Search results for: Personal Care Robots.

Authors: Nareelux Suwannobol, JintanaTapin, Khuanchanok Narachan

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The objective of this study was to determine the accuracy to estimation fetal weight by Johnson-s method and compares it with actual birth weight. The sample group was 126 infants delivered in Dan KhunThot hospital from January March 2012. Fetal weight was estimated by measuring fundal height according to Johnson-s method. The information was collected by studying historical delivery records and then analyzed by using the statistics of frequency, percentage, mean, and standard deviation. Finally, the difference was analyzed by a paired t-test.The results showed had an average birth weight was 3093.57 ± 391.03 g (mean ± SD) and 3,455 ± 454.55 g average estimated fetal weight by Johnson-s method higher than average actual birth weight was 384.09 grams. When classifying the infants according to birth weight found that low birth weight (<2500 g) and the appropriate birth weight (2500-3999g) actual birth weight less than estimate fetal weight . But the high birth weight (> 4000 g) actual birth weight was more than estimated fetal weight. The difference was found between actual birth weight and estimation fetal weight of the minimum weight in high birth weight ( > 4000 g) , the appropriate birth weight (2500-3999g) and low birth weight (<2500 g) respectively. The rate of estimates fetal weight within 10% of actual birth weight was 35.7%. Actual birth weight were compared with the found that the difference is statistically significant (p <.000). Employing Johnson-s method to estimate fetal weight can estimate initial fetal weight before passing to special examinations, which may require excessive high cost. A variety of methods should be employed to estimate fetal weight more precisely, which will help plan care for mother-s and infant-s safety.

Keywords: Johnson's method, Fetal weight estimate, Delivery Room, Student nurse.

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Authors: Tanida Julvanichpong

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Exercise has been regarded as a necessary and important aspect to enhance physical performance and psychology health. Body weight statistics of students in junior high school students in Chonburi Province beyond a standard risk of obesity. Promoting exercise among Junior high school students in Chonburi Province, essential knowledge concerning factors influencing exercise is needed. Therefore, this study aims to (1) determine the levels of perceived exercise behavior, exercise behavior in the past, perceived barriers to exercise, perceived benefits of exercise, perceived self-efficacy to exercise, feelings associated with exercise behavior, influence of the family to exercise, influence of friends to exercise, and the perceived influence of the environment on exercise. (2) examine the predicting ability of each of the above factors while including personal factors (sex, educational level) for exercise behavior. Pender’s Health Promotion Model was used as a guide for the study. Sample included 652 students in junior high schools, Chonburi Provience. The samples were selected by Multi-Stage Random Sampling. Data Collection has been done by using self-administered questionnaires. Data were analyzed using descriptive statistics, Pearson’s product moment correlation coefficient, Eta, and stepwise multiple regression analysis. The research results showed that: 1. Perceived benefits of exercise, influence of teacher, influence of environmental, feelings associated with exercise behavior were at a high level. Influence of the family to exercise, exercise behavior, exercise behavior in the past, perceived self-efficacy to exercise and influence of friends were at a moderate level. Perceived barriers to exercise were at a low level. 2. Exercise behavior was positively significant related to perceived benefits of exercise, influence of the family to exercise, exercise behavior in the past, perceived self-efficacy to exercise, influence of friends, influence of teacher, influence of environmental and feelings associated with exercise behavior (p < .01, respectively) and was negatively significant related to educational level and perceived barriers to exercise (p < .01, respectively). Exercise behavior was significant related to sex (Eta = 0.243, p=.000). 3. Exercise behavior in the past, influence of the family to exercise significantly contributed 60.10 percent of the variance to the prediction of exercise behavior in male students (p < .01). Exercise behavior in the past, perceived self-efficacy to exercise, perceived barriers to exercise, and educational level significantly contributed 52.60 percent of the variance to the prediction of exercise behavior in female students (p < .01).

Keywords: Predictive factors, exercise behaviors, junior high school.

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Authors: Rania Mustafa

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This audit was conducted at Manchester University NHS Foundation Trust, Wythenshawe Hospital Radiology and Accident and Emergency [A&E] Department to assess the appropriateness of clinical information in X-ray requests, specifically in cases of acute ankle injuries. As per the Ottawa Ankle Rules and the recommendations of National Institute for Health and Care Excellence [NICE] and the Royal College of Radiology, we aimed to evaluate the appropriateness of referrals and the thoroughness of clinical information provided by Emergency Department [ED] clinicians for ankle radiography. Our goal was to achieve 100% compliance with these guidelines. The audit involved a comprehensive analysis spanning the period from August 2022 to January 2023, encompassing patient records, radiographic orders, and clinical assessments. Data collection included patient demographics, presenting complaints, clinical assessments, adherence to Ottawa Ankle Rules criteria, and subsequent radiography orders. Here we conducted two audit cycles, involving 38 patients in the first cycle and 86 patients in the second cycle. The data were furtherly filtered to include all patients who were referred from the ED for an ankle Xray with a history of acute trauma and age of more than 18 years. The key finding was that in August 2022, 60% of cases met the Ottawa Ankle Rules criteria accurately, indicating a need for improvement in adherence. However, by January 2023, there was a notable improvement, with 95% of cases accurately meeting the criteria. This significant change reflects an increased alignment with best practices for ankle radiography referrals.

Keywords: Ankle, injuries, Ottawa Ankle Rule, X-rays.

