Search results for: Accountable Care Organizations

Authors: Murat Ayyıldız, Oya Kalıpsız, Sırma Yavuz

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Software project effort estimation is frequently seen as complex and expensive for individual software engineers. Software production is in a crisis. It suffers from excessive costs. Software production is often out of control. It has been suggested that software production is out of control because we do not measure. You cannot control what you cannot measure. During last decade, a number of researches on cost estimation have been conducted. The metric-set selection has a vital role in software cost estimation studies; its importance has been ignored especially in neural network based studies. In this study we have explored the reasons of those disappointing results and implemented different neural network models using augmented new metrics. The results obtained are compared with previous studies using traditional metrics. To be able to make comparisons, two types of data have been used. The first part of the data is taken from the Constructive Cost Model (COCOMO'81) which is commonly used in previous studies and the second part is collected according to new metrics in a leading international company in Turkey. The accuracy of the selected metrics and the data samples are verified using statistical techniques. The model presented here is based on Multi-Layer Perceptron (MLP). Another difficulty associated with the cost estimation studies is the fact that the data collection requires time and care. To make a more thorough use of the samples collected, k-fold, cross validation method is also implemented. It is concluded that, as long as an accurate and quantifiable set of metrics are defined and measured correctly, neural networks can be applied in software cost estimation studies with success

Keywords: Software Metrics, Software Cost Estimation, Neural Network.

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Authors: Nevine M. Labib, Michael N. Malek

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Data Mining aims at discovering knowledge out of data and presenting it in a form that is easily comprehensible to humans. One of the useful applications in Egypt is the Cancer management, especially the management of Acute Lymphoblastic Leukemia or ALL, which is the most common type of cancer in children. This paper discusses the process of designing a prototype that can help in the management of childhood ALL, which has a great significance in the health care field. Besides, it has a social impact on decreasing the rate of infection in children in Egypt. It also provides valubale information about the distribution and segmentation of ALL in Egypt, which may be linked to the possible risk factors. Undirected Knowledge Discovery is used since, in the case of this research project, there is no target field as the data provided is mainly subjective. This is done in order to quantify the subjective variables. Therefore, the computer will be asked to identify significant patterns in the provided medical data about ALL. This may be achieved through collecting the data necessary for the system, determimng the data mining technique to be used for the system, and choosing the most suitable implementation tool for the domain. The research makes use of a data mining tool, Clementine, so as to apply Decision Trees technique. We feed it with data extracted from real-life cases taken from specialized Cancer Institutes. Relevant medical cases details such as patient medical history and diagnosis are analyzed, classified, and clustered in order to improve the disease management.

Keywords: Data Mining, Decision Trees, Knowledge Discovery, Leukemia.

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Authors: Saima Hirani, Emmanuela Ojukwu, Nilanga Aki Bandara

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Mental health challenges that begin during the youth age period may continue across the entire life course. One way to support youth mental health is to encourage youth engagement in prosocial activities. This study aimed to explore youth’s perceptions about helping others and mental wellbeing, barriers, and enablers for youth to initiate and continue prosocial activities, and strategies for developing the attribute of helping others in youth. We conducted a qualitative study using semi-structured, virtual interviews with 18 young individuals (aged 16-24 years) living in Vancouver, British Columbia, Canada. Youth perceived helping others as a source of feeling peace and calm, finding meaning in life, experiencing social connection and promoting self-care, and relieving stress. Participants reported opportunities to learn new skills, the role of religion, social connections, previous positive experiences, and role modeling as enablers for their prosocial behavior. Heavy time commitment, negative behavior from others, self-doubt, and late exposure to such activities were considered barriers by youth when participating in prosocial activities. Youth also brought forward key recommendations for engaging youth in helping others. The findings of this study support the notion that youth have positive experiences when engaging in helping others and that involving young people in prosocial activities could be used as a protective intervention for promoting youth mental health and overall wellbeing.

Keywords: Helping others, prosocial behavior, youth, mental wellbeing.

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Authors: S. R. Shamili, C. Natarajan, J. Karthikeyan

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Rapid growth of world population and widespread urbanization has remarkably increased the development of the construction industry which caused a huge demand for sand and gravels. Environmental problems occur when the rate of extraction of sand, gravels, and other materials exceeds the rate of generation of natural resources; therefore, an alternative source is essential to replace the materials used in concrete. Now-a-days, electronic products have become an integral part of daily life which provides more comfort, security, and ease of exchange of information. These electronic waste (E-Waste) materials have serious human health concerns and require extreme care in its disposal to avoid any adverse impacts. Disposal or dumping of these E-Wastes also causes major issues because it is highly complex to handle and often contains highly toxic chemicals such as lead, cadmium, mercury, beryllium, brominates flame retardants (BFRs), polyvinyl chloride (PVC), and phosphorus compounds. Hence, E-Waste can be incorporated in concrete to make a sustainable environment. This paper deals with the composition, preparation, properties, classification of E-Waste. All these processes avoid dumping to landfills whilst conserving natural aggregate resources, and providing a better environmental option. This paper also provides a detailed literature review on the behaviour of concrete with incorporation of E-Wastes. Many research shows the strong possibility of using E-Waste as a substitute of aggregates eventually it reduces the use of natural aggregates in concrete.

