Search results for: quality of care

Authors: Amandeep Sharma, Digvaijay Verma, Ruplal Choudhary

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Food processing is an activity across the globe that help in better handling of agricultural produce, including dairy, meat, and fish. The operations carried out in the food industry includes raw material quality authenticity; sorting and grading; processing into various products using thermal treatments – heating, freezing, and chilling; packaging; and storage at the appropriate temperature to maximize the shelf life of the products. All this is done to safeguard the food products and to ensure the distribution up to the consumer. The approaches to develop predictive models based on mathematical or statistical tools or empirical models’ development has been reported for various milk processing activities, including plant maintenance and wastage. Recently AI is the key factor for the fourth industrial revolution. AI plays a vital role in the food industry, not only in quality and food security but also in different areas such as manufacturing, packaging, and cleaning. A new conceptual model was developed, which shows that smaller sample size as only spectra would be required to predict the other values hence leads to saving on raw materials and chemicals otherwise used for experimentation during the research and new product development activity. It would be a futuristic approach if these tools can be further clubbed with the mobile phones through some software development for their real time application in the field for quality check and traceability of the product.

Keywords: predictive modlleing, ann, ai, food

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Authors: Nikhil Deshpande, Rahul Mahajan

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Laser Beam Machining (LBM) is a non-traditional machining process that has inherent problems like dross, striation, and Heat Affected Zone (HAZ) which reduce the quality of machining. In the present day scenario, these problems are controlled only by iteratively adjusting a large number of process parameters. This paper applies Axiomatic Design principles to design LBM process so as to eliminate the problem of dross and striation and minimize the effect of HAZ. Process parameters and their ranges are proposed to set-up the LBM process, execute the cut and finish the workpiece so as to obtain the best quality cut.

Keywords: laser beam machining, dross, striation, heat affected zone, axiomatic design

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Authors: Enido Fabiano de Ramos, Ieda Kanashiro Makiya, Francisco I. Giocondo Cesar

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This study investigates the application of Digital Twins (DT) in Smart Hospital Environments (SHE), through a bibliometric study and literature review, including comparison with the principles of Industry 4.0. It aims to analyze the current state of the implementation of digital twins in clinical and non-clinical operations in healthcare settings, identifying trends and challenges, comparing these practices with Industry 4.0 concepts and technologies, in order to present a basic framework including stages and maturity levels. The bibliometric methodology will allow mapping the existing scientific production on the theme, while the literature review will synthesize and critically analyze the relevant studies, highlighting pertinent methodologies and results, additionally the comparison with Industry 4.0 will provide insights on how the principles of automation, interconnectivity and digitalization can be applied in healthcare environments/operations, aiming at improvements in operational efficiency and quality of care. The results of this study will contribute to a deeper understanding of the potential of Digital Twins in Smart Hospitals, in addition to the future potential from the effective integration of Industry 4.0 concepts in this specific environment, presented through the practical framework, after all, the urgent need for changes addressed in this article is undeniable, as well as all their value contribution to human sustainability, designed in SDG3 – Health and well-being: ensuring that all citizens have a healthy life and well-being, at all ages and in all situations. We know that the validity of these relationships will be constantly discussed, and technology can always change the rules of the game.

Keywords: digital twin, smart hospital, healthcare operations, industry 4.0, SDG3, technology

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Authors: Balogun Azeez Olawale, Azeez S. A.

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Post occupancy evaluation (POE) is a process of assessing building performance for its users and intended function during the occupation. User satisfaction impacts the performance of educational environments and their users: students, faculty, and staff. In addition, buildings are maintained and managed by teams that spend a large amount of time and capital on their long-term sustenance. By evaluating the feedback from users of higher education facilities, university planning departments are more prepared to understand the inputs for programming and future project planning. In addition, university buildings will be closer to meeting user and maintenance needs. This paper reports on a research team made up of academics, facility personnel, and users that have developed a plan to improve the quality of campus facilities through a POE exercise on a recently built project. This study utilized a process of focus group interviews representing the different users and subsequent surveys. The paper demonstrates both the theory and practice of POE in higher education and learning environment through the case example of four universities in Nigeria's POE exercise.

Keywords: post occupancy evaluation, building performance, building analysis, building evaluation, quality control, building assessment, facility management, design quality

