Search results for: practice guidelines

Authors: Brid Dinnee, Jessica Taylor, Joseph Hartland, Michael Natarajan

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Background:The third stage of labour (TSL) can be complicated by Post-Partum Haemorrhage (PPH), which can have a significant impact on maternal mortality and morbidity. In Africa, 33.9% of maternal deaths are attributable to PPH1. In order to minimise this figure, current recommendations for the developing world are that all women have active management of the third stage of labour (AMTSL). The aim of this project was to examine TSL practice in a rural Ugandan Hospital, highlight any deviation from best practice and identify barriers to change in resource limited settings as part of a 4th year medical student External Student Selected Component field trip. Method: Five key elements from the current World Health Organisation (WHO) guidelines on AMTSL were used to develop an audit tool. All daytime vaginal deliveries over a two week period in July 2016 were audited. In addition to this, a retrospective comparison of PPH rates, between 2006 (when ubiquitous use of intramuscular oxytocin for management of TSL was introduced) and 2015 was performed. Results: Eight vaginal deliveries were observed; at all of which intramuscular oxytocin was administered and controlled cord traction used. Against WHO recommendation, all umbilical cords were clamped within one minute, and no infants received early skin-to-skin contact. In only one case was uterine massage performed after placental delivery. A retrospective comparison of data rates identified a 40% reduction in total number of PPHs from November 2006 to November 2015. Maternal deaths per delivery reduced from 2% to 0.5%. Discussion: Maternal mortality and PPH are still major issues in developing countries. Maternal mortality due to PPH can be reduced by good practices regarding TSL, but not all of these are used in low-resource settings. There is a notable difference in outcomes between the developed and developing world. At Kitovu Hospital, there has been a reduction in maternal mortality and number of PPHs following introduction of IM Oxytocin administration. In order to further improve these rates, staff education and further government funding is key.

Keywords: post-partum haemorrhage, PPH, third stage labour, Uganda

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Authors: Zarini Ismail, Mas Ayu Arina Mohd Anuwar, Ling Chai Ying, Tengku Zetty Maztura Tengku Jamaluddin, Nurul Azmawati Mohamed, Nadeeya Ayn Umaisara Mohamad Nor

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The transmission of infectious diseases can occur anywhere, including in the swimming pools. A large number of swimmers turnover and poor hygienic behaviours will increase the occurrence of direct and indirect water contamination. A wide variety of infections such as the gastrointestinal illnesses, skin rash, eye infections, ear infections and respiratory illnesses had been reported following the exposure to the contaminated water. Understanding the importance of pool hygiene with a healthy practice will reduce the risk of infection. The aims of the study are to investigate the knowledge, attitude and practices on pool hygiene among swimming pool users and to determine the microbial contaminants in swimming pools. A cross-sectional study was conducted using self-administered questionnaires to 600 swimming pool users from four swimming pools belong to the three educational institutions in Selangor. Data was analyzed using SPSS Statistics version 22.0 for Windows. The knowledge, attitude and practice of the study participants were analyzed using the sum score based on Bloom’s cut-off point (80%). Having a score above the cut-off point was classified as having high levels of knowledge, positive attitude and good practice. The association between socio-demographic characteristics, knowledge and attitude with practice on pool hygiene was determined by Chi-Square test. The physicochemical parameters and the microbial contamination were determined using a standard method for examination of waste and wastewater. Of the 600 respondents, 465 (77.5%) were females with the mean age of 21 years old. Most of the respondents are the students (98.8%) which belong to the three educational institutions in Selangor. Overall, the majority of the respondents (89.2%) had low knowledge on pool hygiene, but had positive attitudes (91.3%). Whereas only half of the respondents (50%) practice good hygiene while using the swimming pools. There was a significant association between practice level on pool hygiene with knowledge (p < 0.001) and also the attitude (p < 0.001). The measurements of the physicochemical parameters showed that all 4 swimming pools had low levels of pH and two had low levels of free chlorine. However, all the water samples tested were negative for Escherichia coli. The findings of this study suggested that high knowledge and positive attitude towards pool hygiene ensure a good practice among swimming pool users. Thus, it is recommended that educational interventions should be given to the swimming pool users to increase their knowledge regarding the pool hygiene and this will prevent the unnecessary outbreak of infectious diseases related to swimming pool.

Keywords: attitude, knowledge, pool hygiene, practice

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Authors: Mohammed Aman Kassim

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This study aims to investigate attitudes of resort hotel managers toward environmental sustainability practice in Bishoftu Town, Ethiopia. Six resorts were selected out of twelve by using systematic sampling method and totally fifty-six managers were taken for the survey. The findings revealed that more than 99% of hotel managers possess positive attitudes but low level of performance. Owners’ attitudes and personal beliefs, government regulation and incentives for good achievement were the most important factors that motivate or influence the adoptions of environmental sustainability practices. Hotel managers’ environmental attitudes more significantly influenced by their social demographics, such as level of education and age. Therefore, in order to increase hotels commitment to become more sustainable, some measurement should be implemented, such as vigorous support of the government, cooperation with hotel associations, continuous behaviors of hotel environmental protection, and local community participation in environmental practice.

Keywords: environmental attitude, environmental sustainability, hotel managers, resorts

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Authors: Mohammed Lawal Danrimi, Ervina Alfan, Mazni Abdullah

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The purpose of this study is to investigate whether the adoption of International Financial Reporting Standards (IFRS) encourages information-based trading and mitigates investors’ herding practice in emerging EU equity markets. Utilizing a modified non-linear model of cross-sectional absolute deviation (CSAD), we find that the hypothesis that mandatory IFRS adoption improves the information set of investors and reduces irrational investment behavior may in some cases be incorrect, and the reverse may be true. For instance, with regard to herding concerns, the new reporting benchmark has rather aggravated investors’ herding practice. However, we also find that mandatory IFRS adoption does not appear to be the only instigator of the observed herding practice; national institutional factors, particularly regulatory quality, political stability and control of corruption, also significantly contribute to investors’ herd formation around the new reporting regime. The findings would be of interest to academics, regulators and policymakers in performing a cost-benefit analysis of the so-called better reporting regime, as well as financial statement users who make decisions based on firms’ fundamental variables, treating them as significant indicators of future market movement.

