Search results for: Patient-related outcomes

Authors: Agbor Ekama Prisca Anne

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Current data on the prevalence and psychosocial correlates of sexual violence in the Cameroon is lacking, with the most recent sexual abuse and violence survey dating back to 2001. The current study sought to identify what proportion of University students have experienced sexual violence, if there are sex differences in exposure to different forms of sexual violence, and to what extent different forms of sexual violence are associated with adverse psychosocial outcomes. A nationally representative sample of University students (N = 1,020) completed self-report measures of history of sexual violence and mental health. Approximately one-in-three (34.4%) students experienced some form of sexual violence, including 14.8% who were sexually assaulted (raped) and 31.1% who were sexually harassed. Female students were significantly more likely than men to have experienced all forms of sexual violence (ps < .001), with the exception of sexual assault by teachers or guardian. All forms of sexual violence were associated with an increased likelihood of serious mental health problems, with sexual assault by a teacher associated with several other psychosocial outcomes in life, including education achievement, and behavior disorder. Sexual violence is a common experience in the general population and female students are disproportionately affected (1-in-2 girls versus 1-in-5 boys). Additional resources to increase mental health care among survivors of sexual violence is urgently needed.

Keywords: psychosocial, effects sexual, violence, females, students

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Authors: Lilian Nantume Wampande

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Group-based strategies in the delivery of HIV care have opened up new avenues not only for meaningful participation for HIV positive people but also platforms for deconstruction and reconstruction of knowledge about living with the virus. Yet the contributions of such strategies among patients who live in high risk areas are still not explored. This case study research assessed the impact of HIV support networks on sexual health outcomes of HIV positive out-of-school adolescents residing in fishing islands of Kalangala in Uganda. The study population was out-of-school adolescents living with HIV and their sexual partners (n=269), members of their households (n=80) and their health service providers (n=15). Data were collected via structured interviews, observations and focus group discussions between August 2016 and March 2017. Data was then analyzed inductively to extract key themes related to the approaches and outcomes of the groups’ activities. The study findings indicate that support groups unite HIV positive adolescents in a bid for social renegotiation to achieve change but individual constraints surpass the groups’ intentions. Some adolescents for example reported increased fear which led to failure to cope, sexual violence, self-harm and denial of status as a result of the high expectations placed on them as members of the support groups. Further investigations around this phenomenon show that HIV networks play a monotonous role as information sources for HIV positive out-of-school adolescents which limit their creativity to seek information elsewhere. Results still indicate that HIV adolescent groups recognize the complexity of long-term treatment and stay in care leading to improved immunity for the majority yet; there is still scattered evidence about how effective they are among adolescents at different phases in the disease trajectory. Nevertheless, the primary focus of developing adolescent self-efficacy and coping skills significantly address a range of disclosure difficulties and supports autonomy. Moreover, the peer techniques utilized in addition to the almost homogeneous group characteristics accelerates positive confidence, hope and belongingness. Adolescent HIV-support groups therefore have the capacity to both improve and/or worsen sexual health outcomes for a young adolescent who is out-of-school. Communication interventions that seek to increase awareness about ‘self’ should therefore be emphasized more than just fostering collective action. Such interventions should be sensitive to context and gender. In addition, facilitative support supervision done by close and trusted health care providers, most preferably Village Health Teams (who are often community elected volunteers) would help to follow-up, mentor, encourage and advise this young adolescent in matters involving sexuality and health outcomes. HIV/AIDS prevention programs have extended their efforts beyond individual focus to those that foster collective action, but programs should rekindle interpersonal level strategies to address the complexity of individual behavior.

Keywords: adolescent, HIV, support groups, Uganda

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Authors: Elizabeth Laguaite, Alexandria Purdy

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Heart transplant recipients face psycho-physiological stressors, including pain, lengthy hospitalizations, delirium, and existential crises. They pose an increased risk for Post Traumatic Stress Disorder (PTSD) and can be a predictor of poorer mental and physical Health-Related Quality of Life (HRQOL) outcomes and increased mortality. There is limited research on the prevention of Post Traumatic Stress Symptoms (PTSS) in transplant patients. This case report focuses on a collaborative Music and Art Therapy intervention used to improve outcomes for HMH transplant recipient John (Alias). John, a 58-year-old man with congestive heart failure, was admitted to HMH in February of 2021 with cardiogenic shock, cannulated with an Intra-aortic Balloon Pump, Impella 5.5, and Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a bridge to heart and kidney transplant. He was listed as status 1 for transplant. Music Therapy and Art Therapy (MT and AT) were ordered by the physician for mood regulation, trauma processing and anxiety management. During MT/AT sessions, John reported a history of anxiety and depression exacerbated by medical acuity, shortness of breath, and lengthy hospitalizations. He expressed difficulty sleeping, pain, and existential questions. Initially seen individually by MT/AT, it was determined he could benefit from a collaborative approach due to similar thematic content within sessions. A Life Review intervention was developed by MT/AT. The purpose was for him to creatively express, reflect and process his medical narrative, including the identification of positive and negative events leading up to admission at HMH, the journey to transplant, and his hope for the future. Through this intervention, he created artworks that symbolized each event and paired them with songs, two of which were composed with the MT during treatment. As of September 2023, John has not been readmitted to the hospital and expressed that this treatment is what “got him through transplant”. MT and AT can provide opportunities for a patient to reminisce through creative expression, leading to a shift in the personal meaning of these experiences, promoting resolution, and ameliorating associated trauma. The closer to trauma it is processed, the less likely to develop PTSD. This collaborative MT/AT approach could improve long-term outcomes by reducing mortality and readmission rates for transplant patients.

Keywords: art therapy, music therapy, critical care, PTSD, trauma, transplant

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Authors: Aida Nurul Safitri, Rosita Sari

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Physics is science, which in its learning there are some product such as theory, fact, concept, law and formula. So that to understand physics lesson students not only need a theory or concept but also mathematical calculation to solve physics problem through formula or equation. This is can be taken from mathematics lesson which obtained by students. This research is to know the influence of mathematics learning outcomes towards physics ability in Senior High School through authentic assessment system. Based on the researches have been discussed, is obtained that mathematic lesson have an important role in physics learning but it according to one aspect only, namely cognitive aspect. In Indonesia, curriculum of 2013 reinforces displacement in the assessment, from assessment through test (measuring the competence of knowledge based on the result) toward authentic assessment (measuring the competence of attitudes, skills, and knowledge based on the process and results). In other researches are mentioned that authentic assessment system give positive responses for students to improve their motivation and increase the physics learning in the school.

