Search results for: categories of practice

Authors: Esam Roshdy, Saleh AlRashdi, Turki Alharbi, Rawan Eskandarani, Zurina Cabilo

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Introduction/ background: Consultation in the Emergency Department constitute a major part of the work flow every day. Any delay in the consultation process have a major impact on the length of stay and patient disposition and thus affect the total waiting time of patients in the ED. King Fahad medical City in Riyadh City, Saudi Arabia is considered a major Tertiary hospital where there is high flow of patients of different categories visiting the ED. The importance of decreasing consultation time and decision for final disposition of patients was recognized and interpreted in this project to find ways to improve the patient flow in the department and thus the total patient disposition and outcome. Aim / Objectives: 1. To monitor the time of consultation for patients in the Emergency department and its impact on the length of stay of patients in the ED. 2. To detect and assess the problems that lead to long consultation times in the ED, and reach a targeted time of 2 hours for final disposition of patients, according to recognized international and our institutional consultation policy, to reach the final goal of decreasing total length of stay and thus improve the patient flow in the ED. Methods: Data was collected retrospectively for a 92 charts of consultations done in the ED over 2 month’s period. The data was analyzed to get the median of Total Consultation Time. A survey was conducted among all ED staff to determine the level of knowledge about the total consultation time and the compliance to the institutional policy target of 2 hours. A second Data sample of 168 chart was collected after awareness campaign and education of all ED staff about the importance of reaching the target consultation time and compliance to the institutional policy. Results: We have found that there is room for improvement in our overall consultation time. This was found to be more frequent with certain specialties. Our surveys have showed that many ED staff are not familiar or not compliant with our consultation policy which was not clear for everyone. Post-intervention data have showed that awareness of the importance to decrease the total consultation time and compliance alone to the targeted goal have had a huge impact on overall improvement and decreasing the time of final decision and disposition of the patient and the overall patient length of stay in the ED. Conclusion: Working on improving Consultation time in the Emergency Department is a major factor in improving overall length of stay and patient flow. This improvement helps in the overall patient disposition and satisfaction. Plan: As a continuation of our project we are planning to focus on the conflict of admission cases where more than one specialty is involved in the care of patients. We are planning to collect data on the time it takes to resolve and reach final disposition of those patients, and its impact on the length of stay and our department flow and the overall patient outcome and satisfaction.

Keywords: consultation time, impact, length of stay, in the ED

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Authors: Muhammad Naveed Babur, Maria Liaqat

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Background & Objective: People with disabilities especially neurological disabilities have many unmet health and rehabilitation needs, face barriers in accessing mainstream health-care services, and consequently have poor health. There are not sufficient epidemiological studies from Pakistan which assess barriers to neurorehabilitation and ways to counter it. Objectives: The objective of the study was to determine the challenges and to evaluate the barriers for neuro-rehabilitation services in developing countries. Methods: This is Exploratory sequential qualitative study based on the Panel discussion forum in International rehabilitation sciences congress and national rehabilitation conference 2017. Panel group discussion has been conducted in February 2017 with a sample size of eight professionals including Rehabilitation medicine Physician, Physical Therapist, Speech Language therapist, Occupational Therapist, Clinical Psychologist and rehabilitation nurse working in multidisciplinary/Interdisciplinary team. A comprehensive audio-videography have been developed, recorded, transcripted and documented. Data was transcribed and thematic analysis along with characteristics was drawn manually. Data verification was done with the help of two separate coders. Results: After extraction of two separate coders following results are emerged. General category themes are disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. Barriers identified at the level are high cost, stigma, lengthy course of recovery. Hospital related barriers are lack of social support and individually tailored goal setting processes. Organizational barriers identified are lack of basic diagnostic facilities, lack of funding and human resources. Recommendations given by panelists were investment in education, capacity building, infrastructure, governance support, strategies to promote communication and realistic goals. Conclusion: It is concluded that neurorehabilitation in developing countries need attention in following categories i.e. disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. This study also revealed barriers at the level of patient, hospital, organization. Recommendations were also given by panelists.

Keywords: disability, neurorehabilitation, telerehabilitation, disability

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Authors: Yael Wolff Sagy, Yiska Loewenberg Weisband, Vered Kaufman Shriqui, Michal Krieger, Arie Ben Yehuda, Ronit Calderon Margalit

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Background: Obesity is both a risk factor and common comorbidity of diabetes. Obesity impedes the achievement of glycemic control, and enhances damage caused by hyperglycemia to blood vessels; thus it increases diabetes-related complications. This study assessed the prevalence of obesity and morbid obesity among Israeli adults with diabetes, and estimated disparities associated with sex and socioeconomic position (SEP). Methods: A cross-sectional study was conducted in the setting of the Israeli National Program for Quality Indicators in Community Healthcare. Data on all the Israeli population is retrieved from electronic medical records of the four health maintenance organizations (HMOs). The study population included all Israeli patients with diabetes aged 20-64 with documented body mass index (BMI) in 2016 (N=180,451). Diabetes was defined as the existence of one or more of the following criteria: (a) Plasma glucose level >200 mg% in at least two tests conducted at least one month apart in the previous year; (b) HbA1c>6.5% at least once in the previous year (c) at least three prescriptions of diabetes medications were dispensed during the previous year. Two measures were included: the prevalence of obesity (defined as last BMI≥ 30 kg/m2 and <35 kg/m2) and the prevalence of morbid obesity (defined as last BMI≥ 35 kg/m2) in individuals aged 20-64 with diabetes. The cut-off value for morbid obesity was set in accordance with the eligibility criteria for bariatric surgery in diabetics. Data were collected by the HMOs and aggregated by age, sex and SEP. SEP was based on statistical areas ranking by the Israeli Central Bureau of Statistics and divided into 4 categories, ranking from 1 (lowest) to 4 (highest). Results: BMI documentation among adults with diabetes was 84.9% in 2016. The prevalence of obesity in the study population was 30.5%. Although the overall rate was similar in both sexes (30.8% in females, 30.3% in males), SEP disparities were stronger in females (32.7% in SEP level 1 vs. 27.7% in SEP level 4; 18.1% relative difference) compared to males (30.6% in SEP level 1 vs. 29.3% in SEP level 4; 4.4% relative difference). The overall prevalence of morbid obesity in this population was 20.8% in 2016. The rate among females was almost double compared to the rate in males (28.1% and 14.6%, respectively). In both sexes, the prevalence of morbid obesity was strongly associated with lower SEP. However, in females, disparities between SEP levels were much stronger (34.3% in SEP level 1 vs. 18.7% in SEP level 4; 83.4% relative difference) compared to SEP-disparities in males (15.7% in SEP level 1 vs. 12.3% in SEP level 4; 27.6% relative difference). Conclusions: The overall prevalence of BMI≥ 30 kg/m2 among adults with diabetes in Israel exceeds 50%; and the prevalence of morbid obesity suggests that 20% meet the BMI-criteria for bariatric surgery. Prevalence rates show major SEP- and sex-disparities; especially strong SEP disparities in morbid obesity among females. These findings highlight the need for greater consideration of different population groups when implementing interventions.