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Authors: Jamie Lee Harder

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In the context of rapidly changing social and economic circumstances in the developing world, this paper analyses access to public healthcare for poor people with disabilities in Cambodia. Like other countries of South East Asia, Cambodia is developing at rapid pace. The historical past of Cambodia, however, has set former social policy structures to zero. This past forces Cambodia and its citizens to implement new public health policies to align with the needs of social care, healthcare, and urban planning. In this context, the role of people with disabilities (PwDs) is crucial as new developments should and can take into consideration their specific needs from the beginning onwards. This paper is based on qualitative research with expert interviews and focus group discussions in Cambodia. During the field work it became clear that the identification tool for the poorest households (HHs) does not count disability as a financial risk to fall into poverty neither when becoming sick nor because of higher health expenditures and/or lower income because of the disability. The social risk group of poor PwDs faces several barriers in accessing public healthcare. The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about their rights and negative social and cultural beliefs. Shortened budgets and the lack of prioritizations lead to the need for reorientation of local communities, international and national non-governmental organizations and social policy. The poorest HHs are identified with a questionnaire, the IDPoor program, for which the Ministry of Planning is responsible. The identified HHs receive an ‘Equity Card’ which provides access free of charge to public healthcare centers and hospitals among other benefits. The dataset usually does not include information about the disability status. Four focus group discussions (FGD) with 28 participants showed various barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The contents of the FGDs were ratified and repeated during the expert interviews with the local Ministries, NGOs, international organizations and private persons working in the field. The participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence in their lives. When discussing their health situation, we identified, a huge difference between those who are identified and hold an Equity Card and those who do not. Participants reported high costs without IDPoor identification, positive experiences when going to the health center in terms of attitude and treatment, low satisfaction with specific capacities for treatments, negative rumors, and discrimination with the consequence of fear to seek treatment in many cases. The problem of accessing public healthcare by risk groups can be adapted to situations in other countries.

Keywords: access, disability, health, inequality, Cambodia

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Authors: Silvano Salvador, Maryam Zarrinderakht, Alan Martin

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Open pits, which are the result of mining, are filled by water over time until the water reaches the elevation of the local water table and generates mine pit lakes. There are several specific regulations about the water quality of pit lakes, and mining operations should keep the quality of groundwater above pre-defined standards. Therefore, an accurate, acceptable numerical model predicting pit lakes’ water balance and water quality is needed in advance of mine excavation. We carry on analyzing and developing the model introduced by Crusius, Dunbar, et al. (2002) for pit lakes. This model, called “PitMod”, simulates the physical and geochemical evolution of pit lakes over time scales ranging from a few months up to a century or more. Here, a lake is approximated as one-dimensional, horizontally averaged vertical layers. PitMod calculates the time-dependent vertical distribution of physical and geochemical pit lake properties, like temperature, salinity, conductivity, pH, trace metals, and dissolved oxygen, within each model layer. This model considers the effect of pit morphology, climate data, multiple surface and subsurface (groundwater) inflows/outflows, precipitation/evaporation, surface ice formation/melting, vertical mixing due to surface wind stress, convection, background turbulence and equilibrium geochemistry using PHREEQC and linking that to the geochemical reactions. PitMod, which is used and validated in over 50 mines projects since 2002, incorporates physical processes like those found in other lake models such as DYRESM (Imerito 2007). However, unlike DYRESM PitMod also includes geochemical processes, pit wall runoff, and other effects. In addition, PitMod is actively under development and can be customized as required for a particular site.

Keywords: pit lakes, mining, modeling, hydrology

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Authors: Emery Coppola Jr., Marwan Sadat, Il Kim, Diane Trube, Richard Kurisko

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Contamination sites like landfills often pose significant risks to receptors like surface water bodies. Surface water bodies are often a source of recreation, including fishing and swimming, which not only enhances their value but also serves as a direct exposure pathway to humans, increasing their need for protection from water quality degradation. In this paper, a case study presents the potential effects of leachate-impacted groundwater from a large closed sanitary landfill on the surface water quality of the nearby Raritan River, situated in New Jersey. The study, performed over a two year period, included in-depth field evaluation of both the groundwater and surface water systems, and was supplemented by computer modeling. The analysis required delineation of a representative average daily groundwater discharge from the Landfill shoreline into the large, highly tidal Raritan River, with a corresponding estimate of daily mass loading of potential contaminants of concern. The average daily groundwater discharge into the river was estimated from a high-resolution water level study and a 24-hour constant-rate aquifer pumping test. The significant tidal effects induced on groundwater levels during the aquifer pumping test were filtered out using an advanced algorithm, from which aquifer parameter values were estimated using conventional curve match techniques. The estimated hydraulic conductivity values obtained from individual observation wells closely agree with tidally-derived values for the same wells. Numerous models were developed and used to simulate groundwater contaminant transport and surface water quality impacts. MODFLOW with MT3DMS was used to simulate the transport of potential contaminants of concern from the down-gradient edge of the Landfill to the Raritan River shoreline. A surface water dispersion model based upon a bathymetric and flow study of the river was used to simulate the contaminant concentrations over space within the river. The modeling results helped demonstrate that because of natural attenuation, the Landfill does not have a measurable impact on the river, which was confirmed by an extensive surface water quality study.

Keywords: groundwater flow and contaminant transport modeling, groundwater/surface water interaction, landfill leachate, surface water quality modeling

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Authors: Elizelle Juanee Cilliers

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Recent planning thinking has laid the foundations for a general sense of best practice that aims to enhance the quality of life, suggesting an open and participatory process. It is accepted that integration of top-down and bottom-up approaches may lead to efficient action in environments and sustainable planning and development, although it is also accepted that such an integrated approach has various challenges of implementation. A flexible framework in which the strengths of both the top-down and bottom-up approaches were explored in this research, based on the EU Interreg VALUE Added project and five case studies where student education and student involvement played a crucial role within the participation process of the redesign of the urban environment. It was found that international student workshops were an effective tool to integrate bottom-up and top-down structures, as it acted as catalyst for communication, interaction, creative design, quick transformation from planning to implementation, building social cohesion, finding mutual ground between stakeholders and thus enhancing overall quality of life and quality of environments. It offered a good alternative to traditional participation modes and created a platform for an integrative planning approach. The role and importance of education and integration within the urban environment were emphasized.

