Search results for: surgical skills

Authors: E. Tan, O. McKay, T. Clarnette T., D. Croagh

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Background: Historically with pancreatic trauma, complete disruption of the main pancreatic duct (MPD), classified as Grade IV-V by the American Association for the Surgery of Trauma (AAST), necessitated a damage-control laparotomy. This was to avoid mortality, shorten diet upgrade timeframe, and hence shorter length of stay. However, acute pancreatic resection entailed complications of pancreatic fistulas and leaks. With the advance of imaging-guided interventions, non-operative management such as percutaneous and transpapillary drainage of traumatic peripancreatic collections have been trialled favourably. The aim of this case series is to evaluate the efficacy of endoscopic ultrasound-guided (EUS) transmural drainage in managing traumatic peripancreatic collections as a less invasive alternative to traditional approaches. This study also highlights the importance of anatomical knowledge regarding peripancreatic collection’s common location in the lesser sac, the pancreas relationship to adjacent organs, and the formation of the main pancreatic duct in regards to the feasibility of therapeutic internal drainage. Methodology: A retrospective case series was conducted at a single tertiary endoscopy unit, analysing patient data over a 5-year period. Inclusion criteria outlined patients age 5 to 80-years-old, traumatic pancreatic injury of at least Grade IV and haemodynamic stability. Exclusion criteria involved previous episodes of pancreatitis or abdominal trauma. Patient demographics and clinicopathological characteristics were retrospectively collected. Results: The study identified 7 patients with traumatic pancreatic injuries that were managed from 2018-2022; age ranging from 5 to 34 years old, with majority being female (n=5). Majority of the mechanisms of trauma were a handlebar injury (n=4). Diagnosis was confirmed with an elevated lipase and computerized tomotography (CT) confirmation of proximal pancreatic transection with MPD disruption. All patients sustained an isolated single organ grade IV pancreatic injury, except case 4 and 5 with other intra-abdominal visceral Grade 1 injuries. 6 patients underwent early ERCP-guided transpapillary drainage with 1 being unsuccessful for pancreatic duct stent insertion (case 1) and 1 complication of stent migration (case 2). Surveillance imaging post ERCP showed the stents were unable to bridge the disrupted duct and development of symptomatic collections with an average size of 9.9cm. Hence, all patients proceeded to EUS-guided transmural drainage, with 2/7 patients requiring repeat drainages (case 6 and 7). Majority (n=6) had a cystogastrostomy, whilst 1 (case 6) had a cystoenterostomy due to feasibility of the peripancreatic collection being adjacent to duodenum rather than stomach. However, case 6 subsequently required repeat EUS-guided drainage with cystogastrostomy for ongoing collections. Hence all patients avoided initial laparotomy with an average index length of stay of 11.7 days. Successful transmural drainage was demonstrated, with no long-term complications of pancreatic insufficiency; except for 1 patient requiring a distal pancreatectomy at 2 year follow-up due to chronic pain. Conclusion: The early results of this series support EUS-guided transmural drainage as a viable management option for traumatic peripancreatic collections, showcasing successful outcomes, minimal complications, and long-term efficacy in avoiding surgical interventions. More studies are required before the adoption of this procedure as a less invasive and complication-prone management approach for traumatic peripancreatic collections.

Keywords: endoscopic ultrasound, cystogastrostomy, pancreatic trauma, traumatic peripancreatic collection, transmural drainage

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Authors: Wissam Saliba, Mandy Nicholson

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Secretory carcinoma (SC) is a rare type of salivary gland cancer. It was first realized as a distinct type of malignancy in 2010and wasinitially termed “mammary analogue secretory carcinoma” because of similarities with secretory breast cancer. The name was later changed to SC. Most SCs originate in parotid glands, and most harbour a rare gene mutation: ETV6-NTRK3. This mutation is rare in common cancers and common in rare cancers; it is present in most secretory carcinomas. Disease outcomes for SC are usually described as favourable as many cases of SC are lowgrade (LG), and cancer growth is slow. In early stages, localized therapy is usually indicated (surgery and/or radiation). Despitea favourable prognosis, a sub-set of casescan be much more aggressive.These cases tend to be of high-grade(HG).HG casesare associated with a poorer prognosis.Management of such cases can be challenging due to limited evidence for effective systemic therapy options. This case report describes the clinical management of a 46-year-oldmale patient with a unique case of SC. He was initially diagnosed with a low/intermediate grade carcinoma of the left parotid gland in 2009; he was treated with surgery and adjuvant radiation. Surgical pathology favoured primary salivary adenocarcinoma, and 2 lymph nodes were positive for malignancy. SC was not yet realized as a distinct type of cancerat the time of diagnosis, and the pathology reportvalidated this gap by stating that the specimen lacked features of the defined types of salivary carcinoma.Slow-growing pulmonary nodules were identified in 2017. In 2020, approximately 11 years after the initial diagnosis, the patient presented with malignant pleural effusion. Pathology from a pleural biopsy was consistent with metastatic poorly differentiated cancer of likely parotid origin, likely mammary analogue secretory carcinoma. The specimen was sent for Next Generation Sequencing (NGS); ETV6-NTRK3 gene fusion was confirmed, and systemic therapy was initiated.One cycle ofcarboplatin/paclitaxel was given in June 2020. He was switched to Larotrectinib (NTRK inhibitor (NTRKi)) later that month. Larotrectinib continued for approximately 9 months, with discontinuation in March 2021 due to disease progression. A second-generation NTRKi (Selitrectinib) was accessed and prescribedthrough a single patient study. Selitrectinib was well tolerated. The patient experienced a complete radiological response within~4 months. Disease progression occurred once again in October 2021. Progression was slow, and Selitrectinib continuedwhile the medical team performed a thorough search for additional treatment options. In January 2022, a liver lesion biopsy was performed, and NGS showed an NTRKG623R solvent-front resistance mutation. Various treatment pathways were considered. The patient pursuedanother investigational NTRKi through a clinical trial, and Selitrectinib was discontinued in July 2022. Excellent performance status was maintained throughout the entire course of treatment.It can be concluded that NTRK inhibitors provided satisfactory treatment efficacy and tolerance for this patient with high-grade transformation and NTRK gene fusion cancer. In the future, more clinical research is needed on systemic treatment options for high-grade transformations in NTRK gene fusion SCs.