Keywords: equity markets, herding, IFRS, CSAD

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Authors: Eman Ayman, Gehan Nagy

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The learning environment has four main parameters that affect its efficiency which they are: pedagogy, user, technology, and space. According to Morrone, enhancing these parameters to be adaptable for future developments is essential. The educational organization will be in need of developing its learning spaces. Flexibility of design an immersive technology could be used as tools for this development. when flexible design concepts are used, learning spaces that can accommodate a variety of teaching and learning activities are created. To accommodate the various needs and interests of students, these learning spaces are easily reconfigurable and customizable. The immersive learning opportunities offered by technologies like virtual reality, augmented reality, and interactive displays, on the other hand, transcend beyond the confines of the traditional classroom. These technological advancements could improve learning. This thesis highlights the problem of the lack of innovative, flexible learning spaces in educational institutions. It aims to develop guidelines for enhancing the learning environment by the integration of flexible design and immersive technology. This research uses a mixed method approach, both qualitative and quantitative: the qualitative section is related to the literature review theories and case studies analysis. On the other hand, the quantitative section will be identified by the results of the applied studies of the effectiveness of redesigning a learning space from its traditional current state to a flexible technological contemporary space that will be adaptable to many changes and educational needs. Research findings determine the importance of flexibility in learning spaces' internal design as it enhances the space optimization and capability to accommodate the changes and record the significant contribution of immersive technology that assists the process of designing. It will be summarized by the questionnaire results and comparative analysis, which will be the last step of finalizing the guidelines.

Keywords: flexibility, learning space, immersive technology, learning environment, interior design

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Authors: Nissim Avissar

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This paper aims to question the practice of bringing together people belonging to groups in conflict with the aim of bridging differences through universal empathy and interpersonal connections. It is argued that in cases where one group has the power, and the other is in a struggle to change the balance assuming universal equality between the groups and encouraging emphatic understanding is a non-emphatic practice. Accordingly, a new concept is posited–justice-sensitive empathy, conditioning empathy in such situations on the acknowledgement of an imbalance of power/injustice. With this reframing in mind, educational practices promoting social justice are discussed. In order to create conditions for justice-seeking or politically sensitive empathy, we need to go beyond the conventional definitions of empathy and offer other means and possibilities. Three possibilities are discussed. The first focuses on intra-group (as opposed to inter-group) processes within each group. It means temporary and tactical separation that may allow each group to focus on its own needs and values and perhaps to return to the dialogue more confidently. The second option emphasizes the notion of "constructive conflict," which means that each side still aspires to promote his own interests but without demolishing the other side (which is a rival but also an unwanted and forced partner). Here, alongside the "obligation to resist" and to act to promote justice as we view and understand it, we have to take into account the other side. The third and last option relates to the practice of Restorative Justice. This practice originated in the Truth and Reconciliation committees in South Africa, but it is now widely used in other contexts. Those committees had the authority to punish (or pardon) people; however, their main purpose was to seek truth and, from there, nourish reconciliation. This is the main idea of restorative justice; it seeks justice for the sake of restoring relationships. All the above options involve action and are aware of power relations (i.e., politics). They all seek justice. They may create conditions for the more conventional empathic practice to evolve, but no less than that, they are examples of justice-seeking and politically sensitive empathetic practice.

Keywords: education, empathy, justice, reconciliation

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Authors: M. A. Marlow, R. Sørly, H. K. Kaatrakoski

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Social work practice produces and circulates dominant narratives of young women in residential care. These stories are characterised by negative descriptions and hopelessness while dismissing the capabilities of narrative practice. This paper gives an account of how young women with histories in residential care can resist the dominant narratives. The analysis is based on a study of five young women aged 17 to 26 years old with different backgrounds and experiences with Norwegian residential care. The meaning of the context is analysed based on two interviews that were completed and one that was cancelled in the field. The contextual narrative analysis was oriented around the understanding of stories as performances and provided insight into a possible future storytelling practice in social work. The first author’s field notes are included as part of the data material in the analysis and provide a picture of important knowledge development related to stories and the value of being able to tell one’s own experiences. Faced with the dominant narratives that define young women with negative experiences with residential care, we provide a more contextualised understanding of storytelling as a possibility for positive change. To allow young women to create new stories from their lives, we, as both social workers and researchers, must be aware of what kinds of stories we relate to our own practices.