Keywords: top-down, bottom-up, flexible, student involvement

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Authors: Nazmin Akter, Tariqul Islam, Abu Sayed

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Food loss and waste have become critical global issues, with approximately one-third of the world's food production being wasted. Among the various food products, horticultural fruits and vegetables are especially susceptible to loss due to their relatively short shelf lives. Litchi (Litchi chinensis) is one of Bangladesh's most important horticultural fruits. But the problem with this fruit is its short shelf life by losing weight faster after harvest. The experiment was carried out at Hajee Mohammad Danesh Science and Technology University, Dinajpur-5200 Bangladesh during 2020-2021. The objective of this experiment was to see the impact of nutrients viz., urea (1%), calcium chloride (1%), borax (1%), and their combinations on fruit quality and shelf life of litchi cv. Bombai. The experiment was laid out in a randomized block design with 7 treatments and 3 replications. Two sprays of each treatment were applied from the last week of May to June (at 20-day intervals). The results indicated that all the treatments significantly improved the quality parameters of litchi fruits as compared to the control. In terms of physicochemical characteristics fruit weight (20.30g), fruit volume (20m ml), and pulp percent (17.14) were found maximum with minimum stone percent (11.09) with the application of urea 1% + borax 1%+ calcium chloride 1%. Maximum TSS (19.62oBrix), TSS/acidity ratio (24.57), maximum ascorbic acid (45.19 mg/100 g pulp), and minimum acidity (0.80%) were reported with the application of T6 (Urea 1% + borax 1%+ calcium chloride 1%) treatments whereas fruits treated with urea 1% + borax 1% gave maximum total sugars (26.64%) and reducing sugars (19.19%) as compared to control. In the case of storage characters, application of Urea 1% + borax 1%+ calcium chloride 1% resulted in a minimum physiological loss in weight (6.11%), (8.41%), and (10.65%) for 2 days, 4 days, and 6 days respectively. In conclusion, to obtain better quality and increased storage period of litchi fruits, two sprays of urea, borax, and calcium chloride (1%) could be used during the fruit growth and development period at fortnightly intervals.

Keywords: litchi chinensis, preharvest, quality, shelf life, postharvest

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Authors: Nassim Salmi

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This study aimed to identify the administrative, social, cultural, economic and psychological challenges facing the nursing s ector in the Tebessa Algeria. It also seeks to identify whether there are differences between the opinions of managers in public and private hospitals about these challenges. To achieve the objectives of the study, the descriptive analytical method was adopted. The study also used the questionnaire as a tool for collecting the necessary data and information, which was applied to a sample of directors of public and private hospitals in the Tebessa, which amounted to (114) individuals. The study reached a set of results, including: that there are no statistically significant differences between the opinions of managers in public and private hospitals about the administrative, social, cultural, economic and psychological challenges facing the nursing sector in the Tebessa . The results also showed agreement between the views of managers in private public hospitals that the most important administrative challenges are the lack of training programs that affect the efficiency and performance of nursing work, and that the most important social and cultural challenges are the hospital’s failure to provide suitable nurseries for Saudi female nurses, and that the most important economic challenges are the lack of Availability of medical equipment and devices, and the most important psychological challenge is the tense relationship between the administration and the hospital's nursing staff. The study recommended focusing on the importance of rehabilitation and training together, activating the role of training in the ministry and making it compulsory and a condition of renewal for practicing and continuing the nursing profession, and providing the social and economic needs of the nursing staff.

Keywords: postoperative care, gynecology, nursing documentation, database

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Authors: Marijn Tangelder, Ingeborg Mulder, Jeroen Wijsman, John Janssen, Tom Ysebaert

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The delta works in the Southwest Netherlands drastically changed the estuarine nature of this area. The Grevelingen estuary was dammed off and became a lake in 1971. Since 1978 a connection with the North Sea exists to keep the lake saline but management of the sluices varied over time. Our research of several decades of monitoring data shows that water management practices lead to drastic changes in water quality and consequent ecological shifts in benthic fauna, fish, and bird species. Benthic biomass, dominated by molluscs, showed major changes with an important role for invasive species. Fish migration and, therefore, fish stock in the lake changed with recently smaller fish species and lower biomass values, with consequences for fish eating birds. Implications are made towards future management to re-introduce micro-tide in connection with the North Sea to improve water quality and the ecological status of the lake, as well as consequences for the bordering Natura 2000 terrestrial habitats, including rare dune vegetations, are discussed.

