Search results for: Engineering Accreditation Committee

Authors: Lubica Hikkerova, Jean-Michel Sahut

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Environmental protection remains a global challenge but, since 2012, there has been a progressive decline in corporate engagement in environmental protection issues. This study seeks to investigate the role of financial capacity and governance in improving the level of environmental engagement of companies. The regression technique is applied to data on 351 large European companies from the ASSET4-ESG database for the 2007-2015 period. Firstly, the results show that the companies in the sample are fairly engaged in environmental protection, with a strong dispersion representing nearly four times the average. This means that the companies in the sample do not share the same level of engagement in matters of environmental protection, some being more committed than others. Secondly, the results reveal that the financial capacity of the company, as assessed through its indicators, has a significant effect on its level of environmental protection engagement in the present sample. This effect is more positive the higher the profits the company makes, and more negative the more heavily indebted or, the higher the rates of dividends it pays per share. Lastly, the results also show that a better quality of governance plays an important role in the decision to undertake actions leading to environmental protection. More specifically, the degree of management implication in the running of the business, the respect of the rights of the shareholders, the effectiveness of the control exerted by the board of directors, and, to a lesser extent, the independence of the audit committee, are variables which have a positive and significant influence on the level of environmental engagement of companies.

Keywords: financial capacity, corporate governance, environmental engagement, stakeholder theory, theory of organizational legitimacy, theory of resources and capabilities

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Authors: Jitender Sodhi, Shweta Talati, A. K. Gupta, Pankaj Arora

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Background:Equipment donation to hospitals in resource-limited settings can significantly benefit services in these settings albeit requires important ethical, practical and financial issues to be considered before accepting donations. Objective: To understand the decision making process leading to acceptance/ rejection/ deferment of equipment donation from the perspective of a public sector teaching tertiary care hospital. Design: Retrospective, record based study. Setting: 2000-bedded public sector teaching tertiary care hospital in North India. Methods: A total of 30 cases of equipment donation from March 2010-October 2013, were analysed for their decision process leading to acceptance/rejection/deferment.Each case was studied retrospectively and data pertaining to the agenda and decision taken was collected. Results: A total of 30 cases of equipment donation received from March 2010- October 2013 were screened, out of which 17 (56.6%) were for diagnostic purpose and 13 (43.3%) for therapeutic purpose. Out of 30 cases, 16 (53.3%) were accepted and 8 (26.6%) were rejected. The remaining 6 cases included 3 (10%) which required further clarification and other 3 (10%) which were out of the domain of committee. Conclusion: This study highlights the importance of equipment donation in resource limited settings and considerations involved while making decisions for acceptance/rejections/defermentof such donations.

Keywords: equipment donation, teaching hospital, decision-making, North India

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Authors: Nipawan Tharasak, Sajeewan Darbavasu

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This research aims 1) to study the opinion, problems and obstacles to internal educational quality assurance system for individual and the university levels, 2) to propose an approach to the development of quality assurance system of Suan Sunandha Rajabhat University. A study of problems and obstacles to internal educational quality assurance system of the university conducted with sample group consisting of staff and quality assurance committee members of the year 2010. There were 152 respondents. 5 executives were interviewed. Tool used in the research was document analysis. The structure of the interview questions and questionnaires with 5-rate scale. Reliability was 0.981. Data analysis were percentage, mean and standard deviation with content analysis. Results can be divided into 3 main points: (1) The implementation of the internal quality assurance system of the university. It was found that in overall, input, process and output factors received high scores. Each item is considered, the preparation, planning, monitoring and evaluation. The results of evaluation to improve the reporting and improvement according to an evaluation received high scores. However, the process received an average score. (2) Problems and obstacles. It was found that the personnel responsible for the duty still lack understanding of indicators and criteria of the quality assurance. (3) Development approach: -Staff should be encouraged to develop a better understanding of the quality assurance system. -Database system for quality assurance should be developed. -The results and suggestions should be applied in the next year development planning.

Keywords: development system, internal quality assurance, education, educational quality assurance

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Authors: Natida Thongsima, Patompong Satapornpong

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Introduction: Lamotrigine is widely used in the treatment of epilepsy and bipolar disorder. However, lamotrigine leads to adverse drug reactions (ADRs) consist of severe cutaneous adverse reactions (SCARs) include Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and drug rash with eosinophilia and systemic symptoms (DRESS). Moreover, lamotrigine-induced SCARs are usually manifested between 2 and 8 weeks after treatment initiation. According to a previous study, the association between HLA-B*15:02 and lamotrigine-induced cutaneous adverse drug reactions in the Thai population (odds ratio 4.89; 95% CI 1.28–18.66; p-value = 0.014) was found. Therefore, the distribution of pharmacogenetics markers a major role in predicting the culprit drugs for SCARs in many populations. Objective: In this study, we want to investigate the prevalence of HLA-B allele, which correlates with lamotrigine-induced SCARs in the healthy Thai population. Materials and Methods: We enrolled 350 healthy Thai individuals and were approved by the ethics committee of Rangsit University. HLA-B alleles were genotyped by the Lifecodes HLA SSO typing kits (Immucor, West Avenue, Stamford, USA). Results: The results presented HLA-B allele frequency in healthy Thai population were 14.71% (HLA-B*46:01), 8.57% (HLA-B*15:02), 6.71% (HLA-B*40:01), 5.86% (HLA-B*13:01), 5.71% (HLA-B*58:01), 5.14% (HLA-B*38:02), 4.86% (HLA-B*18:01), 4.86% (HLA-B*51:01), 3.86% (HLA-B*44:03) and 2.71% (HLA-B*07:05). Especially, HLA-B*15:02 allele was the high frequency in the Thais (8.57%), Han Chinese (7.30%), Vietnamese (13.50%), Malaysian (6.06%) and Indonesian (11.60%). Nevertheless, this allele was much lower in other populations, namely, Africans, Caucasians, and Japanese. Conclusions: Although the sample size of the healthy Thai population in this research was limited, there were found the frequency of the HLA-B*15:02 allele could predispose them toward to lamotrigine-induced SCARs in Thailand.

