Search results for: critical care transition program

Authors: Nesengani Elelwani Clinton

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This paper presents reflective learning as an opportunity commonly available and used for food waste learning in a food processing company in the transition to sustainable and just food systems. In addressing how employees learn about food waste during food processing, the opportunities available for food waste learning were investigated. Reflective learning appeared to be the most used approach to learning about food waste. In the case of food waste learning, reflective learning was a response after employees wasted a substantial amount of food, where process controllers and team leaders would highlight the issue to employees who wasted food and explain how food waste could be reduced. This showed that learning about food waste is not proactive, and there continues to be a lack of structured learning around food waste. Several challenges were highlighted around reflective learning about food waste. Some of the challenges included understanding the language, lack of interest from employees, set times to reach production targets, and working pressures. These challenges were reported to be hindering factors in understanding food waste learning, which is not structured. A need was identified for proactive learning through structured methods. This is because it was discovered that in the plant, where food processing activities happen, the signage and posters that are there are directly related to other sustainability issues such as food safety and health. This indicated that there are low levels of awareness about food waste. Therefore, this paper argues that food waste learning should be proactive. The proactive learning approach should include structured learning materials around food waste during food processing. In the structuring of the learning materials, individual trainers should be multilingual. This will make it possible for those who do not understand English to understand in their own language. And lastly, there should be signage and posters in the food processing plant around food waste. This will bring more awareness around food waste, and employees' behaviour can be influenced by the posters and signage in the food processing plant. Thus, will enable a transition to a just and sustainable food system.

Keywords: sustainable and just food systems, food waste, food waste learning, reflective learning approach

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Authors: Mario Isaza-Ruget, Claudia C. Colmenares-Mejia, Nancy Yomayusa, Camilo A. González, Andres Cely, Jossie Murcia

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Quantification of risks associated with complications development from chronic kidney disease (CKD) through accurate survival models can help with patient management. A retrospective cohort that included patients diagnosed with CKD from a primary care program and followed up between 2013 and 2018 was carried out. Time-dependent and static covariates associated with demographic, clinical, and laboratory factors were included. Deep Learning (DL) survival analyzes were developed for three CKD outcomes: CKD stage progression, >25% decrease in Estimated Glomerular Filtration Rate (eGFR), and Renal Replacement Therapy (RRT). Models were evaluated and compared with Random Survival Forest (RSF) based on concordance index (C-index) metric. 2.143 patients were included. Two models were developed for each outcome, Deep Neural Network (DNN) model reported C-index=0.9867 for CKD stage progression; C-index=0.9905 for reduction in eGFR; C-index=0.9867 for RRT. Regarding the RSF model, C-index=0.6650 was reached for CKD stage progression; decreased eGFR C-index=0.6759; RRT C-index=0.8926. DNN models applied in survival analysis context with considerations of longitudinal covariates at the start of follow-up can predict renal stage progression, a significant decrease in eGFR and RRT. The success of these survival models lies in the appropriate definition of survival times and the analysis of covariates, especially those that vary over time.

Keywords: artificial intelligence, chronic kidney disease, deep neural networks, survival analysis

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Authors: Ontima Yamchuti, Waruntorn Kanitpanyacharoen, Chakkaphan Sutthirat, Wantana Klysuban, Penphitcha Amonpattarakit

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Natural corundum occurs in various colors due to impurities or trace elements in its structure. Sapphire and ruby are essentially the same mineral, corundum, but valued differently due to their red and blue varieties, respectively. Color is one of the critical factors used to determine the value of natural and synthetic corundum. Despite the abundance of research on impurities in natural corundum, little is known about trace elements in synthetic corundum. This project thus aims to quantify trace elements and identify their oxidation states in synthetic corundum. A total of 15 corundum samples in red, blue, and yellow, synthesized by melt growth process, were first investigated by X-ray diffraction (XRD) analysis to determine the composition. Electron probe micro-analyzer (EPMA) was used to identify the types of trace elements. Results confirm that all synthetic corundums contain crystalline Al₂O₃ and a wide variety type of trace element, particularly Cr, Fe, and Ti. In red, yellow, and blue corundums respectively. To further determine their oxidation states, synchrotron X-ray absorption near edge structure spectrometry (XANES) was used to observe absorbing energy of each element. XANES results show that red synthetic corundum has Cr³⁺ as a major trace element (62%). The pre-edge absorption energy of Cr³⁺ is at 6001 eV. In addition, Fe²⁺ and Fe³⁺ are dominant oxidation states of yellow synthetic corundum while Ti³⁺and Ti⁴⁺ are dominant oxidation states of blue synthetic corundum. the average absorption energy of Fe and Ti is 4980 eV and 7113 eV respectively. The presence of Fe²⁺, Fe³⁺, Cr³⁺, Ti³⁺, and Ti⁴⁺ in synthetic corundums in this study is governed by comparison absorption energy edge with standard transition. The results of oxidation states in this study conform with natural corundum. However yellow synthetic corundums show difference oxidation state of trace element compared with synthetic in electron spin resonance spectrometer method which found that Ni³⁺ is a dominant oxidation state.

