Clustering for Detection of Population Groups at Risk from Anticholinergic Medication

Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. This work evaluates the association between the average risk score and measures of socioeconomic status (index of multiple deprivation) and health (index of health and disability). The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, suggesting that females are more at risk from this kind of multiple medication. The risk may be monitored and controlled in a healthcare management system that is well-equipped with tools implementing appropriate techniques of artificial intelligence.

Governance, Risk Management, and Compliance Factors Influencing the Adoption of Cloud Computing in Australia

A business decision to move to the cloud brings fundamental changes in how an organization develops and delivers its Information Technology solutions. The accelerated pace of digital transformation across businesses and government agencies increases the reliance on cloud-based services. Collecting, managing, and retaining large amounts of data in cloud environments make information security and data privacy protection essential. It becomes even more important to understand what key factors drive successful cloud adoption following the commencement of the Privacy Amendment Notifiable Data Breaches (NDB) Act 2017 in Australia as the regulatory changes impact many organizations and industries. This quantitative correlational research investigated the governance, risk management, and compliance factors contributing to cloud security success. The factors influence the adoption of cloud computing within an organizational context after the commencement of the NDB scheme. The results and findings demonstrated that corporate information security policies, data storage location, management understanding of data governance responsibilities, and regular compliance assessments are the factors influencing cloud computing adoption. The research has implications for organizations, future researchers, practitioners, policymakers, and cloud computing providers to meet the rapidly changing regulatory and compliance requirements.

Development of a Quantitative Material Wastage Management Plan for Effective Waste Reduction in the Building Construction Industry

Combating climate change is becoming a hot topic in various sectors. Building construction and infrastructure sectors contributed a significant proportion of waste and greenhouse gas (GHG) emissions in the environment of different countries and cities. However, there is little research on the micro-level of waste management, “building construction material wastage management,” and fewer reviews about regulatory control in the building construction sector. This paper focuses on the potentialities and importance of material wastage management and reviews the deficiencies of the current standard to take into account the reduction of material wastage in a systematic and quantitative approach.

Microservices-Based Provisioning and Control of Network Services for Heterogeneous Networks

Microservices architecture has been widely embraced for rapid, frequent, and reliable delivery of complex applications. It enables organizations to evolve their technology stack in various domains. Today, the networking domain is flooded with plethora of devices and software solutions which address different functionalities ranging from elementary operations, viz., switching, routing, firewall etc., to complex analytics and insights based intelligent services. In this paper, we attempt to bring in the microservices based approach for agile and adaptive delivery of network services for any underlying networking technology. We discuss the life cycle management of each individual microservice and a distributed control approach with emphasis for dynamic provisioning, management, and orchestration in an automated fashion which can provide seamless operations in large scale networks. We have conducted validations of the system in lab testbed comprising of Traditional/Legacy and Software Defined Wireless Local Area networks.

Indian Women’s Inner -World and Female Protest in Githa Hariharan’s Novel ‘The Thousand Faces of Night’

Gender statuses are inherently unequal; it is difficult to establish equality between men and women in the light of traditional inequalities across the world. This research focuses on the similarities and differences among women from different generations, different kinds of educational backgrounds and highlights the conflict experiences of the characters in Githa Hariharan’s novel “The Thousand Faces of Night”. The purpose is to show how women are suffering and are being humiliated in a male-dominated society. The paper depicts how women in India grapple from male domination aggressiveness as well as the cultural, social and religious controlling in the society they live in. The paper also seeks to explore the importance of knowledge as a powerful component which produces positive effects at the level of desire. The paper is based on the theories of Simone Beauvoir, Pierre Bourdieu, Edward Said, Rene Descartes and Amy Bhatt. Finally, the research emphasizes survival against hegemonic regimes and hope of Indian women for better life.

The CommonSense Platform for Conducting Multiple Participant Field-Experiments Using Mobile-Phones

This paper presents CommonSense, a platform that provides researchers with the infrastructure and tools that enable the efficient and smooth creation, execution and processing of multiple participant experiments taking place outside the laboratory environment. The platform provides the infrastructure and tools to accompany the researchers throughout the life cycle of an experiment – from its inception, through its execution, to its processing and termination. The approach of our platform is based on providing a comprehensive solution, which puts emphasis on the support for the entire life-cycle of an experiment, starting from its definition, the setting up and the configuration of the platform, through the management of the experiment itself and its post processing. Some of the components that support those processes are constructed and configured automatically from the experiment definition.

