Search results for: practice of ADR reporting

Authors: Afolabi K. Esther, Kuye Tolulope, Babafemi, L. Olayemi, Omikunle Yemisi

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Background: Cervical cancer is a potentially preventable disease of public significance. All sexually active women are at risk of cervical cancer; however, the uptake and coverage are low in low-middle resource countries. Hence, the programme explored the feasibility of demonstrating an innovative and low-cost system approach to cervical cancer screening service delivery among reproductive-aged women in low–resource settings in Southwestern Nigeria. This was to promote the uptake and quality improvement of cervical cancer screening services. Methods: This study was an intervention project in three senatorial districts in Osun State that have primary, secondary and tertiary health facilities. The project was in three phases; Pre-intervention, Intervention, and Post-intervention. The study utilised the existing infrastructure, facilities and staff in project settings. The study population was nurse-midwives, community health workers and reproductive-aged women (30-49 years). The intervention phase entailed using innovative, culturally appropriate strategies to create awareness of cervical cancer and preventive health-seeking behaviour among women in the reproductive-aged group (30-49) years. Also, the service providers (community health workers, Nurses, and Midwives) were trained on screening methods and treatment of pre-cancerous lesions, and there was the provision of essential equipment and supplies for cervical cancer screening services at health facilities. Besides, advocacy and engagement were made with relevant stakeholders to integrate the cervical cancer screening services into related reproductive health services and greater allocation of resources. The expected results compared the pre and post-intervention using the baseline and process indicators and the effect of the intervention phase on screening coverage using a plausibility assessment design. The project lasted 12 months; visual Inspection with Acetic acid (VIA) screening for the women for six months and follow-up in 6 months for women receiving treatment. Results: The pre-intervention phase assessed baseline service delivery statistics in the previous 12 months drawn from the retrospective data collected as part of the routine monitoring and reporting systems. The uptake of cervical cancer screening services was low as the number of women screened in the previous 12 months was 156. Service personnel's competency level was fair (54%), and limited availability of essential equipment and supplies for cervical cancer screening services. At the post-intervention phase, the level of uptake had increased as the number of women screened was 1586 within six months in the study settings. This showed about a 100-%increase in the uptake of cervical cancer screening services compared with the baseline assessment. Also, the post-intervention level of competency of service delivery personnel had increased to 86.3%, which indicates quality improvement of the cervical cancer screening service delivery. Conclusion: the findings from the study have shown an effective approach to strengthening and improving cervical cancer screening service delivery in Southwestern Nigeria. Hence, the intervention promoted a positive attitude and health-seeking behaviour among the target population, significantly influencing the uptake of cervical cancer screening services.

Keywords: cervical cancer, screening, nigeria, health system strengthening

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Authors: Daniel Francis, Mo Yassin

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Transverse patella fractures are routinely fixed using tension band wiring (TBW) using Kirschner wires and a wire in the shape of a figure of 8. The idea of the study was to compare the outcomes of the traditional technique against the more recently used cannulated screws and fiber tape in the shape of a figure of 8. We performed a retrospective cohort study of all the surgically fixed patella fractures from the year 2019 to 2022. The patients were divided into two groups TBW group and cannulated screws group. The primary outcome measure was the failure of fixation and the need for the removal of metalwork. Twenty-six patellar fractures were studied. TBW was used in 14 (53.8%), and cannulated screws were used for fixation in 12 (46.2%). There was one incident of metalwork failure in the TBW and one incident in the cannulated screws group. Five (35.7%) of patients in the TBW needed symptomatic metal work removed and One (8.3%) in the cannulated screw group. In both groups, the rate of fixation failure was low. Symptomatic implants, the most common complication observed, were higher in the TBW group in our practice. Although the small numbers in both groups, the hope of this study is to shine the light on the use of cannulated screws for patella fractures as it would reduce the need for a second operation and reduce the load on the already stretched services as well as improving the patient experience by not requiring further surgery. Although this is not a brand-new technique, it is not commonly used as there have not yet been any studies that demonstrate the lower rates of second surgery needed.

Keywords: patella, tension band wiring, randomised, new technique

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Authors: Andres Portocarrero Bonifaz, Caterina Sandra Camarena Rodriguez, Ricardo Palma Esparza, Nicolas Antonio Romero Carlos

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Reference levels for common X-rays procedures have been set in many protocols. In Peru, during quality control tests, the dose tolerance is set by these international recommendations. Nevertheless, further studies can be made to assess the national reality and relate dose levels with different parameters such as kV, mA/mAs, exposure time, type of processing (digital, digitalized or conventional), etc. In this paper three radiologic procedures were taken into account for study, general X-rays (fixed and mobile), intraoral X-rays (fixed, mobile and portable) and mammography. For this purpose, an Unfors Xi detector was used; the dose was measured at a focus - detector distance which varied depending on the procedure, and was corrected afterward to find the surface entry dose. The data used in this paper was gathered over a period of over 3 years (2015-2018). In addition, each X-ray machine was taken into consideration only once. The results hope to achieve a new standard which reflects the local practice, and address the issues of the ‘Bonn Call for Action’ in Peru. For this purpose, the 75% percentile of the dose of each radiologic procedure was calculated. In future quality control services, those machines with dose values higher than the selected threshold should be informed that they surpass the reference dose levels established in comparison other radiological centers in the country.

Keywords: general X-rays, intraoral X-rays, mammography, reference dose levels

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Authors: Minaj Ranjita Singh, Meghna Mukherjee, Abhijeet Jadhav

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This is an exploratory qualitative study with an objective to understand the bathing practices followed by rural women and its consequences. Access to safe bathing spaces in rural India is a neglected issue due to which women are affected in various ways. Today, government policies are largely focused towards the building of toilets, but no importance has been given to the construction of bathrooms. Both qualitative and quantitative data were collected using in-depth interviews and focused group discussions with rural women in six villages of Odisha, India. The study was approved by an Institutional Research and Ethics Committee, and informed consent was taken from participants. For most of the participants, the access to water, bathing space and toilet was compromised posing various challenges in their daily lives. Women's daily schedule, hygiene practices, dignity, and health are greatly affected due to this lack. Since bathing in the open has been an ancient practice, the community's perception is benign towards the hardship of women. Lack of exposure to concealed bathing, necessary funds, and competing priorities are some of the household level factors which never let them think about having bathrooms and the lack of water supply, proper drainage system, subsidy or financial support are the governance and policy related factors which prevent their access to secured bathing spaces.