Keywords: corundum, trace element, oxidation state, XANES technique

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Authors: Md Iqbal Hossain, Tahmeed Ahmed, Kenneth H. Brown

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Objective: To assess the effect of community-based follow up, with or without food-supplementation and/or psychosocial stimulation, as an alternative to current hospital-based follow-up of children with moderate-acute-malnutrition (WHZ < -2 to -3) (MAM). Design/methods: The study was conducted at the ICDDR,B Dhaka Hospital and in four urban primary health care centers of Dhaka, Bangladesh during 2005-2007. The efficacy of five different randomly assigned interventions was compared with respect to the rate of completion of follow-up, growth and morbidity in 227 MAM children aged 6-24 months who were initially treated at ICDDR,B for diarrhea and/or other morbidities. The interventions were: 1) Fortnightly follow-up care (FFC) at the ICDDR,B’s outpatient-unit, including growth monitoring, health education, and micro-nutrient supplementation (H-C, n=49). 2) FFC at community follow-up unit (CNFU) [established in the existing urban primary health-care centers close to the residence of the child] but received the same regimen as H-C (C-C, n=53). 3) As per C-C plus cereal-based supplementary food (SF) (C-SF, n=49). The SF packets were distributed on recruitment and at every visit in CNFU [@1 packet/day for 6–11 and 2 packets/day for 12-24 month old children. Each packet contained 20g toasted rice-powder, 10g toasted lentil-powder, 5g molasses, and 3g soy bean oil, to provide a total of ~ 150kcal with 11% energy from protein]. 4) As per C-C plus psychosocial stimulation (PS) (C-PS, n=43). PS consisted of child-stimulation and parental-counseling conducted by trained health workers. 5) As per C-C plus both SF+PS (C-SF+PS, n=33). Results: A total of 227children (48.5% female), with a mean ± SD age of 12.6 ±3.8 months, and WHZ of - 2.53±0.28 enrolled. Baseline characteristics did not differ by treatment group. The rate of spontaneous attendance at scheduled follow-up visits gradually decreased in all groups. Follow-up attendance and gain in weight and length were greater in groups C-SF, C-SF+PS, and C-PS than C-C, and these indicators were observed least in H-C. Children in the H-C group more often suffered from diarrhea (25 % vs. 4-9%) and fever (28% vs. 8-11%) than other groups (p < 0.05). Children who attended at least five of the total six scheduled follow-up visits gained more in weight (median: 0.86 vs. 0.62 kg, p=0.002), length (median: 2.4 vs. 2.0 cm, p=0.009) than those who attended fewer. Conclusions: Community-based service delivery, especially including supplementary food with or without psychosocial stimulation, permits better rehabilitation of children with MAM compared to current hospital outpatients-based care. By scaling the community-based follow-up including food supplementation with or without psychosocial stimulation, it will be possible to rehabilitate a greater number of MAM children in a better way.

Keywords: community-based management, moderate acute malnutrition, psychosocial stimulation, supplementary food

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Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

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Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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Authors: Wai Yan Shih, Sau Man Wong, Wing Chung Chang, Wai Chi Chan

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Background: Late-life depression is associated with significant consequences. Although symptomatic reduction is achievable through pharmacological interventions, older adults are more vulnerable to the side effects than their younger counterparts. In addition, drugs do not address underlying cognitive dysfunctions such as rumination and reduced autobiographical memory specificity (AMS), both shown to be maladaptive coping styles that are associated with a poorer prognosis in depression. Considering how aging is accompanied by cognitive, psychological and physical changes, the interplay of these age-related factors may potentially aggravate and interfere with these depressive cognitive dysfunctions in late-life depression. Special care should, therefore, be drawn to ensure these cognitive dysfunctions are adequately addressed. Aim: This randomized controlled trial aims to examine the effect of mindfulness-based cognitive therapy (MBCT) on depressed older adults, and whether the potential benefits of MBCT are mediated by improvements in rumination and AMS. Method: Fifty-seven participants with an average age of 70 years old were recruited from multiple elderly centers and online mailing lists. Participants were assessed with: (1) Hamilton depression scale, (2) ruminative response scale, (3) autobiographical memory test, (4) mindful attention awareness scale, and (5) Montreal cognitive assessment. Eligible participants with mild to moderate depressive symptoms and normal cognitive functioning were randomly allocated to an 8-week MBCT group or active control group consisting of a low-intensity exercise program and health education. Post-intervention assessments were conducted after the 8-week program. Ethics approval was given by the Institutional Review Board of the University of Hong Kong/Hospital Authority. Results: Mixed-factorials ANOVAs demonstrated significant time x group interaction effects for depressive symptoms, AMS, and dispositional mindfulness. A marginally significant interaction effect was found for rumination. Simple effect analyses revealed a significant reduction in depressive symptoms for the both the MBCT group (mean difference = 7.1, p = .000), and control group (mean difference = 2.7, p = .023). However, only participants in the MBCT group demonstrated improvements in rumination, AMS, and dispositional mindfulness. Bootstrapping-based mediation analyses showed that the effect of MBCT in alleviating depressive symptoms was only mediated by the reduction in rumination. Conclusions: The findings support the use of MBCT as an effective intervention for depressed older adults, considering the improvements in depressive symptoms, rumination, AMS and dispositional mindfulness despite their age. Reduction in ruminative tendencies plays a major role in the cognitive mechanism of MBCT.