Keywords: secretory carcinoma, high-grade transformations, NTRK gene fusion, NTRK inhibitor

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Authors: Stephanie Yun Yu Law

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Background: This study aims to investigate into communication between trainee doctors and patients, especially how doctor’s reaction to patient’s emotional issues expressed in the consultation affect patient’s satisfaction. Objectives: Thus, there are three aims in this study, 1.) how do trainee doctors react to patients emotional cues in OSCE station? 2.) Any differences in the respond type to emotional cues between first year students and third year students? 3.) Is response type (reducing space) related to OSCE outcome (patient satisfaction and expert rating)? Methods: Fifteen OSCE stations was videotaped, in which 9 were stations with first-year students and 6 were with third-year students. OSCE outcomes were measured by Communication Assessment Tool and Examiners Checklist. Analyses: All patient’s cues/concerns and student’s reaction were coded by Verona Coding Definitions of Emotional Sequence. Descriptive data was gathered from Observer XT and logistic regression (two-level) was carried out to see if occurrence of reducing space response can be predicted by OSCE outcomes. Results: Reducing space responses from all students were slightly less than a half in total responses to patient’s cues. The mean percentage of reducing space behaviours was lower among first year students when compared to third year students. Patient’s satisfaction significantly (p<0.05) and negatively predicted reducing space behaviours. Conclusions: Most of the medical students, to some extent, did not provide adequate responses for patient’s emotional cues. But first year students did provide more space for patients to talk about their emotional issues when compared to third year students. Lastly, patients would feel less satisfied if trainee doctors use more reducing space responses in reaction to patient’s expressed emotional cues/concerns. Practical implications: Firstly, medical training programme can be tailored on teaching students how to detect and respond appropriately to emotional cues in order to improve underperformed student’s communication skills in healthcare setting. Furthermore, trainee doctor’s relationship with patients in clinical practice can also be improved by reacting appropriately to patient’s emotive cues in consultations (such as limit the use of reducing space behaviours).

Keywords: doctors-patients communication, applied clinical psychology, health psychology, healthcare professionals

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Authors: Ambika Perisamy, Asyriawati binte Mohd Hamzah

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The focus of this presentation is to discuss teacher professional development (TPD) through the use of technology. TPD is necessary to prepare teachers for future challenges they will face throughout their careers and to develop new skills and good teaching practices. We will also be discussing current issues in embracing technology in the field of early childhood education and the impact on the professional development of teachers. Participants will also learn to apply teaching and learning practices through the use of technology. One major objective of this presentation is to coherently fuse practical, technology and theoretical content. The process begins by concretizing a set of preconceived ideas which need to be joined with theoretical justifications found in the literature. Technology can make observations fairer and more reliable, easier to implement, and more preferable to teachers and principals. Technology will also help principals to improve classroom observations of teachers and ultimately improve teachers’ continuous professional development. Video technology allows the early childhood teachers to record and keep the recorded video for reflection at any time. This will also provide opportunities for her to share with her principals for professional dialogues and continuous professional development plans. A total of 10 early childhood teachers and 4 principals were involved in these efforts which identified and analyze the gaps in the quality of classroom observations and its co relation to developing teachers as reflective practitioners. The methodology used involves active exploration with video technology recordings, conversations, interviews and authentic teacher child interactions which forms the key thrust in improving teaching and learning practice. A qualitative analysis of photographs, videos, transcripts which illustrates teacher’s reflections and classroom observation checklists before and after the use of video technology were adopted. Arguably, although PD support can be magnanimously strong, if teachers could not connect or create meaning out of the opportunities made available to them, they may remain passive or uninvolved. Therefore, teachers must see the value of applying new ideas such as technology and approaches to practice while creating personal meaning out of professional development. These video recordings are transferable, can be shared and edited through social media, emails and common storage between teachers and principals. To conclude the importance of reflective practice among early childhood teachers and addressing the concerns raised before and after the use of video technology, teachers and principals shared the feasibility, practical and relevance use of video technology.

Keywords: early childhood education, reflective, improve teaching and learning, technology

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Authors: Mohamad Shamsuri Juhari

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Fathers who positively involve themselves in their children’s lives will have had a constructive influence on the latter’s social, behavioural, and psychological development. This paper will share the preliminary findings of an ongoing research project which investigates Singaporean fathers from the nation’s minority Malay-Muslim community who commit the reverse, that is, it intends to study the reasons behind these fathers’ non-involvement during the period of their children’s developing years be it through absence, disinterest or ignorance. For instance, children from homes with absentee fathers are more likely to develop deficiencies in attitude and conduct. A father’s negative show of parental skills can also cause setbacks in the child’s education, economic instability in the latter’s future family life, as well as the likelihood of an ensuing intergenerational transmission of criminal behaviour. In the context of the minority Singaporean Malay-Muslim community, the need to investigate the challenges faced by fathers from the ethnic group in carrying out their parental roles arose due to the perceptible rise in statistics reflecting delinquency among its youths. This has resulted in other associated issues such as teenage pregnancies (and the subsequent cyclical patterns of divorce and single motherhood), over-representation in the data for drug offences, and under-representation in statistics reflecting academic achievement. While other factors are known to be involved, these negative outcomes have also been attributed to the lack of fatherly guidance in the affected Malay families. This still-ongoing research project is being carried out in two phases: The first by means of secondary research as well as exploratory data collection via roundtable and focus group discussions with fathers from diverse socio-economic backgrounds. This sets the way for the second phase in which a survey will be undertaken, followed by a series of in-depth face-to-face interviews. The research findings will then be translated into intervention initiatives to overcome the identified challenges. Based on the results collated from Phase 1 of the research, this paper will share a ‘first look’ on the challenges to effective parenting faced by Malay-Muslim fathers in Singapore specifically those relating to the socio-cultural domains of attitude, knowledge, and practice.

Keywords: Malay fathers, socio-cultural domains, attitude, knowledge, practice

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Authors: Connie Edang, Siti Arpah Noordin, Shamila Mohamed Shuhidan

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For the past few decades, there are growing numbers of knowledge based industries in Malaysia. As competitive edge has become so important nowadays, the consideration of research and development (R&D) should be put at the highest priority. Alike other industries, HEIs are also contributors to the nation’s development and wealth. Hence, to become a hub for creating a knowledge-based society, HEIs not only responsible for producing skillful human capital, but also to get involved in R&D. With the importance of R&D in today’s modern economy and the rise of Science and Technology, it gives opportunities for researchers to explore this sector as to place Malaysia as a provider in some key strategic industries, including medical and health sciences field. Academic researchers/medical researchers possess unique tacit and skills based in accordance with their experience and professional expert areas. In completing a collaborative research work, there must be platforms to enable the conversion of their knowledge hence beneficial towards creation of new knowledge. The objectives of this study are to: i) explore the knowledge creation activities of medical researchers in the Malaysian Higher Education Institution (HEI); ii) explore the driving forces for knowledge creation activities among the researchers; and iii) explore the interpretation of medical researchers on the establishment of ‘ba’ in the creation of knowledge. Based on the SECI model was introduced by Nonaka and Takeuchi and the Japanese concept of ‘ba’, a qualitative study whereby semi structured interview was used as to gather the informants’ viewpoints and insights based on their experience capitalizing ‘ba’ to support their knowledge creation activities. A single the study was conducted at one of the HEIs located in Sabah. From this study, both face to face and the ICT-assisted tools are found to be significant to support interaction of their knowledge. ICT seems to ease their interaction with other research collaborator. However, this study revealed that interaction conducted in physical settings is still be best preferred by the medical researchers especially situations of whereby their knowledge is hard to be externalized. Moreover, it revealed that motivational factors play important roles as for driving forces affecting their knowledge creation activities. Other than that, the medical researchers addressed that the mix interaction bring forth value in terms of facilitating knowledge creation. Therefore this study would benefit the institution to highly optimize the utilization of good platform so that knowledge can be transferred and be made used by others in appropriate ways.