Keywords: context analysis, narrative research, rejection, residential care, social work practice

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Authors: Ibrahima Diallo

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The literature on teacher education foregrounds reflection as an important aspect of professional practice. Reflection for a teacher consists in critically analysing and evaluating retrospectively a lesson to see what worked, what did not work, and how to improve it for the future. Now, many teacher education programmes worldwide consider the ability to reflect as one of the hallmarks of an effective educator. However, in some context like Senegal, reflection has not been given due consideration in teacher education programmes. In contexts where it has been in the education landscape for some time now, reflection is mostly depicted as an individual written activity and many teacher trainees have become disenchanted by the repeated enactments of this task that is solely intended to satisfy course requirements. This has resulted in whitewashing weaknesses or even ‘faking’ reflection. Besides, the “one-size-fits-all” approach of reflection could not flourish because how reflection impacts on practice is still unproven. Therefore, reflective practice needs to be contextualised and made more thought-provoking through dialogue and by using classroom data. There is also a need to highlight change brought in teachers’ practice through reflection. So, this study introduces reflection in a new context and aims to show evidenced change in novice EFL teachers’ practice through dialogic data-led reflection. The purpose of this study is also to contribute to the scarce literature on reflection in sub-Saharan Africa by bringing new perspectives on contextualised teacher-led reflection. Eight novice EFL teachers participated in this qualitative longitudinal study, and data have been gathered online through post-lesson reflection recordings and lesson videos for a period of four months. Then, the data have been thematically analysed using NVivo to systematically organize and manage the large amount of data. The analysis followed the six steps approach to thematic analysis. Major themes related to teachers’ classroom practice and their conception of reflection emerged from the analysis of the data. The results showed that post-lesson reflection with a peer can help novice EFL teachers gained more awareness on their classroom practice. Dialogic reflection also helped them evaluate their lessons and seek for improvement. The analysis of the data also gave insight on teachers’ conception of reflection in an EFL context. It was found that teachers were more engaged in reflection when using their lesson video recordings. Change in teaching behaviour as a result of reflection was evidenced by the analysis of the lesson video recordings. This study has shown that video-stimulated reflection is practical form of professional development that can be embedded in teachers’ professional life.

Keywords: novice EFL teachers, practice, professional development, video-stimulated reflection

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Authors: Maria Lina Garrido

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This paper aims to reflect upon instruction in English classes with the specific purpose of reading comprehension development, having as its paradigm the considerations presented by William Grabe, in his book Reading in a Second Language: Moving from theory to practice. His concerns regarding the connection between research findings and instructional practices have stimulated the present author to re-evaluate both her long practice as an English reading teacher and as the author of two reading textbooks for graduate students. Elements of the reading process such as linguistic issues, prior knowledge, reading strategies, critical evaluation, and motivation are the main foci of this analysis as far as the activities developed in the classroom are concerned. The experience with university candidates on postgraduate courses with different levels of English knowledge in Bahia, Brazil, has definitely demanded certain adjustments to this author`s classroom setting. Word recognition based on cognates, for example, has been emphasized given the fact that academic texts use many Latin words which have the same roots as the Brazilian Portuguese lexicon. Concerning syntactic parsing, the tenses/verbal aspects, modality and linking words are included in the curriculum, but not with the same depth as the general English curricula. Reading strategies, another essential predictor for developing reading skills, have been largely stimulated in L2 classes in order to compensate for a lack of the appropriate knowledge of the foreign language. This paper presents results that demonstrate that this author`s teaching practice is compatible with the implications and instruction concerning the reading process outlined by Grabe, however, it admits that each class demands specific instructions to meet the needs of that particular group.

Keywords: classroom practice, instructional activities, reading comprehension, reading skills

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Authors: Cornelius Femi Popoola

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Nigerian manufacturing industry, particularly the flour producing firms play vital roles in Nigerian economy. This sector’s quality management practice is given a little attention along with organizational factors that hinder successful practice of total quality management which needs to be documented. Honeywell Flour Mills Plc operate in Nigeria with an appreciable number of products that serves this sector of the economy. Internal-external disposition of the company and total quality practice of the company deserve some elucidations. Hence, this study examined the influence of organizational factors on total quality management practice of Nigerian manufacturing industry, using Honeywell Flour Mills Plc as a case study. The study employed the correlational type of descriptive survey research design. The population consisted of 656 staff of Honeywell Flour Mills Plc, out of which 235 members were selected through scientific sampling method developed by Paler-Calmorin and Calmorin. A total of 235 copies of questionnaires titled 'Organisational Factors and Total Quality Management Practices (QF-TQM) Questionnaire' were administered with a response rate of 66 copies returned. The following variables were applied internal organisational factors (IOFs), external organizational factors (EOFs) and total quality management (TQM). Data generated were analysed using frequency distribution and regression analysis at 0.05 level. The findings revealed that IOFs positively and significantly related with TQM (r = .147**, N= 64, P(.000) < .01). Also, EOFs negatively and significantly related with TQM (r = -.117, N= 64, P(.000) < .01). Findings showed that internal and external organizational factors jointly influenced TQM practiced in F₍₂,₆₁₎=22.250; R²=.629; Adj.R²=.603; P(.000) < .05). The study concluded that organizational factors are determinants of TQM practice in Nigerian manufacturing industry. It is recommended that both internal and external organizational factors influencing TQM practices should be considered in the development of TQM strategies.

Keywords: external organizational factors, internal organisational factors, Nigerian manufacturing industry, total quality management

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Authors: Paul Lam, Kevin Wong, Chi Him Chan

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Constant practicing and accurate, immediate feedback are the keys to improving students’ speaking skills. However, traditional oral examination often fails to provide such opportunities to students. The traditional, face-to-face oral assessment is often time consuming – attending the oral needs of one student often leads to the negligence of others. Hence, teachers can only provide limited opportunities and feedback to students. Moreover, students’ incentive to practice is also reduced by their anxiety and shyness in speaking the new language. A mobile app was developed to use artificial intelligence (AI) to provide immediate feedback to students’ speaking performance as an attempt to solve the above-mentioned problems. Firstly, it was thought that online exercises would greatly increase the learning opportunities of students as they can now practice more without the needs of teachers’ presence. Secondly, the automatic feedback provided by the AI would enhance students’ motivation to practice as there is an instant evaluation of their performance. Lastly, students should feel less anxious and shy compared to directly practicing oral in front of teachers. Technically, the program made use of speech-to-text functions to generate feedback to students. To be specific, the software analyzes students’ oral input through certain speech-to-text AI engine and then cleans up the results further to the point that can be compared with the targeted text. The mobile app has invited English teachers for the pilot use and asked for their feedback. Preliminary trials indicated that the approach has limitations. Many of the users’ pronunciation were automatically corrected by the speech recognition function as wise guessing is already integrated into many of such systems. Nevertheless, teachers have confidence that the app can be further improved for accuracy. It has the potential to significantly improve oral drilling by giving students more chances to practice. Moreover, they believe that the success of this mobile app confirms the potential to extend the AI-assisted assessment to other language skills, such as writing, reading, and listening.

