Search results for: descriptive architecture

Authors: Meenakshi Chaubey

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A principle proposed in the cross-cultural adaption of behavior among Indian and Tibetan societies in which there are not any great variations between their young adults on the mindset of day-to-day marriage, Marriage plays a dominant position in constructing the society, which in large part comprises underneath the domain of lifestyle. Way of life is a social behavior and norm located in human societies where an extensive range of phenomena can be transmitted thru social studying. It acts characteristic of the individual has been the diploma day-to-day which they have got cultivated a specific stage of class in arts, science, architecture. The existing studies preliminarily on young adults of each community, wherein we carried out a comparative observe of the mindset of daily marriage among Indian and Tibetan teens. Further, we studied statistics comprehensively on the mindset closer day by day the marriage between Indian adult males and Tibetan younger males. With the extension of a complete look, we considered the mindset of an everyday marriage of Indian girls and Tibetan young ladies. Studies 1 showed that there might be no sizable distinction within the attitude of the day-to-day marriage of Indian and Tibetan teenagers. It, in addition, showed that they followed each different marriage beliefs and customs. Studies 2 showed that there might be no important difference in the attitude toward the everyday marriage of Indian and Tibetan young males. It similarly showcased that day-to-day secular schooling gadget in Tibetan society complements their clinical approach and changes their point of view on distinct social issues along with marriage. Research three confirmed that there is no substantial difference in the mindset of the daily marriage of Indian and Tibetan younger females. It similarly spread out the strict authorities' recommendations that they may no longer be allowed day-to-day comply with their marriage practices, including polygamy and polyandry. Thus, the information showed that there's a shift of lifestyle from one network every day to some other community because of social every day, which affects the conduct and results of daily past cultural adaptation.

Keywords: culture, marriage, attitude, society, young adults, Indian, Tibetan

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Authors: Emmanuel Iyamuremye, Jean François Maniriho, Irenee Ndayambaje

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Mathematics is the foundational enabling discipline that underpins science, technology, and engineering disciplines. Science, technology, engineering, and mathematics (STEM) subjects are foreseen as the engine for socio-economic transformation. Rwanda has done reforms in education aiming at empowering and preparing students for the real world job by providing career pathways in science, technology, engineering, and mathematics related fields. While that considered so, the performance in mathematics has remained deplorable in both formative and national examinations. Therefore, this paper aims at exploring the extent to which the engage, explore, explain, elaborate and evaluate (5Es) instructional model contributing towards students’ achievement in mathematics. The present study adopted the pre-test, post-test non-equivalent control group quasi-experimental design. The 5Es instructional model was applied to the experimental group while the control group received instruction with the conventional teaching method for eight weeks. One research-made instrument, mathematics achievement test (MAT), was used for data collection. A pre-test was given to students before the intervention to make sure that both groups have equivalent characteristics. At the end of the experimental period, the two groups have undergone a post-test to ascertain the contribution of the 5Es instructional model. Descriptive statistics and analysis of covariance (ANCOVA) were used for the analysis of the study. For determining the improvement in mathematics, Hakes methods of calculating gain were used to analyze the pre-test and post-test scores. Results showed that students exposed to 5Es instructional model achieved significantly better performance in mathematics than students instructed using the conventional teaching method. It was also found that 5Es instructional model made lessons more interesting, easy and created friendship among students. Thus, 5Es instructional model was recommended to be adopted as a close substitute to the conventional teaching method in teaching mathematics in lower secondary schools in Rwanda.

Keywords: 5Es instructional model, achievement, conventional teaching method, mathematics

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Authors: Melba Sheila D'Souza, Anandhi Amirtharaj, Shreedevi Balachandran

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Background: Type 2 diabetes has a significant impact on individuals’ health and well-being. Glycemic control may influence self-efficacy and self-care behaviors, and reduce the risk of complications among adults with type 2 diabetes. Type 2 diabetes has substantial morbidity and mortality and 60% of adults’ poor self-care. Glycemic control is associated with reported self-efficacy and self-care behavior. Adults with type 2 diabetes with less information were less likely to take diabetes self-care. Aim: To examine the relationship between glycemic control, demographic factors, clinical factors on self-efficacy, self-care behaviors among Omani adults with type 2 diabetes. Methods: A correlational, descriptive study was used. Omani adults with type 2 diabetes (n=140) were recruited from a public hospital in Oman. The data were collected during January-March 2015. Ethical approval was given by the college research and ethics committee, College of Nursing, and the Hospital, Sultan Qaboos University Data was collected on self-efficacy, self-care behaviors and glycemic control. The study was approved by the Institution Ethics and Research Committee. Bivariate and multivariate analyses were conducted. Results: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating ‘uncontrolled or poor HbA1c of > 8%’ (65%). Variance of self-care behavior (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. Adults with type 2 diabetes with poor glycemic control were more likely to have poor self-efficacy and poor self-care behaviors. Conclusion: This study confirms that self-efficacy model on outcome predicts self-efficacy and self-care behavior. Higher understanding of diabetes, prevention of normal daily activities, higher ability to fit diabetes life in a positive manner and high patient-physician communication were significant with self-efficacy and self-care behaviors. Hence, glycemic control has a high effect on improving self-care behaviors like diet, exercise, medication, foot care and self-efficacy among type 2 diabetes. Implications: Using these findings to improve self-efficacy, individualized self-care management is recommended for better self-efficacy and self-care behaviors among adults with type 2 diabetes.

Keywords: self-efficacy, self-care behaviors, self-care management, glycemic control, type 2 diabetes, nurse

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Authors: Yananda Siraphatthada

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The objectives of this research were to study the level of influencing factors, leadership, supply chain management, innovation, competitive advantages, business success, and affecting factors to the business success of the mobile phone system service providers in Bangkok Metropolitan. This research was done by the quantitative approach and the qualitative approach. The quantitative approach was used for questionnaires to collect data from the 331 mobile service shop managers franchised by AIS, Dtac and TrueMove. The mobile phone system service providers/shop managers were randomly stratified and proportionally allocated into subgroups exclusive to the number of the providers in each network. In terms of qualitative method, there were in-depth interviews of 6 mobile service providers/managers of Telewiz and Dtac and TrueMove shop to find the agreement or disagreement with the content analysis method. Descriptive Statistics, including Frequency, Percentage, Means and Standard Deviation were employed; also, the Structural Equation Model (SEM) was used as a tool for data analysis. The content analysis method was applied to identify key patterns emerging from the interview responses. The two data sets were brought together for comparing and contrasting to make the findings, providing triangulation to enrich result interpretation. It revealed that the level of the influencing factors – leadership, innovation management, supply chain management, and business competitiveness had an impact at a great level, but that the level of factors, innovation and the business, financial success and nonbusiness financial success of the mobile phone system service providers in Bangkok Metropolitan, is at the highest level. Moreover, the business influencing factors, competitive advantages in the business of mobile system service providers which were leadership, supply chain management, innovation management, business advantages, and business success, had statistical significance at .01 which corresponded to the data from the interviews.

