Search results for: resuscitation team member

Authors: Chander Shekhar Kohli

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In the field of international relations, countries have been experiencing distinct nature of conflicts. But, in the case of Association of Southeast Asian Nations (ASEAN) for a long time, the members have witnessed conflicts, small and large. These conflicts, as a result, have given catastrophic outcomes, such as killings and destroying properties. For the resolution of such conflicts, nonetheless, efforts likewise have been made, simultaneously, in terms of establishing peace and security. In this background, the ASEAN presents a significant example as before it had faced several wars, like Vietnam War, Cambodia conflicts, and so on. This research paper, therefore, strives to examine the ASEAN as a case with the help of both primary and secondary sources. It likewise will be dealt with how changing norms and identity building facilitate the ASEAN countries to deal with their conflicts both internal and external. This paper also will discuss how internal developments within countries affect conflict resolution process as each member of ASEAN is guided by its national interest. It is then argued that conflict resolution in the ASEAN is moving from its existing power-based solution to norms and identity-based solution as member countries have become more dependent on other countries. The research, therefore, is concluded by saying that the conflicts could only be resolved through building norms and common identities, which of course are recognized crucial mechanisms among the ASEAN countries with some exceptions.

Keywords: ASEAN, conflict resolution, norms and identities, peace and security

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Authors: Nisreen Agha

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Investigation of representative core samples under the petrological microscope reveals common petrographic and mineralogical characteristics with distinct faunal assemblages, allowing establishing of the microfacies associations and deducing the paleoenvironmental trends of the Paleocene Farrud and Mabruk rock units. Recognition of the early and post-diagenetic processes, particularly dolomitization and micritization, as well as dissolution and precipitation of spary drusy calcite as a new morphism process affecting the reservoir rocks, is established. The microfacies trends detected from the investigation of 46 core samples from Farrud member (Lower Paleocene) representing six wells; QQQ1-11, GG1-11, LLL1-11, RRR1-11, RRR40-11, and RRR45-11 indicate that the deposition was started within the realm of shallow supratidal and intertidal subenvironments followed by deeper environments of the shelf bays with maximum sea level during inner shelf environment where fossiliferous bioclastic packstone dominated. The microfacies associations determined in 8 core samples from two wells LLL1and RRR40 representing Mabruk Member (Upper Paleocene), indicate paleoenvironmental trends marked by sea level fluctuations accompanied with a relatively marine shelf bay conditions intervened with short-lived shallow intertidal and supratidal warm coastal sedimentation. As a result, dolostone, evaporitic dismicrites, and gypsiferous dolostone of supratidal characters were deposited. They reflect rapid oscillation of the sea level marked by drop land-ward shift of the sea shore deposition prevailed by supratidal gypsiferous dolostone and numerous ferruginous materials as clouds straining many parts of dolomite and surrounded the micritized fossils. This situation ends the deposition of the Farrud Member in most of the studied wells. On the other hand, the facies in the northern part of the Concession -11 field indicates deposition in a deeper marine setting than in the southern facies.

Keywords: Farrud and Mabruk members, paleocene, microfacies associations, diagenesis, sea level oscillation, depositional environments

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Authors: Rishmidevi Kirtie Algoe

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Advocating for gender equality in sports is a global struggle but a greater challenge for small nations with weak economies like Suriname, a Dutch-speaking country in the Caribbean. This paper presents the experience of the Suriname Olympic Committee (SOC) in addressing gender inequality in sports in the global context of the policies implemented by the International Olympic Committee (IOC). The case of Suriname is interesting because it shows the results of a small nation in creating protective measures. The SOC has succeeded in developing a code of conduct for sports and is now taking steps to establish a sports justice institute. All of this is happening in a situation where there are few women leaders in sport: only three of the seventeen national member federations are led by women, and there are two women on SOC's 9-member board. Three arguments are made. First, gender inequality in sports in Suriname is a reflection of national power structures and cultural barriers to women in sports. Second, IOC policies and resources to reduce gender inequality in sports, while important, do not guarantee national change. Third, and more importantly, the SOC has addressed gender inequality with an approach based on the principles of "walk the talk" and "trial and error." All three arguments are elaborated on using the framework of intersectionality. The study draws empirically on data collected during and on SOC Gender and Sport Commission seminars and workshops, including two surveys, transcripts, and newspaper articles.

Keywords: Caribbean, gender inequality, safeguarding, Suriname Olympic Committee

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Authors: Mingyan Hong, Shuozhao Hou

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Collaborative Strategic Learning (CSL) teaches students to use learning strategies while working cooperatively. Student strategies include the following steps: defining the learning task and purpose; conducting ongoing negotiation of the learning materials by deciding "click" (I get it and I can teach it – green card, I get it –yellow card) or "clunk" (I don't get it – red card) at the end of each learning unit; "getting the gist" of the most important parts of the learning materials; and "wrapping up" key ideas. Find out how to help students of mixed achievement levels apply learning strategies while learning content area in materials in small groups. The design of CSL is based on social-constructivism and Vygotsky’s best-known concept of the Zone of Proximal Development (ZPD). The definition of ZPD is the distance between the actual acquisition level as decided by individual problem solution case and the level of potential acquisition level, similar to Krashen (1980)’s i+1, as decided through the problem-solution case under the facilitator’s guidance, or in group work with other more capable members (Vygotsky, 1978). Vygotsky claimed that learners’ ideal learning environment is in the ZPD. An ideal teacher or more-knowledgable-other (MKO) should be able to recognize a learner’s ZPD and facilitates them to develop beyond it. Then the MKO is able to leave the support step by step until the learner can perform the task without aid. Steven Krashen (1980) proposed Input hypothesis including i+1 hypothesis. The input hypothesis models are the application of ZPD in second language acquisition and have been widely recognized until today. Krashen (2019)’s optimal language learning environment (2019) further developed the application of ZPD and added the component of strategic group learning. The strategic group learning is composed of desirable learning materials learners are motivated to learn and desirable group members who are more capable and are therefore able to offer meaningful input to the learners. Purpose-driven Collaborative Strategic Learning Model is a strategic integration of ZPD, i+1 hypothesis model, and Optimal Language Learning Environment Model. It is purpose driven to ensure group members are motivated. It is collaborative so that an optimal learning environment where meaningful input from meaningful conversation can be generated. It is strategic because facilitators in the model strategically assign each member a meaningful and collaborative role, e.g., team leader, technician, problem solver, appraiser, offer group learning instrument so that the learning process is structured, and integrate group learning and team building making sure holistic development of each participant. Using data collected from college year one and year two students’ English courses, this presentation will demonstrate how purpose-driven collaborative strategic learning model is implemented in the second/foreign language classroom, using the qualitative data from questionnaire and interview. Particular, this presentation will show how second/foreign language learners grow from functioning with facilitator or more capable peer’s aid to performing without aid. The implication of this research is that purpose-driven collaborative strategic learning model can be used not only in language learning, but also in any subject area.