Keywords: artificial Intelligence, mobile learning, oral assessment, oral practice, speech-to-text function

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Authors: Teresa Sarmento de Beires, Sofia Padilha, Pedro Arantes, Joana Ribeiro, Andreia Eiras

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Background: Trichotillomania is a psychiatric condition that is very challenging to treat, with no first-line medications approved by any medical agency. It is defined as a recurrent compulsive habit of pulling out one's own hair, usually from the scalp and eyebrows area, but it can also affect eyelashes or any other hair-bearing area. N-acetylcysteine, a glutamate modulator, has been studied as a possible treatment for several psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes responsible for compulsive behaviors and, therefore, trichotillomania. Objective: This study aims to determine the efficacy of N-acetylcysteine in the treatment of adults with trichotillomania. Methodology: The authors researched guidelines, standards of clinical guidance, systematic reviews, meta-analyses, and randomized clinical trials, published in the last 20 years using the MeSH terms: "Trichotillomania” and “N-acetylcysteine” in the following databases: PubMed, Cochrane library, National Guideline Clearing House, National Institute of Health and Care Excellence (NICE), Canadian Medical Association Practice Guidelines and Database of Abstracts of Reviews of Effectiveness (DARE). The Strength of Recommendation Taxonomy (SORT) Scale, from the American Family Physician, was used to evaluate the level of evidence and assign the strength of recommendation. Results: The research found fifteen articles, among which only three were eligible according to the inclusion criteria: 1. systematic review and 2. meta-analyses. There was evidence of a probable beneficial effect of N-acetylcysteine on treatment response and reduction of trichotillomania symptom severity in adults, with moderate certainty in the effect estimate. There was no evidence of effectiveness with the use of inositol, antioxidants, naltrexone, or selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with trichotillomania. Clomipramine and Olanzapine showed potential treatment benefits, with low certainty. N-acetylcysteine had the least severe side effect profile in adults compared with the other potentially beneficial pharmacological treatments. Conclusion: Evidence points towards the effectiveness of N-acetylcysteine in the treatment of adults with trichotillomania, which exhibits a good tolerability profile with minimal adverse effects. Therefore, the authors attribute a level of evidence 2, the strength of recommendation B, to the prescription of N-acetylcysteine in the treatment of adults suffering from trichotillomania (SORT analysis). Further investigation is needed in order to extract high-quality conclusions from the meta-analysis.

Keywords: trichotillomania, hair pulling, treatment, n-acetylcysteine

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Authors: Manasi V. Shah

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Organizations, in the competitive era, are participating in the competency act. They have discerned that, strategically researched and defined competencies when put up on the shelf, can help in achieving business goals. The research focuses on critical elements of competency-based talent acquisition process from practical vantage, with significant experience in a variety of business settings. The research is exploratory and descriptive in nature. The research conduct and outcome is the hinge on with reference to Indian Industries. It elaborates about the concept, practice and a brief model that human resource practitioner can use for effective talent acquisition process, which in turn would be in alignment with business performance. The research helps to present a prudent understanding of recruiting and selecting apt human capital, that can fit in a given job role and has action oriented competency based assessment approach for measuring the probable success of a job incumbent in a given job role.

Keywords: competency based talent acquisition, competency model, talent acquisition concept, talent acquisition practice

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Authors: Regina Bowler

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Rationale & Aims: Complementary interventions such as mindfulness-meditation, gratitude, and self-affirmation are often used by therapists to treat stress. Many studies have been conducted using these interventions either individually or adjunctively with regard to stress. However, there has been little work comparing these interventions to investigate which of them is the most effective in treating stress. This study aims to compare these interventions and to determine which of them has the strongest perceived and physiological impact on stress. Participants: 120 law students preparing to take the bar exam: 3 experimental groups of 30 individuals, 1 control group of 30 individuals. Methods: One day prior to administering the interventions, baseline salivary cortisol samples will be taken, and the participants will complete the perceived stress scale (Cohen et al., 1983). Thirty days prior to the bar exam, each experimental group will be given an intervention to practice. Interventions will be practiced once in the morning after waking and once at night at bedtime. In group one, each participant will do a recorded three-minute mindfulness meditation. In group two, each participant will practice gratitude by writing down three things he/she/they are grateful for. In group three, each participant will practice affirmation by writing three sentences affirming his/her/their core values. The control group will not have an intervention to practice. Starting experimental day 1, upon waking and prior to practicing the intervention, the participants will take a salivary cortisol sample. Then they will practice their given intervention. Every night, before going to bed, the participants will practice their given intervention for a second time. The participants will practice their interventions and take salivary cortisol samples for 28 days. After each seven-day period (days 7, 14, 21, 28), the participants will fill out a brief questionnaire about the effects their intervention has on their stress, daily life, and relationships with themselves and others. On day 29, the participants will take a final salivary cortisol sample and will fill out the Perceived Stress Scale (Cohen et al., 1983). Applications of findings: Findings from this study would inform therapists of best practices when working with clients with stress. Moreover, therapists will gain knowledge of how individuals perceive these interventions and their impact on stress, daily life, somatic symptoms, and relationships with self and others. Thus, therapists will be able to administer these interventions with more precision to the stress-related contexts and issues their clients bring.