Keywords: mobile service providers, facilitating factors, Bangkok Metropolitan, business success

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Authors: Luksanaporn Krungkraipetch

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A pterygium is an eye surface lesion that begins in the limbal conjunctiva and progresses to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a distinctive wing-like aspect. Indications for surgery, in decreasing order of significance, are grown over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and aesthetic concerns. Recurrent pterygium results in the loss of time, the expense of therapy, and the potential for vision impairment. The objective of this study is to find out how often the recurrence of pterygium after surgery occurs, what effect the surgery technique has, and what causes them to come back in people with pterygium. Materials and Methods: Observational case control in retrospect: the study involves a retrospective analysis of 164 patient samples. Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium. For factor analysis, the inferential statistics odds ratio (OR) and 95% confidence interval (CI) ANOVA are utilized. A p-value of 0.05 was deemed statistically important. Results: The majority of patients, according to the results, were female (60.4%). Twenty-four of the 164 (14.6%) patients who underwent surgery exhibited recurrent pterygium. The average age is 55.33 years old. Postoperative recurrence was reported in 19 cases (79.3%) of bare sclera techniques and five cases (20.8%) of conjunctival autograft techniques. The recurrence interval is 10.25 months, with the most common (54.17 percent) being 12 months. In 91.67 percent of cases, all follow-ups are successful. The most common recurrence level is 1 (25%). A surgical complication is a subconjunctival hemorrhage (33.33 percent). Comparing the surgeries done on people with recurrent pterygium didn't show anything important (F = 1.13, p = 0.339). Age significantly affected the recurrence of pterygium (95% CI, 6.79-63.56; OR = 20.78, P 0.001). Conclusion: This study discovered a 14.6% rate of pterygium recurrence after pterygium surgery. Across all surgeries and patients, the rate of recurrence was four times higher with the bare sclera method than with conjunctival autograft. The researchers advise selecting a more conventional surgical technique to avoid a recurrence.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

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Authors: Guillaume Craveur

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This study shows the opportunity to use numerical tools dedicated to Fire Safety Engineering for the Rolling Stock. Indeed, some lawful requirements can now be demonstrated by using numerical tools. The first part of this study presents the use of modelling evacuation tool to satisfy the criteria of evacuation time for the rolling stock. The buildingEXODUS software is used to model and simulate the evacuation of rolling stock. Firstly, in order to demonstrate the reliability of this tool to calculate the complete evacuation time, a comparative study was achieved between a real test and simulations done with buildingEXODUS. Multiple simulations are performed to capture the stochastic variations in egress times. Then, a new study is done to calculate the complete evacuation time of a train with the same geometry but with a different interior architecture. The second part of this study shows some applications of Computational Fluid Dynamics. This work presents the approach of a multi scales validation of numerical simulations of standardized tests with Fire Dynamics Simulations software developed by the National Institute of Standards and Technology (NIST). This work highlights in first the cone calorimeter test, described in the standard ISO 5660, in order to characterize the fire reaction of materials. The aim of this process is to readjust measurement results from the cone calorimeter test in order to create a data set usable at the seat scale. In the second step, the modelisation concerns the fire seat test described in the standard EN 45545-2. The data set obtained thanks to the validation of the cone calorimeter test was set up in the fire seat test. To conclude with the third step, after controlled the data obtained for the seat from the cone calorimeter test, a larger scale simulation with a real part of train is achieved.

Keywords: fire safety engineering, numerical tools, rolling stock, multi-scales validation

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Authors: Taibat Busari

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Electronic media has created new options for enhancing education. It has long been providing innovative methods for arousing students’ attention in learning and improves teachers’ performance in disseminating instructional contents. However, the advancement of electronic media has increased the flexibility, availability, accessibility and improved communications among students-students, students-teacher, and teacher-students. This study investigated: (i) teachers’ accessibility to, and utilization of electronic media for teaching basic science and technology in Ilorin metropolis; (ii) the influence of school proprietorship on teachers’ access to and utilization of electronic media for teaching and; the influence of teachers’ gender on the use of electronic media. The research was a descriptive design using the survey method. The study sample was drawn for private and public secondary schools in Ilorin Metropolis. The respondents were 285 basic science and technology teachers, which comprised of 146 males and 139 females. A structured researcher designed questionnaire was used to gather data for the study. Pilot study was carried out on mini sample of 20 basic science and technology teachers in five schools which are not part of the study’s population. It was then subjected to Cronbach’s Alpha and yielded the values 0.794 for availability, 0.730 for accessibility and 0.84 for utilization of electronic media. The research questions were answered using mean and percentage while research hypotheses one and two was tested using t- test. The findings of the study showed that: (i) electronic media are available for teaching basic science and technology; (ii) teachers’ had access to electronic media for teaching; (iii) teachers’ utilized electronic media for teaching basic science and technology; (iv) there was no significant difference between teachers’ utilization of electronic media for teaching; (v) there was no significant difference between teachers’ utilization of electronic media for teaching based on school proprietorship. The study, therefore, concluded that teachers’ had access to electronic media and utilized it for teaching purposes. Gender had no influence on teachers’ access to and utilization on electronic media for teaching and also, school proprietorship had no influence on access and utilization of electronic media for teaching. Based on findings it was recommended that electronic media should be made available and utilized in all schools across the nation to improve the learning rate of the students.