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Authors: Basant H. El-Refay, Nabeel T. Faiad

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Background: The high prevalence of obesity in Egypt has a great impact on the health care system, economic and social situation. Evidence suggests that even a moderate amount of weight loss can be useful. Aim of the study: To analyze the effects of lower body positive pressure supported treadmill training, conducted with hypocaloric diet, on body composition of obese children. Methods: Thirty children aged between 8 and 14 years, were randomly assigned into two groups: intervention group (15 children) and control group (15 children). All of them were evaluated using body composition analysis through bioelectric impedance. The following parameters were measured before and after the intervention: body mass, body fat mass, muscle mass, body mass index (BMI), percentage of body fat and basal metabolic rate (BMR). The study group exercised with antigravity treadmill three times a week during 2 months, and participated in a hypocaloric diet program. The control group participated in a hypocaloric diet program only. Results: Both groups showed significant reduction in body mass, body fat mass and BMI. Only study group showed significant reduction in percentage of body fat (p = 0.0.043). Changes in muscle mass and BMR didn't reach statistical significance in both groups. No significant differences were observed between groups except for muscle mass (p = 0.049) and BMR (p = 0.042) favoring study group. Conclusion: Both programs proved effective in the reduction of obesity indicators, but lower body positive pressure supported treadmill training was more effective in improving muscle mass and BMR.

Keywords: Children, Hypocaloric diet, Lower body positive pressure supported treadmill, obesity.

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Authors: Mai Miyabe, Taku Fukushima, Takashi Yoshino, Aguri Shigeno

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The need for multilingual communication in Japan has increased due to an increase in the number of foreigners in the country. When people communicate in their nonnative language, the differences in language prevent mutual understanding among the communicating individuals. In the medical field, communication between the hospital staff and patients is a serious problem. Currently, medical translators accompany patients to medical care facilities, and the demand for medical translators is increasing. However, medical translators cannot necessarily provide support, especially in cases in which round-the-clock support is required or in case of emergencies. The medical field has high expectations from information technology. Hence, a system that supports accurate multilingual communication is required. Despite recent advances in machine translation technology, it is very difficult to obtain highly accurate translations. We have developed a support system called M3 for multilingual medical reception. M3 provides support functions that aid foreign patients in the following respects: conversation, questionnaires, reception procedures, and hospital navigation; it also has a Q&A function. Users can operate M3 using a touch screen and receive text-based support. In addition, M3 uses accurate translation tools called parallel texts to facilitate reliable communication through conversations between the hospital staff and the patients. However, if there is no parallel text that expresses what users want to communicate, the users cannot communicate. In this study, we have developed a circulating support environment for multilingual medical communication using parallel texts. The proposed environment can circulate necessary parallel texts through the following procedure: (1) a user provides feedback about the necessary parallel texts, following which (2) these parallel texts are created and evaluated.

Keywords: multilingual medical communication, parallel texts.

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Authors: Frank C. Pan, Che-Long Su, Ching-Hsuen Chen

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Background, measuring an individual-s Health Literacy is gaining attention, yet no appropriate instrument is available in Taiwan. Measurement tools that were developed and used in western countries may not be appropriate for use in Taiwan due to a different language system. Purpose of this research was to develop a Health Literacy measurement instrument specific for Taiwan adults. Methods, several experts of clinic physicians; healthcare administrators and scholars identified 125 common used health related Chinese phrases from major medical knowledge sources that easy accessible to the public. A five-point Likert scale is used to measure the understanding level of the target population. Such measurement is then used to compare with the correctness of their answers to a health knowledge test for validation. Samples, samples under study were purposefully taken from four groups of people in the northern Pingtung, OPD patients, university students, community residents, and casual visitors to the central park. A set of health knowledge index with 10 questions is used to screen those false responses. A sample size of 686 valid cases out of 776 was then included to construct this scale. An independent t-test was used to examine each individual phrase. The phrases with the highest significance are then identified and retained to compose this scale. Result, a Taiwan Health Literacy Scale (THLS) was finalized with 66 health-related phrases under nine divisions. Cronbach-s alpha of each division is at a satisfactory level of 89% and above. Conclusions, factors significantly differentiate the levels of health literacy are education, female gender, age, family members of stroke victims, experience with patient care, and healthcare professionals in the initial application in this study..

Keywords: Health literacy, health knowledge, REALM, THLS.

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Authors: Nina Kaufmans

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Traditional treatments for post-traumatic stress disorder (PTSD) that rely primarily on oral narratives are partially insufficient to prevent PTSD symptoms from recurrence. As a result of the global COVID-19 pandemic, war conflicts, and economic crises, a rising proportion of users of mental health services express somatically based distress in addition to their existing mental health symptoms. Furthermore, the rapid increase in demand for mental health services has resulted in substantial burnout among mental health professionals, which may further impact the quality of services provided and the sustainability of professional life-work balance. This article examines the implications of current developments and challenges in mental health services demand and subsequent responses, as well as the effects of those responses on mental health professionals. The article examines the neurobiological mechanisms underlying traumatic experiences, then discusses the premises for "bottom-up," or somatically oriented, psychotherapy approaches, and concludes with suggestions for clinical skills and interventions to be used by practitioners who work with clients diagnosed with PTSD. In addition, we examine how somatically based psychotherapy interventions performed in sessions might reduce clinician burnout and improve their well-being. We examine how incorporating somatically based therapies into counseling will boost the efficacy of mental health recovery and maintain remission while providing mental health practitioners with chances for self-care.

Keywords: Somatic psychotherapy interventions, trauma counseling, preventing and treating burnout, adults with PTSD, bottom-up skills, the effectiveness of trauma treatment.