Keywords: Disposal, electronic waste, landfill, toxic chemicals.

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Authors: Samuel Kaspi, Sitalakshmi Venkatraman

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In-memory database systems are becoming popular due to the availability and affordability of sufficiently large RAM and processors in modern high-end servers with the capacity to manage large in-memory database transactions. While fast and reliable inmemory systems are still being developed to overcome cache misses, CPU/IO bottlenecks and distributed transaction costs, disk-based data stores still serve as the primary persistence. In addition, with the recent growth in multi-tenancy cloud applications and associated security concerns, many organisations consider the trade-offs and continue to require fast and reliable transaction processing of diskbased database systems as an available choice. For these organizations, the only way of increasing throughput is by improving the performance of disk-based concurrency control. This warrants a hybrid database system with the ability to selectively apply an enhanced disk-based data management within the context of inmemory systems that would help improve overall throughput. The general view is that in-memory systems substantially outperform disk-based systems. We question this assumption and examine how a modified variation of access invariance that we call enhanced memory access, (EMA) can be used to allow very high levels of concurrency in the pre-fetching of data in disk-based systems. We demonstrate how this prefetching in disk-based systems can yield close to in-memory performance, which paves the way for improved hybrid database systems. This paper proposes a novel EMA technique and presents a comparative study between disk-based EMA systems and in-memory systems running on hardware configurations of equivalent power in terms of the number of processors and their speeds. The results of the experiments conducted clearly substantiate that when used in conjunction with all concurrency control mechanisms, EMA can increase the throughput of disk-based systems to levels quite close to those achieved by in-memory system. The promising results of this work show that enhanced disk-based systems facilitate in improving hybrid data management within the broader context of in-memory systems.

Keywords: Concurrency control, disk-based databases, inmemory systems, enhanced memory access (EMA).

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Authors: Robert Koch, Mario Golling, Gabi Dreo

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During the last couple of years, the degree of dependence on IT systems has reached a dimension nobody imagined to be possible 10 years ago. The increased usage of mobile devices (e.g., smart phones), wireless sensor networks and embedded devices (Internet of Things) are only some examples of the dependency of modern societies on cyber space. At the same time, the complexity of IT applications, e.g., because of the increasing use of cloud computing, is rising continuously. Along with this, the threats to IT security have increased both quantitatively and qualitatively, as recent examples like STUXNET or the supposed cyber attack on Illinois water system are proofing impressively. Once isolated control systems are nowadays often publicly available - a fact that has never been intended by the developers. Threats to IT systems don’t care about areas of responsibility. Especially with regard to Cyber Warfare, IT threats are no longer limited to company or industry boundaries, administrative jurisdictions or state boundaries. One of the important countermeasures is increased cooperation among the participants especially in the field of Cyber Defence. Besides political and legal challenges, there are technical ones as well. A better, at least partially automated exchange of information is essential to (i) enable sophisticated situational awareness and to (ii) counter the attacker in a coordinated way. Therefore, this publication performs an evaluation of state of the art Intrusion Detection Message Exchange protocols in order to guarantee a secure information exchange between different entities.

Keywords: Cyber Defence, Cyber Warfare, Intrusion Detection Information Exchange, Early Warning Systems, Joint Intrusion Detection, Cyber Conflict

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Authors: K. Paradkar, S. N. Mudliar, A. Sharma, A. B. Pandit, R. A. Pandey

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The study explores the hybrid combination of Hydrodynamic Cavitation (HC) and Subcritical Wet Air Oxidation-based pretreatment of complex industrial effluent to enhance the biodegradability selectively (without major COD destruction) to facilitate subsequent enhanced downstream processing via anaerobic or aerobic biological treatment. Advanced oxidation based techniques can be less efficient as standalone options and a hybrid approach by combining Hydrodynamic Cavitation (HC), and Wet Air Oxidation (WAO) can lead to a synergistic effect since both the options are based on common free radical mechanism. The HC can be used for initial turbulence and generation of hotspots which can begin the free radical attack and this agitating mixture then can be subjected to less intense WAO since initial heat (to raise the activation energy) can be taken care by HC alone. Lab-scale venturi-based hydrodynamic cavitation and wet air oxidation reactor with biomethanated distillery wastewater (BMDWW) as a model effluent was examined for establishing the proof-of-concept. The results indicated that for a desirable biodegradability index (BOD: COD - BI) enhancement (up to 0.4), the Cavitation (standalone) pretreatment condition was: 5 bar and 88 min reaction time with a COD reduction of 36 % and BI enhancement of up to 0.27 (initial BI - 0.17). The optimum WAO condition (standalone) was: 150oC, 6 bar and 30 minutes with 31% COD reduction and 0.33 BI. The hybrid pretreatment (combined Cavitation + WAO) worked out to be 23.18 min HC (at 5 bar) followed by 30 min WAO at 150oC, 6 bar, at which around 50% COD was retained yielding a BI of 0.55. FTIR & NMR analysis of pretreated effluent indicated dissociation and/or reorientation of complex organic compounds in untreated effluent to simpler organic compounds post-pretreatment.

Keywords: BI, hybrid, hydrodynamic cavitation, wet air oxidation.