Keywords: ecosystem study, Grevelingen, Natura 2000, water management, water quality

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Authors: Chhabi Nigam, S. Ramakrishnan

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This paper brings out the analysis of the airborne Synthetic Aperture Radar (SAR) data to study the impact of Doppler centroid on Image quality and geocoding accuracy from the perspective of Stripmap mode of data acquisition. Although in Stripmap mode of data acquisition radar beam points at 90 degrees broad side (side looking), shift in the Doppler centroid is invariable due to platform motion. In-accurate estimation of Doppler centroid leads to poor image quality and image miss-registration. The effect of Doppler centroid is analyzed in this paper using multiple sets of data collected from airborne platform. Occurrences of ghost (ambiguous) targets and their power levels have been analyzed that impacts appropriate choice of PRF. Effect of aircraft attitudes (roll, pitch and yaw) on the Doppler centroid is also analyzed with the collected data sets. Various stages of the RDA (Range Doppler Algorithm) algorithm used for image formation in Stripmap mode, range compression, Doppler centroid estimation, azimuth compression, range cell migration correction are analyzed to find the performance limits and the dependence of the imaging geometry on the final image. The ability of Doppler centroid estimation to enhance the imaging accuracy for registration are also illustrated in this paper. The paper also tries to bring out the processing of low squint SAR data, the challenges and the performance limits imposed by the imaging geometry and the platform dynamics on the final image quality metrics. Finally, the effect on various terrain types, including land, water and bright scatters is also presented.

Keywords: ambiguous target, Doppler Centroid, image registration, Airborne SAR

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Authors: Lingxiao Yang, Xin Wang, Bo Xu, Zhenqian Chen

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Due to its outstanding environmental performance, higher heating temperature and excellent low-temperature performance, transcritical carbon dioxide (CO₂) heat pumps are receiving more and more attention. However, improperly set operating parameters have a serious negative impact on the performance of the transcritical CO₂ heat pump due to the properties of CO₂. In this study, the heat transfer characteristics of the gas cooler are studied based on the modified “three-stage” gas cooler, then the effect of three operating parameters, compressor speed, gas cooler water-inlet flowrate and gas cooler water-inlet temperature, on the heating process of the system are investigated from the perspective of thermal quality and heat capacity. The results shows that: In the heat transfer process of gas cooler, the temperature distribution of CO₂ and water shows a typical “two region” and “three zone” pattern; The rise in the cooling pressure of CO₂ serves to increase the thermal quality on the CO₂ side of the gas cooler, which in turn improves the heating temperature of the system; Nevertheless, the elevated thermal quality on the CO₂ side can exacerbate the mismatch of heat capacity on both sides of the gas cooler, thereby adversely affecting the system coefficient of performance (COP); Furthermore, increasing compressor speed mitigates the mismatch in heat capacity caused by elevated thermal quality, which is exacerbated by decreasing gas cooler water-inlet flowrate and rising gas cooler water-inlet temperature; As a delegate, the varying compressor speed results in a 7.1°C increase in heating temperature within the experimental range, accompanied by a 10.01% decrease in COP and an 11.36% increase in heating capacity. This study can not only provide an important reference for the theoretical analysis and control strategy of the transcritical CO₂ heat pump, but also guide the related simulation and the design of the gas cooler. However, the range of experimental parameters in the current study is small and the conclusions drawn are not further analysed quantitatively. Therefore, expanding the range of parameters studied and proposing corresponding quantitative conclusions and indicators with universal applicability could greatly increase the practical applicability of this study. This is also the goal of our next research.

Keywords: transcritical CO₂ heat pump, gas cooler, heat capacity, thermal quality

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Authors: Retno Supriyanti, Teguh Budiono, Yogi Ramadhani, Haris B. Widodo, Arwita Mulyawati

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Cervical cancer is the leading cause of mortality in cancer-related diseases. In this diagnosis doctors usually perform several tests to determine the presence of cervical cancer in a patient. However, these checks require support equipment to get the results in more detail. One is by using ultrasonography. However, for the developing countries most of the existing ultrasonography has a low resolution. The goal of this research is to obtain abnormalities on low-resolution ultrasound images especially for cervical cancer case. In this paper, we emphasize our work to use Image Enhancement for pre-processing image quality improvement. The result shows that pre-processing stage is promising to support further analysis.

Keywords: cervical cancer, mortality, low-resolution, image enhancement.

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Authors: Khalid Ahmed Elrabie Abdelrasoul

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The present study was carried out on Sahiwal cattle bulls maintained at the Artificial Breeding Complex, NDRI, Karnal, Hayana, India, to assess the effect of cooling using mist cooling and fanning on Sahiwal bulls in the dry hot summer season. Fourteen Sahiwal bulls were divided into two groups of seven each. Sexual behavior and semen quality traits considered were: Reaction time (RT), Dismounting time (DMT), Total time taken in mounts (TTTM), Flehmen response (FR), Erection Score (ES), Protrusion Score (PS), Intensity of thrust (ITS), Temperament Score (TS), Libido Score (LS), Semen volume, Physical appearance, Mass activity, Initial progressive motility, Non-eosinophilic spermatozoa count (NESC) and post thaw motility percent. Data were analyzed by least squares technique. Group-1 was the control, whereas group-2 (treatment group) bulls were exposed to mist cooling and fanning (thrice a day 15 min each) in the dry hot summer season. Group-2 showed significantly (p < 0.01) higher value in DMT (sec), ES, PS, ITS, LS, semen volume (ml), semen color density, mass activity, initial motility, progressive motility and live sperm.