Keywords: bathrooms, dignity, exploratory, rural, qualitative, women's health, women

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Authors: Mahua Banerjee, Debtanu Maiti

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Zero-tillage cultivation is a farming practice that reduces costs while maintaining harvests and protecting the environment. Innovative partnerships among researchers, farmers, and other actors in the agricultural value chain have enabled the adoption of zero-tillage to sow rice in the Indo-Gangetic Plains, increasing farmers' incomes, fostering more sustainable use of soil and water, and providing a platform for cropping diversification and the introduction of other resource-conserving practices. A field experiment was conducted in the farmer’s field of Ausgram I Block, Burdwan, West Bengal, India under sandy loam soil with soil pH of 5.2, which is low in Nitrogen, medium in Phosphorus and Potassium. There were three techniques of tillage-T1: Zero tillage in Rice, T2: conventional tillage in Rice, T3: Rice grown with Drum seeder and three varieties namely V1: MTU 7029 V2-MTU 1010, V3: Pratikha thus making nine treatment combinations which were replicated thrice and the experiment was laid out in Factorial Randomised Block Design. Among the three varieties, rice variety MTU 7029 gave higher yield in all the tillage techniques. The highest yield was obtained under Zero tillage followed by conventional tillage. From economic analysis it was revealed that the benefit:cost ratio was higher in Zero tillage and rice cultivation by drum seeder. Zero-till is increasingly being adopted because it gives more yield at less cost, saves labour and farmer time. Farmers will be interested in this technology once they overcome their tillage biases.

Keywords: economics, Indo-Gangetic plain, rice, zero tillage, yield

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Authors: Nurul Nadhirah Anuar, Muhammad Fauzi Abdul Ghani

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Scheduled waste management is very important in environmental and health aspects. Despite it is very important, the research study on schedule waste management is very little in the highway industry even though there is a rapid growth of highway operation in the Asian region. It should be noted that there are many unnoticeable wastes in highway industry that should be managed properly. This paper aims to define the scheduled waste, to provide a conceptual framework of the scheduled waste management in highway industry, to highlight the effect of improper management of scheduled waste and to encourage future researchers to identify and share the present practice of scheduled management in their country. The understanding on effective management of scheduled waste will help the operators of highway industry, the academicians, future researchers, and encourage a friendly environment around the world. The study on scheduled waste management in highway industry is very crucial as compared to factories in which the factories are located on specified areas whereas, highway transverse and run along kilometers crossing the various type of environment, residential and schools. Using Environmental Quality (Scheduled Waste) Regulations, 2005 as a guide, this conceptual paper highlight several scheduled wastes produced by highway industry in Malaysia and provide a conceptual framework of scheduled waste management that focused on the highway industry. Understanding on schedule waste management is vital in order to preserve the environment. Besides that, the waste substances are hazardous to human being. Many diseases have been associated with the improper management of scheduled waste such as cancer, throat irritation and respiration problem.

Keywords: Asia region, environment, highway industry, scheduled waste

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Authors: Erica Lima

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In Brazil, considering the (little) age of translation studies, it can be argued that the University of Campinas is traditionally an important place for graduate studies in translation. The story is told from the accreditation for the Masters, in 1987, and the Doctoral program, in 1993, within the Graduate Program in Applied Linguistics. Since the beginning, the program boasted cutting-edge research, with theoretical reflections on various aspects, and with different methodological trends. However, on the one hand, the graduate studies development was continuously growing, but on the other, it is not what was observed in the undergraduate degree program. Currently, there are only a few disciplines of Translation Theory and Practice, which does not seem to respond to student aspirations. The objective of this paper is to present the characteristics of the university’s graduate program as something profitable, considering the concern in relating the research to the historical moment in which we are living, with research conducted in a socially compromised environment and committed to the impact that it will cause ethically and socially, as well as to question the undergraduate program paths. The objective is also to discuss and propose changes, considering the limited scope currently achieved. In light of the information age, in which we have an avalanche of information, we believe that the training of translators in the undergraduate degree should be reviewed, with the goal of retracing current paths and following others that are consistent with our historical period, marked by virtual and real, by the shuffling of borders and languages, the need for new language policies, greater inclusion, and more acceptance of others. We conclude that we need new proposals for the development of the translator in an undergraduate program, and also present suggestions to be implemented in the graduate program.

Keywords: graduate Brazilian program, undergraduate Brazilian program, translator’s education, Unicamp

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Authors: Andres Calderon

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In order to avoid detection and punishment, cartels have recruited the help of third parties to organize, execute and disguise the anticompetitive practices cartel members have agreed upon. These third parties may take the form of consultancy firms, guilds or professional advisors that do not perform an economic activity in the market where the collusion takes place. This paper takes a look into how national competition authorities and national legislators have dealt with the emergence of the cartels’ facilitators in Latin America. Following the practice of other jurisdictions such as United States (Toys R' Us, Apple), European Union (AC Treuhand), United Kingdom (Replica Kits, Hasbro) and Spain (Urban, Snap-On), some countries (e.g. Argentina, Chile) in Latin America have started to conduct investigations and find antitrust liability in cartels’ facilitators for helping others to violate their national competition laws. Some countries (e.g. Peru and Colombia) have also amended their legislation to amplify the subjective scope of application in order to include cartels’ facilitators. The Latin American case is one of special relevance because public officials are often prone to promote or indulge agreements between competitors in sectors of political interest. A broad definition of cartels’ facilitator, consequently, could lead to the prosecution of punishment of public officials that may hinder the competitive process.