Keywords: mindfulness-based cognitive therapy, depression, older adults, rumination, autobiographical memory specificity

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Authors: Bo Ram Choi, Ji Su Kim, Juyeon Cho, Hyukjin Lee

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Food contaminated by bacteria (E.coli), causes food poisoning, which occurs to many patients worldwide annually. We have introduced an application of rolling circle amplification (RCA) as a versatile biosensor and developed a diagnostic platform composed of capillary tube and microbeads for rapid and easy detection of Escherichia coli (E. coli). When specific mRNA of E.coli is extracted from cell lysis, rolling circle amplification (RCA) of DNA template can be achieved and can be visualized by beads aggregation in capillary tube. In contrast, if there is no bacterial pathogen in sample, no beads aggregation can be seen. This assay is possible to detect visually target gene without specific equipment. It is likely to the development of a genetic kit for point of care testing (POCT) that can detect target gene using microbeads.

Keywords: rolling circle amplification (RCA), Escherichia coli (E. coli), point of care testing (POCT), beads aggregation, capillary tube

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Authors: Shalini Tripathi, Pardeep Kumar

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The method of translating observed symptoms into disease names is known as disease diagnosis. The ability to solve clinical problems in a complex manner is critical to a doctor's effectiveness in providing health care. The accuracy of his or her expertise is crucial to the survival and well-being of his or her patients. Artificial Intelligence (AI) has a huge economic influence depending on how well it is applied. In the medical sector, human brain-simulated intellect can help not only with classification accuracy, but also with reducing diagnostic time, cost and pain associated with pathologies tests. In light of AI's present and prospective applications in the biomedical, we will identify them in the paper based on potential benefits and risks, social and ethical consequences and issues that might be contentious but have not been thoroughly discussed in publications and literature. Current apps, personal tracking tools, genetic tests and editing programmes, customizable models, web environments, virtual reality (VR) technologies and surgical robotics will all be investigated in this study. While AI holds a lot of potential in medical diagnostics, it is still a very new method, and many clinicians are uncertain about its reliability, specificity and how it can be integrated into clinical practice without jeopardising clinical expertise. To validate their effectiveness, more systemic refinement of these implementations, as well as training of physicians and healthcare facilities on how to effectively incorporate these strategies into clinical practice, will be needed.

Keywords: Artificial Intelligence, medical diagnosis, virtual reality, healthcare ethical implications 

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Authors: A. Katsman, L. Bloch, Y. Etinger, Y. Kauffmann, B. Pokroy

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Various nanosized amorphous alumina thin films in the range of (2.4 - 63.1) nm were deposited onto amorphous carbon and amorphous Si3N4 membrane grids. Transmission electron microscopy (TEM), electron energy loss spectroscopy (EELS), X-ray photoelectron spectroscopy (XPS) and differential scanning calorimetry (DSC) techniques were used to probe the size effect on the short range order and the amorphous to crystalline phase transition temperature. It was found that the short-range order changes as a function of size: the fraction of tetrahedral Al sites is greater in thinner amorphous films. This result correlates with the change of amorphous alumina density with the film thickness demonstrated by the reflectivity experiments: the thinner amorphous films have the less density. These effects are discussed in terms of surface reconstruction of the amorphous alumina films. The average atomic binding energy in the thin film layer decreases with decease of the thickness, while the average O-Al interatomic distance increases. The reconstruction of amorphous alumina is induced by the surface reconstruction, and the short range order changes being dependent on the density. Decrease of the surface energy during reconstruction is the driving force of the alumina reconstruction (density change) followed by relaxation process (short range order change). The amorphous to crystalline phase transition temperature measured by DSC rises with the decrease in thickness from 997.6°C for 13.9 nm to 1020.4 °C for 2.7 nm thick. This effect was attributed to the different film densities: formation of nanovoids preceding and accompanying crystallization process influences the crystallization rate, and by these means, the temperature of crystallization peak.

Keywords: amorphous alumina, density, short range order, size effect

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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The study was done to determine the microbiological profile and changing pattern of the pathogens causing UTI in the ICU patients. All the patients admitted to the ICU with urinary catheter insertion for more than 48hours were included in the study. Urine samples were collected in a sterile container with aseptic precaution using disposable syringe and was processed as per standards. Antimicrobial susceptibility test was done by Disc Diffusion method as per CLSI guidelines. A total of 100 urine samples were collected from ICU patients, out of which 30% showed significant bacterial growth and 7% showed growth of candida spp. Prevalence of UTI was more in female (73%) than male (27.%). Gram-negative bacilli 26(86.67%) were more common in our study followed by gram-positive cocci 4(13.33%). The most common uropathogens isolated were Escherichia coli 14 (46.67%), followed by Klebsiella spp 7(23.33%), Staphylococcus aureus 4(13.33%), Acinetobacter spp 3(10%), Enterococcus faecalis 1(3.33%) and Pseudomonas aeruginosa 1(3.33%). Most of the Gram-negative bacilli were sensitive to amikacin (80%) and nitrofurantoin (80%), where as all gram-positive organisms were sensitive to Vancomycin. A large number ESBL producers were also observed in this study. The study finding showed that E.coli is the predominant pathogen and has increasing resistance pattern to the commonly used antibiotics. The study proposes that the adherence to antibiotic policy is the key ingredients for successful outcome in ICU patients and also emphasizes that repeated evaluation of microbial characteristics and continuous surveillance of resistant bacteria is required for selection of appropriate antibiotic therapy.