Keywords: diabetes, health disparities, health policy, obesity, socio-economic position

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Authors: Jeonghyun Chang, Taegeun Lee, Heungsup Sung, Yoon-Seon Lee, Youn-Jung Kim, Mi-Na Kim

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Background: Safety device has been applied to improve safety and performance of blood culture practice. BD vacutainer® Safety-Lokᵀᴹ blood collection sets with pre-attached holder (Safety-Lok) (BD, USA) was evaluated in the emergency room (ER) of a tertiary care hospital. Methods: From April to June 2017, interns and nurses in ER were surveyed for blood culture practices with a questionnaire before and after 2 or 3 weeks of experience of Safety-Lok. All of them participated in exercise workshop for 1 hour combined with video education prior to the initial survey. The blood volume, positive and contamination rates of Safety-Lok-drawn (SD) blood cultures were compared to those of overall blood cultures. Results: Eighteen interns and 30 nurses were enrolled. As a result of the initial survey, interns had higher rates of needlestick incidence (27.8%), carriage of the blood-filled syringe with needle (88.9%) and lower rates of vacutainer use (38.9%) than nurses (13.3%, 53.3%, and 60.0%). Interns preferred to use safety devices (88.9%) rather than nurses (40.0%). The number of overall blood cultures and SD blood cultures was 9,053 and 555, respectively. While the overall blood volume of aerobic bottles was 2.6±2.1 mL, those of SD blood cultures were 5.0±3.0 mL in aerobic bottles and 6.0±3.0 mL in anaerobic bottles. Positive and contamination rates were 6.5% and 0.72% with SD blood cultures and 6.2% and 0.3% with overall blood cultures. Conclusions: The introduction of the safety device would encourage healthcare workers to collect adequate blood volume as well as lead to safer practices in the ER.

Keywords: blood culture, needlestick, safety device, volume

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Authors: Shehroz Mukhtar, Maqsood Ahmed, Abdullah Mukhtar, Choudhry Shahid, Waqar Javaid

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Code switching is a common phenomenon, generally observed in multilingual communities across the globe. A critical look at code-switching literature reveals that mostly code-switching has been studied in the classrooms in learning and teaching contexts, while code-switching outside the classroom in settings such as café, hostels and so on has been the least explored areas. The current research investigated the reasons for code-switching in the interactive practices of students and their perceptions regarding the same outside the classroom settings. This paper is the study of the common practice that prevails in the Universities of Sialkot that bilinguals mix two languages when they speak in different classroom situations. In Pakistani classrooms where Multilingual is in abundance, i.e. they can speak two or more two languages at the same time, code-switching or language combination is very common. The teachers of Sialkot switch from one language to another consciously or unconsciously while teaching English in the classrooms. This phenomenon has not been explored in Sialkot’s teaching context. In Sialkot, private educational institutes do not encourage code-switching, whereas public or government institutes use it frequently. The crux of this research is to investigate and identify the importance of code-switching by taking its users into consideration. The survey research method and survey questionnaire will be used to get exact data from teachers and students. We will try to highlight the functions and importance of code switching in foreign language classrooms of Sialkot and will explore why this trend is emerging in Sialkot.

Keywords: code switching, foreign language classrooms, bilingual context, use of L1, importance of L2.

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Authors: Nada Hamed, Mariam Aldhaheri, Sonia Abdennadher

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Islamic Finance is not a new term that emerging in the global market, but it is still under scope by many countries. Its characteristics and regulation are not widely clear and implemented. In 2015, The United Nation announced a plan about potential benefits of using Islamic Finance as a sustainable development approach. Enhancing its application in financial markets could protect from unexpected crisis that might be created from the traditional tools of finance. This paper focuses on this area to test if Islamic finance could be used for maintaining sustainable development and if the term of 'Green Islamic Finance' could be implemented to minimize the deficiencies and 'pollution’ generated from traditional techniques and tools of finance. This paper intends to measure the impact on financial performance and sustainability when financial institutions use Islamic finance or better practice it. The objective of this explanatory research is to measure the performance of Islamic Finance with using a case study of an Islamic bank. The paper would analyze and compare the behavior of financial institutions that used traditional financing tools and converted to Islamic banking system. The methodology used is based on a case study of an Islamic bank in Dubai with comparing its performance before implementing Islamic Finance and after. The selected case study represents the first national bank in Emirates Arab Unis who adopt the Islamic finance approach. Based on a time series analysis, a quantitative analysis would be also used through looking at various set of ratios that are routinely used to measure bank performance.

Keywords: Islamic finance, financial stability, green finance, Islamic finance practices, financial ratios

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Authors: Debasish Chowdhury, Sunil Mekale, Sarvanamurthy Sakthivel, Sukhvinder Kaur, Rambabu Khambampati, Ashok Agarwal