Keywords: ‘ba’, knowledge creation dynamics, Malaysia, higher education institution, medical researchers

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Authors: Petros Dlamini, Bethiweli Malambo, Maggie Masenya

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Knowledge management practices are very important in public libraries, especial in the era of the information society. The success of public libraries depends on the recognition and application of knowledge management practices. The study investigates the value and challenges of knowledge management practices in public libraries. Three research objectives informed the study: to identify knowledge management practices in public libraries, understand the value of knowledge management practices in public libraries, and determine the factors hampering knowledge management practices in public libraries. The study was informed by the interpretivism research paradigm, which is associated with qualitative studies. In that light, the study collected data from eight librarians and or library heads, who were purposively selected from public libraries. The study adopted a social anthropological approach, which thoroughly evaluated each participant's response. Data was collected from the respondents through telephonic semi-structured interviews and assessed accordingly. Furthermore, the study used the latest content concept for data interpretation. The chosen data analysis method allowed the study to achieve its main purpose with concrete and valid information. The study's findings showed that all six (100%) selected public libraries apply knowledge management practices. The findings of the study revealed that public libraries have knowledge sharing as the main knowledge management practice. It was noted that public libraries employ many practices, but each library employed its practices of choice depending on their knowledge management practices structure. The findings further showed that knowledge management practices in public libraries are employed through meetings, training, information sessions, and awareness, to mention a few. The findings revealed that knowledge management practices make the libraries usable. Furthermore, it has been asserted that knowledge management practices in public libraries meet users’ needs and expectations and equip them with skills. It was discovered that all participating public libraries from Umkhanyakude district municipality valued their knowledge management practices as the pillar and foundation of services. Noticeably, knowledge management practices improve users ‘standard of living and build an information society. The findings of the study showed that librarians should be responsible for the value of knowledge management practices as they are qualified personnel. The results also showed that 83.35% of public libraries had factors hampering knowledge management practices. The factors are not limited to shortage of funds, resources and space, and political interference. Several suggestions were made to improve knowledge management practices in public libraries. These suggestions include improving the library budget, increasing libraries’ building sizes, and conducting more staff training.

Keywords: knowledge management, knowledge management practices, storage, dissemination

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Authors: Anne Öman

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Today in Sweden and in other countries, a variety of digital artefacts, such as laptops, tablets, interactive whiteboards, are being used at all school levels. From an educational perspective, digital artefacts challenge traditional teaching because they provide a range of modes for expression and communication and are not limited to the traditional medium of paper. Digital technologies offer new opportunities for representations and physical interactions with objects, which put forward the role of the body in interaction and learning. From a multimodal perspective the emphasis is on the use of multiple semiotic resources for meaning- making and the study presented here has examined the differential use of semiotic resources by pupils interacting in a digitally designed task in a primary school context. The instances analyzed in this paper come from a case study where the learning task was to create an advertising film in a film-software. The study in focus involves the analysis of a single case with the emphasis on the examination of the classroom setting. The research design used in this paper was based on a micro ethnographic perspective and the empirical material was collected through video recordings of small-group work in order to explore pupils’ communication within the group activity. The designed task described here allowed students to build, share, collaborate upon and publish the redesigned products. The analysis illustrates the variety of communicative modes such as body position, gestures, visualizations, speech and the interaction between these modes and the representations made by the pupils. The findings pointed out the importance of embodied communication during the small- group processes from a learning perspective as well as a pedagogical understanding of pupils’ representations, which were similar from a cultural literacy perspective. These findings open up for discussions with further implications for the school practice concerning the small- group processes as well as the redesigned products. Wider, the findings could point out how multimodal interactions shape the learning experience in the meaning-making processes taking into account that language in a globalized society is more than reading and writing skills.

Keywords: communicative learning, interactive learning environments, pedagogical issues, primary school education

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Authors: Jingwen Ou

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Writing for academic purposes in a second or foreign language poses a significant challenge for non-native speakers, particularly at the tertiary level, where English academic writing for L2 students is often hindered by difficulties in academic discourse, including vocabulary, academic register, and organization. The past two decades have witnessed a rising popularity in the application of the data-driven learning (DDL) approach in EAP writing instruction. In light of such a trend, this study aims to enhance the integration of DDL into English for academic purposes (EAP) writing classrooms by investigating the perception of Chinese college students regarding the use of corpus tools for improving EAP writing. Additionally, the research explores their corpus consultation behaviors during training to provide insights into corpus-assisted EAP instruction for DDL practitioners. Given the uprising popularity of DDL, this research aims to investigate Chinese university students’ use of corpus tools with three main foci: 1) the influence of corpus tools on learning behaviours, 2) the influence of corpus tools on students’ academic writing performance outcomes, and 3) students’ perceptions and potential perceptional changes towards the use of such tools. Three corpus tools, CQPWeb, Sketch Engine, and LancsBox X, are selected for investigation due to the scarcity of empirical research on patterns of learners’ engagement with a combination of multiple corpora. The research adopts a pre-test / post-test design for the evaluation of students’ academic writing performance before and after the intervention. Twenty participants will be divided into two groups: an intervention and a non-intervention group. Three corpus training workshops will be delivered at the beginning, middle, and end of a semester. An online survey and three separate focus group interviews are designed to investigate students’ perceptions of the use of corpus tools for improving academic writing skills, particularly the rhetorical functions in different essay sections. Insights from students’ consultation sessions indicated difficulties with DDL practice, including insufficiency of time to complete all tasks, struggle with technical set-up, unfamiliarity with the DDL approach and difficulty with some advanced corpus functions. Findings from the main study aim to provide pedagogical insights and training resources for EAP practitioners and learners.

Keywords: corpus linguistics, data-driven learning, English for academic purposes, tertiary education in China

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Authors: Maria Belen C. Costa, Liza C. Costa

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Teachers have an important influence on students’ academic achievement. Teachers play a crucial role in educational attainment because they stand in the interface of the transmission of knowledge, values, and skills in the learning process through the instructional strategies they employ in the classroom. The level of achievement of students in school depends on the degree of effectiveness of instructional strategies used by the teacher. Thus, this study was conceptualized and conducted to examine the instructional strategies preferred and used by the Science and Mathematics teachers and the impact of those strategies in their teaching performance and students’ academic achievement in Science and Mathematics. The participants of the study comprised a total enumeration of 61 teachers who were chosen through total enumeration and 610 students who were selected using two-stage random sampling technique. The descriptive correlation design was used in this study with a self-made questionnaire as the main tool in the data gathering procedure. Relationship among variables was tested and analyzed using Spearman Rank Correlation Coefficient and Wilcoxon Signed Rank statistics. The teacher participants under study mainly belonged to the age group of ‘young’ (35 years and below) and most were females having ‘very much experienced’ (16 years and above) in teaching. Teaching performance was found to be ‘very satisfactory’ while academic achievement in Science and Mathematics was found to be ‘satisfactory’. Demographic profile and teaching performance of teacher participants were found to be ‘not significant’ to their instructional strategy preferences. Results implied that age, sex, level of education and length of service of the teachers does not affect their preference on a particular instructional strategy. However, the teacher participants’ extent of use of the different instructional strategies was found to be ‘significant’ to their teaching performance. The instructional strategies being used by the teachers were found to have a direct effect on their teaching performance. Academic achievement of student participants was found to be ‘significant’ to the teacher participants’ instructional strategy preferences. The preference of the teachers on instructional strategies had a significant effect on the students’ academic performance. On the other hand, teacher participants’ extent of use of instructional strategies was showed to be ‘not significant’ to the academic achievement of students in Science and Mathematics. The instructional strategy being used by the teachers did not affect the level of performance of students in Science and Mathematics. The results of the study revealed that there was a significant difference between the teacher participants’ preference of instructional strategy and the student participants’ instructional strategy preference as well as between teacher participants’ extent of use and student participants’ perceived level of use of the different instructional strategies. Findings found a discrepancy between the teaching strategy preferences of students and strategies implemented by teachers.

