo-Valderrey, Mónica Moso-Díez

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In the knowledge-based economy, innovation is considered essential in order to achieve survival and growth in organizations. On the other hand, knowledge management is currently understood as one of the keys to innovation process. Both factors are generally admitted as generators of competitive advantage in organizations. Specifically, activities on R&D&I and those that generate internal knowledge have a positive influence in innovation results. This paper examines this effect and if it is similar or not is what we aimed to quantify in this paper. We focus on the impact that proportion of knowledge workers, the R&D&I investment, the amounts destined for ICTs and training for innovation have on the variation of tangible and intangibles returns for the sector of high and medium technology in Spain. To do this, we have performed an empirical analysis on the results of questionnaires about innovation in enterprises in Spain, collected by the National Statistics Institute. First, using clusters methodology, the behavior of these enterprises regarding knowledge management is identified. Then, using SEM methodology, we performed, for each cluster, the study about cause-effect relationships among constructs defined through variables, setting its type and quantification. The cluster analysis results in four groups in which cluster number 1 and 3 presents the best performance in innovation with differentiating nuances among them, while clusters 2 and 4 obtained divergent results to a similar innovative effort. However, the results of SEM analysis for each cluster show that, in all cases, knowledge workers are those that affect innovation performance most, regardless of the level of investment, and that there is a strong correlation between knowledge workers and investment in knowledge generation. The main findings reached is that Spanish high and medium technology companies improve their innovation performance investing in internal knowledge generation measures, specially, in terms of R&D activities, and underinvest in external ones. This, and the strong correlation between knowledge workers and the set of activities that promote the knowledge generation, should be taken into account by managers of companies, when making decisions about their investments for innovation, since they are key for improving their opportunities in the global market.

Keywords: high and medium technology sector, innovation, knowledge management, Spanish companies

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Authors: Stephen Rulisa, Aimee Nyiramahirwe

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Background: Strategies to increase the uptake of contraception services have been adopted in Rwanda, but the unmet need for family planning remains high. Women in the postpartum period are at higher risk for unintended pregnancy due to the silent conversion from lactational amenorrhea to reactivation of ovulatory cycles. The purpose of this study was to explore the role of male partners in the uptake of postpartum contraception. Methods: A prospective cross-sectional study was conducted among women who delivered at the University Teaching Hospital of Kigali for a period of 3 months with random sampling. A questionnaire was used to collect socio-demographic and antenatal data, information on male companionship, and intent to use postpartum contraception at admission. Participants were contacted six weeks later to collect data on contraceptive use. The outcome variables were uptake of postpartum contraception and types of contraceptives taken (long-acting vs. short-acting), controlling for male companionship during the antenatal period. A Chi-square test was used and a p-value ≤0.05 was considered significant. Results: A total of 209 women were recruited with a mean age of 30.8±5.2 years. The majority (60.9%) were multigravida, and 66.5% were multiparous. More than half (55%) had male partner companionship, 18.3% had companionship for four antenatal visits, and 28.2% had education on contraception with their male partner. Factors significantly associated with uptake of postpartum contraception were: age above 30 years, owning or heading a business, multigravidity, multiparity, antenatal care at a health center or district hospital, cesarean delivery, and previous utilization of contraception. Male companionship significantly increased the intent to use contraception, uptake of modern contraception in general, and uptake of long active contraceptives but did not predict the uptake of short-acting contraceptives. Conclusions: Our study demonstrates a positive association between male companionship during antenatal care, labor and delivery with the uptake of postpartum family planning. Our study suggests more sensitization to involve the male partners, improving the education on contraception during antenatal care and further research to assess the sustained uptake of contraception beyond the postpartum period.

Keywords: postpartum, family planning, contraception, male partner, uptake

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Authors: Orlando Ketebu

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Ogbono seed is the seed obtained from African bush mango (Irvingia gabonenesis) and bitter bush mango (Irvingia wombolu). Irvingia gabonenesis is known for its sweet edible pulp while Irvingia wombolu has a bitter pulp. Their seed powder is used in cooking soup known as ogbono soup in Nigeria and in West Africa. The powder thickens when cooked and researches have shown that it has medicinal uses such as lowering cholesterol; aiding weight loss and helps in improving diabetes control. The nutritional composition of the seeds indicated that Irvingia gabonenesis contains 8.60% protein, 13.8% carbohydrate, 2.0% moisture, 1.5% crude fiber, 16.4% ash, and Irvingia wombolu contains 7.38% protein, 25.75% carbohydrate, 11.7% moisture, 0.84% crude fiber, 2.50% ash. Solvent extraction of these seeds has shown that the seed of the two species are oil seeds with approximately 70 % and 52 % for Irvingia gabonenesis and Irvingia wombolu respectively. One major setback using ogbono seed powder in cooking soup is identifying the specie of ogbono seed powder that thickens most within the same cooking condition and how temperature affects the thickness of ogbono seed powder which determines its viscosity and in turn affects the quality of the soup and its nutrients. This research work monitored how the viscosity of ogbono species after being sun dried for one week changes with temperature. The result showed that heating 20 grams of powdered Irvingia gabonenesis and Irvingia wombolu at 30 OC, 45 OC, 55 OC, 65 OC, 75 OC, 85 OC and 95OC respectively in 200 ml beaker mixed with 100 ml of water, the viscosity of both species decreases with increase temperature with Irvingia wombolu having higher average viscosity in Pascal seconds (Pa.s) of 1.059, 1.042, 0.961, 0.778, 0.684, 0.675, and 0.495 at 30 OC, 45 OC, 55 OC, 65 OC, 75 OC, 85 OC and 95 OC respectively compared to Irvingia gabonenesis with result 0.982, 0.920, 0.720, 0.646, 0.597 and 0.446 at 30 OC, 45 OC, 55 OC, 65 OC, 75 OC, 85 OC and 95 OC respectively. Also from the experiment carried out it was found out that the viscosity of both species decreases with ageing of the seeds and the quantity of ogbono seed powder used and amount of water added also affected the viscosity of both species. In conclusion, it was observed that under the same cooking conditions (temperature range, quantity of water added, time and quantity of ogbono seed powder used), Irvingia wombolu had higher viscosity which is a measure of its thickness and quality of nutrients compared to Irvingia gabonenesis and the viscosity of both species decreases with increasing temperature.