The COVID-19 Pandemic: Lessons Learned in Promoting Student Internationalisation

In higher education, a great degree of importance is placed on the internationalisation of the student experience. This is seen as a valuable contributor to elements such as building confidence, broadening knowledge, creating networks, and connections and enhancing employability for current students who will become the next generation of managers in technology and business. The COVID-19 pandemic has affected all areas of people’s lives. The limitations of travel coupled with the fears and concerns generated by the health risks have dramatically reduced the opportunity for students to engage with this agenda. Institutions of higher education have been required to rethink fundamental aspects of their business model from recruitment and enrolment, through learning approaches, assessment methods and the pathway to employment. This paper presents a case study which focuses on student mobility and how the physical experience of being in another country either to study, to work, to volunteer or to gain cultural and social enhancement has of necessity been replaced by alternative approaches. It considers trans-national education as an alternative to physical study overseas, virtual mobility and internships as an alternative to international work experience and adopting collaborative on-line projects as an alternative to in-person encounters. The paper concludes that although these elements have been adopted to address the current situation, the lessons learnt and the feedback gained suggests that they have contributed successfully in new and sometimes unexpected ways, and that they will persist beyond the present to become part of the "new normal" for the future. That being the case, senior leaders of institutions of higher education will be required to revisit their international plans and to rewrite their international strategies to take account of and build upon these changes.

Knowledge, Attitude and Practice of Pregnant Women toward Antenatal Care at Public Hospitals in Sana'a City-Yemen

Background: Antenatal care can be defined as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for both mother and baby during pregnancy. The components of Antenatal Care (ANC) include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. The aim of this study: to assess the knowledge, attitude, and practice of pregnant women regarding ANC. Methodology: A descriptive knowledge, attitude, and practice (KAP) study was conducted in public hospitals in Sana'a City, Yemen. The study population included all pregnant women that intended to the prenatal department and clinical outpatient department; the final sample size was 371 pregnant women. A self-administered questionnaire was used to collect the data, statistical package for social sciences SPSS was used to data analysis. The results: Most (79%) of pregnant women had correct answers in total knowledge regarding ANC, and about two-thirds (67%) of pregnant women had performance practice regarding ANC and two-third (68%) of pregnant women had a positive attitude. Conclusions: More than three quarter of pregnant women had good knowledge level, most of pregnant women had moderate practice level, and more than two-thirds of pregnant women had a positive attitude regarding antenatal care. There was a statistically significant association between overall knowledge and practice level toward ANC and demographic characteristics of pregnant women, at P-value ≤ 0.05. Recommendations: we recommended more education and training courses, lecturers, and education sessions in clinical facilitators focused on ANC, which relies on evidence-based interventions provided to women during pregnancy by skilled healthcare providers such as midwives, doctors, and nurses.

The Significance of Awareness about Gender Diversity for the Future of Work: A Multi-Method Study of Organizational Structures and Policies Considering Trans and Gender Diversity

The future of work becomes less predictable which requires increasing adaptability of organizations to social and work changes. Society is transforming regarding gender identity in the sense that more people come forward to identify as trans and gender diverse (TGD). Organizations are ill-equipped to provide a safe and encouraging work environment by lacking inclusive organizational structures. The qualitative multi-method research about TGD inclusivity in the workplace explores the enablers and barriers for TGD individuals to satisfactorily engage in the work environment and organizational culture. Furthermore, these TGD insights are analyzed based on organizational implications and awareness from a leadership and management perspective. The semi-structured online interviews with TGD individuals and the photo-elicit open-ended questionnaire addressed to leadership and management in diversity, career development, and human resources have been analyzed with a critical grounded theory approach. Findings demonstrated the significance of TGD voices, the support of leadership and management, as well as the synergy between voices and leadership. Hence, it indicates practical implications such as the revision of exclusive language used in policies, data collection, or communication and reconsideration of organizational decision-making by leaders to include TGD voices.

