Integrating Geographic Information into Diabetes Disease Management

Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Comparison of Chemical Coagulation and Electrocoagulation for Boron Removal from Synthetic Wastewater Using Aluminium

Various techniques including conventional and advanced have been employed for the boron treatment from water and wastewater. The electrocoagulation involves an electrolytic reactor for coagulation/flotation with aluminium as anode and cathode. There is aluminium as coagulant to be used for removal which may induce secondary pollution in chemical coagulation. The purpose of this study is to investigate and compare the performance between electrocoagulation and chemical coagulation on boron removal from synthetic wastewater. The effect of different parameters, such as pH reaction, coagulant dosage, and initial boron concentration were examined. The results show that the boron removal using chemical coagulation was lower. At the optimum condition (e.g. pH 8 and 0.8 mol coagulant dosage), boron removal efficiencies for chemical coagulation and electrocoagulation were 61% and 91%, respectively. In addition, the electrocoagulation needs no chemical reagents and makes the boron treatment easy for application.

Managing HR Knowledge in a Large Privately Owned Enterprise: An Empirical Case Analysis

The paper contributes towards the development of scarce literature on HR knowledge management. Drawing literature from knowledge management, the authors define the meaning of HR knowledge and propose that there are social mechanisms in organizations that facilitate the management and sharing of HR knowledge. Instead of investigating the subject in large multinational corporations, the present paper examines it in a large Chinese privately owned enterprise, which has an international standing. The main finding of the case analysis is that communication and feedback plays a pivotal role when managing HR knowledge. Social mechanisms can stimulate the communication and feedback between employees, thus facilitate knowledge exchange.

Predictive Factors of Exercise Behaviors of Junior High School Students in Chonburi Province

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).

The Applications of Four Fingers Theory: The Proof of 66 Acupoints under the Human Elbow and Knee

Through experiences of clinical practices, it is discovered that locations on the body at a level of four fingerbreadth above and below the joints are the points at which muscles connect to tendons, and since the muscles and tendons possess opposite characteristics, muscles are full of blood but lack qi, while tendons are full of qi but lack blood, these points on our body become easily blocked. It is proposed that through doing acupuncture or creating localized pressure to the areas four fingerbreadths above and below our joints, with an elastic bandage, we could help the energy, also known as qi, to flow smoothly in our body and further improve our health. Based on the Four Fingers Theory, we understand that human height is 22 four fingerbreadths. In addition, qi and blood travel through 24 meridians, 50 times each day, and they flow through 6 cun with every human breath. We can also understand the average number of human heartbeats is 75 times per minute. And the function of qi-blood circulation system in Traditional Chinese Medicine is the same as the blood circulation in Western Medical Science. Informed by Four Fingers Theory, this study further examined its applications in acupuncture practices. The research question is how Four Fingers Theory proves what has been mentioned in Nei Jing that there are 66 acupoints under a human’s elbow and knee. In responding to the research question, there are 66 acupoints under a human’s elbow and knee. Four Fingers Theory facilitated the creation of the acupuncture naming and teaching system. It is expected to serve as an approachable and effective way to deliver knowledge of acupuncture to the public worldwide.

Competitive Advantage Effecting Firm Performance: Case Study of Small and Medium Enterprises in Thailand

The objectives of this study are to examine the relationship between the competitive advantage of small and medium enterprises (SMEs) and their overall performance. A mixed method has been applied to identify the effect of determinants toward competitive advantage. The sample is composed of SMEs in product and service businesses. The study has been tested at an organizational level with samples of SME entrepreneurs, business successors, and board of directors or management team. Quantitative analysis has been conducted through multiple regression analysis with 400 samples. The findings illustrate that each aspect of competitive advantage needs a different set of driving factors to explain either the direct or the indirect effect on firm performance. Interestingly, technological capability is a perfect mediator and interorganizational cooperation toward competitive advantage. In addition, differentiation is difficult to be perceived by customers, as well as difficult to manage; however, it is considered important to develop an SMEs product or service for firm sustainably.