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Introduction: The migrant intervention in India was initiated during the National AIDS Control Program (NACP) Phase-2 (2002-2007). HIV Sentinel surveillance Studies (HSS) conducted in 2012-13 indicated higher HIV prevalence among migrants (0.99%) compared to general populations (0.35%). Migrants continue to bear a heightened risk of HIV infection which results from the condition and structure of the migration process. USAID PHFI-PIPPSE project in collaboration with the National AIDS Control Organization (NACO) developed a unique system called Migrant Service Delivery System (MSDS) to capture migrants profile with respect to their risk profile and to provide tailor made services to them. Description: MSDS is a web-based system, designed and implemented to increase service uptake among migrants through evidence based planning. 110 destination migrants Targeted Intervention (TI) from 11 states were selected for study with varied target populations in terms of occupations; to understand occupation related risk behaviors among the migrants. Occupation wise registration data of high risk vulnerable migrants were analyzed through MSDS for the period April 2014–June 2016. Analysis was made on specific indicators among these occupational groups to understand the risk behavior and their vulnerability to HIV and STIs. Findings: Out of total HIV positive migrant’s workers (N= 847) enrolled in MSDS HIV rate is found to be highest among Auto-Rickshaw (18.66%) followed by Daily wage laborers (14.46%), Loom workers (10.73%), Industrial workers (10.04%) and Construction worker 7.93%. With 45.14% positivity, industrial workers are found to be most vulnerable to Sexually Transmitted Infections (STIs) (N=10057) among all occupational categories followed by loom workers (16.28%), Skilled worker (Furniture, Jeweler)-7.14%, daily wage laborers (5.45%). Conclusion: MSDS is an effective tool to assess migrants’ risk and their vulnerability to HIV for designing evidence informed program. This system calls for a replication across all destination TIs by NACO for differential strategies for different occupation groups to ensure better yield through scientific planning of intervention among high risk and high vulnerable migrants.

Keywords: migrants, migrant service delivery system, risk, vulnerability

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Authors: M. L. Yeung

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With the surge of divorce rate and male cancer onset/death rates, the phenomenon of divorced wives in the facing cancer death of their ex-husbands is not uncommon in Hong Kong. Yet, there is a dearth of study on the experiences of bereaved-divorced wives in the Hong Kong cultural context. This project fills the knowledge gap by conducting a qualitative study for having interviewed four bereaved ex-wives, who returned to ex-husbands’ end-of-life caregiving and eventually grieved for the ex-spousal’s death. From the perspectives of attachment theory and disenfranchised grief in the Hong Kong cultural context, a ‘double-loss’ experience is found in which interviewees suffer from the first loss of divorce and the second loss of ex-husbands’ death. Traumatic childhood experiences, attachment needs, role ambiguity, unresolved emotions and unrecognized grief are found significant in their lived experiences which alert the ‘double-loss’ is worthy of attention. Extending a family-centered end-of-life and bereavement care services to divorced couples is called for, in which validation on the attachment needs, ex-couple reconciliation, and acknowledgement on the disenfranchised grief are essential for social work practice on this group of clienteles specifically in Hong Kong cultural context.

Keywords: changing family, disenfranchised grief, divorce, ex-spousal death, marriage

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Authors: Anmol Patel

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Cardiopulmonary resuscitation is medical intervention which should be considered for all inpatients; with a patient centred approach, open communication and accurate documentation of clinical decisions. National enquiries have shown that in a significant number of cases CPR was attempted when it was considered inappropriate. In these circumstances attempting to prevent a natural death and subjecting a patient to trauma at the end of life would deprive them of a dignified death. Anticipatory “do not attempt CPR (DNACPR)” decisions aim to prevent this for those considered appropriate. As a legal document, these forms are required to be completed accurately and thoroughly. The aim of this study was to evaluate the difference in quality of DNACPR forms completed using electronic versus paper formats. A retrospective review of DNACPR forms and related documentation was completed in two District General Hospitals in South-East England, one of which uses electronic forms, while the other uses paper red forms. 50 completed forms from each hospital were analysed to assess for legibility, and quality of completion of all subsections of the form, including communications with family, relatives and the Multidisciplinary team. The hospital using paper forms showed a 40-44% rate of completion of sections relating to communication with patients and family, compared to 70% with the hospital using electronic forms. Similar trends were observed with other sections of the form. Conclusion: This study suggests that the implementation of electronic DNACPR forms significantly improves clinical practice and promotes better open communication with patients, family and the MDT.

Keywords: DNACPR, resuscitation, DNAR, patient communication

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Authors: Kitty Kioskli, Theofanis Fotis, Nineta Polemi

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The European Union (EU) directive Artificial Intelligence (AI) Act in Article 9 requires that risk management of AI systems includes both technical and human oversight, while according to NIST_AI_RFM (Appendix C) and ENISA AI Framework recommendations, claim that further research is needed to understand the current limitations of social threats and human-AI interaction. AI threats within social contexts significantly affect the security and trustworthiness of the AI systems; they are interrelated and trigger technical threats as well. For example, lack of explainability (e.g. the complexity of models can be challenging for stakeholders to grasp) leads to misunderstandings, biases, and erroneous decisions. Which in turn impact the privacy, security, accountability of the AI systems. Based on the NIST four fundamental criteria for explainability it can also classify the explainability threats into four (4) sub-categories: a) Lack of supporting evidence: AI systems must provide supporting evidence or reasons for all their outputs. b) Lack of Understandability: Explanations offered by systems should be comprehensible to individual users. c) Lack of Accuracy: The provided explanation should accurately represent the system's process of generating outputs. d) Out of scope: The system should only function within its designated conditions or when it possesses sufficient confidence in its outputs. Biases may also stem from historical data reflecting undesired behaviors. When present in the data, biases can permeate the models trained on them, thereby influencing the security and trustworthiness of the of AI systems. Social related AI threats are recognized by various initiatives (e.g., EU Ethics Guidelines for Trustworthy AI), standards (e.g. ISO/IEC TR 24368:2022 on AI ethical concerns, ISO/IEC AWI 42105 on guidance for human oversight of AI systems) and EU legislation (e.g. the General Data Protection Regulation 2016/679, the NIS 2 Directive 2022/2555, the Directive on the Resilience of Critical Entities 2022/2557, the EU AI Act, the Cyber Resilience Act). Measuring social threats, estimating the risks to AI systems associated to these threats and mitigating them is a research challenge. In this paper it will present the efforts of two European Commission Projects (FAITH and THEMIS) from the HorizonEurope programme that analyse the social threats by building cyber-social exercises in order to study human behaviour, traits, cognitive ability, personality, attitudes, interests, and other socio-technical profile characteristics. The research in these projects also include the development of measurements and scales (psychometrics) for human-related vulnerabilities that can be used in estimating more realistically the vulnerability severity, enhancing the CVSS4.0 measurement.