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Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md Saad

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Background: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self-administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Keywords: Glyceryl trinitrate, knowledge, adherence.

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Authors: Atul Khurana, Rajul Rastogi, Hans-Joachim Gamperl

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The pharmaceutical companies are getting more inclined towards patient support programs (PSPs) which assist patients and/or healthcare professionals (HCPs) in more desirable disease management and cost-effective treatment. The utmost objective of these programs is patient care. The PSPs may include financial assistance to patients, medicine compliance programs, access to HCPs via phone or online chat centers, etc. The PSP has a crucial role in terms of customer acquisition and retention strategies. During the conduct of these programs, Marketing Authorisation Holder (MAH) may receive information related to concerned medicinal products, which is usually reported by patients or involved HCPs. This information may include suspected adverse reaction(s) during/after administration of medicinal products. Hence, the MAH should design PSP to comply with regulatory reporting requirements and avoid non-compliance during PV inspection. The emergence of wireless health devices is lowering the burden on patients to manually incorporate safety data, and building a significant option for patients to observe major swings in reference to drug safety. Therefore, to enhance the adoption of these programs, MAH not only needs to aware patients about advantages of the program, but also recognizes the importance of time of patients and commitments made in a constructive manner. It is indispensable that strengthening the public health is considered as the topmost priority in such programs, and the MAH is compliant to Pharmacovigilance (PV) requirements along with regulatory obligations.

Keywords: Drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance.

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Authors: Mohammad Mirwais Yusufi

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Skillful management is one of the most important success factors for today’s farms. When a farm is well managed, it can generate funds for its sustainability. Grape is one of the most diffused fruits in the world and one of the most important cash crops with high potential of production in Afghanistan as well. While there are several organizations intervening for improvement of this cash crop, the quality and quantity are still not satisfactory for producers and external markets. The situation has not changed over the years. Therefore, a survey was conducted in 2017 with 60 grape growers, supported by questionnaires in Mirbachakot, Kalakan and Shakardara districts of Kabul province. The purpose was to get an understanding of the current socio-demographic characteristics of farmers, management methods, constraints, farm size, yield and contribution of grape farming to household income. Findings indicate that grape farming was predominant 83.3% male, 16.6% female and small-scale farmers were the main grape producers, 60% < 1 ha of land under grape production. Likewise, 50% had more than > 10 years and 33.3% between 1-5 years’ experience in grape farming. The high level of illiteracy and diseases had significant digit effect on growth, yield and quality of grapes. The results showed that vineyard management operations to protect grapes from mechanical damage are very poor or completely absent. Comparing developed countries, table grape is one of the fruits with the highest input of technology, while in developing countries the cost of labor is low but the purchase of the equipment is very high due to financial situation. Hence the low quality and quantity of grape are influenced by poor management methods, such as non-availability of experts and lack of technical guidance in the study site. Thereby, the study suggested that improved agricultural extension services and managerial skills could contribute to addressing the problems.

Keywords: Efficient resources use, management skills, constraints factors, Kabul.

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Authors: Bohsiu Wu

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Among serious crimes, child homicide is a rather rare event. However, the killing of children stirs up a special type of emotion in society that pales other criminal acts. This study examines the relevancy of three possible community-level explanations for child homicide: social deprivation, female empowerment, and social isolation. The social deprivation hypothesis posits that child homicide results from lack of resources in communities. The female empowerment hypothesis argues that a higher female status translates into a higher level of capability to prevent child homicide. Finally, the social isolation hypothesis regards child homicide as a result of lack of social connectivity. Child homicide data, aggregated by US postal ZIP codes in California from 1990 to 1999, were analyzed with a negative binomial regression. The results of the negative binomial analysis demonstrate that social deprivation is the most salient and consistent predictor among all other factors in explaining child homicide victimization at the ZIP-code level. Both social isolation and female labor force participation are weak predictors of child homicide victimization across communities. Further, results from the negative binomial regression show that it is the communities with a higher, not lower, degree of female labor force participation that are associated with a higher count of child homicide. It is possible that poor communities with a higher level of female employment have a lesser capacity to provide the necessary care and protection for the children. Policies aiming at reducing social deprivation and strengthening female empowerment possess the potential to reduce child homicide in the community.

Keywords: Child homicide, deprivation, empowerment, isolation.

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Authors: Siham Jemal Kedir

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Information communication technology is dramatically transforming the health sector, especially in developing countries with few resources and burgeoning access to an internet connection. As a result, processes such as record keeping, administration, and human resources have been vastly simplified, allowing hospitals to focus on delivering urgent medical care. This paper will explore the impact of IT through a study of the electronic medical record system in the Mekelle City Health Center in Tigray Region, Ethiopia. This paper has four specific objectives: 1. developing artifacts in the Electronic Medical Record system, 2. preparing a diagram for step-by-step development of Electronic Medical Records, 3. creating a draft website with the proposed Electronic Medical Record system, and 4. Testing and evaluating the performance and user acceptance of the system. The research will be done in a qualitative manner employing interviews and in-person observation. The research has found the following major results: firstly, the medical record system has been difficult to implement. Second, the Mekelle Health Center is using a manual recording system which is time-consuming and inefficient. The old recording system in the Center leads to the dissatisfaction of patients as well as the service provider staff. As a result, to transform the manual recording system into a digital system, an electronic medical recording system has been developed. The developed system has been tested for implementation and has been successful. Consequently, the administrator of the health center is ready to implement and use the developed software to introduce a medical recording system in Mekelle Health Center.