Keywords: authentic assessment, curriculum of 2013, mathematic, physics

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Authors: Batool Ismaeel, Umair Farooq, Saad Mushtaq

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Construction projects in the oil industry can be very complex, having unknown outcomes and uncertainties that cannot be easily predicted. Each project has its unique risks generated by a number of factors which, if not controlled, will impact the successful completion of the project mainly in terms of schedule, cost, quality, and safety. This paper highlights the historic risks associated with projects in the south and east region of Kuwait Oil Company (KOC) collated from the company’s lessons learned database. Starting from Contract Award through to handover of the project to the Asset owner, the gaps in project execution in terms of managing risk will be brought to discussion and where a well-defined systematic approach in project risk management reflecting many claims, change of scope, exceeding budget, delays in engineering phase as well as in the procurement and fabrication of long lead items should be adopted. This study focuses on a proposed feasible approach in risk management for engineering, procurement and construction (EPC) level projects including the various stakeholders involved in executing the works from International to local contractors and vendors in KOC. The proposed approach covers the areas categorized into organizational, design, procurement, construction, pre-commissioning, commissioning and project management in which the risks are identified and require management and mitigation. With the effective deployment and implementation of the proposed risk management system and the consideration of it as a vital key in achieving the project’s target, the outcomes will be more predictable in the future, and the risk triggers will be managed and controlled. The correct resources can be allocated on a timely basis for the company for avoiding any unpredictable outcomes during the execution of the project. It is recommended in this paper to apply this risk management approach as an integral part of project management and investigate further in the future, the effectiveness of this proposed system for newly awarded projects and compare the same with those projects of similar budget/complexity that have not applied this approach to risk management.

Keywords: construction, project completion, risk management, uncertainties

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Authors: Hande Aladağ, Gökçe Aydın

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The world’s population is increasing continuously and rapidly. Moreover, there are other problems such as the decline of natural energy resources, global warming, and environmental pollution. These facts have made sustainability an important and primary topic from future planning perspective. From this perspective, constituting sustainable cities and communities can be considered as one of the key issues in terms of sustainable development goals. The concept of sustainable cities can be evaluated under three headings such as green/sustainable buildings, self – contained cities and sustainable transportation. This study only concentrates on how to form and support a sustainable urban transportation system to contribute to the sustainable urbanization. Urban transportation system inevitably requires many engineering projects with various sizes. Engineering projects generally have four phases, in the following order: Planning, design, construction, operation. The order is valid but there are feedbacks from every phase to every phase in its upstream. In this regard, engineering projects are iterative processes. Sustainability is an integrated and comprehensive concept thus it should be among the primary concerns in every phase of transportation projects. In the study, a meta-analysis will be performed on the related studies in the literature. It is targeted and planned that, as a result of the findings of this meta-analysis, a framework for the list of principles and actions for sustainable transport will be formed. The meta-analysis will be performed to point out and clarify sustainability approaches in every phase of the related engineering projects, with also paying attention to the iterative nature of the process and relative contribution of the action for the outcomes of the sustainable transportation system. However, the analysis will not be limited to the engineering projects, non-engineering solutions will also be included in the meta-analysis. The most important contribution of this study is a determination of the outcomes of a sustainable urban transportation system in terms of energy efficiency, resource preservation and related social, environmental and economic factors. The study is also important because it will give light to the engineering and management approaches to achieve these outcomes.

Keywords: meta-analysis, sustainability, sustainable cities, sustainable urban transportation, urban transportation

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Authors: Kailin K. Zhang, Anne W. Thompson

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Electronic learning for continuing professional education (CPE) and interprofessional education (IPE) in healthcare have been shown to improve learners’ satisfaction, attitudes, and performance. Yet, their impact on behavior change in healthcare professionals through continuing interprofessional education (CIPE) is less known. A scoping review of 32 articles from 2010 to 2020 was conducted using the Arksey and O’Malley framework across all healthcare settings. It focused on evaluating the effectiveness of CIPE on behavior change of healthcare professionals, as well as identifying course features of electronic CIPE programs facilitating behavior change. Eight different types of electronic learning methods, including online programs, tele-education, and social media, were identified as interventions. More than 35,542 healthcare professionals participated in the interventions. Electronic learning for CIPE led to positive behavior outcomes in 30 out of 32 studies, especially through a change in patient care practices. The most successful programs provided interactive and authentic learning experiences tailored to learners’ needs while promoting the direct application of what was learned in their clinical settings. Future research should include monitoring of sustained behavior changes and their resultant patient outcomes.

Keywords: behavior change, continuing interprofessional education, distance learning, electronic learning

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Authors: Ayoade Adeyemi, Leo Nherera, Paul Trueman, Antje Emmermann

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Background and objectives: Radiofrequency (RF) generated plasma chondroplasty is considered a promising treatment alternative to mechanical debridement (MD) with a shaver. The aim of the study was to perform a cost-effectiveness analysis comparing costs and outcomes following COBLATION chondroplasty versus mechanical debridement in patients with knee pain associated with a medial meniscus tear and idiopathic ICRS grade III focal lesion of the medial femoral condyle from a payer perspective. Methods: A decision-analytic model was developed comparing economic and clinical outcomes between the two treatment options in German patients following knee chondroplasty. Revision rates based on the frequency of repeat arthroscopy, osteotomy and conversion to total knee replacement, reimbursement costs and outcomes data over a 4-year time horizon were extracted from published literature. One-way sensitivity analyses were conducted to assess uncertainties around model parameters. Threshold analysis determined the revision rate at which model results change. All costs were reported in 2016 euros, future costs were discounted at a 3% annual rate. Results: Over a 4 year period, COBLATION chondroplasty resulted in an overall net saving cost of €461 due to a lower revision rate of 14% compared to 48% with MD. Threshold analysis showed that both options were associated with comparable costs if COBLATION revision rate was assumed to increase up to 23%. The initial procedure costs for COBLATION were higher compared to MD and outcome scores were significantly improved at 1 and 4 years post-operation versus MD. Conclusion: The analysis shows that COBLATION chondroplasty is a cost-effective option compared to mechanical debridement in the treatment of patients with a medial meniscus tear and idiopathic ICRS grade III defect of the medial femoral condyle.