Keywords: antimicrobial sensitivity, intensive care unit, nosocomial infection, urinary tract infection

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Authors: Esayas Geleta

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Within the last two decades in many sub-Saharan African countries, a large-scale acquisition (lease, concession, outright purchase) of extensive areas of farmland commonly labeled as ‘idle’ and ‘under-utilized’ has resulted in displacement and dispossession and dispossession without ‘compensation.’ This paper seeks to critically illustrate the processes and the consequences of the ‘land grabbing project’ in Ethiopia. Drawing on the theory of participatory development and empirical studies undertaken in Ethiopia, the paper elucidates the power dynamics that influence how and why dislocation and dispossession occur. The paper then demonstrates why the land-grabbing project, which was hugely supported by many international organizations, has largely failed in Ethiopia. Through a critical analysis of the process of ‘land grabbing’ in Ethiopia, the paper contributes to a more adequate and critical understanding of contemporary land deals and their social and environmental consequences.

Keywords: land grabbing, human rights, dispossession, resistance, governance

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Authors: Farzad Jalilian, Mehdi Mirzaei Alavijeh, Mohammad Ahmadpanah, Behzad Karami Matin, Abbas Aghaei, Ahmad Ali Eslami

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Background: Smoking is introduced as one of the main risky factors to develop different types of diseases around the world, especially related to non-contagious diseases. The goal of the present study was assessment of the effectiveness of web based education program to prevent cigarette smoking among college students. Methods: In a randomized controlled trial, during 2014, 150 male college students in Isfahan and Kermanshah University of medical sciences were assigned to intervention group (receiving web based education program) and control groups. The study information was analyzed by SPSS software version 21 using cross-tabulation, t-test, repeated measures and GEE. Results: It was found significantly that average response for attitude towards cigarette smoking and sensation seeking after education reduced (P < 0.05). After intervention there was no significant difference between intervention and control group of cigarette smoking (P > 0.05). Conclusion: web based education have usefulness to reduce belief towards cigarette smoking.

Keywords: web-based intervention, smoking, students, Iran

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Authors: K. Boonlertnirun, C. Rawdsiri, R. Suvannasara, S. Boonlertnirun

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Thein corn variety well adapted to several planting conditions is usually accepted by most farmers. The objectives of this work were to evaluate yield potential of Thein corn inbred line grown in various nitrogen rates and plant conditions for selecting good inbred lines to be germ plasm for further breeding program. Split plot design with three replications was utilized as experimental design, three planting conditions: normal (control), low nitrogen, and high plant density condition, and sixteen inbred lines of Thein corn were used as main and subplot respectively. The results showed that no interaction between inbred line and planting condition in terms of yield. Correlation between planting conditions based on yield of inbred line was positive at medium level. Thein corn inbreds, namely L7, L5, L16, and L14 lines were tolerant to low nitrogen condition because they could produce high yield under all planting conditions and they were selected to be germ plasm for further breeding program.

Keywords: inbred line, planting condition, Thein corn, planting conditions

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Authors: Shatha Khuzaee

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The study develops multimodal stylistic approach to analyse a number of BBC online news articles reporting some key events from the so called ‘Arab Uprisings’. Critical stylistics (CS) and visual grammar (VG) provide insightful arguments to the ways ideology is projected through different verbal and visual modes, yet they are mode specific because they examine how each mode projects its meaning separately and do not attempt to clarify what happens intersemiotically when the two modes co-occur. Therefore, it is the task undertaken in this research to propose multimodal stylistic approach that addresses the issue of ideology construction when the two modes co-occur. Informed by functional grammar and social semiotics, the analysis attempts to integrate three linguistic models developed in critical stylistics, namely, transitivity choices, prioritizing and hypothesizing along with their visual equivalents adopted from visual grammar to investigate the way ideology is constructed, in multimodal text, when text/image participate and interrelate in the process of meaning making on the textual level of analysis. The analysis provides comprehensive theoretical and analytical elaborations on the different points of integration between CS linguistic models and VG equivalents which operate on the textual level of analysis to better account for ideology construction in news as non-literary multimodal texts. It is argued that the analysis well thought out a plan that would remark the first step towards the integration between the well-established linguistic models of critical stylistics and that of visual analysis to analyse multimodal texts on the textual level. Both approaches are compatible to produce multimodal stylistic approach because they intend to analyse text and image depending on whatever textual evidence is available. This supports the analysis maintain the rigor and replicability needed for a stylistic analysis like the one undertaken in this study.

Keywords: multimodality, stylistics, visual grammar, social semiotics, functional grammar

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Authors: Moses Jenkins

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Much of the focus when improving energy efficiency in buildings fall on the raising of standards within new build dwellings. However, as a significant proportion of the building stock across Europe is of historic or traditional construction, there is also a pressing need to improve the thermal performance of structures of this sort. On average, around twenty percent of buildings across Europe are built of historic masonry construction. In order to meet carbon reduction targets, these buildings will require to be retrofitted with insulation to improve their thermal performance. At the same time, there is also a need to balance this with maintaining the ability of historic masonry construction to allow moisture movement through building fabric to take place. This moisture transfer, often referred to as 'breathable construction', is critical to the success, or otherwise, of retrofit projects. The significance of this paper is to demonstrate that substantial thermal improvements can be made to historic buildings whilst avoiding damage to building fabric through surface or interstitial condensation. The paper will analyze the results of a wide range of retrofit measures installed to twenty buildings as part of Historic Environment Scotland's technical research program. This program has been active for fourteen years and has seen interventions across a wide range of building types, using over thirty different methods and materials to improve the thermal performance of historic buildings. The first part of the paper will present the range of interventions which have been made. This includes insulating mass masonry walls both internally and externally, warm and cold roof insulation and improvements to floors. The second part of the paper will present the results of monitoring work which has taken place to these buildings after being retrofitted. This will be in terms of both thermal improvement, expressed as a U-value as defined in BS EN ISO 7345:1987, and also, crucially, will present the results of moisture monitoring both on the surface of masonry walls the following retrofit and also within the masonry itself. The aim of this moisture monitoring is to establish if there are any problems with interstitial condensation. This monitoring utilizes Interstitial Hygrothermal Gradient Monitoring (IHGM) and similar methods to establish relative humidity on the surface of and within the masonry. The results of the testing are clear and significant for retrofit projects across Europe. Where a building is of historic construction the use of materials for wall, roof and floor insulation which are permeable to moisture vapor provides both significant thermal improvements (achieving a u-value as low as 0.2 Wm²K) whilst avoiding problems of both surface and intestinal condensation. As the evidence which will be presented in the paper comes from monitoring work in buildings rather than theoretical modeling, there are many important lessons which can be learned and which can inform retrofit projects to historic buildings throughout Europe.