Keywords: collaborative, strategic, optimal input, second language acquisition

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Authors: Mekroud Amel

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Emergency departments are known for the workload, the variety of pathologies and the difficulties in their management with the continuous influx of patients The role of our service in the management of patients with two or three mild to moderate organ failures, involving several disciplines at the same time, as well as the effect of this management on the skills and efficiency of our team has been demonstrated Borderline cases between two or three or even more disciplines, with instability of a vital function, which have been successfully managed in the emergency room, the therapeutic procedures adopted, the consequences on the quality and level of care delivered by our team, as well as that the logistical consequences, and the pedagogical consequences are demonstrated. The consequences found are Positive on the emergency teams, in rare situations are negative Regarding clinical situations, it is the entanglement of hemodynamic distress with right, left or global participation, tamponade, low flow with acute pulmonary edema, and/or state of shock With respiratory distress with more or less profound hypoxemia, with haematosis disorder related to a bacterial or viral lung infection, pleurisy, pneumothorax, bronchoconstrictive crisis. With neurological disorders such as recent stroke, comatose state, or others With metabolic disorders such as hyperkalaemia renal insufficiency severe ionic disorders with accidents with anti vitamin K With or without septate effusion of one or more serous membranes with or without tamponade It’s a Retrospective, monocentric, descriptive study Period 05.01.2022 to 10.31.2022 the purpose of our work: Search for a statistically significant link between the type of moderate to severe pathology managed in the emergency room whose problems are multivisceral on the efficiency of the healthcare team and its level of care and optional care offered for patients Statistical Test used: Chi2 test to prove the significant link between the resolution of serious multidisciplinary cases in the emergency room and the effectiveness of the team in the management of complicated cases Search for a statistically significant link : The management of the most difficult clinical cases for organ specialties has given general practitioner emergency teams a great perspective and has been able to improve their efficiency in the face of emergencies received

Keywords: emergency care teams, management of patients with dysfunction of more than one organ, learning curve, quality of care

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Authors: Nioofar Margarite Rouhani

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Using a case study methodology, this study explores the lived experiences of elite women footballers (soccer) team in the United Arab Emirates (UAE) and the challenges and enablers women in this country encountered in their journey to competing at an international level. Through a series of face-to-face interviews with members of the first all-Emirati (people with UAE passport) women’s football team, members of the team’s coaching staff and key policymakers, the study sought to explore the social and cultural conditions that enabled the emergence of this team. A key aim of the study was to analyze the cultural shifts that have seemingly facilitated changes to gender relations in the UAE and to highlight possibilities for future gender equality work. The study explores the significance of sport in UAE society and its role in disrupting traditional gender boundaries. To do this, the study identifies and analyses contemporary social (religion, class, and culture) conditions that facilitate, and/or restrict, women’s sports participation in the public sphere of sport. Drawing on a feminist poststructural framework the study sought to analyse the discursive enactment of (disruptive) gender identity positions, using lenses such as ‘discourse’ and ‘power’. With a particular focus on elite women’s sport, the study sought to build knowledge around the advance of female participation in what has long been considered as a masculine domain. Here, the study sought to explore the lived experience of social change through a series of face-to-face interviews with members of the first all-Emirati- women’s football team and key support personnel. To maintain representational integrity, the principles of narrative methodology were employed for their ability to privilege the voices of participants while integrating contextual forces that comprised the stories they told about their experiences and the key people who participated in them. This approach supported a key aim of the study, being to analyse the cultural shifts that have supported changes in gender performance in the UAE and to highlight possibilities for future gender disruption. While the results of the study convey a growing sense of opportunity for aspiring sportswomen in the UAE, they also reveal that the participant pathways were full of contestation and restriction. What we learn from the stories of the first Emirate women’s football team is that where the will is strong enough, there can be a way. While it is reasonable to assume that such pathways will become easier in the future, as the participation of women in such sporting arenas becomes less exceptional, there are factors that are likely to enable and disable such journeys. Prominent here is the presence of a ‘powerful’ guardian and mentor who can offer sustained support, and influence. In a society where males continue to have disproportionate access to social and domestic power, such support can be extremely influential. Guardians and mentors can play a crucial role in garnering the support of dominant male figures, or helping to find ways to work around it.