Keywords: anticompetitive practices, cartel, collusion, competition, facilitator, hub and spoke

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Authors: Hanadi Mubarak AL-Mubaraki, Michael Busler

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Innovation is the process of making changes, differences, and novelties in the products and services, adding values and business practices to create economic and social benefit. The purpose of this paper is to identify the strengths and weaknesses of innovation programs in developed and developing countries. We used a mixed-methods approach, quantitative as survey and qualitative as a multi-case study to examine innovation best practices in developed and developing countries. In addition, four case studies of innovation organisations based on the best practices and successful implementation in the developed and developing countries are selected for examination. The research findings provide guidance, suggestions, and recommendations for future implementation in developed and developing countries for practitioners such as policy makers, governments, funded organizations, and strategic institutions. In conclusion, innovation programs are vital tools for economic growth, knowledge, and technology transfer based on the several indicators such as creativity, entrepreneurship, role of government, role of university, strategic focus, new products, survival rate, job creation, start-up companies, and number of patents. The authors aim to conduct future research which will include a comparative study of innovation case studies between developed and developing countries for policy implications worldwide. The originality of this study makes a contribution to the current literature about the innovation best practice in developed and developing countries.

Keywords: economic development, entrepreneurship, innovation program, developed countries

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Authors: Oseni Taiwo Amoo, Bloodless Dzwairo

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In this paper, we extend the versatility and usefulness of GIS as a methodology for any river basin hydrologic characteristics analysis (HCA). The Gurara River basin located in North-Central Nigeria is presented in this study. It is an on-going research using spatial Digital Elevation Model (DEM) and Arc-Hydro tools to take inventory of the basin characteristics in order to predict water abstraction quantification on streamflow regime. One of the main concerns of hydrological modelling is the quantification of runoff from rainstorm events. In practice, the soil conservation service curve (SCS) method and the Conventional procedure called rational technique are still generally used these traditional hydrological lumped models convert statistical properties of rainfall in river basin to observed runoff and hydrograph. However, the models give little or no information about spatially dispersed information on rainfall and basin physical characteristics. Therefore, this paper synthesizes morphometric parameters in generating runoff. The expected results of the basin characteristics such as size, area, shape, slope of the watershed and stream distribution network analysis could be useful in estimating streamflow discharge. Water resources managers and irrigation farmers could utilize the tool for determining net return from available scarce water resources, where past data records are sparse for the aspect of land and climate.

Keywords: hydrological characteristic, stream flow, runoff discharge, land and climate

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Authors: Haftom Teshale Gebre

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According to the ministry of education’s school improvement program blueprint document (2007), the timely and basic aim of the program is to improve students’ academic achievement through creating conducive teaching and learning environments and with the active involvement of parents in the teaching and learning process. The general objective of the research is to examine the practices of cluster school supervisors in implementing school improvement programs and the major factors affecting the study area. The study used both primary and secondary sources, and the sample size was 93. Twelve people are chosen from each of the two clusters (Edaga Hamus and Adi-kelebes). And cluster ferewyni are Tekli suwaat, Edaga robue, and Kiros Alemayo. In the analysis stage, several interrelated pieces of information were summarized and arranged to make the analysis easily manageable by using statistics and data (STATA). Study findings revealed that the major four domains impacted by school improvement programs through their mean, standard deviation, and variance were 2.688172, 1.052724, and 1.108228, respectively. And also, the researcher can conclude that the major factors of the school improvement program and mostly cluster supervisors were inadequate attention given to supervision service and no experience in the practice of supervision in the study area.

Keywords: cluster, eastern Tigray, Saesie Tsaeda Emba, SPI

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Authors: Charles Rutikanga

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As part of the effort to reconstruct Rwanda and foster a shared national identity after the 1994 genocide against Tutsi, the government of Rwanda has drawn on aspects of indigenous culture and traditional practices. One of these traditional practices and cultural values is Ubudehe, which has been re-introduced after it has been gradually lost since colonial times. It is a form of collective action at the village level, which is inclusive, covering men, women, and the most marginalized community members. The philosophy behind Ubudehe is to increase the level of participation and institutional problem-solving capacity at the local level by citizens and local government. Since the early 2000s, the government re-introduced Ubudehe as a neo-traditional cultural institution in order to support the implementation of the country’s poverty reduction and development programs. An empirical study on indigenous and innovative models of social work practice was conducted under the framework of the ‘Professional Social Work in East Africa’ (PROSOWO II) project. Field data were collected on traditional/indigenous approaches, including Ubudehe, from different categories of informants through focus group discussions (FGDs) and personal interviews. The research showed that professional social workers play a significant role in the whole Ubudehe process. While there have been some challenges in the administration and implementation, overall it has contributed to poverty reduction in a post-genocide Rwanda.

Keywords: development, indigenous approach, social work, Ubudehe

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Authors: Ghidey Ghebreyohanes, Eltahir Awad Gasim Khalil, Zemenfes Tsighe, Faiza Ali