Keywords: electronic media, basic science and technology, teachers' accessibility, Nigeria

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Authors: Ali Arazeem Abdullahi, Mariam Seedat-Khan, Bamidele S. Akanni

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Background: Like the rest of the world, cancer of the breast is a life-threatening disease to Nigerian women. The utilization of mammography is however very poor among the general population. Whereas, there strong indications that women who engage in the regular screening of breast cancer using mammography are more likely to have a lower risk of developing and dying from advanced breast cancer compared to unscreened women. This study examined knowledge of breast cancer and utilization of mammography among undergraduate female students at the University of Ilorin, Nigeria. Health Belief Model (HBM) was deployed to guide the conduct of the study. Method: Self-administered questionnaire was used to collect data from 292 undergraduate female students from the faculties of Social and Management Sciences of the University. A simple random sampling technique was used to select the respondents. Data was analyzed using both descriptive and inferential statistics. Results: The study found that apart from high knowledge of breast cancer and mammography, perceived threat, perceived susceptibility and perceived seriousness of breast cancer were equally high. However, the uptake of mammography was very poor largely due to perceived barriers including being single and young and poor history of breast cancer in families (cues to action). The test of hypotheses showed that there is a weak relationship of about 6.8% between knowledge of breast cancer and utilization of mammography (p-value= 0.244) at 0.05 level of significance. However, 64.4% of the respondents were willing to utilize mammography in the future if the opportunity arises. While the study found a significant statistical relationship between the perceived benefits of mammography and its utilization among the respondents, no significant statistical association was found between the socio-demographic characteristics of the respondents and the uptake of mammography. Recommendations: Findings highlight the need for health education interventions to promote breast cancer screening and the utilization mammography, while addressing barriers to the uptake of mammography among female undergraduate students of the University of Ilorin and Nigeria in general.

Keywords: cancer of the breast, mammography, female undergraduate students, health belief model, University of Ilorin

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Authors: Km Tanu

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It has been widely accepted that the learning style of adults and children is different, the learning motivation among adults vary, and even their learning preferences cannot be predetermined. In India, where the population is widely diverse and socio-economic and cultural disparities are there, the learning strategies should also be according to their needs and preferences. The present study explores the concept of adult learners in India in order to understand their needs and styles better. The adult learning principles of Malcolm Knowles have been analyzed, and its presence in the different policies and programs has been traced. To what extent these principles and other such concepts would be beneficial for the Indian population and for effective learning strategies, and what contextual understanding is needed, has been argued in the study. Descriptive research methodology, along with content and thematic analyses, has been used for the paper. It has been argued that there are four areas that play crucial roles in making learning effective. These are the learner, the facilitator, the resources and the policy. The prior experiences of the learners, their motivation, the group to which they belong (i.e., the learning styles and the strategies can be varied for the group of farmers and migrant laborers), and their expected outcome play an important role in making any adult education program successful but along with this, the role of facilitator or the educator is also very important as it is not easy to deal with the adult learners, the understanding that the task is not to teach the adult learners but to make them learn and to use their prior knowledge is a task in itself, proper training is needed for that matter. Many times, it has been seen that adult education programs are poorly funded, or even if they are funded, the fund is not utilized well; the unavailability of the resources is one of the reasons for the failure of adult education programs, and if we see these four points as a triangle, at the bottom, there is a policy document. A well-stated and described doable policy document is also equally important.

Keywords: adult education, Indian adult learner, effective learning styles, Malcolm Knowles learning principles, adult education policies and program

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Authors: Ebenezer O. Ige, Funmilayo H. Oyelami, Joshua Olutayo-Irheren, Joseph T. Okunlola

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Hyperthermia therapy is an adjuvant procedure during which perfused body tissues is subjected to elevated range of temperature in bid to achieve improved drug potency and efficacy of cancer treatment. While a selected class of hyperthermia techniques is shouldered on the thermal radiations derived from single-sourced electro-radiation measures, there are deliberations on conjugating dual radiation field sources in an attempt to improve the delivery of therapy procedure. This paper numerically explores the thermal effectiveness of combined infrared hyperemia having nanoparticle recirculation in the vicinity of imposed magnetic field on subcutaneous strata of a model lesion as ablation scheme. An elaborate Spectral relaxation method (SRM) was formulated to handle equation of coupled momentum and thermal equilibrium in the blood-perfused tissue domain of a spongy fibrous tissue. Thermal diffusion regimes in the presence of external magnetic field imposition were described leveraging on the renowned Roseland diffusion approximation to delineate the impact of radiative flux within the computational domain. The contribution of tissue sponginess was examined using mechanics of pore-scale porosity over a selected of clinical informed scenarios. Our observations showed for a substantial depth of spongy lesion, magnetic field architecture constitute the control regimes of hemodynamics in the blood-tissue interface while facilitating thermal transport across the depth of the model lesion. This parameter-indicator could be utilized to control the dispensing of hyperthermia treatment in intravenous perfused tissue.

Keywords: spectra relaxation scheme, thermal equilibrium, Roseland diffusion approximation, hyperthermia therapy

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Authors: Chien Y. Lin, Jung Y. Huang, Leu-Wei Lo

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A growing body of data reveals that the membrane cholesterol molecules can alter the signaling pathways of living cells. However, the understanding about how membrane cholesterol modulates receptor proteins is still lacking. Single-molecule tracking can effectively probe into the microscopic environments and thermal fluctuations of receptor proteins in a living cell. In this study we applies single-molecule optical tracking on ligand-induced dimerization process of EGFRs in the plasma membranes of two cancer cell lines (HeLa and A431) and one normal endothelial cell line (MCF12A). We tracked individual EGFR and dual receptors, diffusing in a correlated manner in the plasma membranes of live cells. We developed an energetic model by integrating the generalized Langevin equation with the Cahn-Hilliard equation to help extracting important information from single-molecule trajectories. From the study, we discovered that ligand-bound EGFRs move from non-raft areas into lipid raft domains. This ligand-induced motion is a common behavior in both cancer and normal cells. By manipulating the total amount of membrane cholesterol with methyl-β-cyclodextrin and the local concentration of membrane cholesterol with nystatin, we further found that the amount of cholesterol can affect the stability of EGFR dimers. The EGFR dimers in the plasma membrane of normal cells are more sensitive to the local concentration changes of cholesterol than EGFR dimers in the cancer cells. Our method successfully captures dynamic interactions of receptors at the single-molecule level and provides insight into the functional architecture of both the diffusing EGFR molecules and their local cellular environment.

Keywords: membrane proteins, single-molecule tracking, Cahn-Hilliard equation, EGFR dimers

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Authors: Clémence Royer, Stéphane Mazouffre

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Nowadays, electric propulsion systems play a crucial role in space exploration missions due to their high specific impulse and long operational life. The Hall thrusters are one of the most mature EP technologies. It is a gridless ion thruster that has proved reliable and high-performance for decades in various space missions. Operation of HT relies on electron emissions through a cathode placed outside a hollow dielectric channel that includes an anode at the back. Negatively charged particles are trapped in a magnetic field and efficiently slow down. By collisions, the electron cloud ionizes xenon atoms. A large electric field is generated in the axial direction due to the low electron transverse mobility in the region of a strong magnetic field. Positive particles are pulled out of the chamber at high velocity and are neutralized directly at the exhaust area. This phenomenon leads to the acceleration of the spacecraft system at a high specific impulse. While HT’s architecture and operating principle are relatively simple, the physics behind thrust is complex and still partly unknown. Current and voltage oscillations, as well as electron properties, have been captured over a 30 mn time period after ignition. The observed low-frequency oscillations exhibited specific frequency ranges, amplitudes, and stability patterns. Correlations between the oscillations and plasma characteristics we analyzed. The impact of these instabilities on thruster performance, including thrust efficiency, has been evaluated as well. Moreover, strategies for mitigating and controlling these instabilities have been developed, such as filtering. In this contribution, in addition to presenting a summary of the results obtained in the transient regime, we will present and discuss recent advances in Hall thruster plasma discharge filtering and control.