Keywords: insulation, condensation, masonry, historic

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Authors: Omnia Saidani Neffati, Rim Samia Kaabi, Naoufel Kraiem

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In this paper, we propose an approach aiming at (i) representing services at two levels: the intentional level and the organizational level, and (ii) establishing mechanisms allowing to make a transition from the first level to the second one in order to execute intentional services. An example is used to validate our approach.

Keywords: intentional service, business process, BPMN, MDE, intentional service execution

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Authors: Marwa Sahnoun, Chokri Abdennadher

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This article comes, very timely, to look at the effectiveness of active labor market policies (ALMP) in improving labor market outcomes. Using panel data estimates for 19 European countries during the period 2000-2012, this article showed the role of institutional factors, especially the role of employment policies implementation based on three variables: the allocation of resources for the implementation of policies, continuity and timing in the implementation of policies to capture their effectiveness on the labor market. Empirical results shows favor effect of training, employment incentives, sheltered employment and rehabilitation and direct job creation on the entire population employment growth. Results shows also that start-up incentives seems to be more effective in increasing employment than other types of policies. Importantly, two aspects are important in terms of implementation: public expenditure on program administration, e.g. (PES) watches the most favorable aspect and the continuity of policies implemented.

Keywords: active labor market policies, implementation, public expenditure on program administration, start-up incentives, training

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Authors: Dong-Joong Kim, Sangho Choi, Woong Lim

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This paper discusses Sfard’s commognitive approach and provides an empirical study as an example to illustrate the theory as method. Traditionally, research in mathematics education focused on the acquisition of mathematical knowledge and the didactic process of knowledge transfer. Through attending to a distinctive form of language in mathematics, as well as mathematics as a discursive subject, alternative views of making meaning in mathematics have emerged; these views are therefore “critical,” as in critical discourse analysis. The commognitive discourse analysis method has the potential to bring more clarity to our understanding of students’ mathematical thinking and the process through which students are socialized into school mathematics.

Keywords: commognitive framework, discourse analysis, mathematical discourse, mathematics education

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Authors: Siti Badriyah Rushayati, Resti Meilani, Rachmad Hermawan

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A biosphere reserve is developed to create harmony amongst economic development, community development, and environmental protection, through partnership between human and nature. Giam Siak Kecil Bukit Batu Biosphere Reserve (GSKBB BR) in Riau Province, Indonesia, is unique in that it has peat soil dominating the area, many springs essential for human livelihood, high biodiversity. Furthermore, it is the only biosphere reserve covering privately managed production forest areas. The annual occurrences of deforestation and forest fire pose a threat toward such unique biosphere reserve. Forest fire produced smokes that along with mass airflow reached neighboring countries, particularly Singapore and Malaysia. In this research, we aimed at analyzing the threat of deforestation and forest fire, and the potential of CO2 emission at GSKBB BR. We used Landsat image, arcView software, and ERDAS IMAGINE 8.5 Software to conduct spatial analysis of land cover and land use changes, calculated CO2 emission based on emission potential from each land cover and land use type, and exercised simple linear regression to demonstrate the relation between CO2 emission potential and deforestation. The result showed that, beside in the buffer zone and transition area, deforestation also occurred in the core area. Spatial analysis of land cover and land use changes from years 2010, 2012, and 2014 revealed that there were changes of land cover and land use from natural forest and industrial plantation forest to other land use types, such as garden, mixed garden, settlement, paddy fields, burnt areas, and dry agricultural land. Deforestation in core area, particularly at the Giam Siak Kecil Wildlife Reserve and Bukit Batu Wildlife Reserve, occurred in the form of changes from natural forest in to garden, mixed garden, shrubs, swamp shrubs, dry agricultural land, open area, and burnt area. In the buffer zone and transition area, changes also happened, what once swamp forest changed into garden, mixed garden, open area, shrubs, swamp shrubs, and dry agricultural land. Spatial analysis on land cover and land use changes indicated that deforestation rate in the biosphere reserve from 2010 to 2014 had reached 16 119 ha/year. Beside deforestation, threat toward the biosphere reserve area also came from forest fire. The occurrence of forest fire in 2014 had burned 101 723 ha of the area, in which 9 355 ha of core area, and 92 368 ha of buffer zone and transition area. Deforestation and forest fire had increased CO2 emission as much as 24 903 855 ton/year.