Keywords: mist cooling, Sahiwal bulls, semen quality, sexual behavior

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Authors: Ragi Poyyara, V. Vivek, Ashish Khaparde

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The Product Development Process (PDP) in the technology group plays a very important role in the launch of any product. While a manufacturing process encourages the use of certain measures to reduce Health, Safety and Environmental (HSE) risks on the shop floor, the PDP concentrates on the use of Geometric Dimensioning and Tolerancing (GD&T) to develop a flawless design. Furthermore, PDP distributes and coordinates activities between different departments such as marketing, purchasing, and manufacturing. However, it is seldom realized that PDP makes a significant contribution to developing a product that reduces HSE risks by encouraging the Technology group to use effective GD&T. The GD&T is a precise communication tool that uses a set of symbols, rules, and definitions to mathematically define parts to be manufactured. It is a quality assurance method widely used in the oil and gas sector. Traditionally it is used to ensure the interchangeability of a part without affecting its form, fit, and function. Parts that do not meet these requirements are rejected during quality audits. This paper discusses how the Technology group integrates this quality assurance tool into the PDP and how the tool plays a major role in helping the HSE department in its goal towards eliminating HSE incidents. The PDP involves a thorough risk assessment and establishes a method to address those risks during the design stage. An illustration shows how GD&T helped reduce safety risks by ergonomically improving assembling operations. A brief discussion explains how tolerances provided on a part help prevent finger injury. This tool has equipped Technology to produce fixtures, which are used daily in operations as well as manufacturing. By applying GD&T to create good fits, HSE risks are mitigated for operating personnel. Both customers and service providers benefit from reduced safety risks.

Keywords: HSE risks, product development process, geometric dimensioning and tolerances, mechanical engineering

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Authors: Desmond Wade, Alfredo Ormazabal

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Background: Ever since it commenced its registration process of pre-hospital practitioners in the year 2000 through the Irish Government Statute Instrument (SI 109 of 2000) process, the approach to education of its professionals has changed drastically. The progression from the traditional behaviouristic to the current constructivist approach has been based on experiences from other sectors and industries, nationally and internationally. Today, the delivery of a safe and efficient ambulance service heavily depends on its practitioners’ range of technical skills, academic knowledge, and overall competences. As these increase, so does the level of complexity of paramedics’ everyday practice. This has made it inevitable to consider the 'Human Factor' as a source of potential risk and made formative institutions like the National Ambulance Service College to include it in their curriculum. Methods: This paper used a mixed-method approach, where both, an online questionnaire and a set of semi-structured interviews were the source of primary data. An analysis of this data was carried out using qualitative and quantitative data analysis. Conclusions: The evidence presented leads to the conclusion that in the National Ambulance Service there is a considerable lack of education of Human Factors and the levels in understanding of how to manage Human Factors in practice vary across its spectrum. Paramedic Practitioners in Ireland seem to understand that the responsibility of patient care lies on the team, rather than on the most hierarchically senior practitioner present in the scene.

Keywords: human factors, ergonomics, stress, decision making, pre-hospital care, paramedic, education

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Authors: Anan Jarab, Riham Almrayat, Salam Alqudah, Maher Khdour, Tareq Mukattash, Sharell Pinto

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Background: The prevalence of diabetes in Jordan is among the highest in the world, making it a particularly alarming health problem there. It has been indicated that poor adherence to the prescribed therapy lead to poor glycemic control and enhance the development of diabetes complications and unnecessary hospitalization. Purpose: To explore factors associated with medication non-adherence in patients with type 2 diabetes in Jordan. Materials and Methods: Variables including socio-demographics, disease and therapy factors, diabetes knowledge, and health-related quality of life in addition to adherence assessment were collected for 171 patients with type 2 diabetes using custom-designed and validated questionnaires. Logistic regression was performed to develop a model with variables that best predicted medication non-adherence in patients with type 2 diabetes in Jordan. Results: The majority of the patients (72.5%) were non-adherent. Patients were found four times less likely to adhere to their medications with each unit increase in the number of prescribed medications (OR = 0.244, CI = 0.08-0.63) and nine times less likely to adhere to their medications with each unit increase in the frequency of administration of diabetic medication (OR = 0.111, CI = 0.04-2.01). Patients in the present study were also approximately three times less likely (OR = 0.362, CI = 0.24-0.87) to adhere to their medications if they reported having concerns about side effects and twice more likely to adhere to medications (OR = 0.493, CI = 0.08-1.16) if they had one or more micro-vascular complication. Conclusion: The current study revealed low adherence rate to the prescribed therapy among Jordanians with type 2 diabetes. Simplifying dosage regimen, selecting treatments with lower side effects along with an emphasis on diabetes complications should be taken into account when developing care plans for patients with type 2 diabetes.