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Background: reproductive health (RH) is a state of physical, mental and social well-being in all matters relating to the reproductive system at all stages of life. In East Africa including Eritrea, adolescents comprise more than a quarter of the population. The region holds the highest rates of sexually transmitted diseases, HIV, unwanted pregnancy and unsafe abortion with its complications. Young girls carry the highest burden of reproductive health problems due to their risk taking behavior, lack of knowledge, peer pressure, physiologic immaturity and low socioeconomic status. Design: this was a Community-based, randomized, case-controlled and pre-test-post-test intervention study. Setting: Zoba Debub was randomly selected out of the six zobas in Eritrea. The four high schools out of the 26 in Zoba Debub were randomly selected as study target schools. Over three quarter of the people live on farming. The target population was female students attending grade nine with majority of these girls live in the distant villages and walk to school. The study participants were randomly selected (n=165) from each school. Furthermore, the 1 intervention and 3 controls for the study arms were assigned randomly. Objectives: this study aimed to assess the effectiveness of peer reproductive health education in improving knowledge, attitude, and health service use of high school adolescent girls in Eritrea Methods: the protocol was reviewed and approved by the Scientific and Ethics Committees of Faculty of Nursing Sciences, University of Khartoum. Data was collected using pre-designed and pretested questionnaire emphasizing on reproductive health knowledge, attitude and practice. Sample size was calculated using proportion formula (α 0.01; power of 95%). Measures used were scores and proportions. Descriptive and inferential statistics, t-test and chi square at (α .01), 99% confidence interval were used to compare changes of pre and post-intervention scores using SPSS soft ware. Seventeen students were selected for peer educators by the school principals and other teachers based on inclusion criteria that include: good academic performance and acceptable behavior. One peer educator educated one group composed of 8-10 students for two months. One faculty member was selected to supervise peer educators. The principal investigator conducted the training of trainers and provided supervision and discussion to peer educators every two weeks until the end of intervention. Results: following informed consent, 627 students [164 in intervention and 463 in the control group] with a ratio of 1 to 3, were enrolled in the study. The mean age for the total study population was 15.4±1.0 years. The intervention group mean age was 15.3±1.0 year; while the control group had a mean age of 15.4±1.0. The mean ages for the study arms were similar (p= 0.4). The majority (96 %) of the study participants are from Tigrigna ethnic group. Reproductive knowledge scores which was calculated out of a total 61 grade points: intervention group (pretest 6.7 %, post-test 33.6 %; p= 0.0001); control group (pretest 7.3 %, posttest 7.3 %, p= 0.92). Proportion difference in attitude calculated out of 100%: intervention group (pretest 42.3 % post test 54.7% p= 0.001); controls group (pretest 45%, post test 44.8 p= 0.7). Proportion difference in Practice calculated out of 100 %: intervention group (pretest 15.4%, post test 80.4 % p= 0.0001); control group (pretest 16.8%, posttest 16.9 % p= 0.8). Mothers were quoted as major (> 90 %) source of reproductive health information. All focus group discussants and most of survey participants agreed on the urgent need of reproductive health information and services for adolescent girls. Conclusion: reproductive health knowledge and use of facilities is poor among adolescent girls in sub-urban Eretria. School-based peer reproductive health education is effective and is the best strategy to improve reproductive health knowledge and attitudes.

Keywords: reproductive health, adolescent girls, eretria, health education

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Authors: Ioanna Koumi

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The aim of the intervention presented is to show the positive effects a mindfulness programme can have on the behaviour of preschoolers (years 4-6). The programme was implemented as part of the psychologist's work in 5 preschool units on the Greek island of Chios. Classroom-based activities of mindfulness were shown and practiced in 5 sessions, in collaboration with teachers, in order to make preschoolers aware of how their brain affects their behaviour, as well as of how they can have more positive behaviours, especially in instances of negative feelings. The outcomes of the intervention were assessed via questionnaire completion before and after the sessions by the teachers, as well as focus groups procedures with students, teachers, and parents. Implications of how mindfulness programmes can also be implemented at home are further discussed. School year in which the programme is being implemented: 2022-23 Intervention method: based on basic mindfulness theory and practice, the 220 students (age 4-6) in 11 classes of the 5 preschools that participated were given lessons of how to become aware of their states of focusing, regulation, attention, emotional situation, as well as body and social situations. Furthermore, the preschoolers were encouraged to make more mindful choices when it came to negative situations and emotions. Assessment method: The school as a caring community Profile II – Questionnaire completed by 20 preschool teachers prior to and after the intervention, Focus group sessions with teachers, students, parents at the end of the intervention Results: the assessment will be completed in May 2023.

Keywords: preschool, mindfulness training, self-awareness, social-emotional development

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Authors: Jean Pierre Kabue, Emma Meader, Afsatou Ndama Traore, Paul R. Hunter, Natasha Potgieter

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Norovirus is now considered the most common cause of outbreaks of nonbacterial gastroenteritis. Limited data are available for Norovirus strains in Africa, especially in rural and peri-urban areas. Despite the excessive burden of diarrhea disease in developing countries, Norovirus infections have been to date mostly reported in developed countries. There is a need to investigate intensively the role of viral agents associated with diarrhea in different settings in Africa continent. To determine the prevalence and genetic diversity of Norovirus strains circulating in the rural communities in the Limpopo Province, South Africa and investigate the genetic relationship between Norovirus strains, a cross-sectional study was performed on human stools collected from rural communities. Between July 2014 and April 2015, outpatient children under 5 years of age from rural communities of Vhembe District, South Africa, were recorded for the study. A total of 303 stool specimens were collected from those with diarrhea (n=253) and without (n=50) diarrhea. NoVs were identified using real-time one-step RT-PCR. Partial Sequence analyses were performed to genotype the strains. Phylogenetic analyses were performed to compare identified NoVs genotypes to the worldwide circulating strains. Norovirus detection rate was 41.1% (104/253) in children with diarrhea. There was no significant difference (OR=1.24; 95% CI 0.66-2.33) in Norovirus detection between symptomatic and asymptomatic children. Comparison of the median CT values for NoV in children with diarrhea and without diarrhea revealed significant statistical difference of estimated GII viral load from both groups, with a much higher viral burden in children with diarrhea. To our knowledge, this is the first study reporting on the differences in estimated viral load of GII and GI NoV positive cases and controls. GII.Pe (n=9) were the predominant genotypes followed by GII.Pe/GII.4 Sydney 2012 (n=8) suspected recombinant and GII.4 Sydney 2012 variants(n=7). Two unassigned GII.4 variants and an unusual RdRp genotype GII.P15 were found. With note, the rare GIIP15 identified in this study has a common ancestor with GIIP15 strain from Japan previously reported as GII/untypeable recombinant strain implicated in a gastroenteritis outbreak. To our knowledge, this is the first report of this unusual genotype in the African continent. Though not confirmed predictive of diarrhea disease in this study, the high detection rate of NoV is an indication of subsequent exposure of children from rural communities to enteric pathogens due to poor sanitation and hygiene practices. The results reveal that the difference between asymptomatic and symptomatic children with NoV may possibly be related to the NoV genogroups involved. The findings emphasize NoV genetic diversity and predominance of GII.Pe/GII.4 Sydney 2012, indicative of increased NoV activity. An uncommon GII.P15 and two unassigned GII.4 variants were also identified from rural settings of the Vhembe District/South Africa. NoV surveillance is required to help to inform investigations into NoV evolution, and to support vaccine development programmes in Africa.