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Authors: Megumi Nishida, Naoya Motegi, Takurou Kikuchi, Tomoko Tokumura

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In recent years, the power system has been changed and a flexible power pricing system such as demand response has been sought in Japan. The demand response system works simply in the household sector and the owner as the decision-maker, can benefit from power saving. On the other hand, the execution of demand response in the office building is more complex than in the household because various people such as owners, building administrators and occupants are involved in the decision-making process. While the owners benefit from demand saving, the occupants are exposed to restricted benefits of a demand-saved environment. One of the reasons is that building systems are usually under centralized management and each occupant cannot choose freely whether to participate in demand response or not. In addition, it is unclear whether incentives give occupants the motivation to participate. However, the recent development of IT and building systems enables the personalized control of the office environment where each occupant can control the lighting level or temperature individually. Therefore, it can be possible to have a system which each occupant can make a decision of whether or not to participate in demand response in the office building. This study investigates personal responses to demand response requests, under the condition where each occupant can adjust their brightness individually in their workspace. Once workers participate in the demand response, their desk-lights are automatically turned off. The participation rates in the demand response events are compared among four groups, which are divided by different motivation, the presence, or absence of incentives and the method of participation. The result shows that there are significant differences of participation rates in demand response event between four groups. The method of participation has a large effect on the participation rate. The “Opt-out” groups where the occupants are automatically enrolled in a demand response event if they do not express non-participation have the highest participation rate in the four groups. Incentives also have an effect on the participation rate. This study also reports on the impact of low illumination office environment on the occupants, such as stress or fatigue. The electrocardiogram and the questionnaire are used to investigate the autonomic nervous activity and subjective fatigue symptoms of the occupants. There is no big difference between dim workspace during demand response event and bright workspace in autonomic nervous activity and fatigue.

Keywords: Demand response, illumination, questionnaire, electrocardiograph.

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Authors: Virupakshaiah DBM, Chandrakanth Kelmani, Rachanagouda Patil, Prasad Hegade

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Severe acute respiratory syndrome (SARS) is a respiratory disease in humans which is caused by the SARS coronavirus. The treatment of coronavirus-associated SARS has been evolving and so far there is no consensus on an optimal regimen. The mainstream therapeutic interventions for SARS involve broad-spectrum antibiotics and supportive care, as well as antiviral agents and immunomodulatory therapy. The Protein- Ligand interaction plays a significant role in structural based drug designing. In the present work we have taken the receptor Angiotensin converting enzyme 2 and identified the drugs that are commonly used against SARS. They are Lopinavir, Ritonavir, Ribavirin, and Oseltamivir. The receptor Angiotensin converting enzyme 2 (ACE-2) was docked with above said drugs and the energy value obtained are as follows, Lopinavir (-292.3), Ritonavir (-325.6), Oseltamivir (- 229.1), Ribavirin (-208.8). Depending on the least energy value we have chosen the best two drugs out of the four conventional drugs. We tried to improve the binding efficiency and steric compatibility of the two drugs namely Ritonavir and Lopinavir. Several modifications were made to the probable functional groups (phenylic, ketonic groups in case of Ritonavir and carboxylic groups in case of Lopinavir respectively) which were interacting with the receptor molecule. Analogs were prepared by Marvin Sketch software and were docked using HEX docking software. Lopinavir analog 8 and Ritonavir analog 11 were detected with significant energy values and are probable lead molecule. It infers that some of the modified drugs are better than the original drugs. Further work can be carried out to improve the steric compatibility of the drug based upon the work done above for a more energy efficient binding of the drugs to the receptor.

Keywords: Protein data bank, Rasmol, Marvin sketch, Hexdocking.

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Authors: Dinabandhu Mahata, Amit Kumar, Ambarish Kumar Rai

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India is known as a country of diversity regarding the social, cultural and wide geographical variations. In the north and north-west part of the country, the strong patriarchal norms and the male dominance based social structure are the important constructs. Patriarchal social setup adversely affects the women’s social and economic wellbeing and hence in that social structure women are considered as second level citizen. Work participation rate of women has directly linked to the development of society or household. Haryana is one of the developed states of India, still being ahead in economic prosperity, much lagged behind in gender-based equality and male dominance in all dimensions of life. The position of women in the Haryana is no better than the other states of India. Haryana state has the great difference among the male-female sex ratio which is a serious concern for social science research as a demographic problem for the state. Now women are requiring for their holistic empowerment and that will take care of them for an enabling process that must lead to their economic as well as social transformation. Hence, the objective of the paper is to address the role of sex ratio, women literacy and her work participation in the process of their empowerment with special attention to the gender perspective. The study used the data from Census of India from 1991 to 2011. This paper will examine the regional disparity of sex ratio, literacy rate and female work participation and the improvement of empowerment of women in the state of Haryana. This paper will suggest the idea for focusing much intensively on the issues of women empowerment through enhancement of her education, workforce participation and social participation with people participation and holistic approach.

Keywords: Sex ratio, literacy rate, workforce participation rate, women empowerment, Haryana.