Keywords: electric propulsion, Hall Thruster, plasma diagnostics, low-frequency oscillations

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Authors: Maarja Karbus, Elsbet Lippmaa, Kadri Kööp, Mare Tupits

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Aim: The aim is to describe the experiences and needs of mothers of children with cancer in coping with the child's illness. Background: Cancer affects different life areas. Especially if it is a child, in this case the whole family is involved. Loved ones are mentally affected, there are limitations, and life changes need to be made to make the whole treatment regimen and recovery as comfortable as possible. Also, the whole process is expensive and time consuming. The research is part of a larger project that covers the experiences and needs of parents of children with chronic illness and coping strategies related to the child's illness. Design: Qualitative, empirical, descriptive research. Method: Semi-structured interviews were used to collect data and inductive content analysis was used to analyze the data. The interviews were conducted in the autumn of 2020, 5 respondents participated in the research. Results and Conclusions: The research revealed that the mothers' experiences of coping with a child's disease included health-related experiences, material aspects, changes in lifestyle, support systems and contact with professionals. Regarding the organizational and material aspects of life, the subjects presented experiences with economic problems, adaptation of changes in lifestyle, access to information and changes in the treatment process. With regard to health, the respondents identified experiences with the mother's physical and mental health and experiences with the health of an ill child. The experience of different support systems was related to the support of family, friends, acquaintances, various organizations and specialists. Experiences with specialist support included experiences with family relationships and positive and negatiive experiences with staff. The mothers' needs in dealing with the child's disease included the mother's emotional needs, the support of other family members, and the need for various support systems and services. The needs of coping with the child were the need for understanding, support, confidence, the need to be strong and courageous, the need to ignore one's own needs, and the need for personal time and rest. The needs of other family members included the needs of an ill child and the need to pay attention to other children in the family. The needs of different supporters and services were related to different helpers and different services.

Keywords: cancer, mother, coping, child, need, experience, illness

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Authors: M. B. Ricardo De Oliveira, A. Borghi-Silva, E. Paravizo, F. Lizarelli, L. Di Thomazzo, D. Braatz

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Prototypes are a critical feature in the product development process, as they help the project team visualize early concept flaws, communicate ideas and introduce an initial product testing. Involving stakeholders, such as consumers and users, in prototype tests allows the gathering of valuable feedback, contributing for a better product and making the design process more participatory. Even though recent studies have shown that user evaluation of prototypes is valuable, few articles provide a method or protocol on how designers should conduct it. This multidisciplinary study (involving the areas of physiotherapy, engineering and computer science) aims to develop an evaluation protocol, using an ergometric step prototype as the product prototype to be assessed. The protocol consisted of performing two tests (the 2 Minute Step Test and the Portability Test) to allow users (patients) and consumers (physiotherapists) to have an experience with the prototype. Furthermore, the protocol contained four Likert-Scale questionnaires (one for users and three for consumers), that inquired participants about how they perceived the design characteristics of the product (performance, safety, materials, maintenance, portability, usability and ergonomics), in their use of the prototype. Additionally, the protocol indicated the need to conduct interviews with the product designers, in order to link their feedback to the ones from the consumers and users. Both tests and interviews were recorded for further analysis. The participation criteria for the study was gender and age for patients, gender and experience with 2 Minute Step Test for physiotherapists and involvement level in the product development project for designers. The questionnaire's reliability was validated using Cronbach's Alpha and the quantitative data of the questionnaires were analyzed using non-parametric hypothesis tests with a significance level of 0.05 (p <0.05) and descriptive statistics. As a result, this study provides a concise evaluation protocol which can assist designers in their development process, collecting quantitative feedback from consumer and users, and qualitative feedback from designers.

Keywords: Product Design, Product Evaluation, Prototypes, Step

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Authors: Md. Mahamud Hassan, Shantanu Biswas Linkon, Nur Mohammad Khan

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Over the last three decades, the primary education system in Bangladesh has experienced significant improvement, but it has failed to cope with different social and cultural aspects, which present many challenges for children, families, and the public school system. Neglecting our own contextual learning environment, it is a matter of sorrow that much attention has been paid to the more physical outcome-focused model, which is nothing but mere infrastructural development, and less subtle to the environment that suits the child's psychology and improves their social, emotional, physical, and moral competency. In South Asia, the symbol of education was never the little red house of colonial architecture but “A Guru sitting under a tree", whereas a responsive and inclusive design approach could help to create more innovative learning environments. Such an approach incorporates how the built, natural, and cultural environment shapes the learner; in turn, learners shape the learning. This research will be conducted to, i) identify the major issues and drawbacks of government policy for primary education development programs; ii) explore and evaluate the morphology of the conventional model of school, and iii) propose an alternative model in a collaborative design process with the stakeholders for maximizing the relationship between the physical learning environments and learners by treating “the built environment” as “the third teacher.” Based on observation, this research will try to find out to what extent built, and natural environments can be utilized as a teaching tool for a more optimal learning environment. It should also be evident that there is a significant gap in the state policy, predetermined educational specifications, and implementation process in response to stakeholders’ involvement. The outcome of this research will contribute to a people-place sensitive design approach through a more thoughtful and responsive architectural process.

Keywords: built environment, conventional planning, indigenous learning space, responsive design

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Authors: Rachel P. Vasconcellos

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The Russian constructivism is usually enshrined in history as another ''modernist ism'', that is, as an artistic phenomenon related to the early twentieth century‘s zeitgeist. What we aim in this essay is to analyze the constructivist movement not over the Art History field neither through the aesthetic debate, but through a geographical critical theory, taking the main idea of construction in the concrete sense of production of space. Seen from the perspective of the critique of space, the constructivist production is presented as a plan of totality, designed as socialist society‘s spatiality, contemplating and articulating all its scalar levels: the objects of everyday life, the building, the city and the territory. The constructivist avant-garde manifests a geographical ideology, launching the foundation‘s basis of modern planning ideology. Taken in its political sense, the artistic avant-garde of the Russian Revolution intended to anticipate the forms of a social future already put in progress: their plastic research pointed to new formal expressions to revolutionary contents. With the foundation of new institutions under a new State, it was given to the specialized labor of artists, architects, and planners the task of designing the socialist society, based on the thesis of scientific socialism. Their projects were developed under the politico-economics imperatives to the Soviet modernization – that is: the structural needs of industrialization and inclusion of all people in the productive work universe. This context shapes the creative atmosphere of the constructivist avant-garde, which uses the methods of engineering to the transform everyday life. Architecture, urban planning, and state planning integrated must then operate as spatial arrangement morphologically able to produce socialist life. But due to the intrinsic contradictions of the process, the rational and geometric aesthetic of the City-Machine appears, finally, as an image of a scientific socialist utopia.