Language Learning, Drives, and Context: A Grounded Theory of Learning Behavior

This paper presents the Language Learning as a Means of Drive Engagement (LLMDE) theory, derived from a grounded theory analysis of interviews with Japanese university students. According to LLMDE theory, language learning can be understood as a means of engaging one or more of four self-fulfillment drives: the drive to expand one’s horizons (perspective drive); the drive to make a success of oneself (status drive); the drive to engage in interaction with others (communication drive); and the drive to obtain intellectual and affective stimulation (entertainment drive). While many theories of learner psychology focus on conscious agency, LLMDE theory addresses the role of the unconscious. In addition, supplementary thematic analysis of the data revealed the role of context in mediating drive engagement. Unexpected memorable events, for example, play a key role in instigating and, indirectly, in regulating learning, as do institutional and cultural contexts. Given the apparent importance of such factors beyond the immediate control of the learner, and given the pervasive role of habit and drives, it is argued that the concept of motivation merits theoretical reappraisal. Rather than an underlying force determining language learning success or failure, it can be understood to emerge sporadically in consciousness to promote behavioral change, or to protect habitual behavior from disruption.

The Role of People and Data in Complex Spatial-Related Long-Term Decisions: A Case Study of Capital Project Management Groups

Significant long-term investment projects can involve complex decisions. These are often described as capital projects and the factors that contribute to their complexity include budgets, motivating reasons for investment, stakeholder involvement, interdependent projects, and the delivery phases required. The complexity of these projects often requires management groups to be established involving stakeholder representatives, these teams are inherently multidisciplinary. This study uses two university campus capital projects as case studies for this type of management group. Due to the interaction of projects with wider campus infrastructure and users, decisions are made at varying spatial granularity throughout the project lifespan. This spatial-related context brings complexity to the group decisions. Sensemaking is the process used to achieve group situational awareness of a complex situation, enabling the team to arrive at a consensus and make a decision. The purpose of this study is to understand the role of people and data in complex spatial related long-term decision and sensemaking processes. The paper aims to identify and present issues experienced in practical settings of these types of decision. A series of exploratory semi-structured interviews with members of the two projects elicit an understanding of their operation. From two stages of thematic analysis, inductive and deductive, emergent themes are identified around the group structure, the data usage, and the decision making within these groups. When data were made available to the group, there were commonly issues with perception of veracity and validity of the data presented; this impacted the ability of the group to reach consensus and therefore for decision to be made. Similarly, there were different responses to forecasted or modelled data, shaped by the experience and occupation of the individuals within the multidisciplinary management group. This paper provides an understanding of further support required for team sensemaking and decision making in complex capital projects. The paper also discusses the barriers found to effective decision making in this setting and suggests opportunities to develop decision support systems in this team strategic decision-making process. Recommendations are made for further research into the sensemaking and decision-making process of this complex spatial-related setting.

Affective Adaptation Design for Better Gaming Experiences

Affective adaptation is a creative way for game designers to add an extra layer of engagement to their productions. When player’s emotions are an explicit factor in mechanics design, endless possibilities for imaginative gameplay emerge. Whilst gaining popularity, existing affective game research mostly runs controlled experiments in restrictive settings and rely on one or more specialist devices for measuring player’s emotional state. These conditions albeit effective, are not necessarily realistic. Moreover, the simplified narrative and intrusive wearables may not be suitable for players. This exploratory study investigates delivering an immersive affective experience in the wild with minimal requirements, in an attempt for the average developer to reach the average player. A puzzle game is created with rich narrative and creative mechanics. It employs both explicit and implicit adaptation and only requires a web camera. Participants played the game on their own machines in various settings. Whilst it was rated feasible, very engaging and enjoyable, it remains questionable whether a fully immersive experience was delivered due to the limited sample size.

Review of Carbon Materials: Application in Alternative Energy Sources and Catalysis