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Authors: A. Giani

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The current pedagogical culture recognizes an educational scope within the sports practices. It is widely accepted, in the pedagogical culture, that thanks to the acquisition and development of motor skills, it is also possible to exercise abilities that concern the way of facing and managing the difficulties of everyday life. Sport is a peculiar educational environment: the children have the opportunity to discover the possibilities of their body, to correlate with their peers, and to learn how to manage the rules and the relationship with authorities, such as coaches. Educational aspects of the sport concern both non-formal and formal educational environments. Coaches play a critical role in an agonistic sphere: exactly like the competencies developed by the children, coaches have to work on their skills to properly set up the educational scene. Facing these new educational tasks - which are not new per se, but new because they are brought back to awareness - a few questions arise: does the coach have adequate preparation? Is the training of the coach in this specific area appropriate? This contribution aims to explore the issue in depth by focusing on the reality of the Football School. Starting from a possible sense of pedagogical inadequacy detected during a series of meetings with several football clubs in Piedmont (Italy), there have been highlighted some important educational needs within the professional training of sports coaches. It is indeed necessary for the coach to know the processes underlying the educational relationship in order to better understand the centrality of the assessment during the educational intervention and to be able to manage the asymmetry in the coach-athlete relationship. In order to provide a response to these pedagogical needs, a formative plan has been designed to allow both an in-depth study of educational issues and a correct self-evaluation of certain pedagogical skills’ control levels, led by the coach. This plan has been based on particular practices, the Educational Practices of Pre-test (EPP), a specific version of community practices designed for the extracurricular activities. The above-mentioned practices realized through the use of texts meant as pre-tests, promoted a reflection within the group of coaches: they set up real and plausible sports experiences - in particular football, triggering a reflection about the relationship’s object, spaces, and methods. The characteristic aspect of pre-tests is that it is impossible to anticipate the reflection as it is necessarily connected to the personal experience and sensitivity, requiring a strong interest and involvement by participants: situations must be considered by the coaches as possible settings in which they could be found on the field.

Keywords: Relational needs, responsibility, self-evaluation, values.

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Authors: Edith Esparza-Young, Ángel M. Matos, Yaritza Gonzalez, Kirthana Sugunathevan

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Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.

Keywords: Bilingual, English, medicine, doctor.

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Authors: Wan-Yu Liu

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To respond to the Kyoto Protocol, the policy of Payment for Environmental Service (PES), which was entitled “Plain Landscape Afforestation Program (PLAP)", was certified by Executive Yuan in Taiwan on 31 August 2001 and has been implementing for six years since 1 January 2002. Although the PLAP has received a lot of positive comments, there are still many difficulties during the process of implementation, such as insufficient technology for afforestation, private landowners- low interests in participating in PLAP, insufficient subsidies, and so on, which are potential threats that hinder the PLAP from moving forward in future. In this paper, selecting Ping-Tung County in Taiwan as a sample region and targeting those private landowners with and without intention to participate in the PLAP, respectively, we conduct an empirical analysis based on the Logit model to investigate the factors that determine whether those private landowners join the PLAP, so as to realize the incentive effects of the PLAP upon the personal decision on afforestation. The possible factors that might determine private landowner-s participation in the PLAP include landowner-s characteristics, cropland characteristics, as well as policy factors. Among them, the policy factors include afforestation subsidy amount (+), duration of afforestation subsidy (+), the rules on adjoining and adjacent areas (+), and so on, which do not reach the remarkable level in statistics though, but the directions of variable signs are consistent with the intuition behind the policy. As for the landowners- characteristics, each of age (+), education level (–), and annual household income (+) variables reaches 10% of the remarkable level in statistics; as for the cropland characteristics, each of cropland area (+), cropland price (–), and the number of cropland parcels (–) reaches 1% of the remarkable level in statistics. In light of the above, the cropland characteristics are the dominate factor that determines the probability of landowner-s participation in the PLAP. In the Logit model established by this paper, the probability of correctly estimating nonparticipants is 98%, the probability of correctly estimating the participants is 71.8%, and the probability for the overall estimation is 95%. In addition, Hosmer-Lemeshow test and omnibus test also revealed that the Logit model in this paper may provide fine goodness of fit and good predictive power in forecasting private landowners- participation in this program. The empirical result of this paper expects to help the implementation of the afforestation programs in Taiwan.

Keywords: Forestry policy, logit, afforestation subsidy, afforestation policy.

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Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu

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Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.

Keywords: Virological non-suppression, HIV-positive, ART, Woliso Town, Ethiopia.

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Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

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The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: Alcohol screening, AUDIT-C, CAGE, Hazardous drinking.

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Authors: Tatiani D. Mousoura

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Specific learning disability (SLD) in higher education has been partially explored in Greece so far. Moreover, opinions on professional perspectives for university students with SLD, is scarcely encountered in Greek research. The perceptions of the hidden character of SLD along with the university policy towards it and professional perspectives that result from this policy have been examined in the present research. This study has applied the paradigm of a Greek Tertiary Pedagogical Education Department (Early Childhood Education). Via mixed methods, data have been collected from different groups of people in the Pedagogical Department: students with SLD and without SLD, academic staff and administration staff, all of which offer the opportunity for triangulation of the findings. Qualitative methods include ten interviews with students with SLD and 15 interviews with academic staff and 60 hours of observation of the students with SLD. Quantitative methods include 165 questionnaires completed by third and fourth-year students and five questionnaires completed by the administration staff. Thematic analyses of the interviews’ data and descriptive statistics on the questionnaires’ data have been applied for the processing of the results. The use of medical terms to define and understand SLD was common in the student cohort, regardless of them having an SLD diagnosis. However, this medical model approach is far more dominant in the group of students without SLD who, by majority, hold misconceptions on a definitional level. The academic staff group seems to be leaning towards a social approach concerning SLD. According to them, diagnoses may lead to social exclusion. The Pedagogical Department generally endorses the principles of inclusion and complies with the provision of oral exams for students with SLD. Nevertheless, in practice, there seems to be a lack of regular academic support for these students. When such support does exist, it is only through individual initiatives. With regards to their prospective profession, students with SLD can utilize their personal experience, as well as their empathy; these appear to be unique weapons in their hands –in comparison with other educators− when it comes to teaching students in the future. In the Department of Pedagogy, provision towards SLD results sporadic, however the vision of an inclusive department does exist. Based on their studies and their experience, pedagogy students with SLD claim that they have an experiential internalized advantage for their future career as educators.

Keywords: Specific learning disability, dyslexia, pedagogy department, inclusion, professional role of SLDed educators, higher education, university policy.

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Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: Clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring.