Keywords: Electronic Health Record Implementation, EMR System Development, Medical Record.

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Authors: Wernhuar Tarng, Yuan-Yuan Chen, Chien-Lung Li, Kun-Rong Hsie, Mingteh Chen

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An emotional speech recognition system for the applications on smart phones was proposed in this study to combine with 3G mobile communications and social networks to provide users and their groups with more interaction and care. This study developed a mechanism using the support vector machines (SVM) to recognize the emotions of speech such as happiness, anger, sadness and normal. The mechanism uses a hierarchical classifier to adjust the weights of acoustic features and divides various parameters into the categories of energy and frequency for training. In this study, 28 commonly used acoustic features including pitch and volume were proposed for training. In addition, a time-frequency parameter obtained by continuous wavelet transforms was also used to identify the accent and intonation in a sentence during the recognition process. The Berlin Database of Emotional Speech was used by dividing the speech into male and female data sets for training. According to the experimental results, the accuracies of male and female test sets were increased by 4.6% and 5.2% respectively after using the time-frequency parameter for classifying happy and angry emotions. For the classification of all emotions, the average accuracy, including male and female data, was 63.5% for the test set and 90.9% for the whole data set.

Keywords: Smart phones, emotional speech recognition, socialnetworks, support vector machines, time-frequency parameter, Mel-scale frequency cepstral coefficients (MFCC).

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Authors: N. Southiseng, J. Walsh

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Prior to 1975, women in Laos suffered from having reduced levels of power over decision-making in their families and in their communities. This has had a negative impact on their ability to develop their own identities. Their roles were identified as being responsible for household activities and making preparations for their marriage. Many women lost opportunities to get educated and access the outdoor work that might have empowered them to improve their situations. So far, no accurate figures of either emigrants or return migrants have been compiled but it appears that most of them were women, and it was women who most and more frequently remitted money home. However, very few recent studies have addressed the relationship between remittances and the roles of women in Laos. This study, therefore, aims at redressing to some extent the deficiencies in knowledge. Qualitative techniques were used to gather data, including individual in-depth interviews and direct observation in combination with the content analysis method. Forty women in Vientiane Municipality and Savannakhet province were individually interviewed. It was found that the monetary remittance was typically used for family security and well-being; on fungible activities; on economic and business activities; and on community development, especially concerning hospitality and providing daily household necessities. Remittances played important roles in improving many respondents- livelihoods and positively changed their identities in families and communities. Women became empowered as they were able to start commercial businesses, rather than taking care of (just) housework, children and elders. Interviews indicated that 92.5% of the respondents their quality of lives improved, 90% felt happier in their families and 82.5% felt conflicts in their families were reduced.

Keywords: Laos, Monetary Remittances, Social Remittance, Women's Empowerment.

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Authors: Fatima U. Maigari, Musa Halilu, M. Maryam Umar, Rabiu Zainab

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Plants as therapeutic agents are used as drug in many parts of the world. Medicinal plants are mostly used in developing countries due to culture acceptability, belief or due to lack of easy access to primary health care services. Jatropha curcas is a plant from the Euphorbiaceae family which is widely used in Northern Nigeria as an anti-diarrheal agent. This study was conducted to determine the anti-diarrheal effect of the leaf extract on castor oil induced diarrhea in albino rats. The leaves of J. curcas were collected from Balanga Local government in Gombe State, north-eastern Nigeria; due to its bioavailability. The leaves were air-dried at room temperature and ground to powder. Phytochemical screening was done and different concentrations of the extract was prepared and administered to the different categories of experimental animals. From the results, aqueous leaf extract of Jatropha curcas at doses of 200mg/Kg and 400mg/Kg was found to reduce the mean stool score as compared to control rats, however, maximum reduction was achieved with the standard drug of Loperamide (5mg/Kg). Treatment of diarrhea with 200mg/Kg of the extract did not produce any significant decrease in stool fluid content but was found to be significant in those rats that were treated with 400mg/Kg of the extract at 2hours (0.05±0.02) and 4hours (0.01±0.01). A significant reduction of diarrhea in the experimental animals signifies it to possess some anti-diarrheal activity.

Keywords: Anti-diarrhea, Diarrhea, Jatropha curcas, Loperamide.

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Authors: Ritwik Dutta, Marilyn Wolf

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This paper describes the tradeoffs and the design from scratch of a self-contained, easy-to-use health dashboard software system that provides customizable data tracking for patients in smart homes. The system is made up of different software modules and comprises a front-end and a back-end component. Built with HTML, CSS, and JavaScript, the front-end allows adding users, logging into the system, selecting metrics, and specifying health goals. The backend consists of a NoSQL Mongo database, a Python script, and a SimpleHTTPServer written in Python. The database stores user profiles and health data in JSON format. The Python script makes use of the PyMongo driver library to query the database and displays formatted data as a daily snapshot of user health metrics against target goals. Any number of standard and custom metrics can be added to the system, and corresponding health data can be fed automatically, via sensor APIs or manually, as text or picture data files. A real-time METAR request API permits correlating weather data with patient health, and an advanced query system is implemented to allow trend analysis of selected health metrics over custom time intervals. Available on the GitHub repository system, the project is free to use for academic purposes of learning and experimenting, or practical purposes by building on it.

