Search results for: relational communication

Authors: M.J. Seddighi, A. Moradchelleh, M. Keyvan

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The ultimate goal in building a city is to provide pleasant, comfortable and nurturing environment as a context of public life. City environment establishes strong connection with people and their surrounding habitant, acting as relevance in social interactions between citizens itself. Urban environment and appropriate municipal facilities are the only way for proper communication between city and citizens and also citizens themselves. There is a need for complement elements between buildings and constructions to settling city life through which the move, comfort, reactions and anxiety will adjust and reflect the spirit to the city. In the surging development of society, urban’ spaces are encountered evolution, sometimes causing the symbols to fade and waste, and as a result, leading to destroy belongs among humans and their physical liquidate. Houses and living spaces exhibit materialistic reflection of life style. In other words, way of life makes the symbolic essence of living spaces. In addition, it is of sociocultural factor of lifestyle, consisting the concepts and culture, morality, worldview, and national character. Culture is responsible for some crucial meaningful needs which can be wide because they depend on various causes such as perception and interpretation of believes, philosophy of life, interaction with neighbors and protection against climate and enemies. The bilateral relationship between human and nature is the main factor that needs to be properly addressed. It is because of the fact that the approach which is taken against landscape and nature has a pertinent influence on creation and shaping the structure of a house. The first response of human in tackling the environment is to build a “shelter” and place as dwelling. This has been a crucial factor in all time periods. In the proposed study, dwelling in Khorasgan’ Stream, as an area located in one of the important historical city of Iran, has been studied. Khorasgan’ Stream is the basic constituent elements of the present architectural form of Isfahan. The influence of Islamic spiritual culture and neighborhood with the historical elements on the dwelling of the selected location, subsequently on other regions of the town are presented.

Keywords: historical architectural elements, dwelling' neighborhood, Khorasgan’ Stream of Isfahan, architecture

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Authors: Francisco Toledo-Castillo, Pilar Peiró-Torres, María Josefa Sospedra-Baeza, Sergio Hidalgo-Fuentes

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The communication presented is about tasks that are been developed in the research project “safeRoute”, “Information safety system for professional road driving” (IPT-2012-110-370000). This R&D project was proposed by the consortium formed by Fagor Electronica la SEU 3 and the University of Valencia to the Ministry of Economy and Competitiveness, which approved it inside the INNPACTO subprogramme grants. Through this type of calls, the Ministry promote the innovative capacity of the Spanish companies and turn on the mechanism for competing internationally. With this kind of calls, private investments for technological and industrial development join their R & D resources with public entities to implement innovative project that could have an international exposure. Thus INNPACTO subprogramme promotes the creation of research projects with public-private partnerships that create exploitable final products. The “safeRoute” Project pretends develop a tool to help to make more safety the travels of commercial transport vehicles of goods and passengers. To achieve its objectives, the project is focused in three main lines of research: vehicle safety, the safety of the roads that they are using, and the safety which drivers do their job, their behaviour while they are driving. To improve safety, the project gives information about these three factors to all people that are involved in the safety of the professional transport. These three factors have influence to the occurrence of traffic accidents, thanks to the information provided and treated about these factors, we can achieve a significant reduction in occupational accidents in the transport sector. SafeRoute provide information about routes, vehicles, and driver behaviours, and in this manner pretends provide to transport companies a tool which could result in a safer driving results and could reduce their costs related to traffic accidents of their vehicles, in that way, this tool could help them to be more competitive, and give a more reliable service. This paper will focus mainly on the information about routes that drivers use to travel in their professional work, and how the researchers of this project have catalogued and evaluated these routes, and finally how that information will be provided to users.

Keywords: driver support systems, professional drivers, road safety, safeRoute

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Authors: Ju-Hong Lee, Ching-Wei Liao