Keywords: lamotrigine, cutaneous adverse drug reactions, HLA-B, Thai population

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Authors: Samet Aktaş, Nurtekin Erkmen, Faruk Guven, Halil Taskin

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This study aimed to determine the effects of 3 versus 3 small-sided games (SSG) with different recovery times on soma physiological parameters in soccer players. Twelve soccer players from Regional Amateur League volunteered for this study (mean±SD age, 20.50±2.43 years; height, 177.73±4.13 cm; weight, 70.83±8.38 kg). Subjects were performing soccer training for five days per week. The protocol of the study was approved by the local ethic committee in School of Physical Education and Sport, Selcuk University. The subjects were divided into teams with 3 players according to Yo-Yo Intermittent Recovery Test. The field dimension was 26 m wide and 34 m in length. Subjects performed two times in a random order a series of 3 bouts of 3-a-side SSGs with 3 min and 5 min recovery durations. In SSGs, each set were performed with 6 min duration. The percent of maximal heart rate (% HRmax), blood lactate concentration (LA) and Rated Perceived Exertion (RPE) scale points were collected before the SSGs and at the end of each set. Data were analyzed by analysis of variance (ANOVA) with repeated measures. Significant differences were found between %HRmax in before SSG and 1st set, 2nd set, and 3rd set in both SSG with 3 min recovery duration and SSG with 5 min recovery duration (p<0.05). Means of %HRmax in SSG with 3 min recovery duration at both 1st and 2nd sets were significantly higher than SSG with 5 min recovery duration (p<0.05). No significant difference was found between sets of either SSGs in terms of LA (p>0.05). LA in SSG with 3 min recovery duration was higher than SSG with 5 min recovery duration at 2nd sets (p<0.05). RPE in soccer players was not different between SSGs (p>0.05).In conclusion, this study demonstrates that exercise intensity in SSG with 3 min recovery durations is higher than SSG with 5 min recovery durations.

Keywords: small-sided games, soccer, heart rate, lactate

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Authors: Mahnaz Sanjari, Sedigheh Salemi, Mohammad Mirzabeigi

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Nowadays, the world is facing a crisis of workforce and one of the most striking examples is the shortage of nurses. Nursing workforce productivity is related by various factors such as absenteeism, professional effectiveness and quality care. This cross-sectional study was conducted in 700 nurses who work in government hospitals from 35 hospitals of 9 provinces in Iran. The study was approved by the Nursing Council and was carried out with the authorization of the Research Ethics Committee. The questionnaire included 33 questions and 4 sub categories such as human resource, education and management. The reliability was evaluated by Cronbach's alpha (α=0/85). Statistical analyzes were performed, using SPSS version 16. The result showed that nurses emphasized on "respect to nurse-to-bed ratio" and less importance item was "using less experienced nurse". In addition, another important factor in clinical productivity is "Proper physical structure and amenities","good communication with colleagues" and "having good facilities". Also, "human resources at all levels of standard", "promoting on merit" and "well defined relationship in health system" are another important factors in productivity from nurse` view. The main managerial factor is "justice between employees" and the main educational component of productivity is “updating nursing knowledge”. The results show that more than half of the participants emphasized on the management and educational factors. Productivity as one of the main part of the health care quality leads to appropriate use of human and organizational resources, reduce cost services, and organizational development.

Keywords: productivity, nursing services, workforce, cost services

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Authors: Patrice Conner

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Nanotechnologies have enormous potential to contribute to human flourishing in responsible and sustainable ways. They are rapidly developing field of science, technology and innovation. As enabling technologies, their full scope of applications is potentially very wide. Major implications are expected in many areas, e.g. healthcare, information and communication technologies, energy production and storage, materials science/chemical engineering, manufacturing, environmental protection, consumer products, etc. However, nanotechnologies are unlikely to realize their full potential unless their associated societal and ethical issues are adequately attended. Namely nanotechnologies and nanoparticles may expose humans and the environment to new health risks, possibly involving quite different mechanisms of interference with the physiology of human and environmental species. One of the building blocks of the ‘safe, integrated and responsible’ approach is standardization. Both the Economic and Social Committee and the European Parliament have highlighted the importance to be attached to standardization as a means to accompany the introduction on the market of nanotechnologies and nanomaterials, and a means to facilitate the implementation of regulation. ISO and CEN have respectively started in 2005 and 2006 to deal with selected topics related to this emerging and enabling technology. In the beginning of 2010, EC DG ‘Enterprise and Industry’ addressed the mandate M/461 to CEN, CENELEC and ETSI for standardization activities regarding nanotechnologies and nanomaterials. Thus CEN/TC 352 ‘Nanotechnologies’ has been asked to take the leadership for the coordination in the execution of M/461 (46 topics to be standardized) and to contact relevant European and International Technical committees and interested stakeholders as appropriate (56 structures have been identified). Prior requests from M/461 deal with characterization and exposure of nanomaterials and any matters related to Health, Safety and Environment. Answers will be given to: - What are the structures and how they work? - Where are we right now and how work is going from now onwards? - How CEN’s work and targets deal with and interact with global matters in this field?