Keywords: social threats, artificial Intelligence, mitigation, social experiment

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Authors: Bruno Di Pace, Roxanne H. Padley

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Aims: The recent increase in remote video interaction has increased the number of requests for teleconsultations with plastic surgeons in private practice (70% in the UK and 64% in the USA). This study investigated the motivations for such an increase and the underlying psychological impact on patients. Method: An anonymous web-based poll of 8 questions was designed and distributed to patients seeking cosmetic surgery through social networks in both Italy and the UK. The questions gathered responses regarding 1. Reasons for pursuing cosmetic surgery; 2. The effects of delays caused by the SARS-COV-2 pandemic; 3. The effects on mood; 4. The influence of video conferencing on body-image perception. Results: 85 respondents completed the online poll. Overall, 68% of respondents stated that seeing themselves more frequently online had influenced their decision to seek cosmetic surgery. The types of surgeries indicated were predominantly to the upper body and face (82%). Delays and access to surgeons during the pandemic were perceived as negatively impacting patients' moods (95%). Body-image perception and self-esteem were lower than in the pre-pandemic, particularly during lockdown (72%). Patients were more inclined to undergo cosmetic surgery during the pandemic, both due to the wish to improve their “lockdown face” for video conferencing (77%) and also due to the benefits of home recovery while in smart working (58%). Conclusions: Overall, findings suggest that video conferencing has led to a significant increase in requests for cosmetic surgery and the so-called “Zoom Boom” effect.

Keywords: cosmetic surgery, remote communication, telehealth, zoom boom

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Authors: Alan S. Weber

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This contribution reviews the current biomedical and qualitative arts research on arts-in-health interventions to improve both individual and population health outcomes. Arts therapies–for example, music therapy with roots in Aristoxenus’s Ἁρμονικὰ στοιχεῖα and the Pythagorean sect–have long been employed in therapeutic contexts. However, the 20th century witnessed the increasing use of the visual and plastic arts (drawing, painting, sculpting), performing arts (drama and dance), and other expressive arts modalities into occupational therapy, well-being medicine, and psychological and psychiatric counselling, diagnosis, and treatment. A significant body of peer-reviewed evidence in the medical and neurological sciences on the role of arts-in-health has developed, and specifically, research on music and art therapy has led to their inclusion within the current biomedical paradigm of evidence-based practice. The arts cannot only aid in public and population health promotion (promoting healthy behaviors and lifestyles, preventing disease onset) but also in addressing psychological issues (regulation of emotion; stress, anxiety, and depression reduction), behavioural issues (basic life skills, coping), and physiological response (immune system function, hormonal regulation, homeostatis). Working as a cross-disciplinary researcher in the arts in an American medical college, the author has developed several successful arts-in-health programs at the national and international level.

Keywords: arts-in-health, evidence based medicine, arts for health, expressive arts therapies

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Authors: Xiaoming Yang, Abby Folberg, Carey Ryan, Lwetzel, Tgoering

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We examined gender differences in entrepreneurial career interests drawing on goal congruity theory, which posits that people adopt gender-stereotypic goal orientations in response to social pressures to conform to traditional gender roles. Aspiring entrepreneurs (N = 351) first wrote three to five sentences about what they believed made an entrepreneur successful. They then completed measures of agentic and communal goal orientations (i.e., male and female stereotypic orientations, respectively) and indicated their interests in starting ventures in stereotypically feminine (e.g., salon), masculine (e.g., auto-repair) and science, technology, engineering, and mathematics (STEM; e.g., software developer) ventures. Qualitative analyses demonstrated that participants ascribed agentic and, more specifically, dominance, attributes to entrepreneurs; few participants ascribed communal attributes (e.g., warmth). Bifactor structural equation modeling indicated that, as expected, agentic goal orientations included dimensions of competence, self-direction, and dominance orientations and communal goal orientations were unidimensional. Further, as expected, dominance and communal orientations partially accounted for gender differences in all three career types. We discuss implications for entrepreneurial education and practice from a goal congruity perspective and the use of bifactor modeling to improve the measurement of goal orientations.

Keywords: gender, entrepreneurship, gender stereotypes, agentic and communal goal orientations, entrepreneurship education

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Authors: Anjana Rajput, Sandeep Chouksey, Bhaskar Bhandari, Shimpi Chourasia

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Ecologically, grassland is any plant community dominated by grasses, whether they exist naturally or because of management practices. Most forest grasslands are anthropogenic and established plant communities planted for forage production, though some are established for soil and water conservation and wildlife habitat. In Satpura Tiger Reserve, Madhya Pradesh, India, most of the grasslands have been established on evacuated village sites. Total of 42 villages evacuated, and study was carried out in 23 sites to evaluate habitat improvement. Grasslands were classified into three categories, i.e., evacuated sites, established sites, and controlled sites. During the present study impact of various management interventions on grassland health was assessed. Grasslands assessment was done for its composition, status of palatable and non-palatable grasses, the status of herbs and legumes, status of weeds species, and carrying capacity of particular grassland. Presence of wild herbivore species in the grasslands with their abundance, availability of water resources was also assessed. Grassland productivity is dependent mainly on the biotic and abiotic components of the area, but management interventions may also play an important role in grassland composition and productivity. Variation in the status of palatable and non-palatable grasses, legumes, and weeds was recorded and found effected by management intervention practices. Overall in all the studied grasslands, the most dominant grasses recorded are Themeda quadrivalvis, Dichanthium annulatum, Ischaemum indicum, Oplismenus burmanii, Setaria pumilla, Cynodon dactylon, Heteropogon contortus, and Eragrostis tenella. Presence of wild herbivores, i.e., Chital, Sambar, Bison, Bluebull, Chinkara, Barking deer in the grassland area has been recorded through the installation of camera traps and estimated their abundance. Assessment of developed grasslands was done in terms of habitat suitability for Chital (Axis axis) and Sambar (Rusa unicolor). The parameters considered for suitability modeling are biotic and abiotic life requisite components existing in the area, i.e., density of grasses, density of legumes, availability of water, site elevation, site distance from human habitation. Findings of the present study would be useful for further grassland management and animal translocation programmes.