Keywords: COBLATION, cost-effectiveness, knee chondroplasty, mechanical debridement

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Authors: Mokshida Bhat

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This paper examines the representation of patriarchy in the movies 'Qala' and 'Black Swan' and how it affects the mental health of women. Both movies portray female characters who are subject to patriarchal attitudes and structures that limit their choices and opportunities and contribute to negative mental health outcomes. In 'Qala' the central character Qala confronts the patriarchal attitudes of her family and community, which contribute to feelings of frustration and despair. In 'Black Swan' the main character Nina is subject to the demands and expectations of a patriarchal system that leads to anxiety, paranoia, and disconnection from her own body and emotions. Both movies highlight the harmful impact of patriarchal attitudes on women's mental health, including feelings of disempowerment, objectification, and self-doubt. The paper suggests that these negative outcomes can be addressed through a rejection of patriarchal norms and an assertion of one's own agency and identity. Overall, this paper demonstrates the importance of recognizing the role of patriarchy in contributing to mental health struggles for women and the need for more diverse and empowering representations of women in media.

Keywords: patriarchy, mental health, depression, PTSD, mental health in Indian cinema, patriarchy in Indian cinema, feminism and patriarchy, sexism

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Authors: Dimas Tri Anantyo, Zsa-Zsa Ayu Laksmi, Adhie Nur Radityo, Arsita Eka Rini, Gatot Irawan Sarosa

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A six-point-two-magnitude earthquake rocked Mamuju District, West Sulawesi Province, Indonesia, on 15 January 2021, causing significant health issues for the affected community, particularly among vulnerable populations such as neonates and children. The aim of this study is to examine and describe the diseases diagnosed in the pediatric population in Mamuju 14 days after the earthquake. This study uses a prospective observational study of the pediatric population presenting at West Sulawesi Regional Hospital, Mamuju Regional Public Hospital, and Bhayangkara Hospital for the period of 14 days after the earthquake. Demographic and clinical information were recorded. One hundred and fifty-three children were admitted to the health center. Children younger than six years old were the highest proportion (78%). Out of 153 children, 82 of them were male (54%). The most frequently diagnosed disease during the first and second weeks after the earthquake was respiratory problems, followed by gastrointestinal problems that showed an increase in incidence in the second week. This study found that age has a correlation with frequent disease in children after an earthquake. Respiratory and gastrointestinal problems were found to be the most common diseases among the pediatric population in Mamuju after the earthquake.

Keywords: health outcomes, pediatric population, earthquake, Mamuju

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Authors: Brittany E. Coff, Tommy K. K. Ngai, Laura A. S. MacDonald

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Many organizations in the Water, Sanitation and Hygiene (WASH) sector provide education and training in order to increase the effectiveness of their WASH interventions. A key challenge for these organizations is measuring how well their education and training activities contribute to WASH improvements. It is crucial for implementers to understand the returns of their education and training activities so that they can improve and make better progress toward the desired outcomes. This paper presents information on CAWST’s development and piloting of the evaluation methodology. The Centre for Affordable Water and Sanitation Technology (CAWST) has developed a methodology for evaluating education and training activities, so that organizations can understand the effectiveness of their WASH activities and improve accordingly. CAWST developed this methodology through a series of research partnerships, followed by staged field pilots in Nepal, Peru, Ethiopia and Haiti. During the research partnerships, CAWST collaborated with universities in the UK and Canada to: review a range of available evaluation frameworks, investigate existing practices for evaluating education activities, and develop a draft methodology for evaluating education programs. The draft methodology was then piloted in three separate studies to evaluate CAWST’s, and CAWST’s partner’s, WASH education programs. Each of the pilot studies evaluated education programs in different locations, with different objectives, and at different times within the project cycles. The evaluations in Nepal and Peru were conducted in 2013 and investigated the outcomes and impacts of CAWST’s WASH education services in those countries over the past 5-10 years. In 2014, the methodology was applied to complete a rigorous evaluation of a 3-day WASH Awareness training program in Ethiopia, one year after the training had occurred. In 2015, the methodology was applied in Haiti to complete a rapid assessment of a Community Health Promotion program, which informed the development of an improved training program. After each pilot evaluation, the methodology was reviewed and improvements were made. A key concept within the methodology is that in order for training activities to lead to improved WASH practices at the community level, it is not enough for participants to acquire new knowledge and skills; they must also apply the new skills and influence the behavior of others following the training. The steps of the methodology include: development of a Theory of Change for the education program, application of the Kirkpatrick model to develop indicators, development of data collection tools, data collection, data analysis and interpretation, and use of the findings for improvement. The methodology was applied in different ways for each pilot and was found to be practical to apply and adapt to meet the needs of each case. It was useful in gathering specific information on the outcomes of the education and training activities, and in developing recommendations for program improvement. Based on the results of the pilot studies, CAWST is developing a set of support materials to enable other WASH implementers to apply the methodology. By using this methodology, more WASH organizations will be able to understand the outcomes and impacts of their training activities, leading to higher quality education programs and improved WASH outcomes.

Keywords: education and training, capacity building, evaluation, water and sanitation

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Authors: Shahid Nishat, Keith Thomas

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E-government initiatives attract substantial public investments around the world. These investments are based on the premise of digital transformation of the public services, improved efficiency and transparency, and citizen participation in the social democratic processes. However, many e-Government projects, especially in developing countries, fail to achieve their intended outcomes, and a strong disparity exists between the investments made and outcomes achieved, often referred to as e-Government paradox. Further, there is lack of research on evaluating the impacts of e-Government in terms of public value it creates, which ultimately drives usage. This study aims to address these gaps by identifying key enablers of e-Government success and by proposing a public value based framework to examine impact of e-Government services. The study will extend Delone and McLean Information System (IS) Success model by integrating Technology Readiness (TR) characteristics to develop an integrated success model. Level of analysis will be mobile government applications, and the framework will be empirically tested using quantitative methods. The research will add to the literature on e-Government success and will be beneficial for governments, especially in developing countries aspiring to improve public services through the use of Information Communication Technologies (ICT).