Keywords: gender equality, women, sport, Middle East

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Authors: Rumbidzai Sipiwe Zimvumi

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The study aimed to identify the top management team attributes for ambidexterity in small and medium-sized enterprises by utilizing the upper echelons theory. The conventional opinion holds that an organization's ability to pursue both exploitative and explorative innovation methods at the same time is reflected in its ambidexterity. Top-level managers are critical to this matrix because they forecast and explain strategic choices that guarantee success by improving organizational performance. Since the focus of the study was on the unique characteristics of TMTs that can facilitate ambidexterity, the primary goal was to comprehend how TMTs in SMEs can better manage ambidexterity. The study used document analysis to collect information on ambidexterity and TMT traits. Finding, choosing, assessing, and synthesizing data from peer-reviewed publications allowed for the review and evaluation of papers. The fact that SMEs will perform better if they can achieve a balance between exploration and exploitation cannot be overstated. Unfortunately, exploitation is the main priority for most SMEs. The results showed that some of the noteworthy TMT traits that support ambidexterity in SMEs are age diversity, shared responsibility, leadership impact, psychological safety, and self-confidence. It has been shown that most SMEs confront significant obstacles in recruiting people, including formalizing their management and assembling executive teams with seniority. Small and medium-sized enterprises (SMEs) are often held by families or people who neglect to keep their personal lives apart from the firm, which eliminates the opportunity for management and staff to take the initiative. This helps to explain why exploitative strategies, which preserve present success, are used rather than explorative strategies, which open new economic opportunities and dimensions. It is evident that psychological safety deteriorates, and creativity is hindered in the process. The study makes the case that TMTs who are motivated to become ambidextrous can exist. According to the report, small- and medium-sized business owners should value the opinions of all parties involved and provide their managers and regular staff the freedom to think creatively and in a safe environment. TMTs who experience psychological safety are more likely to be inventive, creative, and productive. A team's collective perception that it is acceptable to take chances, voice opinions and concerns, ask questions, and own up to mistakes without fear of unfavorable outcomes is known as team psychological safety. Thus, traits like age diversity, leadership influence, learning agility, psychological safety, and self-assurance are critical to the success of SMEs. As a solution to ensuring ambidexterity is attained, the study suggests a clear separation of ownership and control, the adoption of technology to stimulate creativity, team spirit and excitement, shared accountability, and good management of diversity. Among the suggestions for the SME's success are resource allocation and important collaborations.

Keywords: navigating, ambidexterity, top management team, small and medium enterprises

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Authors: Aditya Manna, L. K. Khanra, S. K. Sarkar

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Aim: Due to financial incapability and the absence of manpower-poor families often fail to carry their advanced cancer patients to the nodal centers. This pilot study will explore whether communication by mobile phone can lessen this burden. Method: Initially a plan was generated regarding management of an advanced cancer patient in a nodal center at District Head Quarter. Subsequently every two week a trained social worker attached to the nodal center will follow up and give necessary advice and emotional support to the patients and their families through their registered mobile phone number. Patient’s family were also encouraged to communicate with the team by phone in case of fresh complain and urgency in between. Results: Since initiation in January 2013, 193 cancer patients were contacted by mobile phone every two weeks to enquire about their difficulties. In 76% of the situation trained social workers could give necessary advice by phone regarding management of their physical symptoms. Moreover, patient’s family was really overwhelmed by the emotional support offered by the team over the phone. Only 24% of cancer patients have to attend the nodal center for expert advice from Palliative Care specialists. Conclusion: This novel approach helped: (a) In providing regular physical and emotional support to the patients and their families. (b) In significantly reducing the financial and manpower problems of carrying patients to the nodal units. (c) In improving the quality of life of patients by continuous guidance. More and more team members can take help of this new strategy for better communication and uninterrupted care.

Keywords: palliative care, terminal care, home based palliative care, rural india

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Authors: Luedech Girdwichai, Withaya Mekhum

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This research intended to develop the model of community management for sustainable utilization by investigating on 2 groups of population, the family heads and the community management team. The population of the former group consisted of family heads from 511 families in 12 areas to complete the questionnaires which were returned at 479 sets. The latter group consisted of the community management team of 12 areas with 1 representative from each area to give the interview. The questionnaires for the family heads consisted of 2 main parts; general information such as occupations, etc. in the form of checklist. The second part dealt with the data on self reliance community development based on 4P Framework, i.e., People (human resource) development, Place (area) development, Product (economic and income source) development, and Plan (community plan) development in the form of rating scales. Data in the 1st part were calculated to find frequency and percentage while those in the 2nd part were analyzed to find arithmetic mean and SD. Data from the 2nd group of population or the community management team were derived from focus group to find factors influencing successful management together with the in depth interview which were analyzed by descriptive statistics. The results showed that 479 family heads reported that the aspect on the implementation of community plan to self reliance community activities based on Sufficient Economy Philosophy and the 4P was at the average of 3.28 or moderate level. When considering in details, it was found that the 1st aspect was on the area development with the mean of 3.71 or high level followed by human resource development with the mean of 3.44 or moderate level, then, economic and source of income development with the mean of 3.09 or moderate level. The last aspect was community plan development with the mean of 2.89. The results from the small group discussion revealed some factors and guidelines for successful community management as follows: 1) on the People (human resource) development aspect, there was a project to support and develop community leaders. 2) On the aspect of Place (area) development, there was a development on conservative tourism areas. 3) On the aspect of Product (economic and source of income) development, the community leaders promoted the setting of occupational group, saving group, and product processing group. 4) On the aspect of Plan (community plan) development, there was a prioritization through public hearing.

Keywords: model of community management, sustainable utilization, family heads, community management team

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Authors: Saou Mohamed Amine

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The construction industry has been identified as a user of substantial amount of materials and energy resources that has an enormous impact on environment. The energy efficient in refurbishment project is being considered as one of the approaches to achieve sustainability in construction industry. The increasing concern for environment has made building owners and designers to incorporate the energy efficiency features into their building projects. However, an overwhelming issue of existing non-energy efficient buildings which exceeds the number of new building could be ineffective if the buildings are not refurbished through the energy efficient measures. Thus, energy efficient in refurbishment project is being considered as one of the approaches to achieve sustainability that offers significant opportunities for reducing global energy consumption and greenhouse gas emissions. However, the quality of design team attributes and the characteristics of the refurbishment building projects have been argued to be the main factors that determine the energy efficiency performance of the building.