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Authors: Akhtar N, Khan BA, Khan MS, Mahmood T, Khan HMS, Iqbal M, Bashir S

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This study was designed to formulate, pharmaceutically evaluate a topical skin-care cream (w/o emulsion) of Aloe Vera versus its vehicle (Base) as control and determine their effects on Stratum Corneum (SC) water content and Transepidermal water loss (TEWL). Base containing no extract and a Formulation containing 3% concentrated extract of Aloe Vera was developed by entrapping in the inner aqueous phase of w/o emulsion (cream). Lemon oil was incorporated to improve the odor. Both the Base and Formulation were stored at 8°C ±0.1°C (in refrigerator), 25°C±0.1°C, 40°C±0.1°C and 40°C± 0.1°C with 75% RH (in incubator) for a period of 4 weeks to predict their stability. The evaluation parameters consisted of color, smell, type of emulsion, phase separation, electrical conductivity, centrifugation, liquefaction and pH. Both the Base and Formulation were applied to the cheeks of 21 healthy human volunteers for a period of 8 weeks Stratum corneum (SC) water content and Transepidermal water loss (TEWL) were monitored every week to measure any effect produced by these topical creams. The expected organoleptic stability of creams was achieved from 4 weeks in-vitro study period. Odor was disappeared with the passage of time due to volatilization of lemon oil. Both the Base and Formulation produced significant (p≤0.05) changes in TEWL with respect to time. SC water content was significantly (p≤0.05) increased by the Formulation while the Base has insignificant (p 0.05) effects on SC water content. The newly formulated cream of Aloe Vera, applied is suitable for improvement and quantitative monitoring of skin hydration level (SC water content/ moisturizing effects) and reducing TEWL in people with dry skin.

Keywords: Aloe Vera; Skin; Stratum corneum (SC) water content and Transepidermal water loss (TEWL).

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Authors: Ayelet Gur

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Background: In recent years we are witnessing a welcome trend in which more children/persons with disabilities are living at home with their families and within their communities. This trend is related to various policy innovations as the UN Convention on the Rights of People with Disabilities that reflect a shift from the medical-institutional model to a human rights approach. We also witness the emergence of family centered approaches that perceive the family and not just the individual with the disability as a worthy target of policy planning, implementation and evaluation efforts. The current investigation aims to explore economic, psychological and social factors among households of families of children or adults with intellectual disabilities in Israel and to present policy recommendation. Methods: A national sample of 301 households was recruited through the education and employment settings of persons with intellectual disability. The main caregiver of the person with the disability (a parent) was interviewed. Measurements included the income and expense surveys; assets and debts questionnaire; the questionnaire on resources and stress; the social involvement questionnaire and Personal Wellbeing Index. Results: Findings indicate significant gaps in financial circumstances between households of families of children with intellectual disabilities and households of the general Israeli society. Households of families of children with intellectual disabilities report lower income and higher expenditures and loans than the general society. They experience difficulties in saving and coping with unexpected expenses. Caregivers (the parents) experience high stress, low social participation, low financial support from family, friend and non-governmental organizations and decreased well-being. They are highly dependent on social security allowances which constituted 40% of the household's income. Conclusions: Households' dependency on social security allowances may seem contradictory to the encouragement of persons with intellectual disabilities to favor independent living in light of the human rights approach to disability. New policy should aim at reducing caregivers' stress and enhance their social participation and support, with special emphasis on families of lower socio-economic status. Finally, there is a need to continue monitoring the economic and psycho-social needs of households of families of children with intellectual disabilities and other developmental disabilities.

Keywords: Disability policy, family policy, intellectual and developmental disabilities, Israel, households study, parents of children with disabilities.

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Authors: Frodouard Minani

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Since last decade, wireless sensor networks (WSNs) have been used in many areas like health care, agriculture, defense, military, disaster hit areas and so on. Wireless Sensor Networks consist of a Base Station (BS) and more number of wireless sensors in order to monitor temperature, pressure, motion in different environment conditions. The key parameter that plays a major role in designing a protocol for Wireless Sensor Networks is energy efficiency which is a scarcest resource of sensor nodes and it determines the lifetime of sensor nodes. Maximizing sensor node’s lifetime is an important issue in the design of applications and protocols for Wireless Sensor Networks. Clustering sensor nodes mechanism is an effective topology control approach for helping to achieve the goal of this research. In this paper, the researcher presents an energy efficiency protocol to prolong the network lifetime based on Energy efficient clustering algorithm. The Low Energy Adaptive Clustering Hierarchy (LEACH) is a routing protocol for clusters which is used to lower the energy consumption and also to improve the lifetime of the Wireless Sensor Networks. Maximizing energy dissipation and network lifetime are important matters in the design of applications and protocols for wireless sensor networks. Proposed system is to maximize the lifetime of the Wireless Sensor Networks by choosing the farthest cluster head (CH) instead of the closest CH and forming the cluster by considering the following parameter metrics such as Node’s density, residual-energy and distance between clusters (inter-cluster distance). In this paper, comparisons between the proposed protocol and comparative protocols in different scenarios have been done and the simulation results showed that the proposed protocol performs well over other comparative protocols in various scenarios.

Keywords: Base station, clustering algorithm, energy efficient, wireless sensor networks.