Keywords: ogbono seed powder, temperature, viscosity , soup

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Authors: Jin-Siang Shaw, Patricia Moya Caceres, Sheng-Xiang Xu

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This paper aims to integrate the particle swarm optimization (PSO) method with the adaptive fuzzy sliding mode controller (AFSMC) to achieve vibration attenuation in a piezoelectric actuator subject to base excitation. The piezoelectric actuator is a complicated system made of ferroelectric materials and its performance can be affected by nonlinear hysteresis loop and unknown system parameters and external disturbances. In this study, an adaptive fuzzy sliding mode controller is proposed for the vibration control of the system, because the fuzzy sliding mode controller is designed to tackle the unknown parameters and external disturbance of the system, and the adaptive algorithm is aimed for fine-tuning this controller for error converging purpose. Particle swarm optimization method is used in order to find the optimal controller parameters for the piezoelectric actuator. PSO starts with a population of random possible solutions, called particles. The particles move through the search space with dynamically adjusted speed and direction that change according to their historical behavior, allowing the values of the particles to quickly converge towards the best solutions for the proposed problem. In this paper, an initial set of controller parameters is applied to the piezoelectric actuator which is subject to resonant base excitation with large amplitude vibration. The resulting vibration suppression is about 50%. Then PSO is applied to search for an optimal controller in the neighborhood of this initial controller. The performance of the optimal fuzzy sliding mode controller found by PSO indeed improves up to 97.8% vibration attenuation. Finally, adaptive version of fuzzy sliding mode controller is adopted for further improving vibration suppression. Simulation result verifies the performance of the adaptive controller with 99.98% vibration reduction. Namely the vibration of the piezoelectric actuator subject to resonant base excitation can be completely annihilated using this PSO based adaptive fuzzy sliding mode controller.

Keywords: adaptive fuzzy sliding mode controller, particle swarm optimization, piezoelectric actuator, vibration suppression

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Authors: Anum Obaid, Bushra Noor, Zoshia Zainab

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In South Asian countries, Pakistan faces significant public health challenges regarding maternal and neonatal health (MNH). Despite global efforts to improve maternal, newborn, child, and health (MNCH) outcomes through initiatives like the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs), high maternal and neonatal mortality rates persist. In patriarchal societies, cultural norms, family dynamics, and gender roles heavily influence healthcare accessibility and decision-making processes, often leading to delayed and inadequate maternal care. Addressing these socio-cultural barriers and enhancing healthcare resources is crucial to improving maternal health outcomes in areas like Faisalabad. A qualitative study was conducted involving two groups of informants: gynecologists practicing in private clinics and first-time pregnant women receiving care in government hospitals. Data collection included obtaining institutional permission, conducting semi-structured in-depth interviews, and using non-probability sampling techniques. A proactive strategy to overcome maternal health challenges involves using aversion therapy and disseminating knowledge among family members. This approach aims to foster a deep understanding within the family unit regarding the importance of maternal well-being, thereby creating a supportive environment and facilitating informed decision-making related to healthcare access and lifestyle choices. The findings indicate that maternal health is compromised both physiologically and psychologically, with significant implications for the baby's health. Mental well-being, in particular, is profoundly affected, largely due to familial behavior and entrenched cultural taboos.

Keywords: maternal health, neonatal health, socio-cultural norms, primigravida women, gynecologist, familial conduct, cultural taboos

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Authors: Anum Obaid, Bushra Noor, Zoshia Zainab

Abstract:

In South Asian countries, Pakistan faces significant public health challenges regarding maternal and neonatal health (MNH). Despite global efforts to improve maternal, newborn, child, and health (MNCH) outcomes through initiatives like the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs), high maternal and neonatal mortality rates persist. In patriarchal societies, cultural norms, family dynamics, and gender roles heavily influence healthcare accessibility and decision-making processes, often leading to delayed and inadequate maternal care. Addressing these socio-cultural barriers and enhancing healthcare resources is crucial to improving maternal health outcomes in areas like Faisalabad. A qualitative study was conducted involving two groups of informants: gynecologists practicing in private clinics and first-time pregnant women receiving care in government hospitals. Data collection included obtaining institutional permission, conducting semi-structured in-depth interviews, and using non-probability sampling techniques. A proactive strategy to overcome maternal health challenges involves using aversion therapy and disseminating knowledge among family members. This approach aims to foster a deep understanding within the family unit regarding the importance of maternal well-being, thereby creating a supportive environment and facilitating informed decision-making related to healthcare access and lifestyle choices. The findings indicate that maternal health is compromised both physiologically and psychologically, with significant implications for the baby's health. Mental well-being, in particular, is profoundly affected, largely due to familial behavior and entrenched cultural taboos.

Keywords: maternal health, neonatal health, socio-cultural norms, primigravida women, gynecologist, familial conduct, cultural taboos.

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