Keywords: Flask, Java, JavaScript, health monitoring, long term care, Mongo, Python, smart home, software engineering, webserver.

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Authors: Cristina M. R. Caridade, Ana Rita F. Morais

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The use of computational tools has become essential in the context of interactive learning, especially in engineering education. In the medical industry, teaching medical image processing techniques is a crucial part of training biomedical engineers, as it has integrated applications with health care facilities and hospitals. The aim of this article is to present a teaching-learning simulation tool, developed in MATLAB using Graphical User Interface, for medical image fusion that explores different image fusion methodologies and processes in combination with image pre-processing techniques. The application uses different algorithms and medical fusion techniques in real time, allowing to view original images and fusion images, compare processed and original images, adjust parameters and save images. The tool proposed in an innovative teaching and learning environment, consists of a dynamic and motivating teaching simulation for biomedical engineering students to acquire knowledge about medical image fusion techniques, necessary skills for the training of biomedical engineers. In conclusion, the developed simulation tool provides a real-time visualization of the original and fusion images and the possibility to test, evaluate and progress the student’s knowledge about the fusion of medical images. It also facilitates the exploration of medical imaging applications, specifically image fusion, which is critical in the medical industry. Teachers and students can make adjustments and/or create new functions, making the simulation environment adaptable to new techniques and methodologies.

Keywords: Image fusion, image processing, teaching-learning simulation tool, biomedical engineering education.

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Authors: Şenay Pehli̇van, Gülümser Kublay

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Female inmates placed in a Correctional Institution (CI) have more physical health problems than other women and their male counterparts. Thus, they require more health care services in the CI and nursing services in particular. CI nurses also have the opportunity to teach behaviors which will protect and improve their health to these women who are difficult to reach in the community. The aim of this study was to evaluate effect of nursing services provided in a CI on the physical health levels and health behaviors of female inmates. The study has a quasi-experimental design. The study was done in Female Closed CI in Ankara, Turkey. The study was conducted on 30 female inmates. Before the implementation of nursing interventions in the initial phase of the study, female inmates were evaluated in terms of physical health problems and health behavior using forms, a physical examination, medical history, health files (file containing medical information related to prisons) and the Omaha System (OS). Findings obtained from evaluations were grouped and symptoms-findings were expressed with OS diagnosis codes. Knowledge, behavior and status scores of prisoners in relation to health problems were determined. After the implementation of the nursing interventions, female inmates were evaluated in terms of physical health problems and health behavior using OS. The research data were collected using the Female Evaluation Form developed by the researcher and the OS. It was found that knowledge, behavior and status scores of prisoners significantly increased after the implementation of nursing interventions (p < 0.05).

Keywords: Correctional institution, correctional nursing, prison nursing, female inmates, physical health problems, health behaviors.

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Authors: D. Bheenick, M. Young, M. Elmussareh, A. Ali

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Coronavirus disease 2019 (COVID-19) has had unprecedented effects on the healthcare system in the UK. The pandemic has impacted every service within secondary care, including urology. Our objective is to determine how COVID-19 has influenced acute urology admissions in a busy district general hospital in the UK. To conduct the study, retrospective data of patients presenting acutely to the urology department were collected between January 13 to March 22, 2020 (pre-lockdown period) and March 23 to May 31, 2020 (lockdown period). The nature of referrals, types of admission encountered, and management required in accordance with the new set of protocols established during the lockdown period were analysed and compared to the same data prior to UK lockdown. Included in the study were 1092 patients. The results show that an overall reduction of 32.5% was seen in the total number of admissions. A marked decrease was seen in non-urological pathology as compared to other categories. Urolithiasis showed the highest proportional increase. Treatment varied proportionately to the diagnosis, with conservative management accounting for the most likely treatment during lockdown. However, the proportion of patients requiring interventions during the lockdown period increased overall. No comparative differences were observed during the two periods in terms of source of referral, length of stay and patient age. The results of the study concluded that the admission rate showed a decrease, with no significant difference in the nature and timing of presentation. Our department was able to continue providing effective management to patients presenting acutely during the COVID-19 outbreak.

Keywords: COVID-19, lockdown, admissions, urology

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Authors: Muhammad Naseem Baig, Razia Sharif

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From past many decades human beings are suffering from plethora of natural disasters. Occurrence of disasters is a frequent process; it changes conceptual myths as more and more advancement are made. Although we are living in technological era but in developing countries like Pakistan disasters are shaped by socially constructed roles. The need is to understand the most vulnerable group of society i.e. females; their issues are complex in nature because of undermined gender status in the society. There is a need to identify maximum issues regarding females and to enhance the achievement of millennium development goals (MDGs). Gender issues are of great concern all around the globe including Pakistan. Here female visibility in society is low, and also during disasters, the failure to understand the reality that concentrates on double burden including productive and reproductive care. Women have to contribute a lot in society so we need to make them more disaster resilient. For this non-structural measures like awareness, trainings and education must be carried out. In rural and in urban settings in any disaster like earthquake or flood, elements like gender perspective, their age, physical health, demographic issues contribute towards vulnerability. In Pakistan the gender issues in disasters were of less concern before 2005 earthquake and 2010 floods. Significant achievements are made after 2010 floods when gender and child cell was created to provide all facilities to women and girls. The aim of the study is to highlight all necessary facilities in a disaster to build coping mechanism in females from basic rights till advance level including education.