Keywords: characterization, environmental protection, exposure, health risks, nanotechnologies, responsible and sustainable ways, safety

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Authors: Vaia N. Koukou, Niki D. Martini, George P. Fountos, Christos M. Michail, Athanasios Bakas, Ioannis S. Kandarakis, George C. Nikiforidis

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Various substitute materials of calcifications are used in phantom measurements and simulation studies in mammography. These include calcium carbonate, calcium oxalate, hydroxyapatite and aluminum. The aim of this study is to compare the contrast-to-noise ratio (CNR) values of the different calcification types using the dual energy method. The constructed calcification phantom consisted of three different calcification types and thicknesses: hydroxyapatite, calcite and calcium oxalate of 100, 200, 300 thicknesses. The breast tissue equivalent materials were polyethylene and polymethyl methacrylate slabs simulating adipose tissue and glandular tissue, respectively. The total thickness was 4.2 cm with 50% fixed glandularity. The low- (LE) and high-energy (HE) images were obtained from a tungsten anode using 40 kV filtered with 0.1 mm cadmium and 70 kV filtered with 1 mm copper, respectively. A high resolution complementary metal-oxide-semiconductor (CMOS) active pixel sensor (APS) X-ray detector was used. The total mean glandular dose (MGD) and entrance surface dose (ESD) from the LE and HE images were constrained to typical levels (MGD=1.62 mGy and ESD=1.92 mGy). On average, the CNR of hydroxyapatite calcifications was 1.4 times that of calcite calcifications and 2.5 times that of calcium oxalate calcifications. The higher CNR values of hydroxyapatite are attributed to its attenuation properties compared to the other calcification materials, leading to higher contrast in the dual energy image. This work was supported by Grant Ε.040 from the Research Committee of the University of Patras (Programme K. Karatheodori).

Keywords: calcification materials, CNR, dual energy, X-rays

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Authors: Shantanu Prakash, Suruchi Shukla, Amita Jain

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Introduction: The hepatitis C virus (HCV) is a major public health problem and a leading cause of chronic liver disease. Injection drug use and individuals receiving blood and blood products are the primary modes of HCV transmission. Our study aims to establish the prevalent genotypes/ subtypes of HCV circulating in Uttar Pradesh, North India, as reported from a tertiary care hospital. Methods: It is a retrospective observational analysis of consecutive 404 HCV RNA positive cases referred to our hospital during September 2014 to April 2017. The study was approved by an institutional ethics committee. Written informed consent was taken from each participant. Clinical and demographic details of these patients were recorded using predesigned questionnaires. All the laboratory testing was carried on stored serum sample of enrolled cases. Genotyping of all 404 strains was done by Sanger’s sequencing of the core region. The phylogenetic analysis of 179 HCV strains with high -quality sequencing data was performed. Results: The distribution of prevalent genotypes/ subtypes as noted in the present study was; Genotype (GT)1a [n-101(25%)], GT1b [n-12(2.9%)], GT1c [1(0.25%)], GT3a [275(68.07%)], GT3b [9(2.2%)], GT3g [2(0.49%)], GT3i [3(0.74%)], and GT4a [1(0.24%)]. HCV genotypes GT2, GT5 and GT6 were not detected from our region. Sequence analysis showed high genotypic variability in HCV GT3. Phylogenetic analysis showed that HCV GT3 and GT1 circulating in our region were related to Indian strains reported earlier. Conclusions: HCV genotypes 3a and 1a are commonest circulating genotypes in Uttar Pradesh (UP), India.

Keywords: Hepatitis C virus, genetic variation, bioinformatics, genotype, HCV

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Authors: Orkide Donma, M. Metin Donma, Burcin Nalbantoglu, Birol Topcu, Feti Tulubas, Murat Aydin, Tuba Gokkus, Ahmet Gurel

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Increasing prevalence of childhood obesity has increased the interest in early and late indicators of gaining weight. Cell blood counts may be indicators of proinflammatory states. The aim was to evaluate associations of hematological parameters, including Hematocrit (HTC), hemoglobin, blood cell counts, and their indices with the degree of obesity in pediatric population. A total of 249; -139 morbidly obese (MO), 82 healthy Normal Weight (NW) and 28 Overweight (OW) children were included into the scope of the study. WHO BMI-for age percentiles were used to form age- and sex-matched groups. Informed consent forms and the Ethics Committee approval were obtained. Anthropometric measurements were performed. Hematological parameters were determined. Statistical analyses were performed using SPSS. The degree for statistical significance was p≤0.05. Significant differences (p=0.000) between waist-to-hip ratios and head-to-neck ratios (hnrs) of MO and NW children were detected. A significant difference between hnrs of OW and MO children (p=0.000) was observed. Red cell Distribution Width (RDW) was higher in OW children than NW group (p=0.030). Such finding couldn’t be detected between MO and NW groups. Increased RDW was prominent in OW children. The decrease in Mean Corpuscular Hemoglobin Concentration (MCHC) values in MO children was sharper than the values in OW children (p=0.006 vs p=0.042) compared to those in NW group. Statistically higher HTC levels were observed between MO-NW (p=0.014), but none between OW-NW. Though the cause-effect relationship between obesity and erythrocyte indices still needs further investigation, alterations in RDW, HTC, MCHC during obesity may be of significance in the early life.

Keywords: anthropometry, children, erythrocytes, obesity

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Authors: Cecilia Amponsem-Boateng, Timothy Bonney Oppongx, Weidong Zhang, Jonathan Boakye Yiadom, Lianke Wang, Kwabena Acheampong, Godfrey Opolot

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In Ghana, the management of hypertension in primary health care is a cost-effective way of addressing premature deaths from vascular disorders that include hypertension. There is little or no evidence of large-scale studies on the prevalence, risk, and knowledge/awareness of hypertension in students aged 12–22 years in Ghana. In a cross-sectional study, blood pressure, anthropometric indices, and knowledge/awareness assessment of students at second-cycle schools were recorded from 2018 to 2020 in three regions of Ghana. Multistage cluster sampling was used in selecting regions and the schools. Prevalence of prehypertension and hypertension was categorized by the Joint National Committee 7, where appropriate, chi-square, scatter plots, and correlations were used in showing associations. A total of 3165 students comprising 1776 (56.1%) females and 1389 (43.9%) males participated in this study within three regions of Ghana. The minimum age was 12 years and the maximum age was 22 years. The mean age was 17.21 with standard deviation (SD: 1.59) years. A 95% confidence interval was set for estimations and a P value < 0.05 was set as significant. The prevalence rate of overall hypertension was 19.91% and elevated (prehypertension) was 26.07%. Risk indicators such as weight, BMI, waist circumference, physical activity, and form of the diet were positively correlated with hypertension. Among Ghanaian students currently in second-cycle educational institutions, 19.91% were hypertensive and 26.07% were prehypertensive. This may indicate a probable high prevalence of hypertension in the future adult population if measures are not taken to curb the associated risks.