Keywords: stress, mindfulness-meditation, gratitude, affirmations, complementary interventions

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Authors: William Thomas Worster

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This paper will highlight the failure of international adjudication to prevent a state from evading an order of provisional measures by simply issuing a diplomatic assurance to the court. This practice changes the positions of the litigants as equals before a court, prevents the court from inquiring into the reliability of the political pledge as it would with assurances from a state to an individual, and diminishes the court’s ability to control its own proceedings in the face of concerns over sovereignty. Both the European Court of Human Rights (ECtHR) and International Court of Justice (ICJ) will entertain these kinds of unilateral pledges, but they consider them differently when the declaration is made between states or between a state and an individual, and when made directly to the court. In short, diplomatic assurances issued between states or to individuals are usually considered not to be legally binding and are essentially questions of fact, but unilateral assurances issued directly to an international court are questions of law, and usually legally binding. At the same time, orders for provisional measures are now understood also to be legally binding, yet international courts will sometimes permit a state to substitute an assurance in place of an order for provisional measures. This emerging practice has brought the nature of a state as a sovereign capable of creating legal obligations into the forum of adjudication where the parties should have equality of arms and permitted states to create legal obligations that escape inquiry into the reliability of the outcome. While most recent practice has occurred at the ICJ in state-to-state litigation, there is some practice potentially extending the practice to human rights courts. Especially where the litigants are factually unequal – a state and an individual – this practice is problematic since states could more easily overcome factual failings in their pledges and evade the control of the court. Consider, for example, the potential for evading non-refoulement obligations by extending the current diplomatic assurances practice from the state-to-state context to the state-to-court context. The dual nature of assurances, as both legal and factual instruments, should be considered as addressed to distinct questions, each with its own considerations, and that we need to be more demanding about their precise legal and factual effects.

Keywords: unilateral, diplomacy, assurances, undertakings, provisional measures, interim measures

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Authors: T. Arkle, D. Pournaras, S. Lam, B. Kumar

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Introduction: Fundoplication is widely recognised as the best surgical option for gastro-oesophageal reflux disease (GORD) in the general population. However, there is controversy surrounding the use of conventional fundoplication in obese patients. Whilst the intra-operative failure of fundoplication, including wrap disruption, is reportedly higher in obese individuals, the more significant issue surrounds symptom recurrence post-surgery. Could a bariatric procedure be considered in obese patients for weight management, to treat the GORD, and to also reduce the risk of recurrence? Roux-en-Y gastric bypass, a widely performed bariatric procedure, has been shown to be highly successful both in controlling GORD symptoms and in weight management in obese patients. Furthermore, NICE has published clear guidelines on eligibility for bariatric surgery, with the main criteria being type 3 obesity or type 2 obesity with the presence of significant co-morbidities that would improve with weight loss. This study aims to identify the proportion of patients who undergo conventional fundoplication for GORD and/or hiatus hernia, which would have been eligible for bariatric surgery referral according to NICE guidelines. Methods: All patients who underwent fundoplication procedures for GORD and/or hiatus hernia repair at a single NHS foundation trust over a 10-year period will be identified using the Trust’s health records database. Pre-operative patient records will be used to find BMI and the presence of significant co-morbidities at the time of consideration for surgery. This information will be compared to NICE guidelines to determine potential eligibility for the bariatric surgical referral at the time of initial surgical intervention. Results: A total of 321 patients underwent fundoplication procedures between January 2011 and December 2020; 133 (41.4%) had available data for BMI or to allow BMI to be estimated. Of those 133, 40 patients (30%) had a BMI greater than 30kg/m², and 7 (5.3%) had BMI >35kg/m². One patient (0.75%) had a BMI >40 and would therefore be automatically eligible according to NICE guidelines. 4 further patients had significant co-morbidities, such as hypertension and osteoarthritis, which likely be improved by weight management surgery and therefore also indicated eligibility for referral. Overall, 3.75% (5/133) of patients undergoing conventional fundoplication procedures would have been eligible for bariatric surgical referral, these patients were all female, and the average age was 60.4 years. Conclusions: Based on this Trust’s experience, around 4% of obese patients undergoing fundoplication would have been eligible for bariatric surgical intervention. Based on current evidence, in class 2/3 obese patients, there is likely to have been a notable proportion with recurrent disease, potentially requiring further intervention. These patient’s may have benefitted more through undergoing bariatric surgery, for example a Roux-en-Y gastric bypass, addressing both their obesity and GORD. Use of patient written notes to obtain BMI data for the 188 patients with missing BMI data and further analysis to determine outcomes following fundoplication in all patients, assessing for incidence of recurrent disease, will be undertaken to strengthen conclusions.

Keywords: bariatric surgery, GORD, Nissen fundoplication, nice guidelines

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Authors: Andreas Jede, Frank Teuteberg

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Cloud computing (CC) has already gained overall appreciation in research and practice. Whereas the willingness to integrate cloud services in various IT environments is still unbroken, the previous CC procurement processes run mostly in an unorganized and non-standardized way. In practice, a sufficiently specific, yet applicable business process for the important acquisition phase is often lacking. And research does not appropriately remedy this deficiency yet. Therefore, this paper introduces a field-tested approach for CC procurement. Based on an extensive literature review and augmented by expert interviews, we designed a model that is validated and further refined through an in-depth real-life case study. For the detailed process description, we apply the event-driven process chain notation (EPC). The gained valuable insights into the case study may help CC research to shift to a more socio-technical area. For practice, next to giving useful organizational instructions we will provide extended checklists and lessons learned.