Effect of Spatially Correlated Disorder on Electronic Transport Properties of Aperiodic Superlattices (GaAs/AlxGa1-xAs)

We examine the electronic transport properties in AlxGa1-xAs/GaAs superlattices. Using the transfer-matrix technique and the exact Airy function formalism, we investigate theoretically the effect of structural parameters on the electronic energy spectra of trimer thickness barrier (TTB). Our numerical calculations showed that the localization length of the states becomes more extended when the disorder is correlated (trimer case). We have also found that the resonant tunneling time (RTT) is of the order of several femtoseconds.

Hydro-Geochemistry of Qare-Sou Catchment and Gorgan Gulf, Iran: Examining Spatial and Temporal Distribution of Major Ions and Determining the River’s Hydro-Chemical Type

This study examined the hydro-geochemistry of Qare-Sou catchment and Gorgan Gulf in order to determine the spatial distribution of major ions. In this regard, six hydrometer stations in the catchment and four stations in Gorgan Gulf were chosen and the samples were collected. Results of spatial and temporal distribution of major ions have shown similar variation trends for calcium, magnesium, and bicarbonate ions. Also, the spatial trend of chloride, sulfate, sodium and potassium ions were same as Electrical Conductivity (EC) and Total Dissolved Solid (TDS). In Nahar Khoran station, the concentrations of ions were more than other stations which may be related to human activities and the role of geology. The Siah Ab station’s ions showed high concentration which is may be related to the station’s close proximity to Gorgan Gulf and the return of water to Qare-Sou River. In order to determine the interaction of water and rock, the Gibbs diagram was used and the results showed that water of the river falls in the rock range and it is affected more by weathering and reaction between water and stone and less by evaporation and crystallization. Assessment of the quality of river water by using graphic methods indicated that the type of water in this area is Ca-HCO3-Mg. Major ions concentration in Qare-Sou in the universal average was more than but not more than the allowed limit by the World Health Organization and China Standard Organization. A comparison of ions concentration in Gorgan Gulf, seas and oceans showed that the pH in Gorgan Gulf was more than the other seas but in Gorgan Gulf the concentration of anion and cation was less than other seas.

Metallurgy of Friction Welding of Porous Stainless Steel-Solid Iron Billets

The research work reported here was aimed at investigating the feasibility of joining high-porosity stainless steel discs and wrought iron bars by friction welding. The sound friction-welded joints were then subjected to a metallurgical investigation and an analysis of failure resulting from tensile loading. Discs having 50 mm diameter and 10 mm thickness were produced by loose sintering of stainless steel powder at a temperature of 1350 oC in an argon atmosphere for one hour. Minor machining was then carried out to control the dimensions of the discs, and the density of each disc could then be determined. The level of porosity was calculated and was found to be about 40% in all of those discs. Solid wrought iron bars were also machined to facilitate tensile testing of the joints produced by friction welding. Using our previously gained experience, the porous stainless steel disc and the wrought iron tube were successfully friction welded. SEM was employed to examine the fracture surface after a tensile test of the joint in order to determine the type of failure. It revealed that the failure did not occur in the joint, but rather in the in the porous metal in the area adjacent to the joint. The load carrying capacity was actually determined by the strength of the porous metal and not by that of the welded joint. Macroscopic and microscopic metallographic examinations were also performed and showed that the welded joint involved a dense heat-affected zone where the porous metal underwent densification at elevated temperature, explaining and supporting the findings of the SEM study.

Preservation of Artistic Heritage: Effect of Modernization on Antiquities and Traditional Murals in Nigeria

Traditional art is one of Nigerian cultural heritage. It is an excellent instrument for documentation and identification. Antiquities are priceless and irreplaceable. They are basically preserved for future generations. Sadly, preserving these highly prized cultural heritage is becoming a serious challenge. This paper examines the extent modernization has affected the preservation of traditional art in Nigeria. Particularly hit is the antiquities and traditional murals of eastern part of Nigeria. Participatory visual methods were used for this study. Efforts were made to reach the few surviving and aged mural artists. Oral information was collected from them as well as first hand drawings and some photographs of their works. Findings indicate that modernization has seriously affected the preservation of Nigerian artistic heritage. Further findings show that traditional mural artists are gradually dwindling and dangerously going into extinct. Antiquities are indiscriminately destroyed due to sheer ignorance and the blind quest to fit into the so called modern world.  