Keywords: carrying capacity, dominant grasses, grassland, habitat suitability, management intervention, wild herbivore

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Authors: Mo'ath F. Bataineh

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Exercise is highly effective against obesity. Milk contains several components that support exercising and physical performance. However, there is a lack of published studies on the relationship between camel milk and ability to exercise. A pilot study was conducted with the purpose of comparing the impact of milk type (Cow vs Camel) compared with water on physical performance. Seven male obese participants (age: 20.3 ± 1.5 years; BMI: 35.7 ± 2.7 kg/m2; resting heart rate: 92.7 ± 4.7 beats per minute; training frequency: 4.4 ± 0.8 days/week) were recruited for this pilot study. In a randomized counterbalanced crossover design, participants took part in 3 trials that included ingesting 3 different pre workout drinks in a random order. The pre workout drinks were water (W), whole cow milk (CW), and whole camel milk (CM). On each trial day, participants were asked to report to the laboratory after an overnight fasting. Following a 15-minute short recovery period after their arrival to the laboratory, each participant was presented with a 500 ml of the assigned experimental drink and were asked to ingest it in one minute and at least 120 minutes prior to performing the 6-minute walk test. All drinks were presented at room temperature. Trials with different experimental drinks were performed on separate days. Participants were given at least 4 days of washout period between trials. The trial order was randomized to avoid bias due to learning effect. The 6-minute walk test was performed by all participants and immediately at the conclusion of the test, the covered distance in meters and the rating of perceived exertion (RPE) were recorded. All data were analysed using SPSS software (Version 29.0). The repeated measures ANOVA testing of collected data showed a significant main effect for treatment on covered distance in meters, F (2, 8) = 5.794, p=0.028 with a large effect size (partial eta squared (ηp2) =0.592). Also, LSD post hoc pairwise comparison analysis revealed that Camel milk and Cow milk were significantly (p = 0.044 and p = 0.020 respectively) superior to water in improving the covered distance during the test and that Camel milk tended to be better than Cow’s milk. The RPE values were not significantly different between experimental drinks (p>0.05). In conclusion, milk is superior to water as a pre workout drink, and camel milk is comparable to cow’s milk in enhancing ability to support a higher level of performance compared with water, therefore, camel milk could be used to replace cow’s milk as a suitable pre-exercise drink without expecting any negative consequences on physical performance. The fact that these positive results were obtained with obese individuals should encourage using camel milk without the fear of disturbing physical performance in other weight categories.

Keywords: camel milk, cow milk, obesity, physical performance, pre-workout drink

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Authors: Dina Mahmoud Hammouri

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The study investigates the Jordanian EFL learners’ pragmatic competence through their production of the speech acts of responding to requests, making suggestions, making threats and expressing farewells. The sample of the study consists of 130 Jordanian EFL learners and native speakers. 2600 responses were collected through a Discourse Completion Test (DCT). The findings of the study revealed that the tested students showed similarities and differences in performing the strategies of four speech acts. Differences in the students’ performances led to pragmatic failure instances. The pragmatic failure committed by students refers to a lack of linguistic competence (i.e., pragmalinguistic failure), sociocultural differences and pragmatic transfer (i.e., sociopragmatic failure). EFL learners employed many mechanisms to maintain their communicative competence; the analysis of the test on speech acts showed learners’ tendency towards using particular strategies, resorting to modify strategies and relating them to their grammatical competence, prefabrication, performing long forms, buffing and transfer. The results were also suggestive of the learners’ lack of pragmalinguistic and sociopragmatic knowledge. The implications of this study are for language teachers to teach interlanguage pragmatics explicitly in EFL contexts to draw learners’ attention to both pragmalinguistic and sociopragmatic features, pay more attention to these areas and allocate more time and practice to solve learners’ problems in these areas. The implication of this study is also for pedagogical material designers to provide sufficient and well-organized pragmatic input.

Keywords: pragmatic failure, Jordanian EFL learner, sociopragmatic competence, pragmalinguistic competence

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Authors: Vivien Chee Pei Wei

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Today we live in a scenario in which letters share space with images on screens that vary in size, shape, and style. The popularization of television, then the computer and now the e-readers, tablets, and smartphones made the electronic assume the role that previously was restricted to printed materials. Since the extensive use of new technologies to produce, disseminate, collect and access electronic publications began, the changes to reading has been intensified. To be able to read online, it involves more than just utilizing specific skills, strategies, and practices, but also in negotiating multiple information sources. In this study, different perspectives of digital reading are being explored in order to define the key aspects of the term. The focus is to explore how new technologies affect how undergraduates’ reading behavior, which in turn, gives readers different reading levels and engagement with the text and other support materials in the same media. There is also the importance of the relationship between reading platforms, reading levels and formats of electronic publications. The study looks at the online reading practices of about 100 undergraduates from a local university. The data collected using the survey and interviews with the respondents are analyzed thematically. Findings from this study found that both digital and traditional reading are interrelated, and should not be viewed as separate, but complementary to each other. However, reading online complicates some of the skills required by traditional reading. Consequently, in order to successfully read and comprehend multiple sources of information online, undergraduates need regular opportunities to practice and develop their skills as part of their natural reading practices.

Keywords: concepts, digital reading, literacy, traditional reading

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Authors: Jonathan J. Foo, Keng Hao Chew

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Interest in virtual reality (VR) technologies as virtual learning environments have been on the rise in recent years. With thanks to the aggressively competitive consumer electronics environment, VR technology has been made affordable and accessible to the average person with developments like Google Cardboard and Oculus Go. While the promise of virtual access to unique virtual learning environments with the benefits of experiential learning sounds extremely attractive, there are still concerns over user comfort in the psychomotor, cognitive, and affective domains. Reports of motion sickness and short durations create doubt and have stunted its growth. In this paper, a multidimensional framework is proposed for the evaluation of VR learning environments within the three dimensions: tactual quality, didactic quality, and autodidactic quality. This paper further proposes a mixed-methods experimental research plan that sets out to evaluate a virtual reality training simulator in the context of amateur sports fencing. The study will investigate if an immersive VR learning environment can effectively simulate an authentic learning environment suitable for instruction, practice, and assessment while providing the user comfort in the tactual, didactic, and autodidactic dimensions. The models and recommendations developed for this study are designed in the context of fencing, but the potential impact is a guide for the future design and evaluation of all VR developments across sports and technical classroom education.