Keywords: e-Government, IS success model, public value, technology adoption, technology readiness

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Authors: Daphne Alroy-Thiberge

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Trauma-impacted individuals present unique treatment challenges that include high reactivity, hyper-and hypo-arousal, poor adherence to therapy, as well as powerful transference and counter-transference experiences in therapy. This work provides an overview of the clinical tenets most often encountered in trauma-impacted individuals. Further, it provides readily applicable clinical techniques to optimize therapeutic rapport and facilitate accelerated positive mental health outcomes. Finally, integrated neuroscience and clinical evidence-based data are discussed to shed new light on crisis states in trauma-impacted individuals. This knowledge is utilized to provide effective and concrete interventions towards rapid and successful de-escalation of the impacted individual. A highly interactive, adult-learning-principles-based modality is utilized to provide an organic learning experience for participants. The information and techniques learned aim to increase clinical effectiveness, reduce staff injuries and burnout, and significantly enhance positive mental health outcomes and self-determination for the trauma-impacted individuals treated.

Keywords: clinical competencies, crisis interventions, psychotherapy techniques, trauma informed care

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Authors: Ricardo Bragança, Tom Vinaimont

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This paper discusses the introduction of processes of self-determined learning (heutagogy) into a graduate course on financial modeling, using elements of entangled pedagogy and Biggs’ constructive alignment. To encourage learners to take control of their own learning journey and develop critical thinking and problem-solving skills, each session in the course receives tailor-made media-enhanced pedagogical assets. The design of those assets specifically supports entangled pedagogy, which opposes technological or pedagogical determinism in support of the collaborative integration of pedagogy and technology. Media assets for each of the ten sessions in this course consist of three components. The first component in this three-pronged approach is a game-cut-like cinematographic representation that introduces the context of the session. The second component represents a character from an open-source-styled community that encourages self-determined learning. The third component consists of a character, which refers to the in-person instructor and also aligns learning outcomes and assessment tasks, using Biggs’ constructive alignment, to the cinematographic and open-source-styled component. In essence, the course's metamorphosis helps students apply the concepts they've studied to actual financial modeling issues. The audio-visual media assets create a storyline throughout the course based on gamified and real-world applications, thus encouraging student engagement and interaction. The structured entanglement of pedagogy and technology also guides the instructor in the design of the in-class interactions and directs the focus on outcomes and assessments. The transformation process of this graduate course in financial modeling led to an institutional teaching award in 2021. The transformation of this course may be used as a model for other courses and programs in many disciplines to help with intended learning outcomes integration, constructive alignment, and Assurance of Learning.

Keywords: innovative education, active learning, entangled pedagogy, heutagogy, constructive alignment, project based learning, financial modeling, graduate business education

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Authors: Anshu Radha Aggarwal

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Higher Education (HE) in the India has experienced a series of remarkable changes over the last fifteen years as successive governments have sought to make the sector more efficient and more accountable for investment of public funds. Rapid expansion in student numbers and pressures to widen Participation amongst non-traditional students are key challenges facing HE. Learning outcomes can act as a benchmark for assuring quality and efficiency in HE and they also enable universities to describe courses in an unambiguous way so as to demystify (and open up) education to a wider audience. This paper examines how learning outcomes are used in HE and evaluates the implications for curriculum design and student learning. There has been huge expansion in the field of higher education, both technical and non-technical, in India during the last two decades, and this trend is continuing. It is expected that another about 400 colleges and 300 universities will be created by the end of the 13th Plan Period. This has lead to many concerns about the quality of education and training of our students. Many studies have brought the issues ailing our curricula, delivery, monitoring and assessment. Govt. of India, (via MHRD, UGC, NBA,…) has initiated several steps to bring improvement in quality of higher education and training, such as National Skills Qualification Framework, making accreditation of institutions mandatory in order to receive Govt. grants, and so on. Moreover, Outcome-based Education and Training (OBET) has also been mandated and encouraged in the teaching/learning institutions. MHRD, UGC and NBAhas made accreditation of schools, colleges and universities mandatory w.e.f Jan 2014. Outcome-based Education and Training (OBET) approach is learner-centric, whereas the traditional approach has been teacher-centric. OBET is a process which involves the re-orientation/restructuring the curriculum, implementation, assessment/measurements of educational goals, and achievement of higher order learning, rather than merely clearing/passing the university examinations. OBET aims to bring about these desired changes within the students, by increasing knowledge, developing skills, influencing attitudes and creating social-connect mind-set. This approach has been adopted by several leading universities and institutions around the world in advanced countries. Objectives of this paper is to highlight the issues concerning quality in higher education and quality frameworks, to deliberate on the various education and training models, to explain the outcome-based education and assessment processes, to provide an understanding of the NAAC and outcome-based accreditation criteria and processes and to share best-practice outcomes-based accreditation system and process.

Keywords: learning outcomes, curriculum development, pedagogy, outcome based education

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Authors: Khaled M. Alqahtani

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Copy number alterations (CNA) are variations in the structure of the genome, where certain regions deviate from the typical two chromosomal copies. These alterations are pivotal in understanding tumor progression and are indicative of patients' survival outcomes. However, effectively modeling patients' survival based on their genomic CNA profiles while identifying relevant genomic regions remains a statistical challenge. Various methods, such as the Cox proportional hazard (PH) model with ridge, lasso, or elastic net penalties, have been proposed but often overlook the inherent dependencies between genomic regions, leading to results that are hard to interpret. In this study, we enhance the elastic net penalty by incorporating an additional penalty that accounts for these dependencies. This approach yields smooth parameter estimates and facilitates variable selection, resulting in a sparse solution. Our findings demonstrate that this method outperforms other models in predicting survival outcomes, as evidenced by our simulation study. Moreover, it allows for a more meaningful interpretation of genomic regions associated with patients' survival. We demonstrate the efficacy of our approach using both real data from a lung cancer cohort and simulated datasets.