Keywords: asymptomatic, common, outpatients, norovirus genetic diversity, sporadic gastroenteritis, South African rural communities, symptomatic

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Authors: Rujnan Tuna, Ulku Baykal

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The antineoplastic drugs used in cancer treatment directly have adverse effects on health of both patients receiving the treatment and oncology nurses preparing and administering the treatment. The purpose of this study is to determine the working conditions of the oncology nurses in terms of employee safety as well as their knowledge levels regarding the safe use of antineoplastic drugs. This is a qualitative study conducted in the phenomenological design. Purposeful sampling method was used to carry out the interviews. The individual, in-depth, and semi-structured face-to-face interviews continued with 25 oncology nurses, who were working in an oncology centre in the city of Istanbul. Qualitative content analysis approach was used for the analysis of the obtained data in the study. The results of the study were gathered under 4 main themes; work-related factors, employee safety, working conditions, and training. The interviewed oncology nurses stated that the protective measures related to the safe use of the antineoplastic drugs were insufficient, and only 20% of the nurses have chemotherapy preparation certificate and they received this certificate after they started working in this unit. Also, after they had begun to work in that unit, they started to experience with so many health problems As happens all over the world, there have also been policies and standards regarding the safe use of antineoplastic drugs in Turkey; however, it is found that they remain insufficient to put into practice.

Keywords: antineoplastic drug, employee safety, nurse, oncology, qualitative study

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Authors: Jui-Chien Hsieh

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Background:12-lead electrocardiography(ECG) is one of frequently-used tools to detect atrial fibrillation (AF), which might degenerate into life-threaten stroke, in clinical Practice. Based on this study, the AF detection by the clinically-used 12-lead ECG device has only 0.73~0.77 positive predictive value (ppv). Objective: It is on great demand to develop a new algorithm to improve the precision of AF detection using 12-lead ECG. Due to the progress on artificial intelligence (AI), we develop an ECG deep model that has the ability to recognize AF patterns and reduce false-positive errors. Methods: In this study, (1) 570-sample 12-lead ECG reports whose computer interpretation by the ECG device was AF were collected as the training dataset. The ECG reports were interpreted by 2 senior cardiologists, and confirmed that the precision of AF detection by the ECG device is 0.73.; (2) 88 12-lead ECG reports whose computer interpretation generated by the ECG device was AF were used as test dataset. Cardiologist confirmed that 68 cases of 88 reports were AF, and others were not AF. The precision of AF detection by ECG device is about 0.77; (3) A parallel 4-layer 1 dimensional convolutional neural network (CNN) was developed to identify AF based on limb-lead ECGs and chest-lead ECGs. Results: The results indicated that this model has better performance on AF detection than traditional computer interpretation of the ECG device in 88 test samples with 0.94 ppv, 0.98 sensitivity, 0.80 specificity. Conclusions: As compared to the clinical ECG device, this AI ECG model promotes the precision of AF detection from 0.77 to 0.94, and can generate impacts on clinical applications.

Keywords: 12-lead ECG, atrial fibrillation, deep learning, convolutional neural network

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Authors: Sifen Abreham

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Employees are resources in organizations; as such, they need to be trained and developed properly to achieve an organization's goals and expectations. The initial development of the human resource management concept is based on the effective utilization of people to treat them as resources, leading to the realization of business strategies and organizational objectives. The study aimed to assess the effect of training and development practices on employee performance. The researcher used an explanatory research design, which helps to explain, understand, and predict the relationship between variables. To collect the data from the respondents, the study used probability sampling. From the probability, the researcher used stratified random sampling, which can branch off the entire population into homogenous groups. The result was analyzed and presented by using the statistical package for the social science (SPSS) version 26. The major finding of the study was that the training has an impact on employees' job performance to achieve organizational objectives. The district has a policy and procedure for training and development, but it doesn’t apply actively, and it’s not suitable for district-advised reform this policy and procedure and applied actively; the district gives training for the majority of its employees, but most of the time, the training is theoretical the district advised to use practical training method to see positive change, the district gives evaluation after the employees take training and development, but the result is not encouraging the district advised to assess employees skill gap and feel that gap, the district has a budget, but it’s not adequate the district advised to strengthen its financial ground.

Keywords: training, development, employees, performance, policy

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Authors: K. C. Sony

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This paper investigates the coping strategies of households confronting disease in large cardamom (Amomum Subulatum Roxb.) in eastern Nepal. Cardamom farmers draw on various coping strategies to reduce the impact of crop disease in their livelihoods. Yet farmers face tremendous decline in production with a constant effort for revival. Past evidences provides dearth of information about coping strategies employed by farmers and institutional intervention to combat disease. Using factual data from Ilam district, and conducting a political economic analysis, this research addresses the gap by 1) understanding the impact of crop disease in farmers’ livelihoods, 2) identifying the coping strategies adopted by farmers and, 3) examining the existing institutional arrangements to address the disease. Coping strategies vary by household’s status defined by size of land, alternative income, and access to supporting institutions. Measures adopted are burning the cardamom field, changing land use pattern, diversifying crops, and visiting institutions for support. The local government’s support is limited to providing trainings and producing new varieties of cardamom. During crisis, farmers expect institutions to help revive the cardamom production, despite customary practice to combat disease. To retain and improve the livelihoods of farmers, there needs to be institutional innovation at the community level and policies that endorse immediate and sustainable support during hazards.