Keywords: autodidactic quality, didactic quality, tactual quality, virtual reality

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Authors: Patarapan Odton

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This study investigates demographic and socio-economic factors of breastfeeding practice, including exclusively breastfeeding among children in Thailand using the Multiple Indicator Cluster Survey (MICS3 and MICS4). Logistic regression models were used to examine the determinants of initial breastfeeding, exclusively breastfeeding, and predominant breastfeeding, using data from women and children section of the survey. For initial breastfeeding, women live in rural area were more likely to start breastfeeding within one day of birth rather than who live in urban area in both round of the surveys. In year 2012, there were significantly higher probabilities of women in rural area started breastfeeding within one hour of birth compare to urban area. Women in southern Thailand have higher probabilities of start breastfeeding within one hour and one day than women in Bangkok and central region. During the year 2005-2006, children aged less than 5 years old lived in rural area have been breastfed higher than children in urban area. Children live in the northeast region were more likely to have been breastfed than the other regions. Only the second wealth quintile group was significant higher probability of ever been breastfed than the poorest group. The findings in the second round of the survey are different from the year 2005-06. In 2012, there was no difference in probability of ever been breastfed among children live in urban and rural area, children in Bangkok and central region were less probability of ever been breastfed than the others.

Keywords: Breastfeeding, Exclusive Breastfeeding, Predominant Breastfeeding, Urban-Rural Difference

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Authors: Abrar Noorain, Zeinab Amara, Sulaf Abdelaziz

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Background: Diabetic foot disease imposes a financial burden on diabetic patients and healthcare services. In Sudan, diabetic foot ulcer prevalence reached 18.1%. This study aims to assess the knowledge, attitudes, and practices and the correlation between the level of foot care knowledge and self-care practices among diabetic patients in Sudan. Methodology: In a cross-sectional study involving 262 patients with type 1 and type 2 diabetes attending diabetic clinics in three primary care centers in Khartoum, Sudan, during September to November 2022, information regarding participants sociodemographic status, foot care knowledge, attitudes, and practices was gathered using a validated, structured questionnaire in a face-to-face interview method. These data were analyzed using the statistical package for the social sciences (SPSS) 22. Results: The patients’ mean age was 54.9 years, with a female predominance (56%). Of the participants, 37% had diabetes mellitus for over ten years. On the topic of foot care, 35.5% of patients showed good knowledge, and 76% were aware of the risk of reduced foot sensation. In relation to nail care, only 19% knew how to cut nails correctly. Conclusion: Knowledge, attitudes, and practices about diabetic foot care are substandard. There is a positive correlation between foot care knowledge and self-care practices. Hence, educating diabetic patients with foot care knowledge through an awareness program and the characteristics of diabetic shoes may improve self-care practices.

Keywords: DM, DFD, DFU, PHC, SPSS

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Authors: Meseret Mulugeta, Alemmebrat Kiflu, Belaynehchikle

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The purpose of the present study was to examine the preferred leadership style and motivation of premier league volleyball players. The sample encompassed 46 female premier league volleyball players whose ages ranged between 15 and 35 years. The data were collected using standardized questionnaires. The questionnaires were distributed to 46 female players from five volleyball clubs in the Premier League. To evaluate the motivational level of the players, the Sports Motivation Scale (SMS-6) was used. The leadership scale for sport was used to evaluate leadership. Descriptive statistics and the person correlation coefficient (P <0.05) were used to validate the relationship between leadership style and motivation. The result showed that there is a meaningful and significant relationship between leadership style and motivation. Concerning preferred coaching styles, the most preferred style was training and instruction, with a mean score of 4.10, and the least preferred style was autocratic, with a mean score of 3.37. The result of the Pearson correlation coefficient showed that the correlation between motivation types and leadership styles showed that motivation was significantly and positively correlated with all independent variables except autocratic leadership style, which is negatively correlated with motivation. This study’s nobility is to provide evidence for the most effective coaching to practice the training and instruction behaviour and social support behaviour leadership styles and refrain from using the autocratic leadership style.

Keywords: autocratic, training and instruction, motivation, leadership style

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Authors: Pellecchia M. T., Savarese G., Carpinelli L., Calabrese M.

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Introduction: Parkinson's disease (PD) is characterized by a progressive loss of autonomy which undoubtedly has a significant impact on the quality of life of caregivers, and parents are the main informal caregivers. Caring for a person with PD is associated with an increased risk of psychiatric morbidity and persistent anxiety-depressive distress. The aim of the study is to investigate the burden on caregivers of patients with PD, through the use of multidimensional scales and to identify their personological and environmental determinants. Methods: The study has been approved by the Ethic Committee of the University of Salerno and informed consent for participation to the study was obtained from patients and their caregivers. The study was conducted at the Neurology Department of the A.O.U. "San Giovanni di Dio and Ruggi D’Aragona" of Salerno between September 2020 and May 2021. Materials: The questionnaires used were: a) Caregiver Burden Inventory - CBI a questionnaire of 24 items that allow identifying five sub-categories of burden (objective, psychological, physical, social, emotional); b) Depression Anxiety Stress Scales Short Version - DASS-21 questionnaire consisting of 21 items and valid in examining three distinct but interrelated areas (depression, anxiety and stress); c) Family Strain Questionnaire Short Form - FSQ-SF is a questionnaire of 30 items grouped in areas of increasing psychological risk (OK, R, SR, U); d) Zarit Caregiver Burden Inventory - ZBI, consisting of 22 items based on the analysis of two main factors: personal stress and pressure related to his role; e) Life Satisfaction, a single item that aims to evaluate the degree of life satisfaction in a global way using a 0-100 Likert scale. Findings: N ° 29 caregivers (M age = 55.14, SD = 9.859; 69% F) participated in the study. 20.6% of the sample had severe and severe burden (CBI score = M = 26.31; SD = 22.43) and 13.8% of participants had moderate to severe burden (ZBI). The FSQ-SF highlighted a minority of caregivers who need psychological support, in some cases urgent (Area SR and Area U). The DASS-21 results show a prevalence of stress-related symptoms (M = 10.90, SD = 10.712) compared to anxiety (M = 7.52, SD = 10.752) and depression (M = 8, SD = 10.876). There are significant correlations between some specific variables and mean test scores: retired caregivers report higher ZBI scores (p = 0.423) and lower Life Satisfaction levels (p = -0.460) than working caregivers; years of schooling show a negative linear correlation with the ZBI score (p = -0.491). The T-Test indicates that caregivers of patients with cognitive impairment are at greater risk than those of patients without cognitive impairment. Conclusions: It knows the factors that affect the burden the most would allow for early recognition of risky situations and caregivers who would need adequate support.