Keywords: copy number alterations, cox proportional hazard, lung cancer, regression, sparse solution

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Authors: Laura C. Dapp, Claudia M. Roebers

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Being physically active has many benefits for children and adolescents. It is crucial for various aspects of physical and mental health, the development of a healthy self-concept, and also positively influences academic performance and school achievement. In addressing the still incomplete understanding of the link between physical activity (PA) and academic achievement, the current study scrutinized the open issue of how PA has to be implemented to positively affect mathematical outcomes in N = 138 fourth graders. Therefore, the current study distinguished between structured PA (formal, organized, adult-led exercise and deliberate sports practice) and unstructured PA (non-formal, playful, peer-led physically active play and sports activities). Results indicated that especially structured PA has the potential to contribute to mathematical outcomes. Although children spent almost twice as much time engaging in unstructured PA as compared to structured PA, only structured PA was significantly related to mathematical achievement as well as to mathematical self-concept. Furthermore, the pending issue concerning the quantity of PA needed to enhance children’s mathematical achievement was addressed. As to that, results indicated that the amount of time spent in structured PA constitutes a critical factor in accounting for mathematical outcomes, since children engaging in PA for two hours or more a week were shown to be both the ones with the highest mathematical self-concept as well as those attaining the highest mathematical achievement scores. Finally, the present study investigated the indirect effect of PA on mathematical achievement by controlling for the mathematical self-concept as a mediating variable. The results of a maximum likelihood mediation analysis with a 2’000 resampling bootstrapping procedure for the 95% confidence intervals revealed a full mediation, indicating that PA improves mathematical self-concept, which, in turn, positively affects mathematical achievement. Thus, engaging in high amounts of structured PA constitutes an advantageous leisure activity for children and adolescents, not only to enhance their physical health but also to foster their self-concept in a way that is favorable and encouraging for promoting their academic achievement. Note: The content of this abstract is partially based on a paper published elswhere by the authors.

Keywords: Academic Achievement, Mathematical Performance, Physical Activity, Self-Concept

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Authors: Husain A. Murad, Ali A. Dashti, Ali Al-Kandari

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The outbreak of Coronavirus during the Spring semester of 2020 brought new challenges for the teaching of vocational mass communication courses at universities in Kuwait. Using the Media Richness Theory (MRT), this study examines the response of 252 university students on mass communication programs. A questionnaire regarding their perceptions and preferences concerning modes of instruction on vocational courses online, focusing on the four factors of MRT: immediacy of feedback, capacity to include personal focus, conveyance of multiple cues, and variety of language. The outcomes show that immediacy of feedback predicted all criterion variables: suitability of distance learning (DL) for teaching vocational courses, sentiments of students toward DL, perceptions of easiness of evaluation of DL coursework, and the possibility of retaking DL courses. Capacity to include personal focus was another positive predictor of the criterion variables. It predicted students’ sentiments toward DL and the possibility of retaking DL courses. The outcomes are discussed in relation to implications for using DL, as well as constructing an agenda for DL research.

Keywords: distance learning, media richness theory, traditional learning, vocational media courses

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Authors: Darius Danesh, Michael J. Ryan, Alireza Abbasi

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Project Portfolio Management (PPM) is an essential component of an organisation’s strategic procedures, which requires attention of several factors to envisage a range of long-term outcomes to support strategic project portfolio decisions. To evaluate overall efficiency at the portfolio level, it is essential to identify the functionality of specific projects as well as to aggregate those findings in a mathematically meaningful manner that indicates the strategic significance of the associated projects at a number of levels of abstraction. PPM success is directly associated with the quality of decisions made and poor judgment increases portfolio costs. Hence, various Multi-Criteria Decision Making (MCDM) techniques have been designed and employed to support the decision-making functions. This paper reviews possible option to improve the decision-making outcomes in the organisational portfolio management processes using the Analytic Hierarchy Process (AHP) both from academic and practical perspectives and will examine the usability, certainty and quality of the technique. The results of the study will also provide insight into the technical risk associated with current decision-making model to underpin initiative tracking and strategic portfolio management.

Keywords: analytic hierarchy process, decision support systems, multi-criteria decision making, project portfolio management

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Authors: Fatma Ahmed, Heba Mostafa, Bassem Ramdan, Azza El-Soussi

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Background: World Health Organization stated that by 2020 cardiac disease will be the number one cause of death worldwide and estimates that 25 million people per year will suffer from heart disease. Cardiac surgery is considered an effective treatment for severe forms of cardiovascular diseases that cannot be treated by medical treatment or cardiac interventions. In spite of the benefits of cardiac surgery, it is considered a major stressful experience for patients who are candidate for surgery. Prehabilitation can decrease incidences of postoperative complications as it prepares patients for surgical stress through enhancing their defenses to meet the demands of surgery. When patients anticipate the postoperative sequence of events, they will prepare themselves to act certain behaviors, identify their roles and actively participate in their own recovery, therefore, anxiety levels are decreased and functional capacity is enhanced. Prehabilitation programs can comprise interventions that include physical exercise, psychological prehabilitation, nutritional optimization and risk factor modification. Physical exercises are associated with improvements in the functioning of the various physiological systems, reflected in increased functional capacity, improved cardiac and respiratory functions and make patients fit for surgical intervention. Prehabilitation programs should also prepare patients psychologically in order to cope with stress, anxiety and depression associated with postoperative pain, fatigue, limited ability to perform the usual activities of daily living through acting in a healthy manner. Notwithstanding the benefits of psychological preparations, there are limited studies which investigated the effect of psychological prehabilitation to confirm its effect on psychological, quality of life and physiological outcomes of patients who had undergone cardiac surgery. Aim of the study: The study aims to determine the effect of prehabilitation interventions on outcomes of patients undergoing cardiac surgeries. Methods: Quasi experimental study design was used to conduct this study. Sixty eligible and consenting patients were recruited and divided into two groups: control and intervention group (30 participants in each). One tool namely emotional, physiological, clinical, cognitive and functional capacity outcomes of prehabilitation intervention assessment tool was utilized to collect the data of this study. Results: Data analysis showed significant improvement in patients' emotional state, physiological and clinical outcomes (P < 0.000) with the use of prehabilitation interventions. Conclusions: Cardiac prehabilitation in the form of providing information about surgery, circulation exercise, deep breathing exercise, incentive spirometer training and nutritional education implemented daily by patients scheduled for elective open heart surgery one week before surgery have been shown to improve patients' emotional state, physiological and clinical outcomes.