Keywords: academic achievement, extent of use, instructional strategy, preferences

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Authors: Lucia Ceccherini Nelli, Alessandra Donato

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The ABITA Master course of the University of Florence offered by the Department of Architecture covers nearly all the energy-relevant issues that can arise in public and private companies and sectors. The main purpose of the Master course, active since 2003, is to analyse the energy consumption of building technologies, components, and structures at the conceptual design stage, so it could be very helpful, for designers, when making decisions related to the selection of the most suitable design alternatives and for the materials choice that will be used in an energy-efficient building. The training course provides a solid basis for increasing the knowledge and skills of energy managers and is developed with an emphasis on practical experiences related to the knowledge through case studies, measurements, and verification of energy-efficient solutions in buildings, in the industry and in the cities. The main objectives are: i)To raise the professional standards of those engaged in energy auditing, ii) To improve the practice of energy auditors by encouraging energy auditing professionals in a continuing education program of professional development, iii) Implement in the use of instrumentations for the typical measurements, iv) To propose an integrated methodology that links energy analysis tools with green building certification systems. This methodology will be applied at the early design stage of a project’s life. The final output of the practical training is to achieve an elevated professionalism in the study of environmental design and Energy management in buildings. The results are the redaction of line guides instruction for the energy refurbishment of Public schools in Florence. The school heritage of the Municipality of Florence requires interventions for the control of energy performance, as old construction buildings are often made without taking into account the necessary envelope performance. For this reason, every year, the Master's course aims to study groups of public schools to enable the Municipality to carry out energy redevelopment interventions on the existing building heritage. The future challenges of the education and training program are related to follow-up activities, the development of interactive tools and the curriculum's customization to meet the constantly growing needs of energy experts from industry.

Keywords: expert in energy, energy auditing, public buildings, thermal analysis

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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: Ayami Umemura

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The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

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Authors: Dina Siniora, Jasia Baig

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During the past few decades, the healthcare system has undergone profound changes in their healthcare decision-making competencies and moral aptitudes due to the vast advancement in technology, clinical skills, and scientific knowledge. Healthcare decision-making deals with morally contentious dilemmas ranging from illness, life and death judgments that require sensitivity and awareness towards the patient’s preferences while taking into consideration medicine’s abilities and boundaries. As the ever-evolving field of medicine continues to become more scientifically and morally multifarious; physicians and the hospital administrators increasingly rely on ethics committees to resolve problems that arise in everyday patient care. The role and latitude of responsibilities of ethics committees which includes being dispute intermediaries, moral analysts, policy educators, counselors, advocates, and reviewers; suggest the importance and effectiveness of a fully integrated committee. Despite achievements on Integrated Ethics and progress in standards and competencies, there is an imminent necessity for further improvement in quality within ethics consultation services in areas of credentialing, professionalism and standards of quality, as well as the quality of healthcare throughout the system. These concerns can be resolved first by collecting data about particular quality gaps and comprehend the level to which ethics committees are consistent with newly published ASBH quality standards. Policymakers should pursue improvement strategies that target both academic bioethics community and major stakeholders at hospitals, who directly influence ethics committees. This broader approach oriented towards education and intervention outcome in conjunction with preventive ethics to address disparities in quality on a systematic level. Adopting tools for improving competencies and processes within ethics consultation by implementing a credentialing process, upholding normative significance for the ASBH core competencies, advocating for professional Code of Ethics, and further clarifying the internal structures will improve productivity, patient satisfaction, and institutional integrity. This cannot be systemically achieved without a written certification exam for HCEC practitioners, credentialing and privileging HCEC practitioners at the hospital level, and accrediting HCEC services at the institutional level.

Keywords: ethics consultation, hospital, medical ethics, quality

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Authors: A. Vaidya-Soocheta, K. M. Wong-Hon-Lang

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Craft and fashion have always been interlinked. The combination of both often gives stunning results. The present study introduces ‘Paper Cutting Craft Techniques’ like the Japanese –Kirigami, Mexican –PapelPicado, German –Scherenschnitte, Polish –Wycinankito in textiles to develop innovative and novel design structures as embellishments and ornamentation. The project studies various ways of using these paper cutting techniques to obtain interesting features and delicate design patterns on fabrics. While paper has its advantages and related uses, it is fragile rigid and thus not appropriate for clothing. Fabric is sturdy, flexible, dimensionally stable and washable. In the present study, the cut out techniques develop creative design motifs and patterns to give an inventive and unique appeal to the fabrics. The beauty and fascination of lace in garments have always given them a nostalgic charm. Laces with their intricate and delicate complexity in combination with other materials add a feminine touch to a garment and give it a romantic, mysterious appeal. Various textured and decorative effects through fabric manipulation are experimented along with the use of paper cutting craft skills as an innovative substitute for developing lace or “Broderie Anglaise” effects on textiles. A number of assorted fabric types with varied textures were selected for the study. Techniques to avoid fraying and unraveling of the design cut fabrics were introduced. Fabrics were further manipulated by use of interesting prints with embossed effects on cut outs. Fabric layering in combination with assorted techniques such as cutting of folded fabric, printing, appliqué, embroidery, crochet, braiding, weaving added a novel exclusivity to the fabrics. The fabrics developed by these innovative methods were then tailored into garments. The study thus tested the feasibility and practicability of using these fabrics by designing a collection of evening wear garments based on the theme ‘Nostalgia’. The prototypes developed were complemented by designing fashion accessories with the crafted fabrics. Prototypes of accessories add interesting features to the study. The adaptation and application of this novel technique of paper cutting craft on textiles can be an innovative start for a new trend in textile and fashion industry. The study anticipates that this technique will open new avenues in the world of fashion to incorporate its use commercially.