Keywords: hypertension, second-cycle schools, Ghana, youth

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Authors: Jadwiga Klukow, Anna Ksykiewicz-Dorota

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An analysis of the distribution of nurses’ working time constitutes vital information for the management in planning employment. The objective of the study was to analyze the distribution of nurses’ working time in an emergency department. The study was conducted in an emergency department of a teaching hospital in Lublin, in Southeast Poland. The catalogue of activities performed by nurses was compiled by means of continuous observation. Identified activities were classified into four groups: Direct care, indirect care, coordination of work in the department and personal activities. Distribution of nurses’ working time was determined by work sampling observation (Tippett) at random intervals. The research project was approved by the Research Ethics Committee by the Medical University of Lublin (Protocol 0254/113/2010). On average, nurses spent 31% of their working time on direct care, 47% on indirect care, 12% on coordinating work in the department and 10% on personal activities. The most frequently performed direct care tasks were diagnostic activities – 29.23% and treatment-related activities – 27.69%. The study has provided information on the complexity of performed activities and utilization of nurses’ working time. Enhancing the effectiveness of nursing actions requires working out a strategy for improved management of the time nurses spent at work. Increasing the involvement of auxiliary staff and optimizing communication processes within the team may lead to reduction of the time devoted to indirect care for the benefit of direct care.

Keywords: emergency nurses, nursing care, workload, work sampling

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Authors: Sony Baral, Harald Vacik

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This study analyzes the sustainability of community forest management in two community forests in Terai and Hills of Nepal, representing four forest types: 1) Shorearobusta, 2) Terai hardwood, 3) Schima-Castanopsis, and 4) other Hills. The sustainability goals for this region include maintaining and enhancing the forest stocks. Considering this, we analysed changes in species composition, stand density, growing stock volume, and growth-to-removal ratio at 3-5 year intervals from 2005-2016 within 109 permanent forest plots (57 in the Terai and 52 in the Hills). To complement inventory data, forest users, forest committee members, and forest officials were consulted. The results indicate that the relative representation of economically valuable tree species has increased. Based on trends in stand density, both forests are being sustainably managed. Pole-sized trees dominated the diameter distribution, however, with a limited number of mature trees and declined regeneration. The forests were over-harvested until 2013 but under-harvested in the recent period in the Hills. In contrast, both forest types were under-harvested throughout the inventory period in the Terai. We found that the ecological dimension of sustainable forest management is strongly achieved while the economic dimension is lacking behind the current potential. Thus, we conclude that maintaining a large number of trees in the forest does not necessarily ensure both ecological and economical sustainability. Instead, priority should be given on a rational estimation of the annual harvest rates to enhance forest resource conditions together with regular benefits to the local communities.

Keywords: community forests, diversity, growing stock, forest management, sustainability, nepal

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Authors: Larissa M. Vargas, Julia M. Sacchi, Renata O. Pereira, Lucas S. Asano, Iara C. Araújo, Patricia Fiorino, Vera Farah

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The aim of this study was to evaluate the occurrence of subclinical organ injuries induced by high-fat diet. Male wistar rats (n=5/group) were divided in control diet group (CD), commercial rat chow, and hyperlipidic diet (30% lipids) group (HD) administrated during 8 weeks, starting after weaning. All the procedures followed the rules of the Committee of Research and Ethics of the Mackenzie University (CEUA Nº 077/03/2011). At the end of protocol the animals were euthanized by anesthesia overload and the left kidney was removed. Intrarenal lipid deposition was evaluated by histological analyses with oilred. Kidney slices were stained with picrosirius red to evaluate the area of the Bowman's capsule (AB) and space (SB), and glomerular tuft area (GT). The renal expression of sterol regulatory element–binding protein (SREBP-2) was performed by Western Blotting. Creatinine concentration (serum and urine) and lipid profile were determined by colorimetric kit (Labtest). At the end of the protocol there was no differences in body weight between the groups, however the HD showed a marked increase in lipid deposits, glomeruli and tubules, and biochemical analysis for cholesterol and triglycerides. Moreover, in the kidney, the high-fat diet induced a reduction in the AB (13%), GT (18%) and SB (17%) associated with a reduction in glomerular filtration rate (creatinine clearance). The renal SRBP2 expression was increased in HD group. These data suggests that consumption of high-fat diet starting in childhood is associated with subclinical renal damage and function.

Keywords: high-fat diet, kidney, intrarenal lipid deposition, SRBP2

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Authors: Rigas Dimakopoulos, Marianna Papadopoulou, Roser Pons

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Background: Participation in family, recreational activities and self-care is an integral part of health. It is also the main outcome of rehabilitation services for children and adolescents with motor disabilities. There are currently no tools in Greek to assess participation in young children. Purpose: To culturally adapt and validate the Greek version of the Child Engagement in Daily Living (CEDL). Method: The CEDL was cross-culturally translated into Greek using forward-backward translation, review by the expert committee, pretest application and final review. Internal consistency was evaluated using the Cronbach alpha and test-retest reliability using the intra-class correlation coefficient (ICC). Parents of children aged 18 months to 5 years and with motor disabilities were recruited. Participants completed the CEDL and the children’s gross motor function was classified using the Gross Motor Function Classification System (GMFCS). Results: Eighty-three children were included, GMFCS I-V. Mean ± standard deviation of the CEDL domains “frequency of participation” “enjoyment of participation” and “self-care” were 58.4±14.0, 3.8±1.0 and 49.9±24, respectively. Internal consistency of all domains was high; Cronbach alpha for “frequency of participation” was 0.83, for “enjoyment of participation” was 0.76 and for “self-care” was 0.92. Test-retest reliability (ICC) was excellent for the “self-care” (0.95) and good for “frequency of participation” and “enjoyment of participation” domains (0.90 and 0.88, respectively). Conclusion: The Greek CEDL has good reliability. It can be used to evaluate participation in Greek young children with motor disabilities GMFCS levels I-V.