Keywords: emotional recovery, clinical recovery, coronary artery bypass grafting patients, prehabilitation

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Authors: Ali Rashash Alzahrani, Elizabeth Stojanovski

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Data on various aspects of education are collected at the institutional and government level regularly. In Australia, for example, students at various levels of schooling undertake examinations in numeracy and literacy as part of NAPLAN testing, enabling longitudinal assessment of such data as well as comparisons between schools and states within Australia. Another source of educational data collected internationally is via the PISA study which collects data from several countries when students are approximately 15 years of age and enables comparisons in the performance of science, mathematics and English between countries as well as ranking of countries based on performance in these standardised tests. As well as student and school outcomes based on the tests taken as part of the PISA study, there is a wealth of other data collected in the study including parental demographics data and data related to teaching strategies used by educators. Overall, an abundance of educational data is available which has the potential to be used to help improve educational attainment and teaching of content in order to improve learning outcomes. A multivariate assessment of such data enables multiple variables to be considered simultaneously and will be used in the present study to help develop profiles of students based on performance in mathematics using data obtained from the PISA study.

Keywords: cluster analysis, education, mathematics, profiles

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Authors: Wendy I. E. Wesseling

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The unemployment rate has been on the rise since the outbreak of the global financial crisis in 2008. Especially labor market entrants suffer from economic downfall. Despite the abundance of programs and agencies that help to reintegrate unemployed youth, considerable less research attention has been paid to 'fit' between these programs and its participants that ensure a durable labor market transition. According to Self-Determination Theory, need satisfaction is associated with better (mental) adjustment. As such, three hypothesis were formulated: when workers’ needs for competence (H1), relatedness (H2), and autonomy (H3) are satisfied in the workplace, they are more likely to remain employed at the same employer. To test these assumptions, a sample of approximately 800 young people enrolled in a youth unemployment policy participated in a longitudinal study. The unemployment policy was aimed at the development of generic and vocational competences, and had a maximum duration of six months. Need satisfaction during the program was measured, as well as their employment outcomes up to 12 months after completion of the policy. All hypotheses were (partly) supported. Some limitations should be noted. First, since our sample consisted primarily of highly educated white graduates, it remains to be tested whether our results generalize to other groups of unemployed youth. Moreover, we are unable to conclude whether the results are due to the intervention, participants (selection effect), or both, because of the lack of a control group.

Keywords: need satisfaction, person-job fit, self-determination theory, youth unemployment policy

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Authors: Ghiwa Dandach

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By challenging the anti-failure bias and contributing to the theoretical territory of the attribution theory, this thesis develops a comprehensive process for entrepreneurial learning from failure. The practical implication of the findings suggests assisting entrepreneurs (current, failing, and nascent) in effectively anticipating and reflecting upon failure. Additionally, the process is suggested to enhance the level of institutional and private (accelerators and financers) support provided to entrepreneurs, the implications of which may improve future opportunities for entrepreneurial success. Henceforth, exploring learning from failure is argued to impact the potential survival of future ventures, subsequently revitalizing the economic contribution of entrepreneurship. This learning process can be enhanced with the cognitive development of causal ascriptions for failure, which eventually impacts learning outcomes. However, the mechanism with which entrepreneurs make sense of failure, reflect on the journey, and transform experience into knowledge is still under-researched. More specifically, the cognitive process of failure attribution is under-explored, majorly in the context of developing economies, calling for a more insightful understanding on how entrepreneurs ascribe failure. Responding to the call for more thorough research in such cultural contexts, this study expands the understanding of the dimensions of failure attributions as perceived by entrepreneurs and the impact of these dimensions on learning outcomes in the Lebanese context. The research adopted the exploratory interpretivism paradigm and collected data from interviews with industry experts first, followed by narratives of entrepreneurs using the qualitative multimethod approach. The holistic and categorical content analysis of narratives, preceded by the thematic analysis of interviews, unveiled how entrepreneurs ascribe failure by developing minor and major dimensions of each failure attribution. The findings have also revealed how each dimension impacts the learning from failure when accompanied by emotional resilience. The thesis concludes that exploring in-depth the dimensions of failure attributions significantly determines the level of learning generated. They are moving beyond the simple categorisation of ascriptions as primary internal or external unveiled how learning may occur with each attribution at the individual, venture, and ecosystem levels. This has further accentuated that a major internal attribution of failure combined with a minor external attribution generated the highest levels of transformative and double-loop learning, emphasizing the role of personal blame and responsibility on enhancing learning outcomes.

Keywords: attribution, entrepreneurship, reflection, sense-making, emotions, learning outcomes, failure, exit

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Authors: Nicholas Bayfield, Liam Bibo, Charley Budgeon, Robert Larbalestier, Tom Briffa

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Introduction: Stress hyperglycaemia is common following cardiac surgery. Its optimal management is uncertain and may differ by diabetic status. This study assesses the in-hospital glycaemic management of cardiac surgery patients and associated postoperative outcomes. Methods: A retrospective cohort analysis of all patients undergoing cardiac surgery at Fiona Stanley Hospital from February 2015 to May 2019 was undertaken. Management and outcomes of hyperglycaemia following cardiac surgery were assessed. Follow-up was assessed to 1 year postoperatively. Multivariate regression modelling was utilised. Results: 1050 non-diabetic patients and 689 diabetic patients were included. In the non-diabetic cohort, patients with mild (peak blood sugar level [BSL] < 14.3), transient stress hyperglycaemia managed without insulin were not at an increased risk of wound-related morbidity (P=0.899) or mortality at 1 year (P=0.483). Insulin management was associated with wound-related readmission to hospital (P=0.004) and superficial sternal wound infection (P=0.047). Prolonged or severe stress hyperglycaemia was predictive of hospital re-admission (P=0.050) but not morbidity or mortality (P=0.546). Diabetes mellitus was an independent risk factor 1-year mortality (OR; 1.972 [1.041–3.736], P=0.037), graft harvest site wound infection (OR; 1.810 [1.134–2.889], P=0.013) and wound-related readmission (OR; 1.866 [1.076–3.236], P=0.026). In diabetics, postoperative peak BSL > 13.9mmol/L was predictive of graft harvest site infections (OR; 3.528 [1.724-7.217], P=0.001) and wound-related readmission OR; 3.462 [1.540-7.783], P=0.003) regardless of modality of management. A peak BSL of 10.0-13.9 did not increase the risk of morbidity/mortality compared to a peak BSL of < 10.0 (P=0.557). Diabetics with a peak BSL of 13.9 or less did not have significantly increased morbidity/mortality outcomes compared to non-diabetics (P=0.418). Conclusion: In non-diabetic patients, transient mild stress hyperglycaemia following cardiac surgery does not uniformly require treatment. In diabetic patients, postoperative hyperglycaemia with peak BSL exceeding 13.9mmol/L was associated with wound-related morbidity and hospital readmission following cardiac surgery.