Keywords: construction industry, design team attributes, energy efficient performance, refurbishment projects characteristics

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Authors: Anjana Sreedharan, Harish Rao

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Background: India has the world’s third largest population of people living with HIV/AIDS, with a prevalence rate of 0.69 in the state of Karnataka. This study aims at assessing the HIV/AIDS related knowledge, attitude and behavior of the medical personnel in 3 hospitals in the city of Mangalore. Methods: Surgeons, Anesthetists, OT staff nurses, ward nursing staff, House surgeons working in the hospitals associated with Kasturba Medical college, Mangalore were given questionnaires and interviewed. Their knowledge about HIV, their attitude towards HIV positive patients and bias in management of the patients was assessed. Conclusion: So far, it has been found that amongst doctors, discrimination was mainly in the form of HIV testing without consent and a lack of confidentiality. However, the doctors rarely changed the treatment plan on knowing the HIV status of the patient. Amongst the nursing staff and interns, there is a serious lacuna of knowledge regarding HIV transmission, as compared to consultants. The patient seldom faced verbal abuse from the team. Use of universal precautions is less among the entire team due to insufficient availability of the same.

Keywords: discrimination, HIV/ AIDS, medical colleges, stigma

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Authors: L. M. H. Mustonen, S. A. Heikkilä

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The focus of the paper is to describe team teaching as a HAMK’s pedagogical method, and its impacts to the teachers work. Background: Traditionally it is thought that teaching is a job where one mostly works alone. More and more teachers feel that their work is getting more stressful. Solutions to these problems have been sought in Häme University of Applied sciences’ (From now on referred to as HAMK). HAMK has made a strategic change to move to the group oriented working of teachers. Instead of isolated study courses, there are now larger 15 credits study modules. Implementation: As examples of the method, two cases are presented: technical project module and summer studies module, which was integrated into the EU development project called Energy Efficiency with Precise Control. In autumn 2017, technical project will be implemented third time. There are at least three teachers involved in it and it is the first module of the new students. Main focus is to learn the basic skills of project working. From communicational viewpoint, they learn the basics of written and oral reporting and the basics of video reporting skills. According to our quality control system, the need for the development is evaluated in the end of the module. There are always some differences in each implementation but the basics are the same. The other case summer studies 2017 is new and part of a larger EU project. For the first time, we took a larger group of first to third year students from different study programmes to the summer studies. The students learned professional skills and also skills from different fields of study, international cooperation, and communication skills. Benefits and challenges: After three years, it is possible to consider what the changes mean in the everyday work of the teachers - and of course – what it means to students and the learning process. The perspective is HAMK’s electrical and automation study programme: At first, the change always means more work. The routines born after many years and the course material used for years may not be valid anymore. Teachers are teaching in modules simultaneously and often with some subjects overlapping. Finding the time to plan the modules together is often difficult. The essential benefit is that the learning outcomes have improved. This can be seen in the feedback given by both the teachers and the students. Conclusions: A new type of working environment is being born. A team of teachers designs a module that matches the objectives and ponders the answers to such questions as what are the knowledge-based targets of the module? Which pedagogical solutions will achieve the desired results? At what point do multiple teachers instruct the class together? How is the module evaluated? How can the module be developed further for the next execution? The team discusses openly and finds the solutions. Collegiate responsibility and support are always present. These are strengthening factors of the new communal university teaching culture. They are also strong sources of pleasure of work.

Keywords: pedagogical development, summer studies, team teaching, well-being at work

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Authors: Juliette MacDonald, Jun Li, Wenji Xiang, Mingwei Zhao

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Shanghai International College of Fashion and Innovation (SCF) was created as a result of a collaborative partnership agreement between the University of Edinburgh and Donghua University. The College provides two programmes: Fashion Innovation and Fashion Interior Design and the overarching curriculum has the intention of developing innovation and creativity within an international learning, teaching, knowledge exchange and research context. The research problem presented here focuses on the multi-national/cultural faculty in the team, the challenges arising from difficulties in communication and the associated limitations of management frameworks. The teaching faculty at SCF are drawn from China, Finland, Korea, Singapore and the UK with input from Flying Faculty from Fashion and Interior Design, Edinburgh College of Art (ECA), for 5 weeks each semester. Rather than fully replicating the administrative and pedagogical style of one or other of the institutions within this joint partnership the aim from the outset was to create a third way which acknowledges the quality assurance requirements of both Donghua and Edinburgh, the academic and technical needs of the students and provides relevant development and support for all the SCF-based staff and Flying Academics. It has been well acknowledged by those who are involved in teaching across cultures that there is often a culture shock associated with transnational education but that the experience of being involved in the delivery of a curriculum at a Joint Institution can also be very rewarding for staff and students. It became clear at SCF that if a third way might be achieved which encourages innovative approaches to fashion education whilst balancing the expectations of Chinese and western concepts of education and the aims of two institutions, then it was going to be necessary to construct a framework which developed close working relationships for the entire teaching team, so not only between academics and students but also between technicians and administrators at ECA and SCF. The attempts at co-construction and integration are built on the sharing of cultural and educational experiences and knowledge as well as provision of opportunities for reflection on the pedagogical purpose of the curriculum and its delivery. Methods on evaluating the effectiveness of these aims include a series of surveys and interviews and analysis of data drawn from teaching projects delivered to the students along with graduate successes from the last five years, since SCF first opened its doors. This paper will provide examples of best practice developed by SCF which have helped guide the faculty and embed common core values and aims of co-construction regulations and management, whilst building a pro-active TNE (Trans-National Education) team which enhances the learning experience for staff and students alike.