Keywords: biosphere reserve, CO2 emission, deforestation, forest fire

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Authors: Smithinun Thairoongrojana

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This research is a qualitative research with three main purposes: (1) to develop the local tax map software system to be linked to the main Local Tax Map System (LTAX3000) system; (2) to design and develop a program for tax data fieldwork on wireless devices and link it to LTAX3000 database of Surat Thani Municipality; (3) to develop the human resource responsible for the fieldwork to be able to use the program and maintain the system and also to be able to work with the dynamic of technologies. In-depth interviews with the two groups of samples, the board of Surat Thani Municipality and operation staff responsible for observing and taxing fieldworks were conducted. The result of this study demonstrates the new developed fieldworks system that can be used both stand-alone usage and networking usage. The fieldworks system to collect and store the variety of taxing information within Surat Thani Municipality will be explained. Then the fieldwork operation process development and the replacement of transferring and storing the information via the network communication.

Keywords: Local tax map, software system development, wireless devices, human resource

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Authors: Pi-Chi Wu, Tsui-Ping Chu, Hsiu-Hung Wang

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Background: The ability to provide immediate medical service in outpatient departments is one of the keys to patient satisfaction. Objectives: This project used electronic equipment to integrate nursing care information to patient care at a blood pressure diagnostic counter. Through process reengineering, the average patient waiting time decreased from 35 minutes to 5 minutes, while service satisfaction increased from a score of 2.7 to 4.6. Methods: Data was collected from a local hospital in Southern Taiwan from a daily average of 2,200 patients in the outpatient department. Previous waiting times were affected by (1) space limitations, (2) the need to help guide patient mobility, (3) the need for nurses to appease irate patients and give instructions, (4), the need for patients to replace lost counter tickets, (5) the need to re-enter information, (6) the replacement of missing patient information. An ad hoc group was established to enhance patient satisfaction and shorten waiting times for patients to see a doctor. A four step strategy consisting of (1) counter relocation, (2) queue reorganization, (3) electronic information integration, (4) process reengineering was implemented. Results: Implementation of the developed strategy decreased patient waiting time from 35 minutes to an average of 5 minutes, and increased patient satisfaction scores from 2.7 to 6.4. Conclusion: Through the integration of information technology and process transformation, waiting times were drastically reduced, patient satisfaction increased, and nurses were allowed more time to engage in more cost-effective services. This strategy was simultaneously enacted in separate hospitals throughout Taiwan.

Keywords: process reengineering, electronic information integration, patient satisfaction, patient waiting time

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Authors: Kong Ngai Pei

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The argument scheme approach to argumentation has two components. One is to identify the recurrent patterns of inferences used in everyday discourse. The second is to devise critical questions to evaluate the inferences in these patterns. Although this approach is intuitive and contains many insightful ideas, it has been noted to be not free of problems. One is that due to its disavowing the probability calculus, it cannot give the exact strength of an inference. In order to tackle this problem, thereby paving the way to a more complete normative account of argument strength, it has been proposed, the most promising way is to combine the scheme-based approach with Bayesian networks (BNs). This paper pursues this line of thought, attempting to combine three common schemes, Appeal to Ignorance, Composition, and Division, with BNs. In the first part, it is argued that most (if not all) formulations of the critical questions corresponding to these schemes in the current argumentation literature are incomplete and not very informative. To remedy these flaws, more thorough and precise formulations of these questions are provided. In the second part, how to use graphical idioms (e.g. measurement and synthesis idioms) to translate the schemes as well as their corresponding critical questions to graphical structure of BNs, and how to define probability tables of the nodes using functions of various sorts are shown. In the final part, it is argued that many misuses of these schemes, traditionally called fallacies with the same names as the schemes, can indeed be adequately accounted for by the BN models proposed in this paper.

Keywords: appeal to ignorance, argument schemes, Bayesian networks, composition, division

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Authors: Ravshan A. Ibadov, Sardor Kh. Ibragimov

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Objective. The aim of the study was to optimize the protocol of cardiopulmonary resuscitation (CPR) after cardiovascular surgical interventions. Methods. The experience of CPR conducted on patients after cardiovascular surgical interventions in the Department of Intensive Care and Resuscitation (DIR) of the Republican Specialized Scientific-Practical Medical Center of Surgery named after Academician V. Vakhidov is presented. The key to the new approach is the rapid elimination of reversible causes of cardiac arrest, followed by either defibrillation or electrical cardioversion (depending on the situation) before external heart compression, which may damage sternotomy. Careful use of adrenaline is emphasized due to the potential recurrence of hypertension, and timely resternotomy (within 5 minutes) is performed to ensure optimal cerebral perfusion through direct massage. Out of 32 patients, cardiac arrest in the form of asystole was observed in 16 (50%), with hypoxemia as the cause, while the remaining 16 (50%) experienced ventricular fibrillation caused by arrhythmogenic reactions. The age of the patients ranged from 6 to 60 years. All patients were evaluated before the operation using the ASA and EuroSCORE scales, falling into the moderate-risk group (3-5 points). CPR was conducted for cardiac activity restoration according to the American Heart Association and European Resuscitation Council guidelines (Ley SJ. Standards for Resuscitation After Cardiac Surgery. Critical Care Nurse. 2015;35(2):30-38). The duration of CPR ranged from 8 to 50 minutes. The ARASNE II scale was used to assess the severity of patients' conditions after CPR, and the Glasgow Coma Scale was employed to evaluate patients' consciousness after the restoration of cardiac activity and sedation withdrawal. Results. In all patients, immediate chest compressions of the necessary depth (4-5 cm) at a frequency of 100-120 compressions per minute were initiated upon detection of cardiac arrest. Regardless of the type of cardiac arrest, defibrillation with a manual defibrillator was performed 3-5 minutes later, and adrenaline was administered in doses ranging from 100 to 300 mcg. Persistent ventricular fibrillation was also treated with antiarrhythmic therapy (amiodarone, lidocaine). If necessary, infusion of inotropes and vasopressors was used, and for the prevention of brain edema and the restoration of adequate neurostatus within 1-3 days, sedation, a magnesium-lidocaine mixture, mechanical intranasal cooling of the brain stem, and neuroprotective drugs were employed. A coordinated effort by the resuscitation team and proper role allocation within the team were essential for effective cardiopulmonary resuscitation (CPR). All these measures contributed to the improvement of CPR outcomes. Conclusion. Successful CPR following cardiac surgical interventions involves interdisciplinary collaboration. The application of an optimized CPR standard leads to a reduction in mortality rates and favorable neurological outcomes.