Keywords: cloud procurement process, IT-organization, event-driven process chain, in-depth case study

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Authors: Eman AbuKhousa, Marwan Z. Bataineh

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The 21^st century higher education and globalization challenge new faculty members to build effective professional networks and partnership with industry in order to accelerate their growth and success. This creates the need for community of practice (CoP)-oriented development approaches that focus on cognitive apprenticeship while considering individual predisposition and future career needs. This work adopts data mining, clustering analysis, and social networking technologies to present the CoP-Network as a virtual space that connects together similar career-aspiration individuals who are socially influenced to join and engage in a process for domain-related knowledge and practice acquisitions. The CoP-Network model can be integrated into higher education to extend traditional graduate and professional development programs.

Keywords: clustering analysis, community of practice, data mining, higher education, new faculty challenges, social network, social influence, professional development

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Authors: Maiss Razem

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The construction sector is considered a major consumer of materials that undergoes processes of extraction, processing, transportation, and maintaining when used in buildings. Several metrics have been devised to capture the environmental impact of the materials consumed during construction using lifecycle thinking. Rarely has the materiality of this sector been explored qualitatively and systemically. This paper aims to explore socio-cultural forces that drive the use of certain materials in the Jordanian construction industry, using practice theory as a heuristic method of analysis, more specifically Shove et al. three-element model. By conducting semi-structured interviews with architects, the results unravel contextually embedded routines when determining qualities of three materialities highlighted herein; stone, glass and spatial openness. The study highlights the inadequacy of only using efficiency as a quantitative metric of sustainable materials and argues for the need to link material consumption with socio-economic, cultural, and aesthetic driving forces. The operationalization of practice theory by tracing materials’ lifetimes as they integrate with competencies and meanings captures dynamic engagements through the analyzed routines of actors in the construction practice. This study can offer policymakers better-nuanced representation to green this sector beyond efficiency rhetoric and quantitative metrics.

Keywords: architects' practices, construction materials, Jordan, practice theory

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Authors: Martina Maria Keitsch

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Critical Design (CD) confronts traditional design practice. Instead of reproducing and reinforcing contemporary perceptions of products and services, CD seeks to challenge them with the goal to stimulate debates and visions on societal innovation. CD methods comprise, among other narratives and design of critical objects. The oral presentation is based on a study that discusses concepts, methods, and applications of CD links CD to traditional design, and identifies CD benefits and challenges for design research and practice. The objective of the study is to introduce CD as an alternative for design researchers and practitioners supplementing commercially oriented design approaches. The study utilizes a literature review on CD concepts and methods based on current publications and online documents and illustrates CD practice with help of selected case studies. Findings of the study indicate that CD contribute, among others, to create new societal roles for designers, foster innovative relationships between designers and users, and encourage creativity through imaginative aesthetics.

Keywords: critical design, postmodern design theories, narratives, rhizome

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Authors: Gavin Quibell, Martin Kleynhans, Margot Soler

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The Sendai Framework notes that disaster risk reduction is essential for sustainable development, and Disaster Risk Reduction is included in 3 of the Sustainable Development Goals (SDGs), and 4 of the SDG targets. However, apart from promoting better governance and resourcing of disaster management agencies, little guidance is given how low-income nations can balance investments across the SDGs to achieve sustainable development in an increasingly climate vulnerable world with increasing prevalence of flood and drought disasters. As one of the world’s poorest nations, Malawi must balance investments across all the SDGs. This paper explores how Malawi’s National Guidelines for Community-based Flood Risk Management integrate sustainable development and flood management objectives at different administrative levels. While Malawi periodically suffers from large, widespread flooding, the greatest impacts are felt through the smaller annual floods and flash floods. The Guidelines address this through principles that recognize that while the protection of human life is the most important priority for flood risk management, addressing the impacts of floods on the rural poor and the economy requires different approaches. The National Guidelines are therefore underpinned by the following; 1. In the short-term investments in flood risk management must focus on breaking the poverty – vulnerability cycle; 2. In the long-term investments in the other SDGs will have the greatest flood risk management benefits; 3. If measures are in place to prevent loss of life and protect strategic infrastructure, it is better to protect more people against small and medium size floods than fewer people against larger floods; 4. Flood prevention measures should focus on small (1:5 return period) floods; 5. Flood protection measures should focus on small and medium floods (1:20 return period) while minimizing the risk of failure in larger floods; 6. The impacts of larger floods ( > 1:50) must be addressed through improved preparedness; 7. The impacts of climate change on flood frequencies are best addressed by focusing on growth not overdesign; and 8. Manage floods and droughts conjunctively. The National Guidelines weave these principles into Malawi’s approach to flood risk management through recommendations for planning and implementing flood prevention, protection and preparedness measures at district, traditional authority and village levels.

Keywords: flood risk management in low-income countries, sustainable development, investments in prevention, protection and preparedness, community-based flood risk management, Malawi

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Authors: Bjørn Salskov, Nicolaj Bang, Charlotte Falko

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Future labour markets demand employees that can carry out a non-linear task which is still not possible for computers. This means that employees must have well-developed soft-skills to perform at high levels in such a work environment. One of these soft-skills is presenting a message effectively. To be able to present a message effectively, one needs to practice this. To practice effectively, the trainee needs feedback on the current performance. Here VR environments can be used as a practice tool because it gives the trainee a sense of presence and reality. VR environments are becoming a cost-effective training method since it does not demand the presence of an expert to provide this feedback. The research article analysed in this study suggests that VR environment can be used and are able to provide the necessary feedback to the trainee which in turn will help the trainee become better at the task. The research analysed in this review does, however, show that there is a need for a study with larger sample size and a study which runs over a longer period.