Keywords: cardiac surgery, pulmonary embolism, pulmonary embolectomy, cardiopulmonary bypass

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Authors: Mohammadreza Mohebbi, Masoumeh Sanagou

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The ability to predict clinical outcomes is of great importance to physicians and clinicians. A number of different methods have been used in an effort to accurately predict these outcomes. These methods include the development of scoring systems based on multivariate statistical modelling, and models involving the use of classification and regression trees. The process usually consists of two consecutive phases, namely model development and external validation. The model development phase consists of building a multivariate model and evaluating its predictive performance by examining calibration and discrimination, and internal validation. External validation tests the predictive performance of a model by assessing its calibration and discrimination in different but plausibly related patients. A motivate example focuses on prediction modeling using a sample of patients undergone coronary artery bypass graft (CABG) has been used for illustrative purpose and a set of primary considerations for evaluating prediction model studies using specific quality indicators as criteria to help stakeholders evaluate the quality of a prediction model study has been proposed.

Keywords: clinical prediction models, clinical decision rule, prognosis, external validation, model calibration, biostatistics

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Authors: Alper Tolga Kumtepe, Erdem Erdogdu, M. Recep Okur, Eda Kaypak, Ozlem Kaya, Serap Ugur, Deniz Dincer, Hakan Yildirim

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Interaction is one of the most important components of open and distance learning. According to Moore, who proposed one of the keystones on interaction types, there are three basic types of interaction: learner-teacher, learner-content, and learner-learner. From these interaction types, learner-content interaction, without doubt, can be identified as the most fundamental one on which all education is based. Efficacy, efficiency, and attraction of open and distance learning systems can be achieved by the practice of effective learner-content interaction. With the development of new technologies, interactive e-learning materials have been commonly used as a resource in open and distance learning, along with the printed books. The intellectual engagement of the learners with the content that is course materials may also affect their satisfaction for the open and distance learning practices in general. Learner satisfaction holds an important place in open and distance learning since it will eventually contribute to the achievement of learning outcomes. Using the learner-content interaction activities in course materials, Anadolu University, by its Open Education system, tries to involve learners in deep and meaningful learning practices. Especially, during the e-learning material design and production processes, identifying appropriate learner-content interaction activities within the context of learning outcomes holds a big importance. Considering the lack of studies adopting this approach, as well as its being a study on the use of e-learning materials in Open Education system, this research holds a big value in open and distance learning literature. In this respect, the present study aimed to investigate a) which learner-content interaction activities included in interactive courses are the most effective in learners’ achievement of verbal information learning outcomes and b) to what extent distance learners are satisfied with these learner-content interaction activities. For this study, the quasi-experimental research design was adopted. The 120 participants of the study were from Anadolu University Open Education Faculty students living in Eskişehir. The students were divided into 6 groups randomly. While 5 of these groups received different learner-content interaction activities as a part of the experiment, the other group served as the control group. The data were collected mainly through two instruments: pre-test and post-test. In addition to those tests, learners’ perceived learning was assessed with an item at the end of the program. The data collected from pre-test and post-test were analyzed by ANOVA, and in the light of the findings of this approximately 24-month study, suggestions for the further design of e-learning materials within the context of learner-content interaction activities will be provided at the conference. The current study is planned to be an antecedent for the following studies that will examine the effects of activities on other learning domains.

Keywords: interaction, distance education, interactivity, online courses

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Authors: Stephen McCarthy, Joanne Gray, Esther Carr, Gerard Danjoux, Paul Baker, Rhiannon Hackett

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Background: The Go Well Health (GWH) platform is a web-based programme that allows patients to access personalised care plans and resources, aimed at prehabilitation prior to surgery. The online digital platform delivers essential patient education and support for patients prior to undergoing total hip replacements (THR) and total knee replacements (TKR). This study evaluated the impact of an online digital platform (ODP) in terms of functional health outcomes, health related quality of life and hospital length of stay following surgery. Methods: A retrospective cohort study comparing a cohort of patients who used the online digital platform (ODP) to deliver patient education and support (PES) prior to undergoing THR and TKR surgery relative to a cohort of patients who did not access the ODP and received usual care. Routinely collected Patient Reported Outcome Measures (PROMs) data was obtained on 2,406 patients who underwent a knee replacement (n=1,160) or a hip replacement (n=1,246) between 2018 and 2019 in a single surgical centre in the United Kingdom. The Oxford Hip and Knee Score and the European Quality of Life Five-Dimensional tool (EQ5D-5L) was obtained both pre-and post-surgery (at 6 months) along with hospital LOS. Linear regression was used to compare the estimate the impact of GWH on both health outcomes and negative binomial regressions were used to impact on LOS. All analyses adjusted for age, sex, Charlson Comorbidity Score and either pre-operative Oxford Hip/Knee scores or pre-operative EQ-5D scores. Fractional polynomials were used to represent potential non-linear relationships between the factors included in the regression model. Findings: For patients who underwent a knee replacement, GWH had a statistically significant impact on Oxford Knee Scores and EQ5D-5L utility post-surgery (p=0.039 and p=0.002 respectively). GWH did not have a statistically significant impact on the hospital length of stay. For those patients who underwent a hip replacement, GWH had a statistically significant impact on Oxford Hip Scores and EQ5D-5L utility post (p=0.000 and p=0.009 respectively). GWH also had a statistically significant reduction in the hospital length of stay (p=0.000). Conclusion: Health Outcomes were higher for patients who used the GWH platform and underwent THR and TKR relative to those who received usual care prior to surgery. Patients who underwent a hip replacement and used GWH also had a reduced hospital LOS. These findings are important for health policy and or decision makers as they suggest that prehabilitation via an ODP can maximise health outcomes for patients following surgery whilst potentially making efficiency savings with reductions in LOS.