Keywords: type 2 diabetes, adherence, glycemic control, clinical pharmacist, Jordan

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Authors: A. Tarantino, F. Lops, G. Disciglio, E. Tarantino

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Apulia region (southern Italy) is excellent for heavy production of apricot (Prunus armeniaca L.). Fruit quality is a combination of physical, chemical and nutritional characteristics. The present experiment was laid in the commercial orchard in Cerignola (Foggia district, Apulia region, 41°15’49’’N; 15°53’59’’E; 126 a.s.l.) during the 2014-2015 season. The experiment consisted of the use of three biostimulant treatments (Hendophyt®, Ergostim® and Radicon®) compared with untreated control on ‘Farbaly’ apricot cultivar, in order to evaluate the vegeto-productive and fruit qualitative attributes. Foliar spray of biostimulants was applied at different times during the growth season (at red ball, fruit setting and fruit development stages). Experimental data showed some specific differences among the biostimulant treatments, which fruit set, growth and productivity were affected. Moderate influences were found regarding the qualitative attributes of fruits. The soluble solid content was positively affected by Hendophyt® treatment. Antioxidant capacity was significantly higher in Hendophyt® and Radicon® treatments respect to the untreated control.

Keywords: Prunus Armeniaca L., biostimulants, fruit set, fruit quality

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Authors: Raimi Abiodun Moronfolu, Anthonia Olusola Moronfolu

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The purpose of this study was to assess athlete’s preparation and quality of opponent as determinants of self-efficacy among university athletes in south-west Nigeria. The descriptive research method was employed in conducting the study. A total of 200 athletes, selected from 4 universities in South-West geopolitical zone of Nigeria through a stratified random sampling technique, were used in the study. The instrument used for data collection was a self-structured questionnaire named ‘Athletes Self-Efficacy Assessment Questionnaire (ASAQ)’. This was developed by the researchers and face validated by three experts in sports psychology. The test-retest method was used in establishing the reliability of the instrument (r=0.79). A total of 200 copies of the validated ASAQ were administered on selected respondents using the spot method. The data collected was used to develop a frequency distribution table for analysis. The descriptive statistics of percentage was used in presenting the data collected, while inferential statistics of linear regression was used in drawing inferences at a 0.05 level of significance. The findings indicated that athlete’s preparation and quality of opponent were significant determinants of self-efficacy among university athletes in South-West Nigeria.

Keywords: athletes, preparation, opponent, self-efficacy

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Authors: Nicolas Galazis, Nikolina Docheva, Constantinos Simillis, Kypros Nicolaides

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Background: Obese women are at increased risk for many pregnancy complications, and bariatric surgery (BS) before pregnancy has shown to improve some of these. Objectives: To review the current literature and quantitatively assess the obstetric and neonatal outcomes in pregnant women who have undergone BS. Search Strategy: MEDLINE, EMBASE and Cochrane databases were searched using relevant keywords to identify studies that reported on pregnancy outcomes after BS. Selection Criteria: Pregnancy outcome in firstly, women after BS compared to obese or BMI-matched women with no BS and secondly, women after BS compared to the same or different women before BS. Only observational studies were included. Data Collection and Analysis: Two investigators independently collected data on study characteristics and outcome measures of interest. These were analysed using the random effects model. Heterogeneity was assessed and sensitivity analysis was performed to account for publication bias. Main Results: The entry criteria were fulfilled by 17 non-randomised cohort or case-control studies, including seven with high methodological quality scores. In the BS group, compared to controls, there was a lower incidence of preeclampsia (OR, 0.45, 95% CI, 0.25-0.80; p=0.007), GDM (OR, 0.47, 95% CI, 0.40-0.56; P<0.001) and large neonates (OR 0.46, 95% CI 0.34-0.62; p<0.001) and a higher incidence of small neonates (OR 1.93, 95% CI 1.52-2.44; p<0.001), preterm birth (OR 1.31, 95% CI 1.08-1.58; p=0.006), admission for neonatal intensive care (OR 1.33, 95% CI 1.02-1.72; p=0.03) and maternal anaemia (OR 3.41, 95% CI 1.56-7.44, p=0.002). Conclusions: BS as a whole improves some pregnancy outcomes. Laparoscopic adjustable gastric banding does not appear to increase the rate of small neonates that was seen with other BS procedures. Obese women of childbearing age undergoing BS need to be aware of these outcomes.

Keywords: bariatric surgery, pregnancy, preeclampsia, gestational diabetes, birth weight