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Authors: M. C. Pardo-Ferreira, J. C. Rubio-Romero, M. Martínez-Rojas

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Resilience Engineering is a new paradigm of safety management that proposes to change the way of managing the safety to focus on the things that go well instead of the things that go wrong. Many complex and high-risk sectors such as air traffic control, health care, nuclear power plants, railways or emergencies, have applied this new vision of safety and have obtained very positive results. In the construction sector, safety management continues to be a problem as indicated by the statistics of occupational injuries worldwide. Therefore, it is important to improve safety management in this sector. For this reason, it is proposed to apply Resilience Engineering to the construction sector. The Construction Phase Health and Safety Plan emerges as a key element for the planning of safety management. One of the key tools of Resilience Engineering is the Resilience Assessment Grid that allows measuring the four essential abilities (respond, monitor, learn and anticipate) for resilient performance. The purpose of this paper is to develop a questionnaire based on the Resilience Assessment Grid, specifically on the ability to learn, to assess whether a Construction Phase Health and Safety Plans helps companies in a construction site to implement this ability. The research process was divided into four stages: (i) initial design of a questionnaire, (ii) validation of the content of the questionnaire, (iii) redesign of the questionnaire and (iii) application of the Delphi method. The questionnaire obtained could be used as a tool to help construction companies to evolve from Safety-I to Safety-II. In this way, companies could begin to develop the ability to learn, which will serve as a basis for the development of the other abilities necessary for resilient performance. The following steps in this research are intended to develop other questions that allow evaluating the rest of abilities for resilient performance such as monitoring, learning and anticipating.

Keywords: Resilience engineering, construction sector, resilience assessment grid, construction phase health and safety plan.

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Authors: K. Jyothi, T. S. Mohamed Saleem, L. Vineela, C. Gopinath, K. B. Yadavender Reddy

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Objective: Acute coronary syndrome is a clinical condition encompassing ST segments elevation myocardial infraction, Non ST segment is elevation myocardial infraction and un stable angina is characterized by ruptured coronary plaque, stress and myocardial injury. Angina pectoris is a pressure like pain in the chest that is induced by exertion or stress and relived with in the minute after cessation of effort or using sublingual nitroglycerin. The present research was undertaken to study the drug utilization pattern of antiplatelet drugs for the ischemic heart disease in a tertiary care hospital. Method: The present study is retrospective drug utilization study and study period is 6months. The data is collected from the discharge case sheet of general medicine department from medical department Rajiv Gandhi institute of medical sciences, Kadapa. The tentative sample size fixed was 250 patients. Out of 250 cases 19 cases was excluded because of unrelated data. Results: A total of 250 prescriptions were collected for the study according to the inclusion criteria 233 prescriptions were diagnosed with ischemic heart disease 17 prescriptions were excluded due to unrelated information. out of 233 prescriptions 128 are male (54.9%) and 105 patients are were female (45%). According to the gender distribution, the prevalence of ischemic heart disease in males are 90 (70.31%) and females are 39 (37.1%). In the same way the prevalence of ischemic heart disease along with cerebrovascular disease in males are 39 (29.6%) and females are 66 (62.6%). Conclusion: We found that 94.8% of drug utilization of antiplatelet drugs was achieved in the Rajiv Gandhi institute of medical sciences, Kadapa from 2011-2012.

Keywords: Angina pectoris, aspirin, clopidogrel, myocardial infarction.

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Authors: Yoshitaka Fujiwara, Jun-ichirou Fukushima, Yasunari Maeda

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Keys to high-quality face-to-face education are ensuring flexibility in the way lectures are given, and providing care and responsiveness to learners. This paper describes a face-to-face education support system that is designed to raise the satisfaction of learners and reduce the workload on instructors. This system consists of a lecture adaptation assistance part, which assists instructors in adapting teaching content and strategy, and a Q&A assistance part, which provides learners with answers to their questions. The core component of the former part is a “learning achievement map", which is composed of a Bayesian network (BN). From learners- performance in exercises on relevant past lectures, the lecture adaptation assistance part obtains information required to adapt appropriately the presentation of the next lecture. The core component of the Q&A assistance part is a case base, which accumulates cases consisting of questions expected from learners and answers to them. The Q&A assistance part is a case-based search system equipped with a search index which performs probabilistic inference. A prototype face-to-face education support system has been built, which is intended for the teaching of Java programming, and this approach was evaluated using this system. The expected degree of understanding of each learner for a future lecture was derived from his or her performance in exercises on past lectures, and this expected degree of understanding was used to select one of three adaptation levels. A model for determining the adaptation level most suitable for the individual learner has been identified. An experimental case base was built to examine the search performance of the Q&A assistance part, and it was found that the rate of successfully finding an appropriate case was 56%.

Keywords: Bayesian network, face-to-face education, lecture adaptation, Q&A assistance.

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Authors: Niwatchai Namwichisirikul

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Due to the emergence of “Humanized Healthcare" introduced by Professor Dr. Prawase Wasi in 2003[1], the development of this paradigm tends to be widely implemented. The organizations included Healthcare Accreditation Institute (public organization), National Health Foundation, Mahidol University in cooperation with Thai Health Promotion Foundation, and National Health Security Office (Thailand) have selected the hospitals or infirmaries that are qualified for humanized healthcare since 2008- 2010 and 35 of them are chosen to be the outstandingly navigating organizations for the development of humanized healthcare, humanized healthcare award [2]. The research aims to study the current issue, characteristics and patterns of hospital administration contributing to humanized healthcare system in Thailand. The selected case studies are from four hospitals including Dansai Crown Prince Hospital, Leoi; Ubolrattana Hospital, Khon Kaen; Kapho Hospital, Pattani; and Prathai Hospital, Nakhonrachasima. The methodology is in-depth interviewing with 10 staffs working as hospital executive directors, and representatives from leader groups including directors, multidisciplinary hospital committees, personnel development committees, physicians and nurses in each hospital. (Total=40) In addition, focus group discussions between hospital staffs and general people (including patients and their relatives, the community leader, and other people) are held by means of setting 4 groups including 8 people within each group. (Total=128) The observation on the working in each hospital is also implemented. The findings of the study reveal that there are five important aspects found in each hospital including (1) the quality improvement under the mental and spiritual development policy from the chief executives and lead teams, leaders as Role model and they have visionary leadership; (2) the participation hospital administration system focusing on learning process and stakeholder- needs, spiritual human resource management and development; (3) the relationship among people especially staffs, team work skills, mutual understanding, effective communication and personal inner-development; (4) organization culture relevant to the awareness of patients- rights as well as the participation policy including spiritual growth achieving to the same goals, sharing vision, developing public mind, and caring; and (5) healing structures or environment providing warmth and convenience for hospital staffs, patients and their relatives and visitors.