Keywords: cultural co-construction, educational team management, multi-cultural challenges, TNE integration for teaching teams

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Authors: Hela Ghali, Sihem Ben Fredj, Mohamed Ben Rejeb, Sawssen Layouni, Salwa Khefacha, Lamine Dhidah, Houyem Said Laatiri

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Background: Antimicrobial resistance is a growing threat to public health and motivates to improve prevention and control programs both at international (WHO) and national levels. Despite their low pathogenicity, vancomycin-resistant enterococci (VRE) are common nosocomial pathogens in several countries. The high potential for transmission of VRE between patients and the threat to send its resistance genes to other bacteria such as staphylococcus aureus already resistant to meticilin, justify strict control measures. Indeed, in Europe, the proportion of Enterococcus faecium responsible for invasive infections, varies from 1% to 35% in 2011 and less than 5% were resistant to vancomycin. In addition, it represents the second cause of urinary tract and wound infections and the third cause of nosocomial bacteremia in the United States. The nosocomial outbreaks of VRE have been mainly described in intensive care services, hematology-oncology and haemodialysis. An epidemic of VRE has affected our hospital and the objective of this work is to describe the measures put in place. Materials/Methods: Following the alert given by the service of plastic surgery concerning a patient carrier of VRE, a team of the prevention and healthcare security service (doctor + technician) made an investigation. A review of files was conducted to draw the synoptic table and the table of cases. Results: By contacting the microbiology laboratory, we have identified four other cases of VRE and who were hospitalized in Medical resuscitation department (2 cases, one of them was transferred to the Physical rehabilitation department), and Nephrology department (2 cases). The visit has allowed to detect several malfunctions in professional practice. A crisis cell has allowed to validate, coordinate and implement control measures following the recommendations of the Technical Center of nosocomial infections. In fact, the process was to technically isolate cases in their sector of hospitalization, to restrict the use of antibiotics, to strength measures of basic hygiene, and to make a screening by rectal swab for both cases and contacts (other patients and health staff). These measures have helped to control the situation and no other case has been reported for a month. 2 new cases have been detected in the intensive care unit after a month. However, these are short-term strategies, and other measures in the medium and long term should be taken into account in order to face similar outbreaks. Conclusion: The efforts to control the outbreak were not efficient since 2 new cases have been reported after a month. Therefore, a continuous monitoring in order to detect new cases earlier is crucial to minimize the dissemination of VRE.

Keywords: hospitals, nosocomial infection, outbreak, vancomycin-resistant enterococci

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Authors: Tomohiko Utsuki, Kyoka Sato

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In emergency medicine, it is recognized that brain resuscitation is very important for the reduction of mortality rate and neurological sequelae. Especially, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) are most required for stabilizing brain’s physiological state in the treatment for such as brain injury, stroke, and encephalopathy. However, the manual control of BT, ICP, and CBF frequently requires the decision and operation of medical staff, relevant to medication and the setting of therapeutic apparatus. Thus, the integration and the automation of the control of those is very effective for not only improving therapeutic effect but also reducing staff burden and medical cost. For realizing such integration and automation, a mathematical model of brain physiological state is necessary as the controlled object in simulations, because the performance test of a prototype of the control system using patients is not ethically allowed. A model of cerebral blood circulation has already been constructed, which is the most basic part of brain physiological state. Also, a migration model of extracellular fluid in brain has been constructed, however the condition that the total volume of intracranial cavity is almost changeless due to the hardness of cranial bone has not been considered in that model. Therefore, in this research, the dynamic migration model of extracellular fluid in brain was constructed on the consideration of the changelessness of intracranial cavity’s total volume. This model is connectable to the cerebral blood circulation model. The constructed model consists of fourteen compartments, twelve of which corresponds to perfused area of bilateral anterior, middle and posterior cerebral arteries, the others corresponds to cerebral ventricles and subarachnoid space. This model enable to calculate the migration of tissue fluid from capillaries to gray matter and white matter, the flow of tissue fluid between compartments, the production and absorption of cerebrospinal fluid at choroid plexus and arachnoid granulation, and the production of metabolic water. Further, the volume, the colloid concentration, and the tissue pressure of/in each compartment are also calculable by solving 40-dimensional non-linear simultaneous differential equations. In this research, the obtained model was analyzed for its validation under the four condition of a normal adult, an adult with higher cerebral capillary pressure, an adult with lower cerebral capillary pressure, and an adult with lower colloid concentration in cerebral capillary. In the result, calculated fluid flow, tissue volume, colloid concentration, and tissue pressure were all converged to suitable value for the set condition within 60 minutes at a maximum. Also, because these results were not conflict with prior knowledge, it is certain that the model can enough represent physiological state of brain under such limited conditions at least. One of next challenges is to integrate this model and the already constructed cerebral blood circulation model. This modification enable to simulate CBF and ICP more precisely due to calculating the effect of blood pressure change to extracellular fluid migration and that of ICP change to CBF.

Keywords: dynamic model, cerebral extracellular migration, brain resuscitation, automatic control

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Authors: Daniela Monteiro

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Considering the entry into force of the new EU audit reform regarding statutory auditors, in effect in all member states since 2016, this research aims to identify which audit regulation rules are associated with a high-level audit quality on both its dimensions, i.e., the actual quality and the perceived quality, in relation to public interest entities, within the European Union, and whether those rules have the same impact on both dimensions. Its measurement was based on the following proxies: the quality of financial information through earnings management and the impact of qualified opinions on financial costs. We considered in the research regulation subjects such as auditors’ rotation and provision of services (NAS) and also the level of market concentration. The criteria to include these issues in the research was its contemplation of the new rules. We studied the period before the audit reform (2009-2015) when the regulation measures were less uniform. Besides the consideration of both dimensions of audit quality and several regulation measures, we believe our conclusions configure an important contribution to this research field, considering the involvement of the first 15 member states of the European Union. The results consolidate the assumption that the balance between competence and independence is not the only challenge related to the regulation of the audit profession. The evidence demonstrates that the balance between actual and perceived quality is also a relevant matter. The major conclusion is that the challenge is to keep balanced both actual and perceived audit quality whilst ensuring the independence and competence of auditors.