Keywords: training, presentation, presentation skills, VR training, VR as a training tool, VR and presentation

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Authors: Charalambos C. Cleanthous, Ryan Sain, Tabitha Black, Stephen Vera, Suzanne Milton

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A concern when administering questionnaires is whether the participant is providing information that is accurate. The results may be invalid because the person is trying to present oneself in an unrealistic positive manner referred to as ‘faking good’, or in an unrealistic negative manner known as ‘faking bad’. The Balanced Inventory of Desirable Responding (BIDR) was used to assess commercial pilots’ responses on the two subscales of the BIDR: impression management (IM) and self-deceptive enhancement (SDE) that result in high or low scores. Thus, the BIDR produces four valid profiles: IM low and SDE low, IM high and SDE low, IM low and SDE high, and IM high and SDE high. The various profiles were used to compare the respondents’ answers to crew resource management (CRM) items developed from the USA Federal Aviation Administration’s (FAA) guidelines for CRM composition and training. Of particular interest were the results on the IM subscale. The comparisons between those scoring high (lying or faking) versus those low on the IM suggest that there were significant differences regarding their views of the various dimensions of CRM. One of the more disconcerting conclusions is that the high IM scores suggest that the pilots were trying to impress rather than honestly answer the questions regarding their CRM training and practice.

Keywords: USA commercial pilots, crew resource management, faking, social desirability

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Authors: Mohammad T. Uddin, Aurup R. Dhar

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The study was conducted to assess the impact of conservation agriculture practice on farmers’ socioeconomic condition and soil environmental quality in Bangladesh. A total of 450 (i.e., 50 focal, 150 proximal and 250 control) farmers from five districts were selected for this study. Descriptive statistics like sum, averages, percentages, etc. were calculated to evaluate the socioeconomic data. Using Enyedi’s crop productivity index, it was found that the crop productivity of focal, proximal and control farmers was increased by 0.9, 1.2 and 1.3 percent, respectively. The result of DID (Difference-in-difference) analysis indicated that the impact of conservation agriculture practice on farmers’ average annual income was significant. Multidimensional poverty index (MPI) indicates that poverty in terms of deprivation of health, education and living standards was decreased; and a remarkable improvement in farmers’ socioeconomic status was found after adopting conservation agriculture practice. Most of the focal and proximal farmers stated about increased soil environmental condition where majority of control farmers stated about constant environmental condition in this regard. The Probit model reveals that minimum tillage operation, permanent organic soil cover, and application of compost and vermicompost were found significant factors affecting soil environmental quality under conservation agriculture. Input support, motivation, training programmes and extension services are recommended to implement in order to raise the awareness and enrich the knowledge of the farmers on conservation agriculture practice.

Keywords: conservation agriculture, crop productivity, socioeconomic status, soil environment quality

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Authors: Hilde Heim

Abstract:

The textile industry is known for its swift adoption of innovations in fashion technology (Fash-Tech). The industry is also known for its harmful effects on the environment. Opportunely, Fash-Tech is expected to facilitate the turn towards more sustainable practice. However, although several technologies have the potential for advancing sustainable practice, many industry players, whether large or small, are confused and misinformed about Fash-Tech adoption, application, and impact. Through a visual poster presentation, this project aims to map global fashion innovations along the supply chain from fibre production to waste management, thus providing a clearer picture of numbers, scale, and adoption. While the project aims to identify Fash-Tech effectiveness in reaching sustainability goals, it also identifies areas of congestion as well as insufficiency in the accessibility of Fash-Tech. This project intends to help inform future decisions in business, investment, and policy for the advancement of sustainable practice.

Keywords: fashion technology, sustainability, supply chain, enterprise management

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Authors: T. Vandeyar

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The purpose of this study is to explore how Government policy on ICT influences teaching and learning in South African schools. An instrumental case study using backward mapping principles as a strategy of inquiry was used. Utilizing a social constructivist lens and guided by a theoretical framework of a sociocultural approach to policy analysis, this exploratory qualitative research study set out to investigate how teachers appropriate government policy on ICT in South African schools. Three major findings emanated from this study. First, although teachers were ignorant of the national e-education policy their professionalism and agency were key in formulating and implementing an e-education policy in practice. Second, teachers repositioned themselves not as recipients or reactors of the e-education policy but as social and cultural actors of policy appropriation and formulation. Third, the lack of systemic support to teachers catalyzed improved school and teacher collaborations, teachers became drivers of ICT integration through collaboration, innovation, institutional practice and institutional leadership.

Keywords: ICT, teachers as change agents, practice as policy, teacher's beliefs, teacher's attitudes

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Authors: Margaret S. Wright

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Background/Significance: During many recent public health emergencies/disasters, public health nursing data has been missing or delayed, potentially impacting the decision-making and response. Data used as evidence for decision-making in response, planning, and mitigation has been erratic and slow, decreasing the ability to respond. Methodology: Applying best practices in data management and data use in public health settings, and guided by the concepts outlined in ‘Disaster Standards of Care’ models leads to the development of recommendations for a model of best practices in data management and use in public health disasters/emergencies by public health nurses. As the ‘patient’ in public health disasters/emergencies is the community (local, regional or national), guidelines for patient documentation are incorporated in the recommendations. Findings: Using model public health nurses could better plan how to prepare for, respond to, and mitigate disasters in their communities, and better participate in decision-making in all three phases bringing public health nursing data to the discussion as part of the evidence base for decision-making.