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Authors: Mariam Kutateladze

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In the twenty-first century, in the customer service settings for hospitality institution’s employee management and their well-being have become a core issue since it is linked to the customers' increased demand for high-quality service. Employees' positive attitude to customers plays an essential role in the serving process; for this reason, in the hospitality institutions service with a smile is a job requirement. This research is devoted to the issues of employee management systems improvement and its effect of the genuine smile as a positive attitude expressed by the employees to the customer. Different researchers work about the effect of the genuine smile, which is analyzed in the present paper. Based on it, the link between satisfied employees from service climate and their genuine smile is determined. An investigation in local resort hotels which are located in the regions of Georgia is conducted. In the methodology of the paper, we have used linkage research, which stated that employee satisfaction in a working place depends on the existing service climate in an organization. We have prepared questioners according to eight dimensions of good service climate by linkage research, and extra questions about the effect of the smile on customers were added. Questionnaires were distributed among employees, and the results have shown that dissatisfaction from organizations’ service climate led to employees' false smile toward customers. Demanding positive emotions from frustrated employees was the mistake of the hotel management. The false smile was easily recognized by the customers, and the frustrated employee with a false smile could not provide high-quality service. The findings of the paper will help managers to realize the importance of forming the positive service climate within the institutions since it is linked to employees' well-being who are the creators of high-quality service. The conclusion drawn from this study indicates there are core issues those managers need to take into account when planning their organizations’ profit. Managers should know their employees very well, their feelings and attitudes toward work before asking them expressing a smile since forced smile does not have a good result and quite often has bad outcomes; therefore, first of all, managers should investigate service climate in the organization. Managers should take into consideration employees’ opinions about the service climate in the organization, motivate their employees, and respect their ideas. Also, they should satisfy employees' basic needs and stress more value on extrinsic goals such as competence, relatedness, and autonomy. Managers should create a positive working environment, positive service climate, which will lead to employee satisfaction and genuine feelings, as well as improve the working environment since negative working climate will cause customers disappointment because of low-quality service provided by the unsatisfied employees.

Keywords: employee management, hotel, quality of service, service climate

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Authors: Nasrin Bakhshizadeh, Ashkan Forootan

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A major problem that affects the quality control of polymer in the industrial polymerization is the lack of suitable on-line measurement tools to evaluate the properties of the polymer such as melt and density indices. Controlling the polymerization in ordinary method is performed manually by taking samples, measuring the quality of polymer in the lab and registry of results. This method is highly time consuming and leads to producing large number of incompatible products. An online application for estimating melt index and density proposed in this study is a neural network based on the input-output data of the polyethylene production plant. Temperature, the level of reactors' bed, the intensity of ethylene mass flow, hydrogen and butene-1, the molar concentration of ethylene, hydrogen and butene-1 are used for the process to establish the neural model. The neural network is taught based on the actual operational data and back-propagation and Levenberg-Marquart techniques. The simulated results indicate that the neural network process model established with three layers (one hidden layer) for forecasting the density and the four layers for the melt index is able to successfully predict those quality properties.

Keywords: polyethylene, polymerization, density, melt index, neural network

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Authors: Nuri Caglayan, H. Kursat Celik

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There are many factors that influence the health and productivity of the animals in livestock production fields, including temperature, humidity, carbon dioxide (CO2), ammonia (NH3), hydrogen sulfide (H2S), physical activity and particulate matter. High NH3 concentrations reduce feed consumption and cause daily weight gain. At high concentrations, H2S causes respiratory problems and CO2 displace oxygen, which can cause suffocation or asphyxiation. Good air quality in livestock facilities can have an impact on the health and well-being of animals and humans. Air quality assessment basically depends on strictly given limits without taking into account specific local conditions between harmful gases and other meteorological factors. The stated limitations may be eliminated. using controlling systems based on neural networks and fuzzy logic. This paper describes a fuzzy logic based ventilation algorithm, which can calculate different fan speeds under pre-defined boundary conditions, for removing harmful gases from the production environment. In the paper, a fuzzy logic model has been developed based on a Mamedani’s fuzzy method. The model has been built on MATLAB software. As the result, optimum fan speeds under pre-defined boundary conditions have been presented.

Keywords: air quality, fuzzy logic model, livestock housing, fan speed

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Authors: Peter R. Reuter

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Health professionals play important roles in helping patients use Complementary and Alternative Medicine (CAM) practices safely and accurately. Consequently, it is important for future health professionals to learn about CAM practices during their time in undergraduate and graduate programs. To satisfy this need for education, teaching CAM in nursing and medical schools and other health professions programs is becoming more prevalent. Our study was the first to look specifically at the knowledge of, and attitude toward CAM of undergraduate health professions students at a university in the U.S. Students were invited to participate in one of two anonymous online surveys depending on whether they were pre-health professions students or graduating health professions seniors. Of the 763 responses analyzed, 71.7% were from pre-health professions students, and 28.3% came from graduating seniors. The overall attitude of participants toward and interest in learning about CAM practices was generally fairly positive with graduating seniors being more positive than pre-health professions students. Yoga, meditation, massage therapy, aromatherapy, and chiropractic care were the practices most respondents had personal experience with. Massage therapy, yoga, chiropractic care, meditation, music therapy, and diet-based therapy received the highest ratings from respondents. Three-quarters of respondents planned on including aspects of holistic medicine in their future career as a health professional. The top five practices named were yoga, meditation, massage therapy, diet-based therapy, and music therapy. The study confirms the need to educate health professions students about CAM practices to give them the background information they need to select or recommend the best practices for their patients' needs.