Keywords: Disaster resilient, Gender cell, Millennium development.

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Authors: L.C. Ram, R.E. Masto, Smriti Singh, R.C. Tripathi, S.K. Jha, N.K. Srivastava, A.K. Sinha, V.A. Selvi, A. Sinha

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Coal will continue to be the predominant source of global energy for coming several decades. The huge generation of fly ash (FA) from combustion of coal in thermal power plants (TPPs) is apprehended to pose the concerns of its disposal and utilization. FA application based on its typical characteristics as soil ameliorant for agriculture and forestry is the potential area, and hence the global attempt. The inferences drawn suffer from the variations of ash characteristics, soil types, and agro-climatic conditions; thereby correlating the effects of ash between various plant species and soil types is difficult. Indian FAs have low bulk density, high water holding capacity and porosity, rich silt-sized particles, alkaline nature, negligible solubility, and reasonable plant nutrients. Findings of the demonstrations trials for more than two decades from lab/pot to field scale long-term experiments are developed as FA soil amendment technology (FASAT) by Central Institute of Mining and Fuel Research (CIMFR), Dhanbad. Performance of different crops and plant species in cultivable and problematic soils, are encouraging, eco-friendly, and being adopted by the farmers. FA application includes ash alone and in combination with inorganic/organic amendments; combination treatments including bio-solids perform better than FA alone. Optimum dose being up to 100 t/ha for cultivable land and up to/ or above 200 t/ha of FA for waste/degraded land/mine refuse, depending on the characteristics of ash and soil. The elemental toxicity in Indian FA is usually not of much concern owing to alkaline ashes, oxide forms of elements, and elemental concentration within the threshold limits for soil application. Combating toxicity, if any, is possible through combination treatments with organic materials and phytoremediation. Government initiatives through extension programme involving farmers and ash generating organizations need to be accelerated

Keywords: Fly ash, soil quality, CIMFR, FASAT, agriculture, forestry, toxicity, remediation

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Authors: Do Thi Ha, Khanitta Nuntaboot

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Background: Competency of nurses is vital to safe nursing practice as well as essential component to drive quality of nursing services. There exists little up to date information concerning actual competency among Vietnamese nurses. Purposes: The purpose of this study is to identify the actual nursing competency among nurses in clinical settings in Vietnam. Methods: A qualitative study, ethnographic method, comprised of the participant-observation, in-depth interview, and focus group discussion with multidisciplinary groups of nurses employing in Cho Ray hospital, Vietnam, managers/administrators, nurse teachers, medical doctors, other health care providers, patients and family members which derived from purposeful sampling technique. Content analysis was used for data analysis. Results: Five essential themes of nursing competencies among nurses were identified include (1) knowledge, (2) skills, (3) attitude and value-based nursing practice, (4) legal and ethical competencies, and (5) transcultural competencies. Basic and advanced knowledge were identified as further two dimensions of knowledge. There were five sub themes identified as further dimensions of skills include technical skills, communication skills, organizing and management skills, teamwork and interrelationship, and critical thinking skills. Conclusions: The findings from this study provide valuable information and understanding of the actual competency among nurses in clinical settings in Vietnam. It is expected that this understanding would assist in developing a guide to nursing education and training, nursing practice and relevant policy regulation used for promoting nursing competency among nurses.

Keywords: Nursing competency, qualitative design, ethnographic method, Vietnam.

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Authors: S. Aberkane, N. Djabali, S. Fafi, A. Baghezza

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Chronic illnesses affect many Algerians. It is possible to investigate the impact of illness representations and coping on quality of life and whether illness representations are indirectly associated with quality of life through their influence on coping. This study aims at investigating the relationship between illness perception, coping strategies and quality of life with chronic illness. Illness perceptions are indirectly associated with the quality of life through their influence on coping mediation. A sample of 316 participants with chronic illness living in the region of Batna, Algeria, has been adopted in this study. A correlation statistical analysis is used to determine the relationship between illness perception, coping strategies, and quality of life. Multiple regression analysis was employed to highlight the predictive ability of the dimensions of illness perception and coping strategies on the dependent variables of quality of life, where mediation analysis is considered in the exploration of the indirect effect significance of the mediator. This study provides insights about the relationship between illness perception, coping strategies and quality of life in the considered sample (r = 0.39, p < 0.01). Therefore, it proves that there is an effect of illness identity perception, external and medical attributions related to emotional role, physical functioning, and mental health perceived, and these were fully mediated by the asking for assistance (c’= 0.04, p < 0.05), the guarding (c’= 0.00, p < 0.05), and the task persistence strategy (c’= 0.05, p < 0.05). The findings imply partial support for the common-sense model of illness representations in a chronic illness population. Directions for future research are highlighted, as well as implications for psychotherapeutic interventions which target unhelpful beliefs and maladaptive coping strategies (e.g., cognitive behavioral therapy).