Keywords: participation, child, disabilities, child engagement in daily living

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Authors: Ghadeer A.Al-Jabaree, Husam Aldeen Al-Khadash, M. Nassar

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This study aimed at investigating the effect of well-designed corporate governance system on the financial stability of insurance companies listed in ASE. Further, this study provides a comprehensive model for evaluating and analyzing insurance companies' financial position and prospective for comparing the degree of corporate governance application provisions among Jordanian insurance companies. In order to achieve the goals of the study, a whole population that consist of (27) listed insurance companies was introduced through the variables of (board of director, audit committee, internal and external auditor, board and management ownership and block holder's identities). Statistical methods were used with alternative techniques by (SPSS); where descriptive statistical techniques such as means, standard deviations were used to describe the variables, while (F) test and ANOVA analysis of variance were used to test the hypotheses of the study. The study revealed the existence of significant effect of corporate governance variables except local companies that are not listed in ASE on financial stability within control variables especially debt ratio (leverage),where it's also showed that concentration in motor third party doesn't have significant effect on insurance companies' financial stability during study period. Moreover, the study concludes that Global financial crisis affect the investment side of insurance companies with insignificant effect on the technical side. Finally, some recommendations were presented such as enhancing the laws and regulation that help the appropriate application of corporate governance, and work on activating the transparency in the disclosures of the financial statements and focusing on supporting the technical provisions for the companies, rather than focusing only on profit side.

Keywords: corporate governance, financial stability and solvency margin, insurance companies, Jordan

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Authors: Takalani Tshitangano

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Background: In Limpopo province the rate of new tuberculosis (TB) cases increase daily. The Infection Control (IC) plan is one of the essential actions for TB IC. This study aimed to establish the availability of these plans at health care facilities. Objectives: The objectives were to explore and describe the awareness and knowledge of health care workers (HCWs) of the availability and content of TB IC plan; and to identity the role of infection control committees from the perspective of HCWs. Method: A qualitative approach using a cross-sectional descriptive design was adopted. The target population was all HCWs from the seven hospitals of Vhembe district. A purposive sampling approach was used to select 57 participants. The approval to conduct this study was obtained from the relevant authorities and participants. Data were collected through seven focus group discussions comprising five to 10 members. An unstructured discussion guide was used to collect data, and an open-coding method was used to analyse the data. Lincoln and Guba’s criteria ensured trustworthiness of the study findings. Results: Findings revealed that HCWs were not aware of the availability and the information contained in the TB IC plans. No person was designated as TB IC officer at hospital level. There was lack of a TB IC Committee and teams as well as ineffective utilisation of those that did exist. Conclusions: It was concluded that if the TB IC plans are not available at health care facilities, then the TB IC practices implemented by HCWs vary, resulting in TB nosocomial infection transmission. It was recommended that the World Health Organisation’s TB IC plans be adopted and implemented in Vhembe district.

Keywords: health care workers' awareness, health care workers' knowledge, availability of TB infection control plans, rural hospitals

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Authors: Patompong Satapornpong, Therdpong Tempark, Pawinee Rerknimitr, Jettanong Klaewsongkram, Chonlaphat Sukasem

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Dapsone (4, 4’-diaminodiphenyl sulfone, DDS) is broadly used for the treatment of inflammatory diseases and infections such as; leprosy, Pneumocystis jiroveci pneumonia in patients with HIV infection, neutrophilic dermatoses, dermatitis herpetiformis and autoimmune bullous disease. The severe cutaneous adverse drug reactions (SCARs) including, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS) are rare but severe life-threatening adverse drug reactions. Dapsone is one of many culprit drugs induced SJS, TEN and DRESS. Notwithstanding, to our knowledge, there are no studies of the association of HLA class I alleles and dapsone-induced SCARs in non-leprosy Thai patients. This investigation was a prospective cohort study, which performed in a total of 45 non-leprosy patients. Fifteen patients of dapsone-induced SCARs were classified as following the RegiSCAR criteria, and 30 dapsone-tolerant controls were exposed to dapsone more than 6 months without any evidence of cutaneous reactions. The genotyping of HLA-A, -B and –C were performed using sequence-specific oligonucleotides (PCR-SSOs). The Ethics Committee of Ramathibodi hospital, Mahidol University, approved this study. Among all HLA class I alleles, HLA-A*24:07, HLA-B*13:01, HLA-B*15:02, HLA-C*03:04 and HLA-C*03:09 were significantly associated with dapsone-induced SCARs (OR = 10.55, 95% CI = 1.06 – 105.04, p = 0.0360; OR = 56.00, 95% CI = 8.27 – 379.22, p = 0.0001; OR = 7.00, 95% CI = 1.17 – 42.00, p = 0.0322; OR = 6.00, 95% CI = 1.24 – 29.07, p = 0.0425 and OR = 17.08, 95% CI = 0.82 – 355.45, p = 0.0321, respectively). Furthermore, HLA-B*13:01 allele had strong association with dapsone-induced SJS-TEN and DRESS when compared with dapsone-tolerant controls (OR = 42.00, 95% CI = 2.88 – 612.31, p = 0.0064 and OR = 63.00, 95% CI = 7.72 – 513.94 and p = 0.0001, respectively). Consequently, HLA-B*13:01 might serve as a pharmacogenetic marker for screening before initiating the therapy with dapsone for prevention of dapsone-induced SCARs.