Keywords: collection, fabric cutouts, nostalgia, prototypes

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Authors: Mohammad Arabi

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Business Process Reengineering (BPR) is a systematic approach to fundamentally redesign organizational processes to achieve significant improvements in organizational performance. At Fars Regional Electric Company, implementing BPR is deemed essential to increase productivity, reduce costs, and improve service quality. This article examines how BPR can help enhance the performance of Fars Regional Electric Company. The objective of this research is to evaluate and analyze the advancements in process modeling and reengineering at Fars Regional Electric Company and to provide solutions for improving the productivity and efficiency of organizational processes. This study aims to demonstrate how BPR can be used to improve organizational processes and enhance the overall performance of the company. This research employs both qualitative and quantitative research methods and includes interviews with senior managers and experts at Fars Regional Electric Company. The analytical tools include process modeling software such as Bizagi and ARIS, and statistical analysis software such as SPSS and Minitab. Data analysis was conducted using advanced statistical methods. The results indicate that the use of BPR techniques can lead to a significant reduction in process execution time and overall improvement in quality. Implementing BPR at Fars Regional Electric Company has led to increased productivity, reduced costs, and improved overall performance of the company. This study shows that with proper implementation of BPR and the use of modeling tools, the company can achieve significant improvements in its processes. Recommendations: (1) Continuous Training for Staff: Invest in continuous training of staff to enhance their skills and knowledge in BPR. (2) Use of Advanced Technologies: Utilize modeling and analysis software to improve processes. (3) Implementation of Effective Management Systems: Employ knowledge and information management systems to enhance organizational performance. (4) Continuous Monitoring and Review of Processes: Regularly review and revise processes to ensure ongoing improvements. This article highlights the importance of improving organizational processes at Fars Regional Electric Company and recommends that managers and decision-makers at the company seriously consider reengineering processes and utilizing modeling technologies to achieve developmental goals and continuous improvement.

Keywords: business process reengineering, electric company, Fars province, process modeling advancements

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Authors: Tan Xin Zhong Timothy, Chang Chen Jie Victor, Yew Kwan Tong, Lim Geok Peng Sandy

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Background: Leaders in crisis response teams such as Trauma Teams in hospitals are essential to the effective coordination and direction of the team. The response to emergency trauma situations must be accurate, rapid, and well executed. To this end, the team leader’s social, technical and leadership skills are essential factors that implicate the success of an emergency trauma intervention. While each emergency trauma case varies in severity and complexity, and the experience and expertise of team leaders may vary, it would be productive to identify certain coordinative and directive functions that improve the capacity for leading a team. Methods: This qualitative study of Trauma Team physicians in Singapore General Hospital (SGH) involved 50 in-depth interviews with doctors and nurses involved in Trauma Team activations, observations of Trauma Teams managing emergency patients, and reviews of audio/video recordings of 65 trauma activations. The interviews were conducted with doctors of various ranks across the relevant departments, 12 from the Emergency Department (ED), 11 from General Surgery (GS) and 8 from Orthopaedics, while the 6 nurses were from ED. In accordance with the grounded theory approach, the content of the interviews was coded and analysed in order to derive broad leadership themes that corresponded with certain behavioural traits exhibited by trauma team leaders, supplemented with the observational and audio/video data. Results: The leadership behaviours of the team leaders could be typified into three broad categories: team orientation, engagement and activeness. Team orientation corresponds with the source and form of cognitive responsibility, decision-making and informational contributions, divisible into individualistic and consultative sub-categories. Engagement refers to the type of activity that leaders prefer to engage in, and which implicates their attentional focus, divisible into participatory and supervisory sub-categories. Activeness is a function of the leader’s attitudes towards the behavioural regulation of the team, which manifests in inactivity or activity to augment or merely align with protocol. These factors are not exhaustive and are contextually sensitive, but collectively implicate a significant portion of the leadership activity observed in trauma teams.

Keywords: trauma team activations, critical event management, leadership, teamwork

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Authors: Zdzisław Kobos, Robert Jędrys, Zbigniew Wochyński

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Motor activity and good health are sine qua non determinants of a proper practice of the profession, especially aviation. Therefore, candidates to the aviation are selected according their psychomotor ability by both specialist medical commissions. Moreover, they must past an examination of the physical fitness. During the studies in the air force academy, eye-hand coordination is formed in two stages. The future aircraft pilots besides all-purpose physical education must practice specialist training on SAGI. Training includes: looping, aerowheel, and gyroscope. Aim of the training on the above listed apparatuses is to form eye-hand coordination during the tasks in the air. Such coordination is necessary to perform various figures in the real flight. Therefore, during the education of the future pilots, determinants of the effective ways of this important parameter of the human body functioning are sought for. Several studies of the sport psychology indicate an important role of the temperament as a factor determining human behavior during the task performance and acquiring operating skills> Polish psychologist Jan Strelau refers to the basic, relatively constant personality features which manifest themselves in the formal characteristics of the human behavior. Temperament, being initially determined by the inborn physiological mechanisms, changes in the course of maturation and some environmental factors and concentrates on the energetic level and reaction characteristics in time. Objectives. This study aimed at seeking a relationship between temperamental features and eye-hand coordination formation during training on SAGI. Material and Methods: Group of 30 students of pilotage was examined in two situations. The first assessment of the eye-hand coordination level was carried out before the beginning of a 30-hour training on SAGI. The second assessment was carried out after training completion. Training lasted for 2 hours once a week. Temperament was evaluated with The Formal Characteristics of Behavior − Temperament Inventory (FCB-TI) developed by Bogdan Zawadzki and Jan Strelau. Eye-hand coordination was assessed with a computer version of the Warsaw System of Psychological Tests. Results: It was found that the training on SAGI increased the level of eye-hand coordination in the examined students. Conclusions: Higher level of the eye-hand coordination was obtained after completion of the training. Moreover, a relationship between eye-hand coordination level and selected temperamental features was statistically significant.

Keywords: temperament, eye-hand coordination, pilot, SAGI

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Authors: Mei-Hui Liu

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This paper reports the progression of language teachers’ learning to assess students’ speech act performance via online videos in a cross-tier professional growth community. This yearlong research project collected multiple data sources from several stakeholders, including 12 preservice and 4 inservice English as a foreign language (EFL) teachers, 4 English professionals, and 82 high school students. Data sources included surveys, (focus group) interviews, online reflection journals, online video-based assessment items/scores, and artifacts related to teacher professional learning. The major findings depicted the effectiveness of this proposed learning module on language teacher development in pragmatic assessment as well as its impact on student learning experience. All these teachers appreciated this professional learning experience which enhanced their knowledge in assessing students’ pragmalinguistic and sociopragmatic performance in an English speech act (i.e., making refusals). They learned how to design online video-based assessment items by attending to specific linguistic structures, semantic formula, and sociocultural issues. They further became aware of how to sharpen pragmatic instructional skills in the near future after putting theories into online assessment and related classroom practices. Additionally, data analysis revealed students’ achievement in and satisfaction with the designed online assessment. Yet, during the professional learning process most participating teachers encountered challenges in reaching a consensus on selecting appropriate video clips from available sources to present the sociocultural values in English-speaking refusal contexts. Also included was to construct test items which could testify the influence of interlanguage transfer on students’ pragmatic performance in various conversational scenarios. With pedagogical implications and research suggestions, this study adds to the increasing amount of research into integrating preservice and inservice EFL teacher education in pragmatic assessment and relevant instruction. Acknowledgment: This research project is sponsored by the Ministry of Science and Technology in the Republic of China under the grant number of MOST 106-2410-H-029-038.