Keywords: Chronic illness, coping, illness perception, quality of life, self-regulation model.

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Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Luca Preis

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A primary healthcare facility in developing countries should be a multifunctional space able to respond to different requirements: Flexibility, modularity, aggregation and reversibility. These basic features could be better satisfied if applied to an architectural artifact that complies with the typological, figurative and constructive aspects of the context in which it is located. Therefore, the purpose of this paper is to identify a procedure that can define the figurative aspects of the architectural structure of the health prototype for the marginal areas of developing countries through a critical approach. The application context is the rural areas of the Northeast of Bahia in Brazil. The prototype should be located in the rural district of Quingoma, in the municipality of Lauro de Freitas, a particular place where there is still a cultural fusion of black and indigenous populations. Based on the historical analysis of settlement strategies and architectural structures in spaces of public interest or collective use, this paper aims to provide a procedure able to identify the categories and rules underlying typological and figurative aspects, in order to detect significant and generalizable elements, as well as materials and constructive techniques typically adopted in the rural areas of Brazil. The object of this work is therefore not only the recovery of certain constructive approaches but also the development of a procedure that integrates the requirements of the primary healthcare prototype with its surrounding economic, social, cultural, settlement and figurative conditions.

Keywords: Architectural typology, Developing countries, Local construction techniques, Primary health care.

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Authors: Rupali, Anil Kumar Jaiswal

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Cloud computing can be defined as one of the prominent technologies that lets a user change, configure and access the services online. it can be said that this is a prototype of computing that helps in saving cost and time of a user practically the use of cloud computing can be found in various fields like education, health, banking etc.  Cloud computing is an internet dependent technology thus it is the major responsibility of Cloud Service Providers(CSPs) to care of data stored by user at data centers. Scheduling in cloud computing environment plays a vital role as to achieve maximum utilization and user satisfaction cloud providers need to schedule resources effectively.  Job scheduling for cloud computing is analyzed in the following work. To complete, recreate the task calculation, and conveyed scheduling methods CloudSim3.0.3 is utilized. This research work discusses the job scheduling for circulated processing condition also by exploring on this issue we find it works with minimum time and less cost. In this work two load balancing techniques have been employed: ‘Throttled stack adjustment policy’ and ‘Active VM load balancing policy’ with two brokerage services ‘Advanced Response Time’ and ‘Reconfigure Dynamically’ to evaluate the VM_Cost, DC_Cost, Response Time, and Data Processing Time. The proposed techniques are compared with Round Robin scheduling policy.

Keywords: Physical machines, virtual machines, support for repetition, self-healing, highly scalable programming model.

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Authors: António Marques, Graça Guedes

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The Portuguese footwear industry had in the last five years a remarkable performance in the exportation values, the trade balance and others economic indicators. After a long period of difficulties and with a strong reduction of companies and employees since 1994 until 2009, the Portuguese footwear industry changed the strategy and is now a success case between the international players of footwear. Only the Italian industry sells footwear with a higher value than the Portuguese and the distance between them is decreasing year by year. This paper analyses how the Portuguese footwear companies innovate and make innovation, according the classification proposed by the Oslo Manual. Also, analyses the strategy follow in the innovation process and shows the linkage between the type of innovation and the strategy of innovation. The research methodology was qualitative and the strategy for data collection was the case study. The qualitative data will be analyzed with the MAXQDA software. The economic results of the footwear companies studied shows differences between all of them and these differences are related with the innovation strategy adopted. The companies focused in product and marketing innovation, oriented to their target market, have higher ratios “turnover per worker” than the companies focused in process innovation. However, all the footwear companies in this “low-tech” industry create value and contribute to a positive foreign trade of 1.310 million euros in 2013. The growth strategies implemented has the participation of the sectorial organizations in several innovative projects. And it’s obvious that cooperation between all of them is a critical element to the performance achieved by the companies and the innovation observed. The Portuguese footwear sector has in the last years an excellent performance (economic results, exportation values, trade balance, brands and international image) and his performance is strongly related with the strategy in innovation followed, the type of innovation and the networks in the cluster. A simplified model, called “Ace of Diamonds”, is proposed by the authors and explains the way how this performance was reached by the seven companies that participate in the study (two of them are the leaders in the setor), and if this model can be used in others traditional and “low-tech” industries.

Keywords: Footwear industry, innovation strategy, low-tech industry, Oslo Manual.

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Authors: Jalil Emadi, Abbas Solemani

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Pressure waves and Water Hammer occur in a pumping system when valves are closed or opened suddenly or in the case of sudden failure of pumps. Determination of maximum water hammer is considered one of the most important technical and economical items of which engineers and designers of pumping stations and conveyance pipelines should take care. Hammer Software is a recent application used to simulate water hammer. The present study focuses on determining significance of each input parameter of the application relative to the maximum amount of water hammer estimated by the software. The study determines estimated maximum water hammer variations due to variations of input parameters including water temperature, pipe type, thickness and diameter, electromotor rpm and power, and moment of inertia of electromotor and pump. In our study, Kuhrang Pumping Station was modeled using WaterGEMS Software. The pumping station is characterized by total discharge of 200 liters per second, dynamic height of 194 meters and 1.5 kilometers of steel conveyance pipeline and transports water to Cheshme Morvarid for farmland irrigation. The model was run in steady hydraulic condition and transferred to Hammer Software. Then, the model was run in several unsteady hydraulic conditions and sensitivity of maximum water hammer to each input parameter was calculated. It is shown that parameters to which maximum water hammer is most sensitive are moment of inertia of pump and electromotor, diameter, type and thickness of pipe and water temperature, respectively.