Keywords: dapsone-induced SCARs, HLA-B*13:01, HLA class I alleles, severe cutaneous adverse reactions, Thai

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Authors: Mark Darius Juszczak

Abstract:

While epistemology, as a sub-field of philosophy, is generally concerned with theoretical questions about the nature of knowledge, the explosion in digital media technologies has resulted in an exponential increase in the storage and transmission of human information. That increase has resulted in a particular non-linear dynamic – digital epistemological functions are radically altering how and what we know. Neither the rate of that change nor the consequences of it have been well studied or taken into account in developing state-level strategies for epistemological functions. At the current time, US Federal policy, like that of virtually all other countries, maintains, at the national state level, clearly defined boundaries between various epistemological agencies - agencies that, in one way or another, mediate the functional use of knowledge. These agencies can take the form of patent and trademark offices, national library and archive systems, departments of education, departments such as the FTC, university systems and regulations, military research systems such as DARPA, federal scientific research agencies, medical and pharmaceutical accreditation agencies, federal funding for scientific research and legislative committees and subcommittees that attempt to alter the laws that govern epistemological functions. All of these agencies are in the constant process of creating, analyzing, and regulating knowledge. Those processes are, at the most general level, epistemological functions – they act upon and define what knowledge is. At the same time, however, there are no high-level strategic epistemological directives or frameworks that define those functions. The only time in US history where a proxy state-level epistemological strategy existed was between 1961 and 1969 when the Kennedy Administration committed the United States to the Apollo program. While that program had a singular technical objective as its outcome, that objective was so technologically advanced for its day and so complex so that it required a massive redirection of state-level epistemological functions – in essence, a broad and diverse set of state-level agencies suddenly found themselves working together towards a common epistemological goal. This paper does not call for a repeat of the Apollo program. Rather, its purpose is to investigate the minimum structural requirements for a national state-level epistemological strategy in the United States. In addition, this paper also seeks to analyze how the epistemological work of the multitude of national agencies within the United States would be affected by such a high-level framework. This paper is an exploratory study of this type of framework. The primary hypothesis of the author is that such a function is possible but would require extensive re-framing and reclassification of traditional epistemological functions at the respective agency level. In much the same way that, for example, DHS (Department of Homeland Security) evolved to respond to a new type of security threat in the world for the United States, it is theorized that a lack of coordination and alignment in epistemological functions will equally result in a strategic threat to the United States.

Keywords: strategic security, epistemological functions, epistemological agencies, Apollo program

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Authors: Maatouk Mohamed, Nouira Mariem

Abstract:

Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

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Authors: David Segun Adeniyi, Tongvwam P. J., Wekpe S., Owolagba F. E., Ofuche E., Samuels J. O., Okonkwo P.

Abstract:

Background: Pediatrics HIV viral suppression remains a major challenge across Africa. In this study, we sought to establish the relationship between AMP and sustained plasma HIV viremia among a population of pediatric clients on Antiretroviral Therapy (ART). We also seek to determine the prevalence of AMP among the study population. Methods: 180 pediatrics clients on ART at four (4) Comprehensive Hospitals in Jos, Nigeria, participated in this study between the months of October to December 2022. The mean age of the study participants was 13 years. Venous blood was drawn from the participants after consent was sought, and ethical approval was obtained from the Plateau State Specialist Hospital (PSSH) Research and Ethics Committee. All samples were screened for AMP using the CareStart® HRP2 Malaria kit. The Absolute and % CD4 values of the clients were obtained using the BD Presto® CD4 Analyzer. The separated plasma samples were assayed for HIV viral load using the Roche Cobas C4800® system. Obtained data were analyzed using simple descriptive statistics. Results: From the 180 participants in this study, 12.8% (23) have AMP. 90.6% (163) were virally suppressed (<1000 copies/ml), while 9.4% (17) were virally unsuppressed (>1000 copies/ml). 11.7% (19/163) of the virally suppressed population have AMP, with mean absolute and % CD4 values of 648 and 31%, respectively. The virally suppressed population without AMP has mean absolute and % CD4 values of 719 and 32%, respectively. 24% (4/17) of the virally unsuppressed population have AMP, with mean absolute and % CD4 values of 514 and 26%, respectively. The virally unsuppressed population without AMP has mean absolute and % CD4 values of 292 and 16%, respectively. Conclusion: Our study shows that there is a high prevalence of AMP among the study populations (11.7% and 24%, respectively). The high prevalence of AMP among the virally unsuppressed with mean absolute and % CD4 values of 514 and 26% alludes to the fact that malaria co-infection with HIV fosters a dysregulated immune complex response which favors an increased HIV plasma viremia. We thus recommend the routine use of Malaria IPT in pediatric HIV clients.

Keywords: pediatrics, HIV, Malaria, viral suppression

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Authors: Ting Hsiang Chang

Abstract:

Nowadays in Taiwan, higher education, which was previously more emphasized on teaching-oriented approaches, has gradually shifted to an approach more focusing on students learning outcomes. With student employment rate as an important indicator for University Program Evaluation periodically held by the Ministry of Education, it becomes extremely critical for a university to build up a teaching and learning quality assurance system to bridge the gap between learning and practice. Teaching and Learning Quality Assurance System has been built and implemented at Chaoyang University of Technology for years and has received substantial results. By employing various forms of evaluation and performance appraisals, the effectiveness of teaching and learning can consistently be tracked as a means of ensuring teaching and learning quality. This study aims to explore the evaluation system of teaching and learning quality assurance system at the Chaoyang University of Technology by means of content analysis. The study contents the evaluation reports on the teaching and learning quality assurance at the Chaoyang University of Technology in the Academic Year 2013-2015. The quantitative results of the assessment were analyzed using the five-point Likert Scale. Quality assurance Committee meetings were further held for examining and discussions on the results. To the end, the annual evaluation report is to be produced as references used to improve approaches in both teaching and learning. The findings indicate that there is a respective relationship between the overall teaching evaluation items and the teaching goals and core competencies. In addition, graduates’ feedbacks were also collected for further analysis to examine if the current educational planning is able to achieve the university’s teaching goal and cultivation of core competencies.