The application of carbon materials in the branches of the electrochemical industry shows an increasing tendency each year due to the many interesting properties they possess. These are, among others, a well-developed specific surface, porosity, high sorption capacity, good adsorption properties, low bulk density, electrical conductivity and chemical resistance. All these properties allow for their effective use, among others in supercapacitors, which can store electric charges of the order of 100 F due to carbon electrodes constituting the capacitor plates. Coals (including expanded graphite, carbon black, graphite carbon fibers, activated carbon) are commonly used in electrochemical methods of removing oil derivatives from water after tanker disasters, e.g., phenols and their derivatives by their electrochemical anodic oxidation. Phenol can occupy practically the entire surface of carbon material and leave the water clean of hydrophobic impurities. Regeneration of such electrodes is also not complicated, it is carried out by electrochemical methods consisting in unblocking the pores and reducing resistances, and thus their reactivation for subsequent adsorption processes. Graphite is commonly used as an anode material in lithium-ion cells, while due to the limited capacity it offers (372 mAh g-1), new solutions are sought that meet both capacitive, efficiency and economic criteria. Increasingly, biodegradable materials, green materials, biomass, waste (including agricultural waste) are used in order to reuse them and reduce greenhouse effects and, above all, to meet the biodegradability criterion necessary for the production of lithium-ion cells as chemical power sources. The most common of these materials are cellulose, starch, wheat, rice, and corn waste, e.g., from agricultural, paper and pharmaceutical production. Such products are subjected to appropriate treatments depending on the desired application (including chemical, thermal, electrochemical). Starch is a biodegradable polysaccharide that consists of polymeric units such as amylose and amylopectin that build an ordered (linear) and amorphous (branched) structure of the polymer. Carbon is also used as a catalyst. Elemental carbon has become available in many nano-structured forms representing the hybridization combinations found in the primary carbon allotropes, and the materials can be enriched with a large number of surface functional groups. There are many examples of catalytic applications of coal in the literature, but the development of this field has been hampered by the lack of a conceptual approach combining structure and function and a lack of understanding of material synthesis. In the context of catalytic applications, the integrity of carbon environmental management properties and parameters such as metal conductivity range and bond sequence management should be characterized. Such data, along with surface and textured information, can form the basis for the provision of network support services.

Affective (and Effective) Teaching and Learning in Higher Education: Getting Social Again

The COVID-19 pandemic has affected the way Higher Education Institutions (HEIs) have given their courses. From emergency remote where all students and faculty were immediately confined to home teaching and learning, the continuing evolving sanitary situation obliged HEIs to adopt other methods of teaching and learning from blended courses that included both synchronous and asynchronous courses and activities to HyFlex models where some students were on campus while others followed the course simultaneously online. Each semester brought new challenges for HEIs and, subsequently, additional emotional reactions. This paper investigates the affective side of teaching and learning in various online modalities and its toll on students and faculty members over the past three semesters. The findings confirm that students and faculty who have more self-efficacy, flexibility, and resilience reported positive emotions and embraced the opportunities that these past semesters have offered. While HEIs have begun a new semester in an attempt to return to ‘normal’ face-to-face courses, this paper posits that there are lessons to be learned from these past three semesters. The opportunities that arose from the challenge of the pandemic should be considered when moving forward by focusing on a greater emphasis on the affective aspect of teaching and learning in HEIs worldwide. 

The Impact of COVID-19 Pandemic on Acute Urology Admissions in a Busy District General Hospital in the UK

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

The Analysis on Leadership Skills in UK Automobile Manufacturing Enterprises

The UK has strong economic growth, which attracts other countries to invest there through globalization. This research process will be based on quantitative and qualitative descriptive analysis using interviews. The secondary analysis will involve a case study approach to understand the important aspects of leadership skills. The research outcomes will be identifying the strength and weakness of the leadership skills of UK automobile manufacturing enterprises and suggest the best practices adopted by the respective countries for better results.

Construction Noise Management: Hong Kong Reviews and International Best Practices

Hong Kong is known worldwide for high density living and the ability to thrive under trying circumstances. The 7.5 million residents of this busy metropolis live primarily in high-rise buildings which are built and demolished incessantly. Hong Kong residents are therefore affected continuously by numerous construction activities. In 2020, the Hong Kong Environmental Protection Department (EPD) commissioned a feasibility study on the management of construction noise, including those associated with renovation of domestic premises. A key component of the study focused on the review of practices concerning the management and control of construction noise in metropolitans in other parts of the world. To benefit from international best practices, this extensive review aimed at identifying possible areas of improvement in Hong Kong. The study first referred to the United Nations “The World’s Cities in 2016” Report and examined the top 100 cities therein. The 20 most suitable cities were then chosen for further review. Upon further screening, 12 cities with more relevant management practices were selected for further scrutiny. These 12 cities include: Asia – Tokyo, Seoul, Taipei, Guangzhou, Singapore; Europe – City of Westminster (London), Berlin; North America – Toronto, New York City, San Francisco; Oceania – Sydney, Melbourne. Subsequently, three cities, namely Sydney, City of Westminster, and New York City, were selected for in-depth review. These three were chosen primarily because of the maturity, success, and effectiveness of their construction noise management and control measures, as well as their similarity to Hong Kong in certain key aspects. One of the more important findings of the review is the importance of early focus on potential noise issues, with the objective of designing the noise away wherever practicable. The study examined the similar yet different construction noise early focus mechanisms of these three cities. This paper describes this landmark, worldwide and extensive review on international best construction noise management and control practices at the source, along the noise transmission path and at the receiver end. The methodology, approach, and key findings are presented succinctly in this paper. By sharing the findings with the acoustics professionals worldwide, it is hoped that more advanced and mature construction noise management practices can be developed to attain urban sustainability.