Keywords: digital prehabilitation, online digital platform, orthopaedics, surgery

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Authors: Tharaki S. Hettiarachchi

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Sustainable construction has gained massive attention in the present world as the construction industry is highly responsible for carbon emissions and other types of unsustainable practices. Yet, the construction industry has not been able to completely attain sustainable goals. Therefore, the present study aims to identify the extent to which sustainability has been considered within the scope of construction project management and to analyze the challenges, gaps, and constraints associated. Accordingly, this study develops a sustainable framework to integrate in construction project management. In accomplishing the research aim, this research integrates a qualitative approach while relying on secondary data sources. The data shall be then analyzed with the use of a systematic literature review (SLR) method while following the PRISMA (2020) guideline and represented in a statistical form. The outcomes of this study may become highly significant in identifying the nature of the existing sustainable frameworks associated with construction project management scopes and to develop a new framework to integrate in order to enhance the effectiveness of sustainable applications in construction management. The outcomes of this research may benefit present and future construction professionals and academicians to organize sustainable construction-related knowledge in a useful way to apply in practical implementation for effective project management. Overall, this study directs present and future construction professionals toward an advanced construction project management mechanism.

Keywords: construction, framework development, project management, sustainability

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Authors: Sania Bashir

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A promising approach to healthcare delivery, telemedicine makes use of communication technology to reach out to remote regions of the world, allowing for beneficial interactions between diabetic patients and healthcare professionals as well as the provision of affordable and easily accessible medical care. The emergence of contemporary care models, fueled by the pervasiveness of mobile devices, provides better information, offers low cost with the best possible outcomes, and is known as digital health. It involves the integration of collected data using software and apps, as well as low-cost, high-quality outcomes. The goal of this study is to assess how well telemedicine works for diabetic patients and how it impacts their HbA1c levels. A questionnaire-based survey of 300 diabetics included 150 patients in each of the groups receiving usual care and via telemedicine. A descriptive and observational study that lasted from September 2021 to May 2022 was conducted. HbA1c has been gathered for both categories every three months. A remote monitoring tool has been used to assess the efficacy of telemedicine and continuing therapy instead of the customary three monthly meetings like in-person consultations. The patients were (42.3) 18.3 years old on average. 128 men were outnumbered by 172 women (57.3% of the total). 200 patients (66.6%) have type 2 diabetes, compared to over 100 (33.3%) candidates for type 1. Despite the average baseline BMI being within normal ranges at 23.4 kg/m², the mean baseline HbA1c (9.45 1.20) indicates that glycemic treatment is not well-controlled at the time of registration. While patients who use telemedicine experienced a mean percentage change of 10.5, those who visit the clinic experienced a mean percentage change of 3.9. Changes in HbA1c are dependent on several factors, including improvements in BMI (61%) after 9 months of research and compliance with healthy lifestyle recommendations for diet and activity. More compliance was achieved by the telemedicine group. It is an undeniable reality that patient-physician communication is crucial for enhancing health outcomes and avoiding long-term issues. Telemedicine has shown its value in the management of diabetes and holds promise as a novel technique for improved clinical-patient communication in the twenty-first century.

Keywords: diabetes, digital health, mobile app, telemedicine

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Authors: Dercan Gencbas, Hatice Bebis, Sue Moorhead

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In the nursing process, many of the nursing classification systems were created to be used in international. From these, NANDA-I, Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC). In this direction, the main objective of this study is to establish a model for caregivers in hospitals and communities in Turkey and to ensure that nursing outputs are assessed by NOC-based measures. There are many scales to measure Urinary Incontinence (UI), which is very common in children, in old age, vaginal birth, NOC scales are ideal for use in the nursing process for comprehensive and holistic assessment, with surveys available. For this reason, the purpose of this study is to evaluate the validity of the NOC outputs and indicators used for UI NANDA-I. This research is a methodological study. In addition to the validity of scale indicators in the study, how much they will contribute to recovery after the nursing intervention was assessed by experts. Scope validations have been applied and calculated according to Fehring 1987 work model. According to this, nursing inclusion criteria and scores were determined. For example, if experts have at least four years of clinical experience, their score was 4 points or have at least one year of the nursing classification system, their score was 1 point. The experts were a publication experience about nursing classification, their score was 1 point, or have a doctoral degree in nursing, their score was 2 points. If the expert has a master degree, their score was 1 point. Total of 55 experts rated Fehring as a “senior degree” with a score of 90 according to the expert scoring. The nursing interventions to be applied were asked to what extent these indicators would contribute to recovery. For coverage validity tailored to Fehring's model, each NOC and NOC indicator from specialists was asked to score between 1-5. Score for the significance of indicators was from 1=no precaution to 5=very important. After the expert opinion, these weighted scores obtained for each NOC and NOC indicator were classified as 0.8 critical, 0.8 > 0.5 complements, > 0.5 are excluded. In the NANDA-I / NOC / NIC system (guideline), 5 NOCs proposed for nursing diagnoses for UI were proposed. These outputs are; Urinary Continence, Urinary Elimination, Tissue Integrity, Self CareToileting, Medication Response. After the scales are translated into Turkish, the weighted average of the scores obtained from specialists for the coverage of all 5 NOCs and the contribution of nursing initiatives exceeded 0.8. After the opinions of the experts, 79 of the 82 indicators were calculated as critical, 3 of the indicators were calculated as supplemental. Because of 0.5 > was not obtained, no substance was removed. All NOC outputs were identified as valid and usable scales in Turkey. In this study, five NOC outcomes were verified for the evaluation of the output of individuals who have received nursing knowledge of UI and variant types. Nurses in Turkey can benefit from the outputs of the NOC scale to perform the care of the elderly incontinence.

Keywords: nursing outcomes, content validity, nursing diagnosis, urinary incontinence

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