Keywords: data management, decision making, disaster planning documentation, public health nursing

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Authors: Sangho Park, Mansoo Kim, Kyujung Chae, Junhyuk Yang

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The International Maritime Organization (IMO) recognized the problem of invasive species invasion and adopted the "International Convention for the Control and Management of Ships' Ballast Water and Sediments" in 2004, which came into force on September 8, 2017. In 2011, the IMO approved the "Guidelines for the Control and Management of Ships' Biofouling to Minimize the Transfer of Invasive Aquatic Species" to minimize the movement of invasive species by hull-attached organisms and required ships to manage the organisms attached to their hulls. Invasive species enter new environments through ships' ballast water and hull attachment. However, several obstacles to implementing these guidelines have been identified, including a lack of underwater cleaning equipment, regulations on underwater cleaning activities in ports, and difficulty accessing crevices in underwater areas. The shipping industry, which is the party responsible for understanding these guidelines, wants to implement them for fuel cost savings resulting from the removal of organisms attached to the hull, but they anticipate significant difficulties in implementing the guidelines due to the obstacles mentioned above. Robots or people remove the organisms attached to the hull underwater, and the resulting wastewater includes various species of organisms and particles of paint and other pollutants. Currently, there is no technology available to sterilize the organisms in the wastewater or stabilize the heavy metals in the paint particles. In this study, we aim to analyze the characteristics of the wastewater generated from the removal of hull-attached organisms and select the optimal treatment technology. The organisms in the wastewater generated from the removal of the attached organisms meet the biological treatment standard (D-2) using the sterilization technology applied in the ships' ballast water treatment system. The heavy metals and other pollutants in the paint particles generated during removal are treated using stabilization technologies such as thermal decomposition. The wastewater generated is treated using a two-step process: 1) development of sterilization technology through pretreatment filtration equipment and electrolytic sterilization treatment and 2) development of technology for removing particle pollutants such as heavy metals and dissolved inorganic substances. Through this study, we will develop a biological removal technology and an environmentally friendly processing system for the waste generated after removal that meets the requirements of the government and the shipping industry and lays the groundwork for future treatment standards.

Keywords: biofouling, ballast water treatment system, filtration, sterilization, wastewater

Procedia PDF Downloads 86

Authors: Shahid Noor, Kazim Najjad, Muhammad Nasir, Irshad Bhutto, Abdul Samad Memon, Khurram Anwar, Tehseen Riaz, Mian Muhammad Hanif, Nauman A. Mallik, Saeed Ahmed, Israr Ahmed, Ali Yasir

Abstract:

Background: Musculoskeletal pain is the most common complaint presented to the health practitioner. It is well known that untreated or under-treated pain can have a significant negative impact on an individual’s quality of life (QoL). Objectives: This study was conducted across 10 sites in six (6) major cities of Pakistan to evaluate the tolerability, safety, and the clinical response of Nuberol Forte® (Paracetamol 650 mg + Orphenadrine 50 mg) to musculoskeletal pain in routine Pakistani practice and its impact on improving the patient’s QoL. Design & Methods: This NFORT-EFFECT observational, prospective multicenter study was conducted in compliance with Good Clinical Practice guidelines and local regulatory requirements. The study sponsor was "The Searle Company Limited, Pakistan. To maintain the GCP compliances, the sponsor assigned the CRO for the site and data management. Ethical approval was obtained from an independent ethics committee. The IEC reviewed the progress of the study. Written informed consent was obtained from the study participants, and their confidentiality was maintained throughout the study. A total of 399 patients with known prescreened musculoskeletal conditions and pain who attended the study sites were recruited, as per the inclusion/exclusion criteria (clinicaltrials.gov ID# NCT04765787). The recruited patients were then prescribed Paracetamol (650 mg) and Orphenadrine (50 mg) combination (Nuberol Forte®) for 7 to 14 days as per the investigator's discretion based on the pain intensity. After the initial screening (visit 1), a follow-up visit was conducted after 1-2 weeks of the treatment (visit 2). Study Endpoints: The primary objective was to assess the pain management response of Nuberol Forte treatment and the overall safety of the drug. The Visual Analogue Scale (VAS) scale was used to measure pain severity. Secondary to pain, the patients' health-related quality of life (HRQoL) was also assessed using the Muscle, Joint Measure (MJM) scale. The safety was monitored on the first dose by the patients. These assessments were done on each study visit. Results: Out of 399 enrolled patients, 49.4% were males, and 50.6% were females with a mean age of 47.24 ± 14.20 years. Most patients were presented with Knee Osteoarthritis (OA), i.e., 148(38%), followed by backache 70(18.2%). A significant reduction in the mean pain score was observed after the treatment with the combination of Paracetamol and Orphenadrine (p<0.05). Furthermore, an overall improvement in the patient’s QoL was also observed. During the study, only ten patients reported mild adverse events (AEs). Conclusion: The combination of Paracetamol and Orphenadrine (Nuberol Forte®) exhibited effective pain management among patients with musculoskeletal conditions and also improved their QoL.

Keywords: musculoskeletal pain, orphenadrine/paracetamol combination, pain management, quality of life, Pakistani population

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Authors: Jacquelene Swanepoel, J. C. Visagie, H. M. Linde

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Purpose: The aim of this article is to investigate the psychosocial risk environment influencing employee behaviour, and subsequently the trust relationship between employer and employee. Design/methodology/approach: The unique nature and commonness of negative acts, such as unsafe behaviour, human errors, poor performance and negligence, also referred to as unsafe practice, are explored. A literature review is formulated to investigate the nature of negative acts or unsafe behaviour. The findings of this study are used to draw comparisons between unsafe behaviour/misconduct and accidents in the workplace and finally conclude how it should be addressed from a labour relations point of view. Findings: The results indicate comparisons between unsafe practice/misconduct and occupational injuries and accidents, as a result of system flaws, human error or psychosocial risk.

Keywords: occupational risks, unsafe practice, misconduct, organisational safety culture, ergonomics, management commitment and leadership, labour relations

Procedia PDF Downloads 341