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Authors: Verónica Arredondo, Miguel Martínez-Panero, Teresa Peña, Victoriano Ramírez

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The Mexican Chamber of Deputies is composed of 500 representatives: 300 of them elected by relative majority and another 200 ones elected through proportional representation in five electoral clusters (constituencies) with 40 representatives each. In this mixed-member electoral system, the seats distribution of proportional representation is not independent of the election by relative majority, as it attempts to correct representation imbalances produced in single-member districts. This two-fold structure has been maintained in the successive electoral reforms carried out along the last three decades (eight from 1986 to 2014). In all of them, the election process of 200 seats becomes complex: Formulas in the Law are difficult to understand and to be interpreted. This paper analyzes the Mexican electoral system after the electoral reform of 2014, which was applied for the first time in 2015. The research focuses on contradictions and issues of applicability, in particular situations where seats allocation is affected by ambiguity in the law and where asymmetrical treatment of political parties arises. Due to these facts, a proposal of electoral reform will be presented. It is intended to be simpler, clearer, and more enduring than the current system. Furthermore, this model is more suitable for producing electoral outcomes free of contradictions and paradoxes. This approach would allow a fair treatment of political parties and as a result an improved opportunity to exercise democracy.

Keywords: electoral mathematics, electoral reform, Mexican electoral system, political asymmetry, proportional representation

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Authors: N. N. Mosola, K. F. Moeketsi, R. Sehobai, N. Pule

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The Internet brings increasing use of Information and Communications Technology (ICT) services and facilities. Consequently, new computing paradigms emerge to provide services over the Internet. Although there are several benefits stemming from these services, they pose several risks inherited from the Internet. For example, cybercrime, identity theft, malware etc. To thwart these risks, this paper proposes a holistic approach. This approach involves multidisciplinary interactions. The paper proposes a top-down and bottom-up approach to deal with cyber security concerns in developing countries. These concerns range from regulatory and legislative areas, cyber awareness, research and development, technical dimensions etc. The main focus areas are highlighted and a cybersecurity model solution is proposed. The paper concludes by combining all relevant solutions into a proposed cybersecurity model to assist developing countries in enhancing a cyber-safe environment to instill and promote a culture of cybersecurity.

Keywords: cybercrime, cybersecurity, computer emergency response team, computer security incident response team

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Authors: Gautam, Arjun, V. R. Sharma

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In the civil construction steel and concrete plays a different role but the same purposes dealing with the design of structures that support or resist loads. Concrete has been used in construction since long time from now. Being brittle and weak in tension, concrete is always reinforced with steel bars for the purposes in beams and columns etc. The paper deals with idea of special designed 3D materials which we named as “BUM629” to be placed/anchored in the structural member and mixed with concrete later on, so as to resist the developments of cracks due to shear failure , buckling,tension and compressive load in concrete. It had cutting edge technology through Draft, Analysis and Design the “BUM629”. The results show that “BUM629” has the great results in Mechanical application. Its material properties are design according to the need of structure; we apply the material such as Mild Steel and Magnesium Alloy. “BUM629” are divided into two parts one is applied at the middle section of concrete member where bending movements are maximum and the second part is laying parallel to vertical bars near clear cover, so we design this material and apply in Reinforcement of Civil Structures. “BUM629” is analysis and design for use in the mega structures like skyscrapers, dams and bridges.

Keywords: BUM629, magnesium alloy, cutting edge technology, mechanical application, draft, analysis and design, mega structures

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Authors: Khodi Morgan, Kasey Crowe, Amanda Morgan

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Canadian High School Students' Attitudes & Objective: To survey Canadian high school students regarding their attitudes and perspectives towards people with disabilities and explore how age, gender, and personal experience with a disability may impact these views. Methods: A survey was developed using the standardized Attitude Toward Persons With Disability Scale as its base, with the addition of questions specifically about Autism and Attention Deficit Hyperactivity Disorder (ADHD). The survey also gathered information about the participant’s age and gender and whether or not they, or a close family member, had any disabilities. Participants were recruited at a public Canadian high school by fellow student researchers. Results: A total of 219 (N=219) students ranging from 13 - 19 years old participated in the study (m= 15.9 years of age). Gender was equally split, with 44% male, 42% female and 14% undeclared. Experience with a disability was common amongst participants, with 25% self-identifying as having a personal disability and 48% claiming to have a close family member with a disability. Exploratory trends indicated that females, people with self-identified disabilities, and people with close family members with disabilities trended towards having more positive attitudes toward persons with disabilities.

Keywords: disability, autism, ADHD, high school, adolescence, community research, acceptance

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Authors: Nur Iman Subono, Meidi Kosandi

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This paper examines the role of regional cooperation in the Association of Southeast Asian Nations (ASEAN) in the fight against human trafficking for Indonesia. Many among scholars suggest that regional cooperation is necessary for combating human trafficking for its transnational and organized character as a crime against humanity. ASEAN members have been collectively active in responding transnational security issues with series of talks and collaboration agreement since early 2000s. Lately in 2015, ASEAN agreed on ASEAN Convention against Trafficking in Persons, particularly Women and Children (ACTIP) that requires each member to collaborate in information sharing and providing effective safeguard and protection of victims. Yet, the frequency of human trafficking crime occurrence remains high and tend to increase in Indonesian in 2017-2018. The objective of this paper is to examine the effectiveness and success of ACTIP implementation in the fight against human trafficking in Indonesia. Based on two years of research (2017-2018) in three provinces with the largest number of victims in Indonesia, this paper shows the tendency of persisting crime despite the implementation of regional and national anti-trafficking policies. The research was conducted by archive study, literature study, discourse analysis, and depth interviews with local government officials, police, prosecutors, victims, and traffickers. This paper argues that the relative success of ASEAN in establishing convention at the high-level meetings has not been followed with the success in its implementation in the society. Three main factors have contributed to the ineffectiveness of the agreements, i.e. (1) ASEAN institutional arrangement as a collection of sovereign states instead of supranational organization with binding authority; (2) the lack of commitment of ASEAN sovereign member-states to the agreements; and (3) the complexity and variety of the nature of the crime in each member-state. In effect, these factors have contributed to generating the regionalism paradox in ASEAN where states tend to revert to national policies instead of seeking regional collective solution.