Keywords: Hospital administration, Humanized healthcare.

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Authors: Ahaskar Pandey, Gaurav Mukherjee, Sushil Kumar

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The ever growing sentiment of environmentalism across the globe has made many people think on the green lines. But most of such ideas halt short of implementation because of the short term economic viability issues with the concept of going green. In this paper we have tried to amalgamate the green concept with social entrepreneurship for solving a variety of issues faced by the society today. In addition the paper also tries to ensure that the short term economic viability does not act as a deterrent. The paper comes up three sustainable models of social entrepreneurship which tackle a wide assortment of issues such as nutrition problem, land problems, pollution problems and employment problems. The models described fall under the following heads: - Spirulina cultivation: The model addresses nutrition, land and employment issues. It deals with cultivation of a blue green alga called Spirulina which can be used as a very nutritious food. Also, the implementation of this model would bring forth employment to the poor people of the area. - Biocomposites: The model comes up with various avenues in which biocomposites can be used in an economically sustainable manner. This model deals with the environmental concerns and addresses the depletion of natural resources. - Packaging material from empty fruit bunches (EFB) of oil palm: This one deals with air and land pollution. It is intended to be a substitute for packaging materials made from Styrofoam and plastics which are non-biodegradable. It takes care of the biodegradability and land pollution issues. It also reduces air pollution as the empty fruit bunches are not incinerated. All the three models are sustainable and do not deplete the natural resources any further. This paper explains each of the models in detail and deals with the operational/manufacturing procedures and cost analysis while also throwing light on the benefits derived and sustainability aspects.

Keywords: Biodegradable, Pollution, Social entrepreneurship, Sustainability.

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Authors: Saeeda Batool, Ather Maqsood Ahmed

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This study investigates the impact of public healthcare facilities and socio-economic circumstances on the status of child health in Pakistan. The complete analysis is carried out in correspondence with fourth and sixth millennium development goals. Further, the health variables chosen are also inherited from targeted indicators of the mentioned goals (MDGs). Trends in the Human Opportunity Index (HOI) for both health inequalities and coverage are analyzed using the Pakistan Social and Living Standards Measurement (PLSM) data set for 2001-02 to 2012-13 at the national and provincial level. To reveal the relative importance of each circumstance in achieving the targeted values for child health, Shorrocks decomposition is applied on HOI. The annual point average growth rate of HOI is used to simulate the time period for the achievement of target set by MDGs and universal access also. The results indicate an improvement in HOI for a reduction in child mortality rates from 52.1% in 2001-02 to 67.3% in 2012-13, which confirms the availability of healthcare opportunities to a larger segment of society. Similarly, immunization against measles and other diseases such as Diphtheria, Polio, Bacillus Calmette-Guerin (BCG), and Hepatitis has also registered an improvement from 51.6% to 69.9% during the period of study at the national level. On a positive note, no gender disparity has been found for child health indicators and that health outcome is mostly affected by the parental and geographical features and availability of health infrastructure. However, the study finds that this achievement has been uneven across provinces. Pakistan is not only lagging behind in achieving its health goals, disappointingly with the current rate of health care provision, but it will take many additional years to achieve its targets.

Keywords: Socio-economic circumstances, unmet MDGs, public healthcare services, child and infant mortality.

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Authors: Chimaobi V. Okolo, Kenneth A. Okpala, Johnbull S. Ogboi

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A teeming set of doctors that graduated from various universities within and outside Nigeria with the hope of practicing in the country, has their hope shattered because of poor financing, lack of medical equipments and a very weak healthcare systems. Such hydra headed challenges, allows room for quackery which increasingly contributes to the cause of mortality in Nigeria. With a view of reversing the challenges of healthcare delivery and financing in Nigeria, African Health Market for Equity (AHME), a project funded by the Bill and Melinda Gates foundation [With contribution from Department For International Development (DFID)] and currently implemented in three African Countries (Nigeria, Kenya and Ghana) over a Five (5) year period supports the healthcare sector via Medical credit fund (MCF). The study examines the impact of credit policy and medical credit funding on Nigerian health market. Ordinary least square analysis, correlation and granger causality tests were employed to measure the extent to which the Nigerian healthcare market has been influenced. Medical credit fund significantly and positively influenced average monthly turnover of private healthcare providers and Commercial bank’s lending rate had a weak relationship with access to credit/approved loans (13.46%). The programme has so far made 13.91% progress, which is very poor, considering the minimum targeted private health care providers (437.6) and expected number of loan approvals (180.4) for the two years. Medical credit policy in Nigeria should be revised to include private healthcare providers in rural area for more positive impact and increased returns. Good brand advert and sensitization of the programme to stakeholders and health pressure group, and an extension of the programme beyond five years is necessary to better address the issues raised in the study.

Keywords: Credit, health market, medical credit facility, policy.