Keywords: cross-tier professional development, inservice EFL teachers, pragmatic assessment, preservice EFL teachers, student learning experience

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Authors: Zichao Zhang, Yifan Zhao, Samuel Court

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The carbon emission problem of the traditional construction industry has long been a pressing issue. With the growing emphasis on environmental protection and advancement of science and technology, the organic integration of digital technology and emission reduction has gradually become a mainstream solution. Among various sophisticated digital technologies, digital twins, which involve creating virtual replicas of physical systems or objects, have gained enormous attention in recent years as tools to improve productivity, optimize management and reduce carbon emissions. However, the relatively high implementation costs including finances, time, and manpower associated with digital twins have limited their widespread adoption. As a result, most of the current applications are primarily concentrated within a few industries. In addition, the creation of digital twins relies on a large amount of data and requires designers to possess exceptional skills in information collection, organization, and analysis. Unfortunately, these capabilities are often lacking in the traditional construction industry. Furthermore, as a relatively new concept, digital twins have different expressions and usage methods across different industries. This lack of standardized practices poses a challenge in creating a high-quality digital twin framework for construction. This paper firstly reviews the current academic studies and industrial practices focused on reducing greenhouse gas emissions in the construction industry using digital twins. Additionally, it identifies the challenges that may be encountered during the design and implementation of a digital twin framework specific to this industry and proposes potential directions for future research. This study shows that digital twins possess substantial potential and significance in enhancing the working environment within the traditional construction industry, particularly in their ability to support decision-making processes. It proves that digital twins can improve the work efficiency and energy utilization of related machinery while helping this industry save energy and reduce emissions. This work will help scholars in this field to better understand the relationship between digital twins and energy conservation and emission reduction, and it also serves as a conceptual reference for practitioners to implement related technologies.

Keywords: digital twins, emission reduction, construction industry, energy saving, life cycle, sustainability

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Authors: Albert Amagyei, Julia Carroll, Amanda R. Amorim Adegboye, Laura Strumidlo, Rosie Kneafsey

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Introduction: Classroom-based learning has persisted as the mainstream model of pre-registration nurse education. This model is often rigid, teacher-centered, and unable to support active learning and the practical learning needs of nursing students. Health Education England (HEE), a public body of the Department of Health and Social Care, hypothesises that blended learning (BL) programmes may address health system and nursing profession challenges, such as nursing shortages and lack of digital expertise, by exploring opportunities for providing predominantly online, remote-access study which may increase nursing student recruitment, offering alternate pathways to nursing other than the traditional classroom route. This study will provide evidence for blended learning strategies adopted in nursing education as well as examine nursing student learning experiences concerning the challenges and opportunities related to using blended learning within nursing education. Objective: This review will explore the challenges and opportunities of BL within pre-registration nurse education from the student's perspective. Methods: The search was completed within five databases. Eligible studies were appraised independently by four reviewers. The JBI-convergent segregated approach for mixed methods review was used to assess and synthesize the data. The study’s protocol has been registered with the International Register of Systematic Reviews with registration number// PROSPERO (CRD42023423532). Results: Twenty-seven (27) studies (21 quantitative and 6 qualitative) were included in the review. The study confirmed that BL positively impacts nursing students' learning outcomes, as demonstrated by the findings of the meta-analysis and meta-synthesis. Conclusion: The review compared BL to traditional learning, simulation, laboratory, and online learning on nursing students’ learning and programme outcomes as well as learning behaviour and experience. The results show that BL could effectively improve nursing students’ knowledge, academic achievement, critical skills, and clinical performance as well as enhance learner satisfaction and programme retention. The review findings outline that students’ background characteristics, BL design, and format significantly impact the success of the BL nursing programme.

Keywords: nursing student, blended learning, pre-registration nurse education, online learning

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Authors: Muhammad Saleem

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Background: The teaching of sports sciences encompasses a broad spectrum of disciplines, including biomechanics, physiology, psychology, and coaching. Effective pedagogical techniques are crucial in imparting both theoretical knowledge and practical skills necessary for students to excel in the field. The impact of these techniques on students’ learning outcomes, engagement, and professional preparedness remains a vital area of study. Objective: This study aims to evaluate the effectiveness of various pedagogical techniques used in the teaching of sports sciences. It seeks to identify which methods most significantly enhance student learning, retention, engagement, and practical application of knowledge. Methods: A mixed-methods approach was employed, including both quantitative and qualitative analyses. The study involved a comparative analysis of traditional lecture-based teaching, experiential learning, problem-based learning (PBL), and technology-enhanced learning (TEL). Data were collected through surveys, interviews, and academic performance assessments from students enrolled in sports sciences programs at multiple universities. Statistical analysis was used to evaluate academic performance, while thematic analysis was applied to qualitative data to capture student experiences and perceptions. Results: The findings indicate that experiential learning and PBL significantly improve students' understanding and retention of complex sports science concepts compared to traditional lectures. TEL was found to enhance engagement and provide students with flexible learning opportunities, but its impact on deep learning varied depending on the quality of the digital resources. Overall, a combination of experiential learning, PBL, and TEL was identified as the most effective pedagogical approach, leading to higher student satisfaction and better preparedness for real-world applications. Conclusion: The study underscores the importance of adopting diverse and student-centered pedagogical techniques in the teaching of sports sciences. While traditional lectures remain useful for foundational knowledge, integrating experiential learning, PBL, and TEL can substantially improve student outcomes. These findings suggest that educators should consider a blended approach to pedagogy to maximize the effectiveness of sports science education.

Keywords: sport sciences, pedagogical techniques, health and physical education, problem-based learning, student engagement

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Authors: Wilfred Emmannuel Dzasu, Sani Usman Kunya, Inuwa Yusuf Mohammed, Moses Jonathan Gambo

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The research aimed at investigating and identifying the strategies for enhancing access to microfinance for housing provision in the informal sector of North East Nigeria, with a focus on addressing the critical issue of housing poverty and lack of access to affordable housing finance among low-income households in the informal sector. The study employed an exploratory sequential mixed method design, combining both qualitative and quantitative data collection and analysis techniques. In the qualitative phase, 12 participants from microfinance institutions (MFIs) in four selected states (Adamawa, Bauchi, Gombe, and Taraba) were interviewed. The interviews were conducted using an interview guide with open-ended questions and were recorded with the consent of the respondents. In the quantitative phase, a survey strategy was adopted to collect data from 500 questionnaires distributed to informal sector workers (ISWs) in the study area. A total of 350 questionnaires were returned, representing a 70.0% response rate. The most preferred strategy for improving access to housing microfinance among ISWs is aggressive awareness of housing financing options by MFIs, with a mean score of 4.213; the most important strategy for improving access to housing microfinance among MFIs is close monitoring and adequate supervision of housing loan beneficiaries by MFIs, with a mean score of 4.675. The study identified several government-related strategies that are necessary for enhancing access to housing microfinance, including the provision of grants and subsidized intervention funds for housing, improvement in infrastructures to aid housing developments, and adequate measures for checking inflation/price fluctuation of building materials. The study also identified several MFI-related strategies that are necessary for enhancing access to housing microfinance, including deliberate expansion in the capital bases of MFIs, adequate training and capacity development of MFIs staff on relevant skills in housing micro-financing, and introduction of loan products that suit the incremental building needs of informal sector workers. Overall, the study highlights the need for a combination of government-related and MFI-related strategies to enhance access to microfinance for housing provision in the informal sector of North East Nigeria.