Keywords: city-machine, critique of space, production of space, soviet territorialization

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Authors: Cyril Deroy, Agata Rumianek, David R. Greaves, Peter R. Cook, Edmond J. Walsh

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Various microfluidic platforms have been developed in the past couple of decades offering experimental methods for the study of cell migration; however, their implementation in the laboratory has remained limited. Some reasons cited for the lack of uptake include the technical complexity of the devices, high failure rate associated with gas-bubbles, biocompatibility concerns with the use of polydimethylsiloxane (PDMS) and equipment/time/expertise requirements for operation and manufacture. As sample handling remains challenging due to the closed format of microfluidic devices, open microfluidic systems have been developed offering versatility and simplicity of use. Rather than confining fluids by solid walls, samples can be accessed directly over the open platform, by removing at least one of the solid boundaries, such as the cover. In this paper, a method for the fabrication of open fluid-walled microfluidic circuits for cell migration studies is introduced, where only materials commonly used by the life-science community are required; tissue culture dishes and cell media. The simplicity of the method, and ability to retrieve cells of interest are two key features of the method. Both passive and active flow-devices can be created in this way. To demonstrate the versatility of the method a cell migration assay is performed, which requires fabricating circuits for establishing chemical gradients, loading cells and incubating, creating chemical gradients, real time imaging of cell migration and finally retrieval of cells. The open architecture has high fidelity as it eliminates air bubble related failures and enables the precise control of gradients. The ability to fabricate custom microfluidic designs in minutes should make this method suitable for use in a wide range of cell migration studies.

Keywords: chemotaxis, fluid walls, gradient generation, open microfluidics

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Authors: Yung Yau

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'Little people' are those who have extremely short stature as they suffer from rare bone diseases. They are commonly known as 'dwarves' or 'people with dwarfism'. Dwarfism is generally regarded as a type of rare disease for its extremely small odds (~1 in 15,000). On account of its rarity, dwarfism, unlike other types of disability, has attracted relatively little attention from the general public and in various academic fields (e.g. architecture, psychology and sociology) except medical science. In view of the extant research gaps, this study aims to investigate the physical barriers facing the little people in the built environment in Hong Kong. Between November 2017 and July 2018, ten little people or their family members participated in in-depth interviews. Responses of the interviewees were transcribed (i.e., speech being converted to text word for word). Interview data were then analyzed using the interpretative phenomenological analysis methodology developed by J. Smith and others in 2009. The findings of the project reveal that although Hong Kong's built environment has been designed barrier-free pursuant to the prevailing building standards, those standards do not cater to the special anthropometric characteristics of little people. As a result, little people face a lot of challenges when using built facilities. For example, most water closets, urinals, and wash hand basins are not fit for little people's use. As indicated by the project findings, we are still far away from providing a discrimination-free and barrier-free living environment for the little people in Hong Kong. To make Hong Kong society more inclusive to the little people, there is a need for further tailored building design. A set of building design principles for better inclusion of the little people in our society are highlighted. These principles include 'the building design should accommodate individuals with different heights' and 'the building design should allow individuals to use comfortably and efficiently with a minimum of fatigue'. At the end of the paper, the author also calls for an agenda for further studies. For instance, we need an anthropometric study on little people for developing practical building design guidelines.

Keywords: dwarfism, little people, inclusive buildings, people with disabilities, social sustainability

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Authors: Prabesh Karki, Shyam Thapa Chettri, Bajarang Prasad Sah, Manoj Bhattarai, Sudeep Mishra

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Introduction: Frontal sinus is frequently described as the most difficult sinus to access surgically due to its proximity to the cribriform plate, orbit, and anterior ethmoid artery. Frontal sinus surgery requires a detailed understanding of the cellular structure and FSDP unique to each patient, making high-resolution CT scans an indispensable tool to assess the difficulty of planned sinus surgery. International Frontal Sinus Anatomy Classification (IFAC) was developed to provide a more precise nomenclature for cells in the frontal recess, classifying cells based on their anatomic origin. Objectives: To assess the proportion of frontal cell variants defined by IFAC, variation with respect to age and gender. Methods: 54 cases were enrolled after a detailed clinical history, thorough general and physical examinations, and CT a report ordered in a film. Assessment and tabulation of the presence of frontal cells according to the IFAC analyzed. The prevalence of each cell type was calculated, and data were entered in MS Excel and analyzed using Statistical Package for the Social Sciences (SPSS). Descriptive statistics and frequencies were defined for categorical and numerical variables. Frequency, percentage, the mean and standard deviation were calculated. Result: Among 54 patients, 30 (55.6%) were male and 24 (44.4%) were female. The patient enrolled ranged from 18 to 78 years. Majority33.3% (n=18) were in age group of >50 years.According to IFAC, Agger nasi cells (92.6%) were most common, whereas supraorbital ethmoidal cells were least common 16 (29.6%). Prevalence of other frontoethmoidal cells was SAC- 57.4%, SAFC- 38.9%, SBC- 74.1%, SBFC- 33.3%, FSC- 38.9% of 54 cases. Conclusion: IFAC is an international consensus document that describes an anatomically precise nomenclature for classifying frontoethmoidal cells' anatomy. This study has defined the prevalence, symmetry and reliability of frontoethmoidal cells as established by the IFAC system as in other parts of the world.