Keywords: cardamom, coping strategy, disease, institutions, Nepal

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Authors: Ali Karrech, Alberto Puccini, Ben Galvin, Davide Galli

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This paper summarises the laboratory tests, numerical models and statistical approach developed to investigate the behaviour of concrete blocks loaded in shear through metallic anchors. This research is proposed to bridge a gap in the state of the art and practice related to anchors loaded against partially confined concrete surfaces. Eight concrete blocks (420 mm x 500 mm x 1000 mm) with 150 and/or 250 deep anchors were tested. The stainless-steel anchors of diameter 16 mm were bonded with HIT-RE 500 V4 injection epoxy resin and were subjected to shear loading against partially supported edges. In addition, finite element models were constructed to validate the laboratory tests and explore the influence of key parameters such as anchor depth, anchor distance from the edge, and compressive strength on the stability of the block. Upon their validation experimentally, the numerical results were used to populate, develop and interpret a systematic parametric study based on the Design of Experiment approach through the Box-Behnken design and Response Surface Methodology. An empirical model has been derived based on this approach, which predicts the load capacity with the desirable intervals of confidence.

Keywords: finite element modelling, design of experiment, response surface methodology, Box-Behnken design, empirical model, interval of confidence, load capacity

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Authors: T. Esteves, S. Mesquita, A. Santos, A. Campina, C. Costa-Lobo

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The theme regarding the differentiation of high-performance athletes has always aroused curiosity and fascination, becoming a target for study, especially in the social and human sciences. It was from the 60's and 70's that the concern for the study of the excellence of athletes that showed indices of high performance in sports began to arise. From the 1990s, it became possible to specify the mental competencies and psychological characteristics associated with Olympic athletes with high levels of success. Several studies considered that well-structured pre-competitive and competitive routines and plans were predictors of sports success. Likewise, the high levels of motivation, commitment and concentration; the high levels of self-confidence and optimism; the presence of effective coping strategies to deal with distractions and unexpected situations or events; adequate regulation of activation and anxiety; the establishment and formulation of objectives; and mental visualization and practice were determinants in the manifestation of excellence in these athletes. As such, the promotion of these cognitive abilities has been emphasized in the good performance of the athletes. With the objective of implementing cognitive stimulation programs to meet the specific needs of talented athletes, together with pedagogical activities to promote educational strategies and promote interpersonal relationships, this communication systematizes a proposal for a psychopedagogical service to promote cognitive abilities in competitive athletes, SPAC, to implement in a Portuguese soccer team. This service will be based on a holistic vision in order to promote talent.

Keywords: athletes, cognitive abilities, high competition, psycho-pedagogical service

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Authors: Nils Haglund, Svenolof Dahlgren, Maria Rastam, Peik Gustafsson, Karin Kalien

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In Sweden, like in most developed countries, there is a substantial increase of children diagnosed with autism and other conditions within the autism spectrum (ASD). The rapid increase of ASD rates stresses the importance of developing care programs to provide support and comprehensive interventions for affected families. The current observational study was conducted in order to evaluate an ongoing Comprehensive Intensive Early Intervention (CIEI) program for children with autism in southern Sweden. The change in autism symptoms among children participating in CIEI (intervention group, n=67) was compared with children who received traditional habilitation services only (comparison group, n=27). Children of parents who accepted the offered CIEI-program, constituted the intervention group, whereas children, whose parents (for some reason) were not interested in the offered CIEI-program, constituted the comparison group. The CIEI-program was individualized to each child by experienced applied behavior analysis (ABA) specialists with different backgrounds as psychologists, speech pathologists or special education teachers, in cooperation with parents and preschool staff. Due to the individualization, the intervention could vary in intensity and techniques. The intensity was calculated to 15-25 hours each week at home and the preschool altogether. Each child was assigned one 'trainer', who was often employed as a preschool teacher but could have another educational background. An agreement between supervisor- parents and preschool staff was reached to confirm the intensity and content of the CIEI- program over an approximately two-year intervention period. Symptom changes were measured as evaluation-ADOS-2-scores, total- and severity-scores, minus the corresponding baseline-scores, divided by the time between baseline and evaluation. The difference between the study-groups regarding change of ADOS-2-scores was estimated using ANCOVA. In the current study, children in the CIEI-group improved their ADOS-2-total scores between baseline and evaluation (-0.8 scores per year; 95%CI: -1.2 to -0.4), whereas no such improvement was detected in the comparison group (+0.1 scores per year; 95%CI: -0.7 to +0.9). The change difference (change in the CIEI-group vs. change in the comparison group) was statistically significant, both crude and after adjusting for possible confounders (-1.1; 95%CI -1.9 to -0.4). Children in the CIEI-group also significantly improved their ADOS-calibrated severity scores, but not significantly differently so from the comparison group. The results from the current study indicate that the CIEI program significantly improves social and communicative skills among children with autism and that children with developmental delay could benefit to a similar degree as other children. The results support earlier studies reporting on the improvement of autism symptoms after early intensive interventions. The results from observational studies are difficult to interpret, but it is nevertheless of uttermost importance to evaluate costly autism intervention programs. Such results may be of immediate importance to healthcare organizations when allocating the already strained resources to different patient groups. Albeit the obvious limitation of the current naturalistic study, the results support previous positive studies and indicate that children with autism benefit from participating in early comprehensive, intensive programs and that investments in these programs may be highly justifiable.

Keywords: autism symptoms, ADOS-scores, evaluation, intervention program

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Authors: Jarrod Haar, David Brougham