Keywords: finanace, microfinance, housing, North East Nigeria

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Authors: Yun Chan Lee

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Background: End-of-life care is a large area of all nursing practice and student nurses are likely to meet dying patients in many placement areas. It is therefore important to understand the emotional responses and coping strategies of student nurses in order for nursing education systems to have some appreciation of how nursing students might be supported in the future. Methodology: This research used a qualitative phenomenological approach. Six student nurses understanding a degree-level adult nursing course were interviewed. Their responses to questions were analyzed using interpretative phenomenological analysis. Finding: The findings identified 3 main themes. First, the common experience of ‘unpreparedness’. A very small number of participants felt that this was unavoidable and that ‘no preparation is possible’, the majority felt that they were unprepared because of ‘insufficient input’ from the university and as a result of wider ‘social taboos’ around death and dying. The second theme showed that emotions were affected by ‘the personal connection to the patient’ and the important sub-themes of ‘the evoking of memories’, ‘involvement in care’ and ‘sense of responsibility’. The third theme, the coping strategies used by students, seemed to fall into two broad areas those ‘internal’ with the student and those ‘external’. In terms of the internal coping strategies, ‘detachment’, ‘faith’, ‘rationalization’ and ‘reflective skills’ are the important components of this part. Regarding the external coping strategies, ‘clinical staff’ and ‘the importance of family and friends’ are the importance of accessing external forms of support. Implication: It is clear that student nurses are affected emotionally by caring for dying patients and many of them have apprehension even before they begin on their placements but very often this is unspoken. Those anxieties before the placement become more pronounced during and continue after the placements. This has implications for when support is offered and possibly its duration. Another significant point of the study is that participants often highlighted their wish to speak to qualified nurses after their experiences of being involved in end-of-life care and especially when they had been present at the time of death. Many of the students spoke that qualified nurses were not available to them. This seemed to be due to a number of reasons. Because the qualified nurses were not available, students had to make use of family members and friends to talk to. Consequently, the implication of this study is not only to educate student nurses but also to educate the qualified mentors on the importance of providing emotional support to students.

Keywords: nursing students, coping strategies, end-of-life care, emotional responses

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Authors: Nidia Thalia Alva Rangel, Ferran Padros Blazquez, Ma. Ines Gomez Del Campo Del Paso

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Happiness has been since antiquity a concept of interest around the world. Positive psychology is the science that begins to study happiness in a more precise and controlled way, obtaining wide amount of research which can be applied. One of the central constructs of Positive Psychology is Carol Ryff’s psychological well-being model as eudaimonic happiness, which comprehends six dimensions: autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Humanistic psychology is a clear precedent of Positive Psychology, which has studied human development topics and it features a great variety of intervention techniques nevertheless has little evidence with controlled research. Therefore, the present research had the aim to evaluate the efficacy of a humanistic intervention program to increase psychological well-being in healthy adults through a mixed methods study. Before and after the intervention, it was applied Carol Ryff’s psychological well-being scale (PWBS) and the Symptom Check List 90 as pretest and posttest. In addition, a questionnaire of five open questions was applied after each session. The intervention program was designed in experiential workshop format, based on the foundational attitudes defined by Carl Rogers: congruence, unconditional positive regard and empathy, integrating humanistic intervention strategies from gestalt, psychodrama, logotherapy and psychological body therapy, with the aim to strengthen skills in the six dimensions of psychological well-being model. The workshop was applied to six volunteer adults in 12 sessions of 2 hours each. Finally, quantitative data were analyzed with Wilcoxon statistic test through the SPSS program, obtaining as results differences statistically significant in pathology symptoms between prettest and postest, also levels of dimensions of psychological well-being were increased, on the other hand for qualitative strand, by open questionnaires it showed how the participants were experiencing the techniques and changing through the sessions. Thus, the humanistic psychology program was effective to increase psychological well-being. Working to promote well-being prompts to be an effective way to reduce pathological symptoms as a secondary gain. Experiential workshops are a useful tool for small groups. There exists the need for research to count with more evidence of humanistic psychology interventions in different contexts and impulse the application of Positive Psychology knowledge.

Keywords: happiness, humanistic psychology, positive psychology, psychological well-being, workshop

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Authors: Kholood A. Baron

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While radiologist numbers specialized in spine interventional procedures are limited in Kuwait, the number of patients demanding these procedures is increasing rapidly. Due to this high demand, the workload of radiologists is increasing, which might represent a radiation exposure concern. During these procedures, the doctor’s hands are in very close proximity to the main radiation beam/ if not within it. The aim of this study is to measure the radiation dose for radiologists during several interventional procedures for the spine. Methods: Two doctors carrying different workloads were included. (DR1) was performing procedures in the morning and afternoon shifts, while (DR2) was performing procedures in the morning shift only. Comparing the radiation exposures that the hand of each doctor is receiving will assess radiation safety and help to set up workload regulations for radiologists carrying a heavy schedule of such procedures. Entrance Skin Dose (ESD) was measured via TLD (ThermoLuminescent Dosimetry) placed at the right wrist of the radiologists. DR1 was covering the morning shift in one hospital (Mubarak Al-Kabeer Hospital) and the afternoon shift in another hospital (Dar Alshifa Hospital). The TLD chip was placed in his gloves during the 2 shifts for a whole week. Since DR2 was covering the morning shift only in Al Razi Hospital, he wore the TLD during the morning shift for a week. It is worth mentioning that DR1 was performing 4-5 spine procedures/day in the morning and the same number in the afternoon and DR2 was performing 5-7 procedures/day. This procedure was repeated for 4 consecutive weeks in order to calculate the ESD value that a hand receives in a month. Results: In general, radiation doses that the hand received in a week ranged from 0.12 to 1.12 mSv. The ESD values for DR1 for the four consecutive weeks were 1.12, 0.32, 0.83, 0.22 mSv, thus for a month (4 weeks), this equals 2.49 mSv and calculated to be 27.39 per year (11 months-since each radiologist have 45 days of leave in each year). For DR2, the weekly ESD values are 0.43, 0.74, 0.12, 0.61 mSv, and thus, for a month, this equals 1.9 mSv, and for a year, this equals 20.9 mSv /year. These values are below the standard level and way below the maximum limit of 500 mSv per year (set by ICRP = International Council of Radiation Protection). However, it is worth mentioning that DR1 was a senior consultant and hence needed less fluoro-time during each procedure. This is evident from the low ESD values of the second week (0.32) and the fourth week (0.22), even though he was performing nearly 10-12 procedures in a day /5 days a week. These values were lower or in the same range as those for DR2 (who was a junior consultant). This highlighted the importance of increasing the radiologist's skills and awareness of fluoroscopy time effect. In conclusion, the radiation dose that radiologists received during spine interventional radiology in our setting was below standard dose limits.