Keywords: human trafficking, transnational security, regionalism, anti trafficking policy

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Authors: Taejin Kim, Heonwoo Lee, Jong-Ho Kim, Dongchul Lee

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Recently, there have been various high-rise building projects which reflect unique inspiration from architects to their feature. And it is frequently found that some of these buildings have diagrid structural system. Diagrid system provides engineers many options for structural plan, since it has triangular module so it can form a number of complex shapes. Unlike braced frame systems, diagonal members in diagrid system resist gravity and horizontal loads simultaneously. Correspondingly, diagrid members take roles of both beams and columns, and it is expected that their ductile capacity may depend on the amount of gravity loads. However, not enough studies have been made for this issue so far, which means that there is demand of examination on the seismic behavior of diagrid members under large gravity loads. Therefore, in this study, the ductile capacity of diagrid members was evaluated through analytical and experimental method. Several cases that have different vertical load condition were set up for both approaches to consider the effect of initial compression force due to gravity load. Regarding the result, it was found that buckling in a diagonal member occurs at smaller drift angle when larger gravity load acts on the specimen, which also reduces the amount of energy dissipation. It means that axial stress in a diagonal member reaches critical buckling force early due to the combined axial force from not only horizontal load but also gravity load.

Keywords: buckling, diagrid, ductility, seismic performance

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Authors: Katie Jerram, Jacqui Nevols, Rebecca Howes, Hayley Richardson, Debbie Suso, Thomas Batten, Reny Mathai

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Pyomyositis is an uncommon acute purulent skeletal muscle infection, usually caused by Staphylococcus aureus, occurring either spontaneously or following local trauma. Immunocompromise is a risk factor. It presents with pyrexia, pain, and tenderness of the affected muscle, which may have a firm ‘woody’ feel. Management usually involves surgery and prolonged courses of antibiotics, but alongside these active treatments, palliation of symptoms such as pain is also a priority. A short case series of diabetic inpatients under the care of the Renal Medicine team with pyomyositis is presented, demonstrating that Hospital Palliative Care Teams may be well placed to provide symptom management advice by working jointly with the patient’s medical or surgical team. A review of the literature on the management of pain in pyomyositis is also presented, and there was no clear consensus on the best strategy. It may be that a combination of analgesics and adjuncts is the most effective strategy, perhaps combined with the holistic approach used within palliative care.

Keywords: pyomyositis, pain, palliation, analgesia

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Authors: Selinda England, Ben Bodnaryk

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With an unprecedented increase in provincial immigration and government support for greater international and culturally diverse learners, a trade/applied learning-focused polytechnic with four campuses within one Canadian province saw the need for intercultural awareness and an intercultural teaching competence strategy for faculty training. An institution-wide pre-assessment needs survey was conducted in 2018, in which 87% of faculty professed to have some/no training when working with international and/or culturally diverse learners. After researching fellow Polytechnics in Canada and seeing very little in the way of faculty support for intercultural competence, an institutional project team comprised of members from all facets of the Polytechnic was created and included: Indigenous experts, Academic Chairs, Directors, Human Resource Managers, and international/settlement subject matter experts. The project team was organized to develop and implement a new academic model focused on enriching intercultural competence among faculty. Utilizing a competency based model, the project team incorporated inclusive terminology into competency indicators and devised a four-phase proposal for implementing intercultural teacher training: a series of workshops focused on the needs of international and culturally diverse learners, including teaching strategies based on current TESOL methodologies, literature and online resources for quick access when planning lessons, faculty assessment examples and models of interculturally proficient instructors, and future job descriptions - all which promote and encourage development of specific intercultural skills. Results from a post-assessment survey (to be conducted in Spring 2020) and caveats regarding improvements and next steps will be shared. The project team believes its intercultural and inclusive teaching competency-based model is one of the first, institution-wide faculty supported initiatives within the Canadian college and Polytechnic post-secondary educational environment; it aims to become a leader in both the province and nation regarding intercultural competency training for trades, industry, and business minded community colleges and applied learning institutions.

Keywords: cultural diversity and education, diversity training teacher training, teaching and learning, teacher training

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Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq

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Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.

Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement

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Authors: Rayed Alyousef, Tim Topper, Adil Al-Mayah

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Many of the reinforced concrete structures subject to cyclic load constructed before the modern bond and fatigue design code. One of the main issue face on exists structure is the bond strength of the longitudinal steel bar and the surrounding concrete. A lap splice is a common connection method to transfer the force between the steel rebar in a reinforced concrete member. Usually, the lap splice is the weak connection on the bond strength. Fatigue flexural loading imposes severe demands on the strength and ductility of the lap splice region in reinforced concrete structures and can lead to a brittle and sudden failure of the member. This paper investigates the effect of different concrete covers on the fatigue bond strength of reinforcing concrete beams containing a lap splice under a fatigue loads. It includes tests of thirty-seven beams divided into three groups. Each group has beams with 30 mm and 50 mm clear side and bottom concrete covers. The variables that were addressed where the concrete cover, the presence or absence of CFRP or GFRP sheet wrapping, the type of loading (monotonic or fatigue) and the fatigue load ranges. The test results showed that an increase in the concrete cover led to an increase in the bond strength under both monotonic and fatigue loading for both the unwrapped and wrapped beams. Also, the FRP sheets increased both the fatigue strength and the ductility for both the 30 mm and the 50 mm concrete covers.

Keywords: bond strength, fatigue, Lap splice, FRp wrapping

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Authors: Bency Ann Massinello, Nancy Day, Janet Fellini