Keywords: core competencies, teaching and learning quality assurance system, teaching goals, university program evaluation

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Authors: Jane E. Hill

Abstract:

Quality of life is an important component for many. With that in mind, everyone will experience some type of loss within his or her lifetime. A person can experience loss due to break up, separation, divorce, estrangement, or death. An individual may experience loss of a job, loss of capacity, or loss caused by human or natural-caused disasters. An individual’s response to such a loss is unique to them, and not everyone will seek services to assist them with their grief due to loss. Counseling can promote positive outcomes for clients that are grieving by addressing the client’s personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as poor health, psychological distress, or an increased risk of depression. Education and training in grief counseling can improve counselors’ problem recognition and skills in treatment planning. The purpose of this study was to examine whether the Council for Accreditation of Counseling and Related Educational Programs (CACREP) master’s degree counseling students view themselves as having been adequately trained in grief theories and skills. Many people deal with grief issues that prevent them from having joy or purpose in their lives and that leaves them unable to engage in positive opportunities or relationships. This study examined CACREP-accredited master’s counseling students’ self-reported competency, training, and education in providing grief counseling. The implications for positive social change arising from the research may be to incorporate and promote education and training in grief theories and skills in a majority of counseling programs and to provide motivation to incorporate professional standards for grief training and practice in the mental health counseling field. The theoretical foundation used was modern grief theory based on John Bowlby’s work on Attachment Theory. The overall research question was how competent do master’s-level counselors view themselves regarding the education or training they received in grief theories or counseling skills in their CACREP-accredited studies. The author used a non-experimental, one shot survey comparative quantitative research design. Cicchetti’s Grief Counseling Competency Scale (GCCS) was administered to CACREP master’s-level counseling students enrolled in their practicum or internship experience, which resulted in 153 participants. Using a MANCOVA, there was significance found for relationships between coursework taken and (a) perceived assessment skills (p = .029), (b) perceived treatment skills (p = .025), and (c) perceived conceptual skills and knowledge (p = .003). Results of this study provided insight for CACREP master’s-level counseling programs to explore and discuss curriculum coursework inclusion of education and training in grief theories and skills.

Keywords: counselor education and training, grief education and training, grief and loss, quality of life

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Authors: Nouira Mariem, Ennigrou Samir

Abstract:

Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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Authors: Ying Zhu

Abstract:

Recent years have witnessed a boom of foreign investments in the field of artificial intelligence (AI). Foreign investments provide critical capital for AI development but also trigger national security concerns of host states. A notable example is an increasing number of cases in which the Committee on Foreign Investment in the United States (CFIUS) has denied Chinese acquisitions of US technology companies on national security grounds. On July 19, 2018, the Congress has reached a deal on the final draft of a new provision to strengthen CFIUS’s authority to review overseas transactions involving sensitive US technology. The question is: how to reconcile the emerging tension between, on the one hand, foreign AI investors’ expectations of a predictable investment environment, and on the other hand, host states’ regulatory power on national security? This paper provides a methodology to reconcile this tension under international investment law. Based on an examination, the national security exception clauses in international investment treaties and the application of national security justification in investor-state arbitration jurisprudence, the paper argues that a traditional interpretation of the national security exception, based on the necessity concept in customary international law, fails to take into account new risks faced by countries, including security concerns over strategic industries such as AI. To overcome this shortage, the paper proposes to incorporate an integrated national security clause in international investment treaties, which includes a two-tier test: a ‘self-judging’ test in the pre-establishment period and a ‘proportionality’ test in the post-establishment period. At the end, the paper drafts a model national security clause for future treaty-drafting practice.

Keywords: foreign investment, artificial intelligence, international investment law, national security exception

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Authors: Saowapa Phaithayawat

Abstract:

The purposes of this study are 1) to study the over 20-year attempt of Mahakan fort community to negotiate with Bangkok Metropolitan Administration (BMA) to remain in their residential area belonging to the state, and 2) to apply the new social and cultural dimension between the state and the community as an alternative for local participation in keeping their residential area. This is a qualitative research, and the findings reveal that the community claimed their ancestors’ right as owners of this piece of land for over 200 years. The community, therefore, requested to take part in the preservation of land, culture and local intellect and the area management in terms of being a learning resource on the cultural road in Rattanakosin Island. However, BMA imposed the law concerning the community area relocation in Rattanakosin Island. The result of law enforcement led to the failure of the area relocation, and the hard hit on physical structure of the area including the overall deterioration of the cultural road renovated in the year 1982, the 200 years’ celebration of Bangkok. The enforcement of law by the state required the move of the community, and the landscape improvement based on the capital city plan. However, this enforcement resulted in the unending conflicts between the community and the state, and the solution of this problem was unclear. At the same time the community has spent a long time opposing the state’s action, and preparing themselves by administrating the community behind Mahakan fortress with community administrative committee under the suggestion of external organization by registering all community members, providing funds for community administration. At the meantime the state lacked the continuation of the enforcement due to political problem and BMA’s administration problem. It is, therefore, suggested that an alternative solution to this problem lie at the negotiation between the state and the community with the purpose of the collaboration between the two to develop the area under the protective law of each side.