Keywords: cardiac surgery, cardiac arrest, resuscitation, critically ill patients

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Authors: Kitti Leangkrua

Abstract:

This paper presents a risk-based maintenance strategy of a power transformer in order to optimize operating and maintenance costs. The methodology involves the study and preparation of a database for the collection the technical data and test data of a power transformer. An evaluation of the overall condition of each transformer is performed by a program developed as a result of the measured results; in addition, the calculation of the main equipment separation to the overall condition of the transformer (% HI) and the criteria for evaluating the importance (% ImI) of each location where the transformer is installed. The condition assessment is performed by analysis test data such as electrical test, insulating oil test and visual inspection. The condition of the power transformer will be classified from very poor to very good condition. The importance is evaluated from load criticality, importance of load and failure consequence. The risk matrix is developed for evaluating the risk of each power transformer. The high risk power transformer will be focused firstly. The computerized program is developed for practical use, and the maintenance strategy of a power transformer can be effectively managed.

Keywords: asset management, risk-based maintenance, power transformer, health index

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Authors: Narayana Murthy Akurathi, Vijaya Lakshmi Marella

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The literature is reviewed with regard to online Super critical fluid extraction (SFE) coupled directly with supercritical fluid chromatography (SFC) -mass spectrometry that have typically more sensitive than conventional LC-MS/MS and GC-MS/MS. It is becoming increasingly interesting to use on-line techniques that combine sample preparation, separation and detection in one analytical set up. This provides less human intervention, uses small amount of sample and organic solvent and yields enhanced analyte enrichment in a shorter time. The sample extraction is performed under light shielding and anaerobic conditions, preventing the degradation of thermo labile analytes. It may be able to analyze compounds over a wide polarity range as SFC generally uses carbon dioxide which was collected as a by-product of other chemical reactions or is collected from the atmosphere as it contributes no new chemicals to the environment. The diffusion of solutes in supercritical fluids is about ten times greater than that in liquids and about three times less than in gases which results in a decrease in resistance to mass transfer in the column and allows for fast high resolution separations. The drawback of SFC when using carbon dioxide as mobile phase is that the direct introduction of water samples poses a series of problems, water must therefore be eliminated before it reaches the analytical column. Hundreds of compounds analysed simultaneously by simple enclosing in an extraction vessel. This is mainly applicable for pharmaceutical industry where it can analyse fatty acids and phospholipids that have many analogues as their UV spectrum is very similar, trace additives in polymers, cleaning validation can be conducted by putting swab sample in an extraction vessel, analysing hundreds of pesticides with good resolution.

Keywords: super critical fluid extraction (SFE), super critical fluid chromatography (SFC), LCMS/MS, GCMS/MS

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Authors: Hsin-Yun Lee

Abstract:

In this study, the pedestrian simulation VISWALK integration and application platform ant algorithms written program made to construct a renovation engineering schedule planning mode. The use of simulation analysis platform construction site when the user running the simulation, after calculating the user walks in the case of construction delays, the ant algorithm to find out the minimum delay time schedule plan, and add volume and unit area deactivated loss of business computing, and finally to the owners and users of two different positions cut considerations pick out the best schedule planning. To assess and validate its effectiveness, this study constructed the model imported floor of a shopping mall floor renovation engineering cases. Verify that the case can be found from the mode of the proposed project schedule planning program can effectively reduce the delay time and the user's walking mall loss of business, the impact of the operation on the renovation engineering facilities in the building to a minimum.

Keywords: pedestrian, renovation, schedule, simulation

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Authors: Vicky Khasandi-Telewa, Sinfree Makoni

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Barrenness is a fundamentally agonizing condition that leads to identity disruption in its victims. In Africa, women are usually referred to as ‘Mother of X,’ and this causes grief to one who does not have a child to be identified with. This paper is an examination and critical appraisal of the impact of barrenness on the self-perception of women and the underlying power relations in how they are discursively constructed in the Bible and Traditional African Society (TAS). It is an analysis of expressive practices to examine how barrenness is constructed in Christianity and TAS with the aim of understanding the intersecting power systems. We approach this from an integrationism and Critical Discourse Analysis perspective that takes seriously both the radical harassment of barren women and the possibilities offered by the ensuing desperation calling for inclusive reinterpretation. We also seek to understand barren women’s coping mechanisms and suggestions on how best to improve their lives. The purpose of this study is to explain how discursive construction of barrenness affects the fundamental rights and freedoms of women and what linguistic strategies they adopt to navigate through the maze of stigma. It seeks to illustrate a more nuanced complexity of barren women's lives through women's own exegesis of the Biblical accounts of barrenness and their traditions and to explore alternative narratives. We explore the linguistic strategies the barren women employ to communicate their coping with limitations imposed upon their rights by the negative constructions.