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Background: The use of an appropriate mode of communication among the multidisciplinary care team members regarding coordination of care is an extremely complicated yet important patient safety initiative. Effective communication among the team members(nursing staff, medical staff, respiratory therapists, rehabilitation therapists, patient-family services team…) become essential to develop a culture of trust and collaboration to deliver the highest quality care to patients are their families. The inpatient post-acute pediatrics, where children and their caregivers come for continuity of care, is no exceptions to the increasing use of text messages as a means to communication among clinicians. One such platform is the Vocera Communications (Vocera Smart Mobile App called Vocera Edge) allows the teams to use the application and share sensitive patient information through an encrypted platform using IOS company provided shared and assigned mobile devices. Objective: This paper discusses the quality initiative of implementing the transition from Vocera Smartbage to Vocera Edge Mobile App, technology advantage, use case expansion, and lessons learned about a secure alternative modality that allows sending and receiving secure text messages in a pediatric post-acute setting using an IOS device. This implementation process included all direct care staff, ancillary teams, and administrative teams on the clinical units. Methods: Our institution launched this transition from voice prompted hands-free Vocera Smartbage to Vocera Edge mobile based app for secure care team texting using a big bang approach during the first PDSA cycle. The pre and post implementation data was gathered using a qualitative survey of about 500 multidisciplinary team members to determine the ease of use of the application and its efficiency in care coordination. The technology was further expanded in its use by implementing clinical alerts and alarms notification using middleware integration with patient monitoring (Masimo) and life safety (Nurse call) systems. Additional use of the smart mobile iPhone use include pushing out apps like Lexicomp and Up to Date to have it readily available for users for evident-based practice in medication and disease management. Results: Successful implementation of the communication system in a shared and assigned model with all of the multidisciplinary teams in our pediatric post-acute setting. In just a 3-monthperiod post implementation, we noticed a 14% increase from 7,993 messages in 6 days in December 2020 to 9,116messages in March 2021. This confirmed that all clinical and non-clinical teams were using this mode of communication for coordinating the care for their patients. System generated data analytics used in addition to the pre and post implementation staff survey for process evaluation. Conclusion: A secure texting option using a mobile device is a safe and efficient mode for care team communication and collaboration using technology in real time. This allows for the settings like post-acute pediatric care areas to be in line with the widespread use of mobile apps and technology in our mainstream healthcare.

Keywords: nursing informatics, mobile secure texting, multidisciplinary communication, pediatrics post acute care

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Authors: Larry Turkish

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Introduction: The NBA is an example of mediocrity and this will be evident in the following paper. The study examines and evaluates the characteristics of the NBA champions. As divisions and playoff teams increase, there is an increase in the probability that the champion originates from the mediocre category. Since it’s inception in 1947, the league has been mediocre and continues to this day. Why does a professional league allow any team with a less than 50% winning percentage into the playoffs? As long as the finances flow into the league, owners will not change the current algorithm. The objective of this paper is to determine if the regular season has meaning in finding an NBA champion. Statistical Analysis: The data originates from the NBA website. The following variables are part of the statistical analysis: Rank, the rank of a team relative to other teams in the league based on the regular season win-loss record; Winning Percentage of a team based on the regular season; Divisions, the number of divisions within the league and Playoff Teams, the number of playoff teams relative to a particular season. The following statistical applications are applied to the data: Pearson Product-Moment Correlation, Analysis of Variance, Factor and Regression analysis. Conclusion: The results indicate that the divisional structure and number of playoff teams results in a negative effect on the winning percentage of playoff teams. It also prevents teams with higher winning percentages from accessing the playoffs. Recommendations: 1. Teams that have a winning percentage greater than 1 standard deviation from the mean from the regular season will have access to playoffs. (Eliminates mediocre teams.) 2. Eliminate Divisions (Eliminates weaker teams from access to playoffs.) 3. Eliminate Conferences (Eliminates weaker teams from access to the playoffs.) 4. Have a balanced regular season schedule, (Reduces the number of regular season games, creates equilibrium, reduces bias) that will reduce the need for load management.

Keywords: alignment, mediocrity, regression, z-score

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Authors: Hang Thuy Tran, Hanh Hong Pham, Ha Thanh Hoa

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From 2009 up to now, the water quantity and water quality of the Mekong River, located in the South of Vietnam, have been significantly reduced. The phenomenon happened as a result of climate change and human activities. The Mekong River is an international source of water, flowing across the borders of 6 countries, with Vietnam downstream. Activities to block the flow or build dams to construct hydroelectricity or diversion in upstream countries are either the direct cause or the risk of further deterioration of the water quality and quantity of the Mekong River, as evidenced by two phenomena which are a saline intrusion and transboundary water pollution. The protection of the crucial source of water is done through bilateral and multilateral cooperation mechanisms, notably the Mekong River Commission, established by members of the Agreement on the Cooperation for the Sustainable Development of the Mekong River Basin 1995. In this document, under Article 7, the 'no-harm' principle requires member states to take appropriate measures to prevent causing substantial damage to other member states. This principle has been practiced through the work of a number of committees established by the commission. However, the content of the rules is undetailed, lacks an implementation monitoring mechanism, and has an unreasonable dispute solution. With such difficulties, the provisions in the principle of no-harm are not adequate to protect the Mekong River's water resources in the current context.

Keywords: no-harm principle, transboundary water pollution, Mekong Commission, international source of water

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Authors: G. Tamanza, A. Bossoni

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84 deaf students (from primary school to college) and their families participated in this inclusion project in cooperation with numerous institutions in northern Italy (Brescia-Lombardy). Participants were either congenitally deaf or their deafness was related to other pathologies. This research promoted the integration of deaf students as they pass from primary school to high school to college. Learning methods and processes were studied that focused on encour­aging individual autonomy and socialization. The research team and its collaborators included school teachers, speech ther­apists, psychologists and home tutors, as well as teaching assistants, child neuropsychiatrists and other external authorities involved with deaf persons social inclusion programs. Deaf children and their families were supported, in terms of inclusion, and were made aware of the research team that focused on the Bisogni Educativi Speciali (BES or Special Educational Needs) (L.170/2010 - DM 5669/2011). This project included a diagnostic and evaluative phase as well as an operational one. Results demonstrated that deaf children were highly satisfied and confident; academic performance improved and collaboration in school increased. Deaf children felt that they had access to high school and college. Empowerment for the families of deaf children in terms of networking among local services that deal with the deaf also improved while family satisfaction also improved. We found that teachers and those who gave support to deaf children increased their professional skills. Achieving autonomy, instrumental, communicative and relational abilities were also found to be crucial. Project success was determined by temporal continuity, clear theoretical methodology, strong alliance for the project direction and a resilient team response.

Keywords: autonomy, inclusion, skills, well-being

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