Perceived Ease-of-Use and Intention to Use E-Government Services in Ghana: The Moderating Role of Perceived Usefulness

Public sector organizations, ministries, departments and local government agencies are adopting e-government as a means to provide efficient and quality service delivery to citizens. The purpose of this research paper is to examine the extent to which perceived usefulness (PU) of e-government services moderates between perceived ease-of-use (PEOU) of e-government services and intention to use (IU) e-government services in Ghana. A structured research questionnaire instrument was developed and administered to 700 potential respondents in Ghana, of which 693 responded, representing 99% of the questionnaires distributed. The Technology Acceptance Model (TAM) was used as the theoretical framework for the study. The Statistical Package for Social Science (SPSS) was used to capture and analyze the data. The results indicate that even though predictors such as PU and PEOU are main determiners of citizens’ intention to adopt and use e-government services in Ghana, it failed to show that PEOU and IU e-government services in Ghana is significantly moderated by the PU of e-government services. The implication of this finding on theory and practice is further discussed.

Production and Purification of Monosaccharides by Hydrolysis of Sugar Cane Bagasse in an Ionic Liquid Medium

The conversion of lignocellulosic waste materials, such as sugar cane bagasse, to biofuels such as ethanol has attracted significant interest as a potential element for transforming transport fuel supplies to totally renewable sources. However, the refractory nature of the cellulosic structure of lignocellulosic materials has impeded progress on developing an economic process, whereby the cellulose component may be effectively broken down to glucose monosaccharides and then purified to allow downstream fermentation. Ionic liquid (IL) treatment of lignocellulosic biomass has been shown to disrupt the crystalline structure of cellulose thus potentially enabling the cellulose to be more readily hydrolysed to monosaccharides. Furthermore, conventional hydrolysis of lignocellulosic materials yields byproducts that are inhibitors for efficient fermentation of the monosaccharides. However, selective extraction of monosaccharides from an aqueous/IL phase into an organic phase utilizing a combination of boronic acids and quaternary amines has shown promise as a purification process. Hydrolysis of sugar cane bagasse immersed in an aqueous solution with IL (1-ethyl-3-methylimidazolium acetate) was conducted at different pH and temperature below 100 ºC. It was found that the use of a high concentration of hydrochloric acid to acidify the solution inhibited the hydrolysis of bagasse. At high pH (i.e. basic conditions), using sodium hydroxide, catalyst yields were reduced for total reducing sugars (TRS) due to the rapid degradation of the sugars formed. For purification trials, a supported liquid membrane (SLM) apparatus was constructed, whereby a synthetic solution containing xylose and glucose in an aqueous IL phase was transported across a membrane impregnated with phenyl boronic acid/Aliquat 336 to an aqueous phase. The transport rate of xylose was generally higher than that of glucose indicating that a SLM scheme may not only be useful for purifying sugars from undesirable toxic compounds, but also for fractionating sugars to improve fermentation efficiency.

Organisational Effectiveness and Its Implications for Seaports

The main purpose of this study was to explore the role of organisational effectiveness (OE) in seaports. OE is an important managerial concept, one that is necessary for leaders and directors in any organisation to understand the output of their work. OE has been applied in many organisations; however, it is a vital concept in the port business. This paper examines various approaches and applications of the OE concept to business management, and describes benefits that are important and applicable to seaport management. This research reviews and classifies articles published in relevant journals and books between 1950 and 2016; from the general literature on OE to the narrower field of OE in seaports. Based on the extensive literature review, this study identifies and discusses several issues relevant to both practices and theories of this concept. The review concludes by presenting a gap in the literature, as it found only a limited amount of research that endeavours to clarify OE in the seaport sector. As a result of this gap, seaports suffer from a lack of empirical study and are largely neglected in this subject area. The implementation of OE in this research has led to the maritime sector interfacing with different disciplines in order to acquire the advantage of enhancing managerial knowledge and competing successfully in the international marketplace.