Keywords: anxious-depressive axis, caregivers’ burden, Parkinson’ disease, psychological risks

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Authors: Swarnali Chakma, Akihiko Hokugo

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Research on three case studies reviewed here explains many aspects and complications of evacuation behavior during an emergency period. The scenario and phenomenon of the disaster were different, but the similarities are that after receiving the warning peoples does not take it seriously. Many individuals evacuated after taking some kind of action, for example; return to home, searching for family members, prepared valuable things etc. Based on a review of the literature, the data identified a number of factors that help explain evacuation behavior during the disaster. In the case of Japan, cultural inhibitors impact people’s behavior; for example, following the traffic rules, some people lost their time to skip because of the slow-moving car makes overcrowded traffic and some of them were washed away by the tsunami. In terms of Bangladeshi culture, women did not want to evacuate without men because staying men and women who do not know each other under the same roof together is not regular practice or comfortable. From these three case studies, it is observed that early warning plays an important role in cyclones, typhoons and earthquakes. A high level of trust from residents in the warning system is important to real evacuation. It is necessary to raise awareness of disaster and provide information on the vulnerability to cyclones, typhoons and earthquakes hazards at community levels. The local level may help decision makers and other stakeholders to make a better decision regarding an effective disaster management.

Keywords: disaster management, emergency period, evacuation, shelter, typhoon

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Authors: Hatice Canan Gungor, Ahmet Akdemir

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The fields of engineering and technological sciences are increasing in quality and quantity day by day all over the world. Countries have to follow, implement and adapt these developments in order to economical empowerments. In our era, it's possible to follow the rapidly developing technology and to produce new technologies by inquisitive, curious, numerical thinking individuals who can show several approaches to problem solving. In this case, countries should develop te result oriented and need-focused curriculums in university education. As in the whole world, there are more space studies in our country as well. Universities should undertake the task of supply the need for staff of this technological race. In this context, questions about the purpose, content and learning outcomes of the space sciences and space engineering departments in our country will be researched answers to reveal the characteristic of this section. In this study, it was determined in which universities the space engineering and the departments of basic sciences educate with formal education and the contents of this education, and the universities were compared with each other as of 2017. In our country three universities provide Aeronautical and Aerospace Engineering, two universities provide Space Sciences and Technologies, two universities provide Aerospace Engineering, two universities provide Aeronautics and Astronautics Engineering education. In all universities, specialized courses are taught after basic engineering education. But the question that needs to be answered is, do the lessons benefit in practice? The answer of this question will reveal the quality of the education. This paper suggests that surveys be conducted to search for the answer to this question. It's thought to be the base for the next works.

Keywords: education, space engineering, space science, quality of systems

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Authors: Stefanos Karanasios, Charkleia Koutri, Maria Moutzouri, Sofia A. Xergia, Vasiliki Sakellari, George Gioftsos

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The precise calculation of arterial occlusive pressure (AOP) is a critical step to accurately prescribe individualized pressures during blood flow restriction training (BFRT). AOP is usually measured in a supine position before training; however, previous reports suggested a significant influence in lower limb AOP across different body positions. The aim of the study was to investigate the effect of three different body positions on upper limb AOP and the reliability of the method for its standardization in clinical practice. Forty-two healthy participants (Mean age: 28.1, SD: ±7.7) underwent measurements of upper limb AOP in supine, seated, and standing positions by three blinded raters. A cuff with a manual pump and a pocket doppler ultrasound were used. A significantly higher upper limb AOP was found in seated compared with supine position (p < 0.031) and in supine compared with standing position (p < 0.031) by all raters. An excellent intraclass correlation coefficient (0.858- 0.984, p < 0.001) was found in all positions. Upper limb AOP is strongly dependent on body position changes. The appropriate measurement position should be selected to accurately calculate AOP before BFRT. The excellent inter-rater reliability and repeatability of the method suggest reliable and consistent results across repeated measurements.

Keywords: Kaatsu training, blood flow restriction training, arterial occlusion, reliability

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Authors: Parisa Mansour

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Introduction: Early diagnosis of coronavirus disease (COVID-19) is extremely important to isolate and treat patients in time, thus preventing the spread of the disease, improving prognosis and reducing mortality. High-resolution computed tomography (HRCT) chest imaging and artificial intelligence (AI)-based analysis of HRCT chest images can play a central role in the treatment of patients with COVID-19. Objective: To investigate different chest HRCT findings in different stages of COVID-19 pneumonia and to evaluate the potential role of artificial intelligence in the quantitative assessment of lung parenchymal involvement in COVID-19 pneumonia. Materials and Methods: This retrospective observational study was conducted between May 1, 2020 and August 13, 2020. The study included 2169 patients with COVID-19 who underwent chest HRCT. HRCT images showed the presence and distribution of lesions such as: ground glass opacity (GGO), compaction, and any special patterns such as septal thickening, inverted halo, mark, etc. HRCT findings of the breast at different stages of the disease (early: andlt) 5 days, intermediate: 6-10 days and late stage: >10 days). A CT severity score (CTSS) was calculated based on the extent of lung involvement on HRCT, which was then correlated with clinical disease severity. Use of artificial intelligence; Analysis of CT pneumonia and quot; An algorithm was used to quantify the extent of pulmonary involvement by calculating the percentage of pulmonary opacity (PO) and gross opacity (PHO). Depending on the type of variables, statistically significant tests such as chi-square, analysis of variance (ANOVA) and post hoc tests were applied when appropriate. Results: Radiological findings were observed in HRCT chest in 1438 patients. A typical pattern of COVID-19 pneumonia, i.e., bilateral peripheral GGO with or without consolidation, was observed in 846 patients. About 294 asymptomatic patients were radiologically positive. Chest HRCT in the early stages of the disease mostly showed GGO. The late stage was indicated by such features as retinal enlargement, thickening and the presence of fibrous bands. Approximately 91.3% of cases with a CTSS = 7 were asymptomatic or clinically mild, while 81.2% of cases with a score = 15 were clinically severe. Mean PO and PHO (30.1 ± 28.0 and 8.4 ± 10.4, respectively) were significantly higher in the clinically severe categories. Conclusion: Because COVID-19 pneumonia progresses rapidly, radiologists and physicians should become familiar with typical TC chest findings to treat patients early, ultimately improving prognosis and reducing mortality. Artificial intelligence can be a valuable tool in treating patients with COVID-19.