Keywords: integrationism, critical discourse analysis, barrenness, communication strategies

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Authors: Peter L. Varkonyi, Andras A. Sipos

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The quasi-static growth of elastic fibers is studied in the presence of distributed contact with an immobile surface, subject to isotropic dry or viscous friction. Unlike classical problems of elastic stability modelled by autonomous dynamical systems with multiple time scales (slowly varying bifurcation parameter, and fast system dynamics), this problem can only be formulated as a non-autonomous system without time scale separation. It is found that the fibers initially converge to a trivial, straight configuration, which is later replaced by divergence reminiscent of buckling phenomena. In order to capture the loss of stability, a new definition of exponential stability against infinitesimal perturbations for systems defined over finite time intervals is developed. A semi-analytical method for the determination of the critical length based on eigenvalue analysis is proposed. The post-critical behavior of the fibers is studied numerically by using variational methods. The emerging post-critical shapes and the asymptotic behavior as length goes to infinity are identified for simple spatial distributions of growth. Comparison with physical experiments indicates reasonable accuracy of the theoretical model. Some applications from modeling plant root growth to the design of soft manipulators in robotics are briefly discussed.

Keywords: buckling, elastica, friction, growth

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Authors: Pei Yi Lin

Abstract:

Objective: The objective of this study is to use machine learning methods to build an early prediction classifier model for acute delirium to improve the quality of medical care for intensive care patients. Background: Delirium is a common acute and sudden disturbance of consciousness in critically ill patients. After the occurrence, it is easy to prolong the length of hospital stay and increase medical costs and mortality. In 2021, the incidence of delirium in the intensive care unit of internal medicine was as high as 59.78%, which indirectly prolonged the average length of hospital stay by 8.28 days, and the mortality rate is about 2.22% in the past three years. Therefore, it is expected to build a delirium prediction classifier through big data analysis and machine learning methods to detect delirium early. Method: This study is a retrospective study, using the artificial intelligence big data database to extract the characteristic factors related to delirium in intensive care unit patients and let the machine learn. The study included patients aged over 20 years old who were admitted to the intensive care unit between May 1, 2022, and December 31, 2022, excluding GCS assessment <4 points, admission to ICU for less than 24 hours, and CAM-ICU evaluation. The CAMICU delirium assessment results every 8 hours within 30 days of hospitalization are regarded as an event, and the cumulative data from ICU admission to the prediction time point are extracted to predict the possibility of delirium occurring in the next 8 hours, and collect a total of 63,754 research case data, extract 12 feature selections to train the model, including age, sex, average ICU stay hours, visual and auditory abnormalities, RASS assessment score, APACHE-II Score score, number of invasive catheters indwelling, restraint and sedative and hypnotic drugs. Through feature data cleaning, processing and KNN interpolation method supplementation, a total of 54595 research case events were extracted to provide machine learning model analysis, using the research events from May 01 to November 30, 2022, as the model training data, 80% of which is the training set for model training, and 20% for the internal verification of the verification set, and then from December 01 to December 2022 The CU research event on the 31st is an external verification set data, and finally the model inference and performance evaluation are performed, and then the model has trained again by adjusting the model parameters. Results: In this study, XG Boost, Random Forest, Logistic Regression, and Decision Tree were used to analyze and compare four machine learning models. The average accuracy rate of internal verification was highest in Random Forest (AUC=0.86), and the average accuracy rate of external verification was in Random Forest and XG Boost was the highest, AUC was 0.86, and the average accuracy of cross-validation was the highest in Random Forest (ACC=0.77). Conclusion: Clinically, medical staff usually conduct CAM-ICU assessments at the bedside of critically ill patients in clinical practice, but there is a lack of machine learning classification methods to assist ICU patients in real-time assessment, resulting in the inability to provide more objective and continuous monitoring data to assist Clinical staff can more accurately identify and predict the occurrence of delirium in patients. It is hoped that the development and construction of predictive models through machine learning can predict delirium early and immediately, make clinical decisions at the best time, and cooperate with PADIS delirium care measures to provide individualized non-drug interventional care measures to maintain patient safety, and then Improve the quality of care.

Keywords: critically ill patients, machine learning methods, delirium prediction, classifier model

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Authors: Zeeshan Hamid, Asher Ramish

Abstract:

The purpose of this paper is to focus on security and safety issues facing by pharmaceutical industry globally when counterfeit drugs are in question. Hence, there is an intense need to secure and authenticate pharmaceutical products in the emerging counterfeit product market. This paper will elaborate the application of radio frequency identification (RFID) in pharmaceutical industry and to identify its key benefits for patient’s care. The benefits are: help to co-ordinate the stream of supplies, accuracy in chains of supplies, maintaining trustworthy information, to manage the operations in appropriate and timely manners and finally deliver the genuine drug to patient. It is discussed that how RFID supported supply chain information sharing (SCIS) helps to combat against counterfeit drugs. And a solution how to tag pharmaceutical products; since, some products prevent RFID implementation in this industry. In this paper, a proposed model for pharma industry distribution suggested to combat against the counterfeit drugs when they are in supply chain.

Keywords: supply chain, RFID, pharmaceutical industry, counterfeit drugs, patients care

Procedia PDF Downloads 313