Keywords: radiation protection, interventional radiology dosimetry, ESD measurements, radiologist radiation exposure

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Authors: Mariam Matiashvili

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Argumentation is an integral part of our daily communications - formal or informal. Argumentative reasoning, techniques, and language tools are used both in personal conversations and in the business environment. Verbalization of the opinions requires the use of extraordinary syntactic-pragmatic structural quantities - arguments that add credibility to the statement. The study of argumentative structures allows us to identify the linguistic features that make the text argumentative. Knowing what elements make up an argumentative text in a particular language helps the users of that language improve their skills. Also, natural language processing (NLP) has become especially relevant recently. In this context, one of the main emphases is on the computational processing of argumentative texts, which will enable the automatic recognition and analysis of large volumes of textual data. The research deals with the linguistic analysis of the argumentative structures of Georgian political speeches - particularly the linguistic structure, characteristics, and functions of the parts of the argumentative text - claims, support, and attack statements. The research aims to describe the linguistic cues that give the sentence a judgmental/controversial character and helps to identify reasoning parts of the argumentative text. The empirical data comes from the Georgian Political Corpus, particularly TV debates. Consequently, the texts are of a dialogical nature, representing a discussion between two or more people (most often between a journalist and a politician). The research uses the following approaches to identify and analyze the argumentative structures Lexical Classification & Analysis - Identify lexical items that are relevant in argumentative texts creating process - Creating the lexicon of argumentation (presents groups of words gathered from a semantic point of view); Grammatical Analysis and Classification - means grammatical analysis of the words and phrases identified based on the arguing lexicon. Argumentation Schemas - Describe and identify the Argumentation Schemes that are most likely used in Georgian Political Speeches. As a final step, we analyzed the relations between the above mentioned components. For example, If an identified argument scheme is “Argument from Analogy”, identified lexical items semantically express analogy too, and they are most likely adverbs in Georgian. As a result, we created the lexicon with the words that play a significant role in creating Georgian argumentative structures. Linguistic analysis has shown that verbs play a crucial role in creating argumentative structures.

Keywords: georgian, argumentation schemas, argumentation structures, argumentation lexicon

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Authors: Sonia Saddiqui, Maya Marcus

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UTS STEAMpunk Girls is an educational program for young women (aged 12-16), to empower them to be more informed and active members of the 21st century workforce. With the number of STEM graduates on the decline, especially among young women, an additional aim of the program is to trial a STEAM (Science, Technology, Engineering, Arts/Humanities/Social Sciences, Mathematics), inter-disciplinary approach to improving STEM engagement. In-line with UNESCO’s recent focus on promoting ‘transversal competencies’ in future graduates, the program utilised co-design, project-based learning, entrepreneurial processes, and inter-disciplinary learning. The program consists of two phases. Taking a participatory design approach, the first phase (co-design workshops) provided valuable insight into student perspectives around engaging young women in STEM and inter-disciplinary thinking. The workshops positioned 26 young women from three schools as subject matter experts (SMEs), providing a platform for them to share their opinions, experiences and findings around the STEAM disciplines. The second (pilot) phase put the co-design phase findings into practice, with 64 students from four schools working in groups to articulate problems with real-world implications, and utilising design-thinking to solve them. The pilot phase utilised project-based learning to engage young women in entrepreneurial and STEAM frameworks and processes. Scalable program design and educational resources were trialed to determine appropriate mechanisms for engaging young women in STEM and in STEAM thinking. Across both phases, data was collected via longitudinal surveys to obtain pre-program, baseline attitudinal information, and compare that against post-program responses. Preliminary findings revealed students’ improved understanding of the STEM disciplines, industries and professions, improved awareness of STEAM as a concept, and improved understanding regarding inter-disciplinary and design thinking. Program outcomes will be of interest to high-school educators in both STEM and the Arts, Humanities and Social Sciences fields, and will hopefully inform future programmatic approaches to introducing inter-disciplinary STEAM learning in STEM curriculum.

Keywords: co-design, STEM, STEAM, project-based learning, inter-disciplinary

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Authors: Maria Tagarelli De Monte

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In 2021, the passage of the law recognizing Italian Sign Language (LIS) as the language of the Italian deaf minority was the input for including this visual-gestural language in the curricula of interpreters and translators choosing the academic setting for their training. Yet, a gap remains concerning LIS education of teachers and communication assistants as referring figures for people who are deaf or hard of hearing in mainstream education. As well documented in the related scientific literature, deaf children often experience severe difficulties with the languages spoken in the country where they grow up, manifesting in all levels of literacy competence. In the research introduced here, the experience of deaf students (and their teachers) attending schools is explored in areas that are characterized by strong native bilingualism, such as Friuli-Venezia Giulia (FVG), facing Italian Northeast borders. This region is peculiar as the native population may be bilingual Italian and Friulian (50% of the local population), German, and/or Slovenian. The research involved all schools of all levels in Friuli to understand the relationship between the language skills expressed by teachers and those shown by deaf learners with a background in sign language. In addition to collecting specific information on the degree of preparation of teachers in deaf-related matters and LIS, the research has allowed to highlight the role, often poorly considered, covered by the communication assistants who work alongside deaf students. On several occasions, teachers and assistants were unanimous in affirming the importance of mutual collaboration and adequate consideration of the educational-rehabilitative history of the deaf child and her family. The research was based on a mixed method of structured questionnaires and semi-structured interviews with the referring teachers. As a result, a varied and complex framework emerged, showing an asymmetry in preparing personnel dedicated to the deaf learner. Considering how Italian education has long invested in creating an inclusive and accessible school system (i.e. with the "Ten Theses for Democratic Language Education"), a constructive analysis will complete the discussion in an attempt to understand how linguistic (and modal) differences can become levers of inclusion.

Keywords: FVG, LIS, linguistic needs, deafness, teacher education, bilingual bimodal children, communication assistants, inclusion model

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Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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Background: A mixed method systematic review was undertaken in order to explore issues related to the experiences of health care providers and parents in the care of children with palliative care needs. The aims of this systematic review were to identify existing evidence about the experiences of communication in the care of children with palliative care needs, to appraise the research conducted in this area and to identify gaps in the literature in order to recommend for future related studies. Method: A mixed method systematic review of research on the experience of communication in the care of children with palliative care needs, conducted with parents and health professionals was undertaken. The electronic databases of CINAHL, Cochrane, PubMed, OVID, Social Care Online, Web of Science, Scopus, and ProQuest were searched for the period of 2000-2016. Inclusion was limited to studies of communication experience in the care of children with palliative care needs. Result: Thirty-eight studies were found. The studies were conducted in a variety of countries: Uganda, Jordan, USA, UK, Taiwan, Turkey, Ireland, Poland, Brazil, Australia, Switzerland, Sweden, Netherland, Lebanon, Spain, Greece, and China. The current review shows that parents tend to protect their children when they are discussing their illnesses with them, particularly where they have a life-threatening or life-limiting condition. The approach of parents towards the discussion of sensitive issues concerning death with their children is significantly affected by the cultural background of the families. Conservative cultures encourage collusion behaviours which tend to keep children unaware of the incurable nature of the disease. The major communication challenges reported by health professionals are facing difficulties in judging how much information should be given to parents, responding to difficult questions, conflicts with families and inadequate skills to support grieving families. Conclusion: It is probably significant for the future studies to consider the change of parent-child communication experience over time in order to understand how the parents could change their interaction styles with their children according to the different stages of their children’s disease. Moreover, further studies are required to investigate the experience of communication of parents of children with non-malignant life-threatening and life-limiting illnesses.

Keywords: children with life-threatening or life- limiting illnesses, end of life, experience of communication, healthcare care providers, paediatric palliative care

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