Keywords: chest, HRCT, covid-19, artificial intelligence, chest HRCT

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Authors: Samanta Tiague, Igor Michel Gachig

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The practice of inclusive education within general education classrooms is becoming more prevalent in Cameroon. In this context, quality Education is an important driver of the development agenda in this era of global sustainable development. This requires that the Cameroon’s educational system be strategically restructured to provide every citizen with the needed quality education for sustainable development. This study thus examined the need for the restructuring of the Cameroon educational system towards inclusive education as a target of the Sustainable Development Goal #4 (Ensure Quality Education), from a critical disability theory perspective. Special focus was on the education of children with visual impairment in the early childhood classroom. This study is suggesting a model design of responsive and contextual inclusive education policies, and the provision of quality human, material and financial educational resources to support the improvement of curriculums and inclusive instructional strategies. This paper is therefore designed as a basic starting point for early childhood educators with limited to no experience in working with students having visual impairments. Ultimately, this work represents a contribution to early childhood educators toward understanding visual impairment challenges and innovative practices to approach accessibility in a meaningful way to students in Cameroon. This is important to achieve quality education due to the peculiar nature of the educational needs of children with visual impairment, toward attainment of the global sustainable development agenda.

Keywords: early childhood educators, inclusive education, sustainable development, visual impairment

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Authors: Jana Beresova

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The paper presents a study carried out in 2015-2016 within the national scheme of research - VEGA 1/0106/15 based on theoretical research and empirical verification of the concept of intercultural communicative competence. It focuses on the current conception concerning target languages teaching compatible with the Common European Framework of Reference for Languages: Learning, teaching, assessment. Our research had revealed how the concept of intercultural communicative competence had been perceived by secondary-school teachers of English in Slovakia before they were intensively trained. Intensive workshops were based on the use of both authentic and instructional materials with the goal to support interculturally oriented language teaching aimed at challenging thinking. The former concept that supported the development of the students´ linguistic knowledge and the use of a target language to obtain information about the culture of the country whose language learners were learning was expanded by the meaning-making framework which views language as a typical means by which culture is mediated. The goal of the workshop was to influence English teachers to better understand the concept of intercultural communicative competence, combining theory and practice optimally. The results of the study will be presented and analysed, providing particular recommendations for language teachers and suggesting some changes in the National Educational Programme from which English learners should benefit in their future studies or professional careers.

Keywords: authentic materials, English language teaching, instructional materials, intercultural communicative competence

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Authors: Zahra Emami, Mohammad Ebrahim Khamseh, Nahid Hashemi Madani, Iman Kermani

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The aim of the study was to map scientific research on adrenal gland diseases in the Middle East countries through the Web of Science database using scientometric analysis. Data were analyzed with Excel software; and HistCite was used for mapping of the scientific texts. In this study, from a total of 268 retrieved records, 1125 authors from 328 institutions published their texts in 138 journals. Among 17 Middle East countries, Turkey ranked first with 164 documents (61.19%), Israel ranked second with 47 documents (15.53%) and Iran came in the third place with 26 documents. Most of the publications (185 documents, 69.2%) were articles. Among the universities of the Middle East, Istanbul University had the highest science production rate (9.7%). The Journal of Clinical Endocrinology & Metabolism had the highest TGCS (243 citations). In the scientific mapping, 7 clusters were formed based on TLCS (Total Local Citation Score) & TGCS (Total Global Citation Score). considering the study results, establishment of scientific connections and collaboration with other countries and use of publications on adrenal gland diseases from high ranking universities can help in the development of this field and promote the medical practice in this regard. Moreover, investigation of the formed clusters in relation to Congenital Hyperplasia and puberty related disorders can be research priorities for investigators.

Keywords: mapping, scientific research, adrenal gland diseases, scientometric

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Authors: Igor Jerkovic

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Biodiversity of flora provides many different nectar sources for the bees. Unifloral honeys possess distinctive flavours, mainly derived from their nectar sources (characteristic volatile organic components (VOCs)). Specific or nonspecific VOCs (chemical markers) could be used for unifloral honey characterisation as addition to the melissopalynologycal analysis. The main honey volatiles belong, in general, to three principal categories: terpenes, norisoprenoids, and benzene derivatives. Some of these substances have been described as characteristics of the floral source, and other compounds, like several alcohols, branched aldehydes, and furan derivatives, may be related to the microbial purity of honey processing and storage conditions. Selection of the extraction method for the honey volatiles profiling should consider that heating of the honey produce different artefacts and therefore conventional methods of VOCs isolation (such as hydrodistillation) cannot be applied for the honey. Two-way approach for the isolation of the honey VOCs was applied using headspace solid-phase microextraction (HS-SPME) and ultrasonic solvent extraction (USE). The extracts were analysed by gas chromatography and mass spectrometry (GC-MS). HS-SPME (with the fibers of different polarity such as polydimethylsiloxane/ divinylbenzene (PDMS/DVB) or divinylbenzene/carboxene/ polydimethylsiloxane (DVB/CAR/PDMS)) enabled isolation of high volatile headspace VOCs of the honey samples. Among them, some characteristic or specific compounds can be found such as 3,4-dihydro-3-oxoedulan (in Centaurea cyanus L. honey) or 1H-indole, methyl anthranilate, and cis-jasmone (in Citrus unshiu Marc. honey). USE with different solvents (mainly dichloromethane or the mixture pentane : diethyl ether 1 : 2 v/v) enabled isolation of less volatile and semi-volatile VOCs of the honey samples. Characteristic compounds from C. unshiu honey extracts were caffeine, 1H-indole, 1,3-dihydro-2H-indol-2-one, methyl anthranilate, and phenylacetonitrile. Sometimes, the selection of solvent sequence was useful for more complete profiling such as sequence I: pentane → diethyl ether or sequence II: pentane → pentane/diethyl ether (1:2, v/v) → dichloromethane). The extracts with diethyl ether contained hydroquinone and 4-hydroxybenzoic acid as the major compounds, while (E)-4-(r-1’,t-2’,c-4’-trihydroxy-2’,6’,6’-trimethylcyclo-hexyl)but-3-en-2-one predominated in dichloromethane extracts of Allium ursinum L. honey. With this two-way approach, it was possible to obtain a more detailed insight into the honey volatile and semi-volatile compounds and to minimize the risks of compound discrimination due to their partial extraction that is of significant importance for the complete honey profiling and identification of the chemical biomarkers that can complement the pollen analysis.

Keywords: honey chemical biomarkers, honey volatile compounds profiling, headspace solid-phase microextraction (HS-SPME), ultrasonic solvent extraction (USE)

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