Keywords: frontal sinus, frontoethmoidal cells, international frontal sinus anatomy classification

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Authors: Visa I. Tyakaray, M. Abdulaziz, O. Badmus, N. Karaye, M. Dalhat, A. Shehu, I. Bello, T. Hussaini, S. Akar, G. Effah, P. Nguku

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Introduction: Nigeria has recorded outbreaks of meningitis in the past, being in the meningitis belt. A multi-state outbreak of Cerebrospinal Meningitis (CSM) from Neisseria meningitides occurred in 2017 involving 24 states, and Kano State reported its first two confirmed CSM cases on 22nd March, 2017. We conducted the outbreak investigation to characterize the outbreak, determine its associated risk factors and institute appropriate control measures. Method: We conducted an unmatched Case-control study with ratio 1:2. A case was defined as any person with sudden onset of fever (>38.5˚C rectal or 38.0˚C axillary) and one of the following: neck stiffness, altered consciousness or bulging fontanelle in toddlers while a control was defined as any person who resides around the case such as family members, caregivers, neighbors, and healthcare personnel. We reviewed and validated line list and conducted active case search in health facilities and neighboring communities. Descriptive, bivariate, stratified and multivariate analysis were performed. Laboratory confirmation was by Latex agglutination and/or Culture. Results: We recruited 48 cases with median age of 11 years (1 month – 65 years), attack rate was 2.4/100,000 population with case fatality rate of 8%; 34 of 44 local government areas were affected.On stratification, age was found to be a confounder. Independent factors associated with the outbreak were age (Adjusted Odds Ratio, AOR =6.58; 95% Confidence Interval (CI) =2.85-15.180, history of Vaccination (AOR=0.37; 95% CI=0.13-0.99) and history of travel (AOR=10.16; (1.99-51.85). Laboratory results showed 22 positive cases for Neisseria meningitides types C and A/Y. Conclusion: Major risk factors associated with this outbreak were age (>14years), not being vaccinated and history of travel. We sensitized communities and strengthened case management. We recommended immediate reactive vaccination and enhanced surveillance in bordering communities.

Keywords: cerebrospinal, factors, Kano-Nigeria, meningitis, risk

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Authors: Allioua Meryem

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Similar to much of the developing world, Algeria is currently undergoing an epidemiological transition. While mal- and under-nutrition and infectious diseases used to be the main causes of poor health, today there is a higher proportion of chronic, non-communicable diseases (NCDs), including cardiovascular disease, diabetes mellitus, cancer, etc. According to estimates for Algeria from the World Health Organization (WHO), NCDs accounted for 63% of all deaths in 2010. The objective of this study was the assessment of eating habits and anthropometric characteristics in a group of youth aged 15 to 19 years in Tlemcen. This study was conducted on a total effective of 806 youth enrolled in a descriptive cross-sectional study; the classification of nutritional status has been established by international standards IOTF, youth were defined as obese if they had a BMI ≥ 95th percentile, and youth with 85th ≤ BMI ≤ 95th percentile were defined as overweight. Wc is classified by the criteria HD, Wc with moderate risk ≥ 90th percentile and Wc with high risk ≥ 95th percentile. The dietary assessment was based on a 24-hour dietary recall assisted by food records. USDA’S nutrient database for Nutrinux® program was used to analyze dietary intake. Nutrients adequacy ratio was calculated by dividing daily individual intake to dietary recommended intake DRI for each nutrient. 9% of the population was overweight, 3% was obese, 7.5% had abdominal obesity, foods eaten in moderation are chips, cookies, chocolate 1-3 times/day and increased consumption of fried foods in the week, almost half of youth consume sugary drinks more than 3 times per week, we observe a decreased intake of energy, protein (P < 0.001, P = 0.003), SFA (P = 0.018), the NAR of phosphorus, iron, magnesium, vitamin B6, vitamin E, folate, niacin, and thiamin reflecting less consumption of fruit, vegetables, milk, and milk products. Youth surveyed have eating habits at risk of developing obesity and chronic disease.

Keywords: food intake, health, anthropometric characteristics, Algeria

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Authors: Chulpan Gromova, Rezeda Khairutdinova, Dina Birman

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One of the most significant issues that schools all over the world face today is the ways teachers respond to increasing diversity. The study was informed by the tripartite model of multicultural competence, with awareness of personal biases a necessary component, together with knowledge of different cultures, and skills to work with students from diverse backgrounds. The paper presents the results of qualitative descriptive studies that help to understand how school teachers in Russia treat migrant children, how they solve the problems of adaptation of migrant children. The purpose of this study was to determine: a) educational practices used by primary school teachers when working with migrant children; b) relationship between practices and attitudes of teachers. Empirical data were collected through interviews. The participants were informed that a conversation was being recorded. They were also warned that the study was voluntary, absolutely anonymous, no personal data was disclosed. Consent was received from 20 teachers. The findings were analyzed using directive content analysis (Graneheim and Lundman, 2004). The analysis was deductive according to the categories of practices and attitudes identified in the literature review and enriched inductively to identify variation within these categories. Studying practices is an essential part of preparing future teachers for working in a multicultural classroom. For language and academic support, teachers mostly use individual work. In order to create a friendly classroom climate and environment teachers have productive conversations with students, organize multicultural events for the whole school or just for an individual class. The majority of teachers have positive attitudes toward migrant children. In most cases, positive attitudes lead to high expectations for their academic achievements. Conceptual orientation of teacher attitudes toward cultural diversity is mostly pluralistic. Positive attitudes, high academic expectations and conceptual orientation toward pluralism are favorably reflected in teachers’ practice.

Keywords: intercultural education, migrant children schooling, teachers attitudes, teaching practices

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Authors: Elizabeth Perry, Jylana Sheats

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Scholars posit that there is an overlap between the fields of Behavioral Economics (BE) and Behavior Science (BSci)—and that consideration of concepts from both may facilitate a greater understanding of health decision-making processes. For example, the ‘intention-action gap’ is one BE concept to explain sup-optimal decision-making. It is described as having knowledge that does not translate into behavior. Complementary best BSci practices may provide insights into behavioral determinants and relevant behavior change techniques (BCT). Within the context of BSci, this exploratory study aimed to apply a BE concept with demonstrated effectiveness in financial decision-making to a health behavior: influenza (flu) vaccine uptake. Adults aged >18 years were recruited on Amazon’s Mechanical Turk, a digital labor market where anonymous users perform simple tasks at low cost. Eligible participants were randomized into 2 groups, reviewed a scenario, and then completed a survey on the likelihood of receiving a flu shot. The ‘usual care’ group’s scenario included standard CDC guidance that supported the behavior. The ‘intervention’ group’s scenario included messaging about people who did not receive the flu shot. The framing was such that participants could learn from others’ (strangers) mistakes and the subsequent health consequences: ‘Last year, other people who didn’t get the vaccine were about twice as likely to get the flu, and a number of them were hospitalized or even died. Don’t risk it.’ Descriptive statistics and chi-square analyses were performed on the sample. There were 648 participants (usual care, n=326; int., n=322). Among racial/ethnic minorities (n=169; 57% aged < 40), the intervention group was 22% more likely to report that they were ‘extremely’ or ‘moderately’ likely to get the flu vaccine (p = 0.11). While not statistically significant, findings suggest that framing messages from the perspective of learning from the mistakes of unknown others coupled with the BCT ‘knowledge about the health consequences’ may help influence flu vaccine uptake among the study population. With the widely documented disparities in vaccine uptake, exploration of the complementary application of these concepts and strategies may be critical.