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The present study explores the links between supporting employee well-being and the potential benefits to employee performance. We focus on employee innovative work behaviors (IWBs), which have three stages: (1) development, (2) adoption, and (3) implementation of new ideas and work methods. We explore the role of organizational support focusing on employee well-being via High-Performance Work Systems (HPWS). HPWS are HR practices that are designed to enhance employees’ skills, commitment, and ultimately, productivity. HPWS influence employee performance through building their skills, knowledge, and abilities and there is meta-analytic support for firm-level HPWS influencing firm performance, but less attention towards employee outcomes, especially innovation. We explore HPWS-wellbeing being offered (e.g., EAPs, well-being App, etc.) to capture organizational commitment to employee well-being. Under social exchange theory, workers should reciprocate their firm's offering of HPWS-wellbeing with greater efforts towards IWBs. Further, we explore playful work design as a mediator, which represents employees proactively creating work conditions that foster enjoyment/challenge but don’t require any design change to the job itself. We suggest HPWS-wellbeing can encourage employees to become more playful, and ultimately more innovative. Finally, beyond direct effects, we examine whether these relations are similar by gender and ultimately test a moderated mediation model. Using N=1135 New Zealand employees, we established measures with confirmatory factor analysis (CFA), and all measures had good psychometric properties (α>.80). We controlled for age, tenure, education, and hours worked and analyzed data using the PROCESS macro (version 4.2) specifically model 8 (moderated mediation). We analyzed overall IWB, and then again across the three stages. Overall, we find HPWS-wellbeing is significantly related to overall IWBs and the three stages (development, adoption, and implementation) individually. Similarly, HPWS-wellbeing shapes playful work design and playful work design predicts overall IWBs and the three stages individually. It only partially mediates the effects of HPWS-wellbeing, which retains a significant indirect effect. Moderation effects are supported, with males reporting a more significant effect from HPWS-wellbeing on playful work design but not IWB (or any of the three stages) than females. Females report higher playful work design when HPWS-wellbeing is low, but the effects are reversed when HPWS-wellbeing is high (males higher). Thus, males respond stronger under social exchange theory from HPWS-wellbeing, at least towards expressing playful work design. Finally, evidence of moderated mediation effects is found on overall IWBs and the three stages. Males report a significant indirect effect from HPWS-wellbeing on IWB (through playful work design), while female employees report no significant indirect effect. The benefits of playful work design fully account for their IWBs. The models account for small amounts of variance towards playful work design (12%) but larger for IWBs (26%). The study highlights a gap in the literature on HPWS-wellbeing and provides empirical evidence of their importance towards worker innovation. Further, gendered effects suggest these benefits might not be equal. The findings provide useful insights for organizations around how providing HR practices that support employee well-being are important, although how they work for different genders needs further exploration.

Keywords: human resource practices, wellbeing, innovation, playful work design

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Authors: Shivani Yadav

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The paper will first elaborate on the concept of soft power as formulated by Joseph Nye, who argues that soft power is as important as hard power in international politics as it replaces coercion with non-coercive forms of co-optation and attraction. The central tenet of the paper is to extrapolate the continued relevance of soft power in international relations in the 21st century. It is argued that the relevance of soft power, in concurrence with hard power, is on the rise in the international system. This is found to be emanating out of two factors. First, the state-centric practice of international relations has expanded to allow other actors to participate in policymaking. This has led to the resources for power generation to become varied, largely move away from the control of governments, and to produce both hard and soft power attributes. Second, as the currency of coercive power seems to be devaluing in global politics, the role of intangible factors like soft power is getting more important in policymaking. The paper will then go on to elaborate on the critiques of the formulation of soft power from various perspectives, as well as the defenses to these critiques presented by soft power proponents. The paper will reflect on the continued relevance of soft power in international politics by giving the example of India, and how soft power has continued to serve its policy objectives over the years. It is observed that even as India is recognized as a rising superpower today, yet it has made a continuous effort in cultivating its soft power resources, which have proven to be its assets in furthering its foreign policy interests. In conclusion, the paper makes the point that soft power, in conjunction with hard power, will shape international politics in the coming times.

Keywords: foreign policy, India’s soft power, international politics, smart power, soft power

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Authors: Andrea N. Ofori-Boadu

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The purpose is to develop a conceptual model of subcontractor development practices and processes that strengthen the integration of subcontractors into construction supply chain systems for improved subcontractor performance on Leadership in Energy and Environmental Design (LEED) certified building projects. The construction management of a LEED project has an important objective of meeting sustainability certification requirements. This is in addition to the typical project management objectives of cost, time, quality, and safety for traditional projects; and, therefore increases the complexity of LEED projects. Considering that construction management organizations rely heavily on subcontractors, poor performance on complex projects such as LEED projects has been largely attributed to the unsatisfactory preparation of subcontractors. Furthermore, the extensive use of unique and non-repetitive short term contracts limits the full integration of subcontractors into construction supply chains and hinders long-term cooperation and benefits that could enhance performance on construction projects. Improved subcontractor development practices are needed to better prepare and manage subcontractors, so that complex objectives can be met or exceeded. While supplier development and supply chain theories and practices for the manufacturing sector have been extensively investigated to address similar challenges, investigations in the construction sector are not that obvious. Consequently, the objective of this research is to investigate effective subcontractor development practices and processes to guide construction management organizations in their development of a strong network of high performing subcontractors. Drawing from foundational supply chain and supplier development theories in the manufacturing sector, a mixed interpretivist and empirical methodology is utilized to assess the body of knowledge within literature for conceptual model development. A self-reporting survey with five-point Likert scale items and open-ended questions is administered to 30 construction professionals to estimate their perceptions of the effectiveness of 37 practices, classified into five subcontractor development categories. Data analysis includes descriptive statistics, weighted means, and t-tests that guide the effectiveness ranking of practices and categories. The results inform the proposed three-phased LEED subcontractor development program model which focuses on preparation, development and implementation, and monitoring. Highly ranked LEED subcontractor pre-qualification, commitment, incentives, evaluation, and feedback practices are perceived as more effective, when compared to practices requiring more direct involvement and linkages between subcontractors and construction management organizations. This is attributed to unfamiliarity, conflicting interests, lack of trust, and resource sharing challenges. With strategic modifications, the recommended practices can be extended to other non-LEED complex projects. Additional research is needed to guide the development of subcontractor development programs that strengthen direct involvement between construction management organizations and their network of high performing subcontractors. Insights from this present research strengthen theoretical foundations to support future research towards more integrated construction supply chains. In the long-term, this would lead to increased performance, profits and client satisfaction.