Keywords: CAM education, health professions, health professions students, pre-health professions students

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

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

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

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Authors: Erin Curtis, Avraham Schwiger

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Neuropsychological testing and evaluation is a crucial step in providing patients with effective diagnoses and treatment while in clinical care. The variety of batteries used in these evaluations can help clinicians better understand the nuanced declivities in a patient’s cognitive, behavioral, or emotional functioning, consequently equipping clinicians with the insights to make intentional choices about a patient’s care. Despite the knowledge these batteries can yield, some aspects of neuropsychological testing remain largely inaccessible to certain patient groups as a result of fundamental cultural, educational, or social differences. One such battery includes the Dot Counting Test (DCT), during which patients are required to count a series of dots on a page as rapidly and accurately as possible. As the battery progresses, the dots appear in clusters that are designed to be easily multiplied. This task evaluates a patient’s cognitive functioning, attention, and level of effort exerted on the evaluation as a whole. However, there is evidence to suggest that certain social groups, particularly Latinx groups, may perform worse on this task as a result of cultural or educational differences, not reduced cognitive functioning or effort. As such, this battery fails to account for baseline differences among patient groups, thus creating questions surrounding the accuracy, generalizability, and value of its results. Accessibility and cultural sensitivity are critical considerations in the testing and treatment of marginalized groups, yet have been largely ignored in the literature and in clinical settings to date. Implications and improvements to applications are discussed.

Keywords: culture, latino, neuropsychological assessment, neuropsychology, accessibility

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Authors: Olga C. Rodrigue

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Long-term care and skilled nursing facilities experience ebbs and flows of nursing staffing, a problem compounded by the perception of the facilities as undesirable workplaces and competition for staff from other healthcare entities. Travel nurses are contracted to fill staffing needs due to increased admissions, increased and unexpected attrition of nurses, or facility expansion of services. Prior to beginning the contracted assignment, the travel nurse must meet industry, company, and regulatory requirements (The Joint Commission and CMS) for skills and knowledge. Travel nurses, however, inconsistently receive the pre-assignment orientation needed to work at the contracted facility, if any information is given at all. When performance expectations are not met, travel nurses may subsequently choose to leave the position without completing the terms of the contract, and some facilities may choose to terminate the contract prior to the expected end date. The overarching goal of the Doctor of Nursing Practice evidence-based practice improvement project is to provide travel nurses with the basic and necessary information to prepare them to begin a long-term and skilled nursing assignment. The project involves the identification of travel nurse learning needs through a survey and the development and provision of web-based learning modules to address those needs prior to arrival for a long-term and skilled nursing assignment.

Keywords: nurse staffing, travel nurse, travel staff, contract staff, contracted assignment, long-term care, skilled nursing, onboarding, orientation, staff development, supplemental staff

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Authors: Néstor Iván Rojas, Wilson Medina Sierra

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Managing spatial information is described through a Geographic Information System (GIS), for some neighborhoods in the city of Tunja, in relation to the structural typology of the buildings. The use of GIS provides tools that facilitate the capture, processing, analysis and dissemination of cartographic information, product quality evaluation of the classification of buildings. Allows the development of a method that unifies and standardizes processes information. The project aims to generate a geographic database that is useful to the entities responsible for planning and disaster prevention and care for vulnerable populations, also seeks to be a basis for seismic vulnerability studies that can contribute in a study of urban seismic microzonation. The methodology consists in capturing the plat including road naming, neighborhoods, blocks and buildings, to which were added as attributes, the product of the evaluation of each of the housing data such as the number of inhabitants and classification, year of construction, the predominant structural systems, the type of mezzanine board and state of favorability, the presence of geo-technical problems, the type of cover, the use of each building, damage to structural and non-structural elements . The above data are tabulated in a spreadsheet that includes cadastral number, through which are systematically included in the respective building that also has that attribute. Geo-referenced data base is obtained, from which graphical outputs are generated, producing thematic maps for each evaluated data, which clearly show the spatial distribution of the information obtained. Using GIS offers important advantages for spatial information management and facilitates consultation and update. Usefulness of the project is recognized as a basis for studies on issues of planning and prevention.

Keywords: microzonation, buildings, geo-processing, cadastral number

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Authors: Mark Angelo Maranon, David Endriga

Abstract:

Objective: The aim of the study is to determine the differences in functional outcome and quality of life of adult patients with Potts disease who have undergone surgical versus non-surgical management. Methods: In this prospective cohort study, 45 patients were followed up for 1 year after undergoing pharmacologic treatment alone versus a combination of anti-Kochs and surgery for Potts disease. Oswestry Disability Index (ODI) and Short Form-36 (SF-36) were obtained on initiation of treatment, after three months, six months and one year. Results: ASIA scores from the onset of treatment and after 1 year significantly improved (p<0.001) for both non-surgical and surgical patients. ODI scores significantly improved after 6 months of treatment for both surgical and non-surgical patients. Both surgical and non-surgical patients showed significant improvement in their SF-36 scores, but scores were noted to be higher in patients who underwent surgery. Conclusions: Significant improvement with regards to functional outcome and quality of life was noted from both surgical and non-surgical patients after 1 year of treatment, with earlier improvements and better final scores in SF 36 and ODI in patients who underwent surgery.

Keywords: tuberculosis, spinal, potts disease, functional outcome

Procedia PDF Downloads 148