Keywords: public health, decision-making, vaccination, behavioral science

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Authors: Hela Ghali, Oumayma Ben Amor, Salwa Khefacha, Mohamed Ben Rejeb, Sirine Frigui, Meriam Tourki Dhidah, Lamine Dhidah, Houyem Said Laatiri

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Background: Blood exposure accidents are the most common problem in hospitals that threaten healthcare professionals with a high risk of infectious complications which weighs heavily on health systems worldwide. Paramedics are the highest risk group due to the nature of their daily activities. We aimed to determine knowledge and attitudes about the management of blood-exposure accidents among nurses and technicians in two pediatric departments. Materials/Methods: This is a cross-sectional descriptive study conducted on March 2017, carried out with the care staff of the pediatric ward of the Farhat Hached Teaching Hospital of Sousse and pediatric surgery of the Fattouma Bourguiba University Hospital in Monastir, using a pre- tested and self-administered questionnaire. Data entry and analysis were performed using Excel software. Results: The response rate was 85.1%. A female predominance (82.5%) was reported among respondents with a sex ratio of 0.21. 80% of the participants were under 35 years old. Seniority of less than 10 years was found in 77.5% of respondents. Only 22.5% knew the definition of a blood- exposure accident. 100% and 95% of participants reported the relative risk, respectively, to hepatitis and AIDS viruses. However, only 15% recognized the severity factors of a blood-exposure accident. Hygiene compliance was the most important dimension for almost the entire population for the prevention. On the other hand, only 12.5% knew the meaning of 'standard precautions' and ¼ considered them necessary for at-risk patients only. 40% reported being exposed at least once, among them, 87.5% used betadine, and 77.5% said that anti-infectious chemoprophylaxis is necessary regardless of the patient's serological status. However, 52.5% did not know the official reporting circuit of management of blood-exposure accident in their institutions. Conclusion: For better management of risks in hospitals and an improvement of the safety of the care, a reinforcement of the sensibilization of the caregivers with regard to the risks of blood exposure accident is necessary, while developing their knowledge to act in security.

Keywords: attitudes, blood-exposure accident, knowledge, pediatric department

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Authors: Saira Maqbool, Qaisara Parveen, Muhammad Arshad Dahar

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Improving females' involvement in management and enterprises in Pakistan requires the development of female entrepreneurs as leaders. Entrepreneurial education aims for providing students the knowledge, aptitudes and motivation to energize innovative accomplishment in various settings. Assortments of venture instruction are advertised at all stages of mentoring, from fundamental or discretionary institutes through graduate institutional platforms. The business enterprise will be considered the procedure by which a looming business visionary or business person pursues after openings without respect to the resources they directly regulate. This entails the ability of the business visionary to join every single other generation. This study explores the relationship between developing Women's Leadership skills and Entrepreneurship Education The essential reason for this consider was to analyze the role of Entrepreneurship Edification (EE) towards women's Leadership and develop entrepreneurial intentions among students. The major goal of this study was to foster entrepreneurial attitudes among PMAS Arid Agriculture University undergraduate students concerning their choice to work for themselves. This study focuses on the motivation and interest of female students in the social sciences to build entrepreneurial leadership skills. The quantitative analysis used a true-experimental, pretest-posttest control group research design. Female undergraduate students from PMAS Arid Agriculture University made up the study population. For entrepreneurial activity, a training module has been created. The students underwent a three-week training program at PMAS Arid Agriculture University, where they learned about entrepreneurial leadership abilities. The quantitative data were analyzed using descriptive statistics and T-tests. The findings indicated that students acquired entrepreneurial leadership skills and intentions after training. They have decided to launch their businesses as leaders. It is advised that other PMAS Arid Agriculture University departments use the training module and course outline because the research's usage of them has important results.

Keywords: business, entrepreneurial, intentions, leadership, women

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Authors: Pierre F. Gerard, Frederic F. Leymarie, William Latham

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Architects have developed a series of objective evaluations, using spatial analysis tools such as Isovist, that show how certain spatial qualities are beneficial to specific human activities hosted in the built environments. In return, they can build more adapted environments by tuning those spatial qualities in their design. In parallel, virtual reality technologies have been developed by engineers with the dream of creating a system that immerses users in a new form of spatial experiences. They already have demonstrated a useful range of benefits not only in simulating critical events to assist people in acquiring new skills, but also to enhance memory retention, to name just a few. This paper investigates the effects of two spatial qualities, openness, and complexity, on cognitive performance within immersive virtual environments. Isovist measure is used to design a series of room settings with different levels of each spatial qualities. In an empirical study, each room was then used by every participant to solve a navigational puzzle game and give a rating of their spatial experience. They were then asked to fill in a questionnaire before solving the visual-spatial memory quiz, which addressed how well they remembered the different rooms. Findings suggest that those spatial qualities have an effect on some of the measures, including navigation performance and memory retention. In particular, there is an order effect for the navigation puzzle game. Participants tended to spend a longer time in the complex room settings. Moreover, there is an interaction effect while with more open settings, participants tended to perform better when in a simple setting; however, with more closed settings, participants tended to perform better in a more complex setting. For the visual-spatial memory quiz, participants performed significantly better within the more open rooms. We believe this is a first step in using virtual environments to enhance participant cognitive performances through better use of specific spatial qualities.