Keywords: Pressure Wave, Water Hammer, Sensitivity Analysis, Hammer Software, Kuhrang, Cheshme Morvarid

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Authors: S. Gharbi, S. Labidi, M. Mars, M. Chelli, F. Ladeb

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The purpose of this study is to reduce radiation dose for chest CT examination by including Tube Current Modulation (TCM) to a standard CT protocol. A scan of an anthropomorphic male Alderson phantom was performed on a 128-slice scanner. The estimation of effective dose (ED) in both scans with and without mAs modulation was done via multiplication of Dose Length Product (DLP) to a conversion factor. Results were compared to those measured with a CT-Expo software. The size specific dose estimation (SSDE) values were obtained by multiplication of the volume CT dose index (CTDIvol) with a conversion size factor related to the phantom’s effective diameter. Objective assessment of image quality was performed with Signal to Noise Ratio (SNR) measurements in phantom. SPSS software was used for data analysis. Results showed including CARE Dose 4D; ED was lowered by 48.35% and 51.51% using DLP and CT-expo, respectively. In addition, ED ranges between 7.01 mSv and 6.6 mSv in case of standard protocol, while it ranges between 3.62 mSv and 3.2 mSv with TCM. Similar results are found for SSDE; dose was higher without TCM of 16.25 mGy and was lower by 48.8% including TCM. The SNR values calculated were significantly different (p=0.03<0.05). The highest one is measured on images acquired with TCM and reconstructed with Filtered back projection (FBP). In conclusion, this study proves the potential of TCM technique in SSDE and ED reduction and in conserving image quality with high diagnostic reference level for thoracic CT examinations.

Keywords: Anthropomorphic phantom, computed tomography, CT-expo, radiation dose.

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Authors: Debolina Chatterjee, Suhita Chopra Chatterjee

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Imprisonment is an expansive concept, as it is regulated by laws under criminal justice system of the state. The state sets principles of punishment to control offenders and also puts limits to excess punitive control. One significant way through which it exercises control is through rules governing healthcare of imprisoned population. Prisons signify specialized settings which accommodate both medical and legal concerns. The provision of care operates within the institutional paradigm of punishment. This requires the state to negotiate adequately between goals of punishment and fulfilment of basic human rights of offenders. The present study is based on a critical analysis of prison healthcare standards in India, which include government policies and guidelines. It also demonstrates how healthcare is delivered by drawing insights from a primary study conducted in a correctional home in the state of West Bengal, India, which houses both male and female inmates. Forty women were interviewed through semi-structured interviews, followed by focus group discussions. Doctors and administrative personnel were also interviewed. Findings show how institutional practices control women through subversion of the role of doctors to prison administration. Also, poor healthcare infrastructure, unavailability of specialized services, hierarchies between personnel and inmates make prisons unlikely sites for therapeutic intervention. The paper further discusses how institutional practices foster gender-based discriminatory practices.

Keywords: Imprisonment, imprisoned women, prison healthcare, prison policies.

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Authors: Theingi Shwe, Riken Homma, Kazuhisa Iki, Juko Ito

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The growing cities of the developing country are characterized by rapid growth and poor infrastructure management inviting and accelerating relative environmental problems. Even though the movements of the sustainability had already been developed around the world, it is still increasing in the developing countries to plant sustainable practices. Aligned with the sustainable development actions, many sustainable assessment tools are also developed to rate and evaluate the sustainability performances through the building to community level. Among them, CASBEE is developed by Japanese organizations and is recognized as one of the international well-known assessment tools. The main purpose of the study is to find out the potential of CASBEE tool reflecting sustainability city level performances in developing countries. The research framework was designed with three major phases: Quantitative Approach, Qualitative Approach and Evaluation Reflection. The first two approaches were based on the investigation of tool’s contents and indicators by means of three sustainable dimensions and sustainability categories. To know the reality and reflection on developing country, Pathein City from Myanmar was selected and evaluated by 2012 version of CASBEE for Cities. The evaluation practices went through assigned indicators and the evaluation outcome presents the performances of Pathein city’s environmental efficiency as a very good in current conditions. The results of this study indicate that the indicators of this tool have balance coverage among three dimensions of sustainability but it has not yet counted enough for some indicators like location, infrastructure and institution which are relative to society dimension. In the developing countries’ cities, the most critical issues on development such as affordable housing and heritage preservation which are already planted in Pathein City but the tool does not account for those issues. Moreover, in some of the indicators, the benchmark and the weighting coefficient are strongly linked to the system birth region. By means of this study, it can be stated that CASBEE for Cities would be potential for delivering sustainable city level development in developing country especially in Myanmar along with further inclusion of the indicators.

Keywords: Assessment tool, CASBEE, developing country, Myanmar, Pathein city, sustainable development.

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