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Authors: Sevgi Özlem Bulu, Arif Furkan Mendi, Tolga Erol, İzzet Gökhan Özbilgin

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The rapid progress of technology in today's competitive conditions has also accelerated companies' technology development activities. As a result, companies are paying more attention to R&D studies and are beginning to allocate a larger share to R&D projects. A more systematic, comprehensive, target-oriented implementation of R&D studies is crucial for the company to achieve successful results. As a consequence, Technology Roadmap (TRM) is gaining importance as a management tool. It has critical prospects for achieving medium and long term success as it contains decisions about past business, future plans, technological infrastructure. When studies on TRM are examined, projects to be placed on the roadmap are selected by many different methods. Generally preferred methods are based on multi-criteria decision making methods. Management of selected projects becomes an important point after the selection phase of the projects. At this stage, TRM are used. TRM can be created in many different ways so that each institution can prepare its own Technology Roadmap according to their strategic plan. Depending on the intended use, there can be TRM with different layers at different sizes. In the evaluation phase of the R&D projects and in the creation of the TRM, HAVELSAN, Turkey's largest defense company in the software field, carries out this process with great care and diligence. At the beginning, suggested R&D projects are evaluated by the Technology Management Board (TMB) of HAVELSAN in accordance with the company's resources, objectives, and targets. These projects are presented to the TMB periodically for evaluation within the framework of certain criteria by board members. After the necessary steps have been passed, the approved projects are added to the time-based TRM, which is composed of four layers as market, product, project and technology. The use of a four-layered roadmap provides a clearer understanding and visualization of company strategy and objectives. This study demonstrates the benefits of using TRM, four-layered Technology Roadmapping and the possibilities for the institutions in the defense industry.

Keywords: Project selection, R&D in defense industry, R&D project selection, technology roadmapping.

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Authors: Prima Gusti Yanti, Fairul Zabadi

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The purpose of the study is to find out relation of moral massage between the authority and globalization in proverb. Proverb is one of the many forms of cultural identity of the Indonesian/Malay people filled with moral values. The values contained within those proverbs are beneficial not only to the society, but also to those who held power amidst on this era of globalization. The method being used is qualitative research through content analysis which is done by describing and uncovering the forms and meanings of proverbs used within Indonesia Minangkabau society. Sources for this study’s data were extracted from a Minangkabau native speaker in the sub district of Tanah Abang, Jakarta. Said sources were retrieved through a series of interviews with the Minangkabau native speaker, whose speech is still adorned with idiomatic expressions. The research findings show that there are 30 existed proverbs or idiomatic expressions in the Minangkabau language often used by its indigenous people. The thirty data contain moral values which are closely interwoven with the matter of power and globalization. Analytical results show that the fourteen moral values contained within proverbs reflect a firm connection between rule and power in globalization; such as: responsible, brave, togetherness and consensus, tolerance, politeness, thorough and meticulous, honest and keeping promise, ingenious and learning, care, self-correction, be fair, alert, arbitrary, self-awareness. Structurally, proverbs possess an unchangeably formal construction; symbolically, proverbs possess meanings that are clearly decided through ethnographic communicative factors along with situational and cultural contexts. Values contained within proverbs may be used as a guide in social management, be it between fellow men, between men and nature, or even between men and their Creator. Therefore, the meanings and values contained within the morals of proverbs could also be utilized as a counsel for those who rule and in charge of power in order to stem the tides of globalization that had already spread into sectoral, territorial and educational continuums.

Keywords: Continuum, globalization, identity, proverb, rule-power.

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Authors: Mohamed Anwar Hammad, Khaled Mohamed Al Akhali, Yasmin Elsobky

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Board certification is a voluntary process that confirms a pharmacist's capability, competency, education, skills, and proficiency beyond what is essential for licensure. This analysis was intended to investigate the prevalence of board-certified pharmacists in the Arab countries and compare the Board of Pharmacy Specialties (BPS) between Egypt, Saudi Arabia, and Canada. A cross-sectional study was conducted. The data were mined from the BPS website. Data were managed by IBM SPSS Statistics 23.0 and presented as descriptive statistics. Of 36918 Board certified pharmacists (BCPs) until February 2018, only 4038 (10.9%) were from the outside United States of America. From 4038 BCPs, about 1782 (44.1%) were from Arab nations. Egypt has the top prevalence of the BPS among the Arab countries 937 (52.6%) BCPs. However, the Kingdom of Saudi Arabia comes in the second position 442 (24.8%). Pharmacotherapy (BCPS), nutrition support pharmacy (BCNSP), critical care pharmacy (BCCCP) and oncology pharmacy (BCOP) are the highest specialties by 1474 (82.7%), 114 (6.4%), 61 (3.42%) and 60 (3.37%) respectively, while, infectious diseases pharmacy (AQID), cardiology pharmacy (AQCD) and nuclear pharmacy (BCNP) are the lowest prevalence of specialties by 7 (0.4%), 6 (0.3%) and 1 (0.06%) respectively. Added qualifications were canceled and became a new specialty in BPS as the rest of the specialties. Both infectious diseases and cardiology specialties exams are not conducted yet all over the world from the beginning of 2018. Egypt has the second prevalence 937 (2.54%), before Canada 920 (2.49%) and after United States of America 32880 (89.06%) in the worldwide in terms of BCPs. In conclusion the BCPS is the uppermost specialty; however, there is still a need for all the other specialties. In a short period, BCCCP jumped to the third position. Cardiology and infectious disease will be new specialties. Egyptian pharmacists are in the top of Arab countries, and 2nd in worldwide BCPs.

Keywords: AQCD, AQID, Arab Countries, BCACP, BCCCP, BCGP, BCNP, BCNSP, BCOP, BCPPS, BCPS, BCPP, Board of Pharmacy Specialties, BPS, Canada, Egypt, Saudi Arabia, USA.

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