Keywords: architecture, navigation, spatial cognition, virtual reality

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Authors: M. Miljkovic, A. Urakpo, M. Simic-Koumoutsaris

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Benefit-risk assessment (BRA) is a valuable tool that takes place in multiple stages during a medicine's lifecycle, and this assessment can be conducted in a variety of ways. The aim was to summarize current BRA methods used during approval decisions and in post-approval settings and to see possible future directions. Relevant reviews, recommendations, and guidelines published in medical literature and through regulatory agencies over the past five years have been examined. BRA implies the review of two dimensions: the dimension of benefits (determined mainly by the therapeutic efficacy) and the dimension of risks (comprises the safety profile of a drug). Regulators, industry, and academia have developed various approaches, ranging from descriptive textual (qualitative) to decision-analytic (quantitative) models, to facilitate the BRA of medicines during the product lifecycle (from Phase I trials, to authorization procedure, post-marketing surveillance and health technology assessment for inclusion in public formularies). These approaches can be classified into the following categories: stepwise structured approaches (frameworks); measures for benefits and risks that are usually endpoint specific (metrics), simulation techniques and meta-analysis (estimation techniques), and utility survey techniques to elicit stakeholders’ preferences (utilities). All these approaches share the following two common goals: to assist this analysis and to improve the communication of decisions, but each is subject to its own specific strengths and limitations. Before using any method, its utility, complexity, the extent to which it is established, and the ease of results interpretation should be considered. Despite widespread and long-time use, BRA is subject to debate, suffers from a number of limitations, and currently is still under development. The use of formal, systematic structured approaches to BRA for regulatory decision-making and quantitative methods to support BRA during the product lifecycle is a standard practice in medicine that is subject to continuous improvement and modernization, not only in methodology but also in cooperation between organizations.

Keywords: benefit-risk assessment, benefit-risk profile, product lifecycle, quantitative methods, structured approaches

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Authors: Abdus-Samiᶜi Imam Arikewuyo

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Islam enjoins the spirit of cooperation among fellow mankind. This is particularly entrenched in the brotherhood phenomenon advocated by Islam. With cooperation, a group of people with diverse qualities and opportunities can facilitate a breakthrough in what is seemingly difficult, if not impossible. This understanding underscores the initiative of establishing multi-purpose cooperative societies for thrifts and savings among bonafide members, especially in developing nations. The spirit and objectives of the Multi-Purpose Cooperatives Societies gave birth to the founding of several of these organizations as a plausible economic outfit in Nigeria to provide succor to the socio-economic predicaments of members. Pertinently, many Islamic cooperative societies sprang up, carving a niche for themselves as Shariᶜah-based economic outfits to accommodate the yearnings of the Muslim populace. KWASU Al-Halal Cooperative Society, Malete, Nigeria, is one such organization that is not only Shariᶜah inclined but also institutional-based. This paper, therefore, aims to examine the operations and activities of this society with a view to determining its strength as a Shariᶜah-based economic outfit for the survival of its clients in a competitive multi-religious atmosphere. The study is both historical and descriptive; thus, it employed interview, observation, focus group discussion and hermeneutical methods as pertinent research tools. The research findings indicated that adopting the Shariᶜah prescriptions, KWASU Al-Halal Cooperative Society, as a representation of the Islamic cooperatives society, fulfilled the essence and goal of its establishment, serving as an outlet for meeting the socio-economic demands of its members regardless of religious inclinations. The paper recommended that stronger efforts should be made on proper record keeping, the conscientiousness of beneficiaries on loan refunds or payments on purchases and education of the loanees and guarantors.

Keywords: efficacy, Islamic cooperatives society, Kwasu al-halal cooperative society, shariᶜah

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Authors: April Hueimin Lu, Liangj-Ju Yao, Jun-Tin Lin, Susan Siru Liu

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This paper discusses the application of aerial survey technology and 3D laser scanning technology in the surveying and mapping work of the settlements and slate houses of the old Taiwanese aborigines. The relics of old Taiwanese aborigines with thousands of history are widely distributed in the deep mountains of Taiwan, with a vast area and inconvenient transportation. When constructing the basic data of cultural assets, it is necessary to apply new technology to carry out efficient and accurate settlement mapping work. In this paper, taking the old Paiwan as an example, the aerial survey of the settlement of about 5 hectares and the 3D laser scanning of a slate house were carried out. The obtained orthophoto image was used as an important basis for drawing the settlement map. This 3D landscape data of topography and buildings derived from the aerial survey is important for subsequent preservation planning as well as building 3D scan provides a more detailed record of architectural forms and materials. The 3D settlement data from the aerial survey can be further applied to the 3D virtual model and animation of the settlement for virtual presentation. The information from the 3D scanning of the slate house can also be used for further digital archives and data queries through network resources. The results of this study show that, in large-scale settlement surveys, aerial surveying technology is used to construct the topography of settlements with buildings and spatial information of landscape, as well as the application of 3D scanning for small-scale records of individual buildings. This application of 3D technology, greatly increasing the efficiency and accuracy of survey and mapping work of aboriginal settlements, is much helpful for further preservation planning and rejuvenation of aboriginal cultural heritage.

Keywords: aerial survey, 3D scanning, aboriginal settlement, settlement architecture cluster, ecological landscape area, old Paiwan settlements, slat house, photogrammetry, SfM, MVS), Point cloud, SIFT, DSM, 3D model

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Authors: Roongtiwa Chobchuen, Angkana Srikhan, Pattra Wattanapan

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Background: Neurogenic bowel is common condition after spinal cord injury. Most of spinal cord injured patients have motor weakness, mobility impairment which leads to constipation. Moreover, the neural pathway involving bowel function is interrupted. Therefore, the bowel management program should be implemented in nursing care in the earliest time after the onset of the disease to prevent the morbidity and mortality. Objective: To study the outcome of bowel management program of the patients with spinal cord injury who admitted for rehabilitation program. Study design: Descriptive study. Setting: Rehabilitation ward in Srinagarind Hospital. Populations: patients with subacute to chronic spinal cord injury who admitted at rehabilitation ward, Srinagarind hospital, aged over 18 years old. Instrument: The neurogenic bowel dysfunction score (NBDS) was used to determine the severity of neurogenic bowel. Procedure and statistical analysis: All participants were asked to complete the demographic data; age gender, duration of disease, diagnosis. The individual bowel function was assessed using NBDS at admission. The patients and caregivers were trained by nurses about the bowel management program which consisted of diet modification, abdominal massage, digital stimulation, stool evacuation including medication and physical activity. The outcome of the bowel management program was assessed by NBDS at discharge. The chi-square test was used to detect the difference in severity of neurogenic bowel at admission and discharge. Results: Sixteen spinal cord injured patients were enrolled in the study (age 45 ± 17 years old, 69% were male). Most of them (50%) were tetraplegia. On the admission, 12.5%, 12.5%, 43.75% and 31.25% were categorized as very minor (NBDS 0-6), minor (NBDS 7-9), moderate (NBDS 10-13) and severe (NBDS 14+) respectively. The severity of neurogenic bowel was decreased significantly at discharge (56.25%, 18.755%, 18.75% and 6.25% for very minor, minor, moderate and severe group respectively; p < 0.001) compared with NBDS at admission. Conclusions: Implementation of the effective bowel program decrease the severity of the neurogenic bowel in patient with spinal cord injury.

Keywords: neurogenic bowel, NBDS, spinal cord injury, bowel program

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