Keywords: construction management, general contractor, supply chain, sustainable construction

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Authors: Tibor Koltay

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Among varied new literacies, information literacy is not only the best-known one but displays numerous models and frameworks. Nonetheless, there is still a lack of its complex theoretical model that could be applied to information literacy education in public (K12) education, which often makes use of constructivist approaches. This paper aims to present the main features of such a model. To develop a complex model, the literature and practice of phenomenographic and sociocultural theories, as well as discourse analytical approaches to information literacy, have been reviewed. Besides these constructivist and expressive based educational approaches, the new model is intended to include the innovation of coupling them with a cognitive model that takes developing informational and operational knowledge into account. The convergences between different literacies (information literacy, media literacy, media and information literacy, and data literacy) were taken into account, as well. The model will also make use of a three-country survey that examined secondary school teachers’ attitudes to information literacy. The results of this survey show that only a part of the respondents feel properly prepared to teach information literacy courses, and think that they can teach information literacy skills by themselves, while they see a librarian as an expert in educating information literacy. The use of the resulting model is not restricted to enhancing theory. It is meant to raise the level of awareness about information literacy and related literacies, and the next phase of the model’s development will be a pilot study that verifies the usefulness of the methodology for practical information literacy education in selected Hungarian secondary schools.

Keywords: communication, data literacy, discourse analysis, information literacy education, media and information literacy media literacy, phenomenography, public education, sociocultural theory

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Authors: Auni Idi Muhire

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Background: Prior to April 2012, resuscitations were often ineffective resulting in poor patient outcomes. An initiative was implemented at Rwanda Military Hospital (RMH) to review root causes and plan strategies to improve patient outcomes. An interdisciplinary committee was developed to review this problem. Purpose: Analyze the frequency, obstacles, and outcome of patient resuscitation following cardiac and/or respiratory arrest. Methods: A form was developed to allow recording of all actions taken during resuscitation including response times, staff present, and equipment and medications used. Results:-The patient population requiring the most resuscitation effort are the intensive care patients, most frequently the neonatal the intensive care patients (42.8%) -Despite having trained staff representatives, not all resuscitations follow protocol -Lack of compliance with drug administration guidelines was noted, particularly in initiating use of drugs despite the drug being available (59%). Lesson Learned: Basic Life Support training for interdisciplinary staff resulted in more effective response to cardiac and/or respiratory arrest at RMH. Obstacles to effective resuscitation included number of staff, knowledge and skill level of staff, availability of appropriate equipment and medications, staff communication, and patient Do not Attempt Resuscitation (DNR) status.

Keywords: resuscitation, case analysis of knowledge versus practice, intensive care, critical care

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Authors: Clive Sealey

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This article will analyse the impact that the increasingly multicultural nature of the UK has had on the nature and direction of social policy. The increasingly multicultural nature of the UK is being driven by a variety of demographic changes, particularly increased net migration from EU10 and the EU 2 enlargement. This has become an increasingly political issue, as exemplified by the specific rise of the United Kingdom Independence Party as a political force with the primary intention of restricting such migration. Perhaps not surprisingly, this has also had a significant impact on the nature and direction of social policies, as evident in the prominence given to efforts to reducing immigration and to restrict welfare benefits paid to such migrants. These policies have largely reflected the retreat away from the emphasis in UK policy on multiculturalism towards assimilation for all migrants, both prior and newly domiciled. Linking these two main policy emphases of reducing immigration and limiting entitlement to benefits is the concept of citizenship. An important point that this article will highlight, is that this changed citizenship does not just relate to new migrants, but also to existing domiciled migrants, such as in relation to specifying the assimilation of ‘Britishness’ and ‘British values’ in their daily life. Additionally, the article also analyses how the changes in welfare entitlements for new migrants is also impacting in an exclusionary way on the living standards of the native population, and therefore also their social rights as citizens. The article discusses the implication that this change presents for social work practice, particularly in terms of both migrants and native population changed citizenship.

Keywords: migration, citizenship, exclusion, social policy, migrant welfare

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Authors: Diana Ruth Caga-Anan

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Classroom management is a critical skill but the styles are constantly evolving. It is constantly under pressure particularly in the college education level due to diversity in student profiles, modes of delivery, and marketization of higher education. This study sought to analyze the extent of implementation of classroom management practices (CMPs) of the college instructors of the Hotel, Restaurant, and Institution Management of a premier university in the Philippines. It was also determined if their length of teaching affects their classroom management style. A questionnaire with sixteen 'evidenced-based' CMPs grouped into five critical features of classroom management, adopted from the literature search of Simonsen et al. (2008), was administered to 4 instructor-respondents and to their 88 students. Weighted mean scores of each of the CMPs revealed that there were differences between the instructors’ self-scores and their students’ ratings on their implementation of CMPs. The critical feature of classroom management 'actively engage students in observable ways' got the highest mean score, corresponding to 'always' from the instructors’ self-rating and 'frequently' from their students’ ratings. However, 'use a continuum of strategies to respond to inappropriate behaviors' got the lowest scores from both the instructors and their students corresponding only to 'occasionally'. Analysis of variance showed that the only CMP affected by the length of teaching is the practice of 'prompting students to respond'. Based on the findings, some recommendations for the instructors to improve on the critical feature where they scored low are discussed and suggestions are included for future research.

Keywords: classroom management, CMPs, critical features, evidence-based classroom management practices

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Authors: Amrutha Jayan

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The cities are attractors of the human population, offering opportunities for economic activities for different linguistic, cultural, and ethnic groups. The urban form and design of the city impact the life of these people. Social and cultural exclusions result in spatial segregation and gentrification. The spaces provided in cities must be inclusive for all these communities for them to feel part of the city and contribute to society. Intercultural urbanism is a theory and practice of city building, planning, and design of urban spaces and architectures that are cognizant of the social impact of the built environment. The postulate acknowledges cultural differences and opportunities for cultural exchange. Literature on intercultural urbanism, culture and space, spatial justice, and cultural inclusion are analyzed to identify parameters contributing to intercultural placemaking. A qualitative study on Mattancherry shows how the precinct has sustained throughout the years with different communities living together within a radius of 5 km, creating a diverse and vibrant environment. The research identifies the urban elements that contribute to intercultural interactions and maintain the synergy between these communities. The public spaces, porous edges, built-form, streets, and accessibility contribute to chance encounters and intercultural interactivity. The research seeks to find the factors that contribute to intercultural placemaking.

Keywords: intercultural urbanism, cultural inclusion, spatial justice, public space

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