Seismic Retrofitting of RC Buildings with Soft Storey and Floating Columns

Open ground storey with floating columns is a typical feature in the modern multistory constructions in urban India. Such features are very much undesirable in buildings built in seismically active areas. The present study proposes a feasible solution to mitigate the effects caused due to non-uniformity of stiffness and discontinuity in load path and to simultaneously hold the functional use of the open storey particularly under the floating column, through a combination of various lateral strengthening systems. An investigation is performed on an example building with nine different analytical models to bring out the importance of recognising the presence of open ground storey and floating columns. Two separate analyses on various models of the building namely, the equivalent static analysis and the response spectrum analysis as per IS: 1893-2002 were performed. Various measures such as incorporation of Chevron bracings and shear walls, strengthening the columns in the open ground storey, and their different combinations were examined. The analysis shows that, in comparison to two short ones separated by interconnecting beams, the structural walls are most effective when placed at the periphery of the buildings and used as one long structural wall. Further, it can be shown that the force transfer from floating columns becomes less horizontal when the Chevron Bracings are placed just below them, thereby reducing the shear forces in the beams on which the floating column rests.

Normalizing Logarithms of Realized Volatility in an ARFIMA Model

Modelling realized volatility with high-frequency returns is popular as it is an unbiased and efficient estimator of return volatility. A computationally simple model is fitting the logarithms of the realized volatilities with a fractionally integrated long-memory Gaussian process. The Gaussianity assumption simplifies the parameter estimation using the Whittle approximation. Nonetheless, this assumption may not be met in the finite samples and there may be a need to normalize the financial series. Based on the empirical indices S&P500 and DAX, this paper examines the performance of the linear volatility model pre-treated with normalization compared to its existing counterpart. The empirical results show that by including normalization as a pre-treatment procedure, the forecast performance outperforms the existing model in terms of statistical and economic evaluations.

Socio-Economic Determinants of Physical Activity of Non-Manual Workers, Including the Early Senior Group, from the City of Wroclaw in Poland

Physical activity as a part of people’s everyday life reduces the risk of many diseases, including those induced by lifestyle, e.g. obesity, type 2 diabetes, osteoporosis, coronary heart disease, degenerative arthritis, and certain types of cancer. That refers particularly to professionally active people, including the early senior group working on non-manual positions. The aim of the study is to evaluate the relationship between physical activity and the socio-economic status of non-manual workers from Wroclaw—one of the biggest cities in Poland, a model setting for such investigations in this part of Europe. The crucial problem in the research is to find out the percentage of respondents who meet the health-related recommendations of the World Health Organization (WHO) concerning the volume, frequency, and intensity of physical activity, as well as to establish if the most important socio-economic factors, such as gender, age, education, marital status, per capita income, savings and debt, determine the compliance with the WHO physical activity recommendations. During the research, conducted in 2013, 1,170 people (611 women and 559 men) aged 21–60 years were examined. A diagnostic poll method was applied to collect the data. Physical activity was measured with the use of the short form of the International Physical Activity Questionnaire with extended socio-demographic questions, i.e. concerning gender, age, education, marital status, income, savings or debts. To evaluate the relationship between physical activity and selected socio-economic factors, logistic regression was used (odds ratio statistics). Statistical inference was conducted on the adopted ex ante probability level of p

Decision Framework for Cross-Border Railway Infrastructure Projects

Transport infrastructure assets are key components of the national asset portfolio. The decision to invest in a new infrastructure in transports could take from a few years to some decades. This is mainly because of the need to reserve and spent many capitals, the long payback period, the number of the stakeholders involved in decision process and –many times- the investment and business risks are high. Therefore, the decision assessment framework is an essential challenge linked with the key decision factors meet the stakeholder expectations highlighting project trade-offs, financial risks, business uncertainties and market limitations. This paper examines the decision process for new transport infrastructure projects in cross border regions, where a wide range of stakeholders with different expectation is involved. According to a consequences analysis systemic approach, the relationship of transport infrastructure development, economic system development and stakeholder expectation is analyzed. Adopting the on system of system methodological approach, the decision making framework, variables, inputs and outputs are defined, highlighting the key shareholder’s role and expectations. The application provides the methodology outputs presenting the proposed decision framework for a strategic railway project in north Greece deals with the upgrade of the existing railway corridor connecting Greece, Turkey and Bulgaria.