Disparities versus Similarities: WHO GPPQCL and ISO/IEC 17025:2017 International Standards for Quality Management Systems in Pharmaceutical Laboratories

Medicines regulatory authorities expect pharmaceutical companies and contract research organizations to seek ways to certify that their laboratory control measurements are reliable. Establishing and maintaining laboratory quality standards are essential in ensuring the accuracy of test results. ‘ISO/IEC 17025:2017’ and ‘WHO Good Practices for Pharmaceutical Quality Control Laboratories (GPPQCL)’ are two quality standards commonly employed in developing laboratory quality systems. A review was conducted on the two standards to elaborate on areas on convergence and divergence. The goal was to understand how differences in each standard's requirements may influence laboratories' choices as to which document is easier to adopt for quality systems. A qualitative review method compared similar items in the two standards while mapping out areas where there were specific differences in the requirements of the two documents. The review also provided a detailed description of the clauses and parts covering management and technical requirements in these laboratory standards. The review showed that both documents share requirements for over ten critical areas covering objectives, infrastructure, management systems, and laboratory processes. There were, however, differences in standard expectations where GPPQCL emphasizes system procedures for planning and future budgets that will ensure continuity. Conversely, ISO 17025 was more focused on the risk management approach to establish laboratory quality systems. Elements in the two documents form common standard requirements to assure the validity of laboratory test results that promote mutual recognition. The ISO standard currently has more global patronage than GPPQCL.

Save Lives: The Application of Geolocation-Awareness Service in Iranian Pre-Hospital EMS Information Management System

For emergency and relief service providers such as pre-hospital emergencies, quick arrival at the scene of an accident or any EMS mission is one of the most important requirements of effective service delivery. EMS Response time (the interval between the time of the call and the time of arrival on scene) is a critical factor in determining the quality of pre-hospital Emergency Medical Services (EMS). This is especially important for heart attack, stroke, or accident patients that seconds are vital in saving their lives. Location-based e-services can be broadly defined as any service that provides information pertinent to the current location of an active mobile handset or precise address of landline phone call at a specific time window, regardless of the underlying delivery technology used to convey the information. According to research, one of the effective methods of meeting this goal is determining the location of the caller via the cooperation of landline and mobile phone operators in the country. The follow-up of the Communications Regulatory Authority (CRA) organization has resulted in the receipt of two separate secured electronic web services. Thus, to ensure human privacy, a secure technical architecture was required for launching the services in the pre-hospital EMS information management system. In addition, to quicken medics’ arrival at the patient's bedside, rescue vehicles should make use of an intelligent transportation system to estimate road traffic using a GPS-based mobile navigation system independent of the Internet. This paper seeks to illustrate the architecture of the practical national model used by the Iranian EMS organization.

Decision-Making Strategies on Smart Dairy Farms: A Review

Farm management and operations will drastically change due to access to real-time data, real-time forecasting and tracking of physical items in combination with Internet of Things (IoT) developments to further automate farm operations. Dairy farms have embraced technological innovations and procured vast amounts of permanent data streams during the past decade; however, the integration of this information to improve the whole farm decision-making process does not exist. It is now imperative to develop a system that can collect, integrate, manage, and analyze on-farm and off-farm data in real-time for practical and relevant environmental and economic actions. The developed systems, based on machine learning and artificial intelligence, need to be connected for useful output, a better understanding of the whole farming issue and environmental impact. Evolutionary Computing (EC) can be very effective in finding the optimal combination of sets of some objects and finally, in strategy determination. The system of the future should be able to manage the dairy farm as well as an experienced dairy farm manager with a team of the best agricultural advisors. All these changes should bring resilience and sustainability to dairy farming as well as improving and maintaining good animal welfare and the quality of dairy products. This review aims to provide an insight into the state-of-the-art of big data applications and EC in relation to smart dairy farming and identify the most important research and development challenges to be addressed in the future. Smart dairy farming influences every area of management and its uptake has become a continuing trend.