Keywords: Pom-Mahakan community, reduction of conflicts, social area disclosure, residential area

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Authors: Nongyao Intasaso, Atchara Rattanama, Navarat Pewnual

Abstract:

This research is survey research purposed to study the factor affected to knowledge management efficiency of personnel in Rajamangala University of Technology Srivijaya, and study the problem of knowledge management affected to knowledge development of personnel in the university. The tool used in this study is structures questioner standardize rating scale in 5 levels. The sample selected by purposive sampling and there are 137 participation calculated in 25% of population. The result found that factor affected to knowledge management efficiency in the university included (1) result from the organization factor found that the university provided project or activity that according to strategy and mission of knowledge management affected to knowledge management efficiency in highest level (x̅ = 4.30) (2) result from personnel factor found that the personnel are eager for knowledge and active to learning to develop themselves and work (Personal Mastery) affected to knowledge management efficiency in high level (x̅ = 3.75) (3) result from technological factor found that the organization brought multimedia learning aid to facilitate learning process affected to knowledge management efficiency in high level (x̅ = 3.70) and (4) the result from learning factor found that the personnel communicated and sharing knowledge and opinion based on acceptance to each other affected to knowledge management efficiency in high level (x̅ = 3.78). The problem of knowledge management in the university included the personnel do not change their work behavior, insufficient of collaboration, lack of acceptance in knowledge and experience to each other, and limited budget. The solutions to solve these problems are the university should be support sufficient budget, the university should follow up and evaluate organization development based on knowledge using, the university should provide the activity emphasize to personnel development and assign the committee to process and report knowledge management procedure.

Keywords: knowledge management, efficiency, personnel, learning process

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Authors: C. Mazziotti Gomez de Teran, D. Fiore, B. Cola, A. Fardelli

Abstract:

The present paper summarizes the analysis of the request for consultation of information and data on industrial emissions made publicly available on the web site of the Ministry of Environment, Land and Sea on integrated pollution prevention and control from large industrial installations, the so called “AIA Portal”. However, since also local Competent Authorities have been organizing their own web sites on IPPC permits releasing procedures for public consultation purposes, as a result, a huge amount of information on national industrial plants is already available on internet, although it is usually proposed as textual documentation or images. Thus, it is not possible to access all the relevant information through interoperability systems and also to retrieval relevant information for decision making purposes as well as rising of awareness on environmental issue. Moreover, since in Italy the number of institutional and private subjects involved in the management of the public information on industrial emissions is substantial, the access to the information is provided on internet web sites according to different criteria; thus, at present it is not structurally homogeneous and comparable. To overcome the mentioned difficulties in the case of the Coordinating Committee for the implementation of the Agreement for the industrial area in Taranto and Statte, operating before the IPPC permit granting procedures of the relevant installation located in the area, a big effort was devoted to elaborate and to validate data and information on characterization of soil, ground water aquifer and coastal sea at disposal of different subjects to derive a global perspective for decision making purposes. Thus, the present paper also focuses on main outcomes matured during such experience.

Keywords: public information, emissions into atmosphere, IPPC permits, territorial information systems

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Authors: Miyako Oulevey, David Lavallee, Naohiko Kohtake

Abstract:

Retirement from sport can be stressful to athletes for many reasons. Accordingly, it is necessary to match coping strategies depending on the stressors. One of the athlete career assistance programs for Japanese top athletes in Japan, the Japan Olympic Committee Career Academy (JCA), has focused on the service contents regarding occupational supports which can be said to cope with financial and occupational stress; however, other supports such as psychological support were unclear due to the lack of psychological professionals in the JCA. Tailoring the program, it is important to match the needs of the athletes at athletic retirement with the service contents. Japanese Olympic athletes have been found to retire for different reasons. Especially female athletes who competed in the Summer Olympic Games were found to retire with psychological reasons. The purpose of this research was to investigate the types of stressors Japanese female athletes experience as a result of athletic retirement. As part of the study, 44 female retired athletes from 13 competitive sports completed an open-ended questionnaire. The KJ method was used to analyze stress experienced as a result of retirement. As a result, nine conceptualized stressors were aggregated such as “Conflict with athletic identity”, “Desire to live as an athlete”, and “Career plan after retirement”. In order to match the coping strategies according to the stressors, each stressor was classified with the four types of adjustments; psychological, social, financial, and occupational changes. As a result, the stressor relating to psychological adjustment accounted for 69.0% of coping-related needs, the financial and occupational adjustment was 21.8%, and social adjustment was 9.2%. In conclusion, coping strategies according to the stressors are suggested.

Keywords: athletic retirement, coping, female athlete, stress

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Authors: C. G. Shashi Kumar, G. Arun Maiya, H. Manjunath Hande, K. V. Rajagopal

Abstract:

Background: Diabetes mellitus (DM) is a metabolic disorder with involvement of neurovascular and muscular system. Studies have documented that the gait parameter is altered in type 2 diabetes mellitus with peripheral neuropathy. However, there is a dearth of literature regarding the gait characteristics in type 2 diabetes mellitus (T2DM) without peripheral neuropathy. Therefore, the present study is focused on identifying gait changes in early type 2 diabetes mellitus without peripheral neuropathy. Objective: To analyze the gait characteristics in Type 2 diabetes mellitus without peripheral neuropathy. Methods: After obtaining ethical clearance from Institutional Ethical Committee (IEC), 36 T2DM without peripheral neuropathy and 32 matched healthy subjects were recruited. Gait characteristics (step duration, gait cycle length, gait cycle duration, stride duration, step length, double stance duration) of all the subjects were analyzed using Windtrack dynamic foot scanner. Data were analyzed using Independent‘t’ test to find the difference between the groups (step duration, gait cycle length, gait cycle duration) and Mann-Whitney test was used to analyze the step length and double stance duration to find difference between the groups. Level of significance was kept at P<0.05. Results: Result analysis showed significant decrease in step duration, gait cycle length, gait cycle duration, step length, double stance duration in T2DM subjects as compared to healthy subjects. We also observed a mean increase in stride duration in T2DM subjects compared to healthy subjects.

Keywords: type 2 diabetes mellitus, dynamic foot scan, gait characteristics, medical and health sciences

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