Comparison of Central Light Reflex Width-to-Retinal Vessel Diameter Ratio between Glaucoma and Normal Eyes by Using Edge Detection Technique

Glaucoma is a disease that causes visual loss in adults. Glaucoma causes damage to the optic nerve and its overall pathophysiology is still not fully understood. Vasculopathy may be one of the possible causes of nerve damage. Photographic imaging of retinal vessels by fundus camera during eye examination may complement clinical management. This paper presents an innovation for measuring central light reflex width-to-retinal vessel diameter ratio (CRR) from digital retinal photographs. Using our edge detection technique, CRRs from glaucoma and normal eyes were compared to examine differences and associations. CRRs were evaluated on fundus photographs of participants from Mettapracharak (Wat Raikhing) Hospital in Nakhon Pathom, Thailand. Fifty-five photographs from normal eyes and twenty-one photographs from glaucoma eyes were included. Participants with hypertension were excluded. In each photograph, CRRs from four retinal vessels, including arteries and veins in the inferotemporal and superotemporal regions, were quantified using edge detection technique. From our finding, mean CRRs of all four retinal arteries and veins were significantly higher in persons with glaucoma than in those without glaucoma (0.34 vs. 0.32, p < 0.05 for inferotemporal vein, 0.33 vs. 0.30, p < 0.01 for inferotemporal artery, 0.34 vs. 0.31, p < 0.01 for superotemporal vein, and 0.33 vs. 0.30, p < 0.05 for superotemporal artery). From these results, an increase in CRRs of retinal vessels, as quantitatively measured from fundus photographs, could be associated with glaucoma.

In vitro Effects of Amygdalin on the Functional Competence of Rabbit Spermatozoa

The present in vitro study was designed to reveal whether amygdalin (AMG) is able to cause changes to the motility, viability and mitochondrial activity of rabbit spermatozoa. New Zealand White rabbits (n = 10) aged four months were used in the study. Semen samples were collected from each animal and used for the in vitro incubation. The samples were divided into five equal parts and diluted with saline supplemented with 0, 0.5, 1, 2.5 and 5 mg/mL AMG. At times 0h, 3h and 5h spermatozoa motion parameters were assessed using the SpermVision™ computer-aided sperm analysis (CASA) system, cell viability was examined with the metabolic activity (MTT) assay, and the eosin-nigrosin staining technique was used to evaluate the viability of rabbit spermatozoa. All AMG concentrations exhibited stimulating effects on the spermatozoa activity, as shown by a significant preservation of the motility (P

Undergraduates Learning Preferences: A Comparison of Science, Technology and Social Science Academic Disciplines in Relations to Teaching Designs and Strategies

Students learn effectively in a learning environment with a suitable teaching approach that matches their learning preferences. The main objective of the study is to examine the learning preferences amongst the students in the Science and Technology (S&T), and Social Science (SS) fields of study at the Universiti Teknologi Mara (UiTM), Pulau Pinang. The measurement instrument is based on the Dunn and Dunn Learning Styles which measure five elements of learning styles; environmental, sociological, emotional, physiological and psychological. Questionnaires are distributed amongst undergraduates in the Faculty of Mechanical Engineering and Faculty of Business Management. The respondents comprise of 131 diploma students of the Faculty of Mechanical Engineering and 111 degree students of the Faculty of Business Management. The results indicate that, both S&T and SS students share a similar learning preferences on the environmental aspect, emotional preferences, motivational level, learning responsibility, persistent level in learning and learning structure. Most of the S&T students are concluded as analytical learners and the majority of SS students are global learners. Both S&T and SS students are concluded as visual learners, preferred to be in an active mobility in a relaxing and enjoying mode with some light of refreshments during the learning process and exhibited reflective characteristics in learning. Obviously, the S&T students are considered as left brain dominant, whereas the SS students are right brain dominant. The findings highlighted that both categories of students exhibited similar learning preferences except on psychological preferences.