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Adaptive beamforming using antenna array of sensors is useful in the process of adaptively detecting and preserving the presence of the desired signal while suppressing the interference and the background noise. For conventional adaptive array beamforming, we require a prior information of either the impinging direction or the waveform of the desired signal to adapt the weights. The adaptive weights of an antenna array beamformer under a steered-beam constraint are calculated by minimizing the output power of the beamformer subject to the constraint that forces the beamformer to make a constant response in the steering direction. Hence, the performance of the beamformer is very sensitive to the accuracy of the steering operation. In the literature, it is well known that the performance of an adaptive beamformer will be deteriorated by any steering angle error encountered in many practical applications, e.g., the wireless communication systems with massive antennas deployed at the base station and user equipment. Hence, developing effective signal processing techniques to deal with the problem due to steering angle error for array beamforming systems has become an important research work. In this paper, we present an effective signal processing technique for constructing an adaptive beamformer against the steering angle error. The proposed array beamformer adaptively estimates the actual direction of the desired signal by using the presumed steering vector and the received array data snapshots. Based on the presumed steering vector and a preset angle range for steering mismatch tolerance, we first create a matrix related to the direction vector of signal sources. Two projection matrices are generated from the matrix. The projection matrix associated with the desired signal information and the received array data are utilized to iteratively estimate the actual direction vector of the desired signal. The estimated direction vector of the desired signal is then used for appropriately finding the quiescent weight vector. The other projection matrix is set to be the signal blocking matrix required for performing adaptive beamforming. Accordingly, the proposed beamformer consists of adaptive quiescent weights and partially adaptive weights. Several computer simulation examples are provided for evaluating and comparing the proposed technique with the existing robust techniques.

Keywords: adaptive beamforming, robustness, signal blocking, steering angle error

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Authors: Kalpana Gupta

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Sexually transmitted infections (STIs) are infections that are spread primarily through sexual contact. In our daily practice, we see gonorrhea, chancroid, syphilis, and chlamydial infections that can be cured, as well as HIV, genital herpes, HPV, and hepatitis B infections that cannot be cured but can be managed with available treatments. Many people in India are infected with Sexually transmitted diseases (STDs), and the figures are quite high because of a lack of awareness and communication, as well as a taboo against these diseases. Numerous taboos and associated stigma shape patients’ lives and have a significant impact on health care policies, medical research, and current issues in medical ethics. Current statistics emphasize the importance of delivering sex education to this important demographic promptly. The long-standing tradition of girls marrying very young, especially in rural areas, and often too much older men, causes a slew of STIs. Stigma and HIV have a cyclical relationship; people who experience stigma and discrimination are marginalized and made more vulnerable to HIV/STDs, while those living with HIV are more vulnerable to stigma and discrimination. As urban pressures have grown, so have slums - and they have fast become ideal breeding grounds for STDs. In developed countries, strict laws have been enacted requiring people suffering from STDs to seek immediate treatment as well as contact the health department. Unfortunately, because of the stigma associated with the disease, patients in India are reluctant to reveal the source of infection. With various schemes, India is attempting to promote sex education and awareness. For example, the Ministry of Health and Family Welfare developed the National Adolescent Health Programme (also known as the Rashtriya Kishor Swasthya Karyakram) in partnership with the United Nations Population Fund (UNFPA). Whereas, National AIDS Control Organisation was set up so that every person living with HIV has access to quality care and is treated with dignity and breaking all taboos. It becomes clear that research and healthcare policies will not be effective in assisting patients with STDs unless these "nonscientific" elements are taken into account.

Keywords: sexually transmitted diseases, sexually transmitted infections, taboo, stigma, HIV/STDs, sex education and awareness, treatment, quality care, medications, healthcare policies

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Authors: Haniyeh Sameie

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In the process of globalization, geographical boundaries gradually lose their importance, and ethnic, local, and regional cultures are integrated with each other and even marginalized. Globalization has many manifestations and aspects, including economic, political, social, etc., but this paper has focused on the cultural aspect of globalization. From this point of view, one of the important issues that have always been raised is the assimilation of diverse and plural cultures, which are gradually disappearing and destroyed in the onslaught of global culture and are dissolved in global culture. In the postmodern paradigm, the tools of the globalized world can be used to preserve and strengthen cultural diversity. For example, the Internet, as a globalization tool, can play an important role in preserving and recognizing local cultures. In today's world, the world nations and ethnic groups are trying to revive their specific and native cultures in different ways in opposition to the rising cultural assimilation and challenge the globalization of culture. One of the manifestations of these actions is addressing the issue of tourism and, specifically, eco-tourism, which is being developed in Iran as well as in other parts of the world, relying on the powerful tool of globalization, the Internet. Considering the significant growth of the ecotourism industry in Iran in recent years, this paper focuses on the role of the Internet in the development of ecotourism in Iran as one of the manifestations of tourism in recent decades and how to preserve and survive diverse local cultures and strengthen local communities against global culture through it. One of the major challenges in the development of communication technology in Iran in the last decade has been the debate over the necessity or non-necessity of access to high-speed Internet in the villages of Iran. Some believe that accessing the broadband internet in the villages may lead to the disappearance of local cultures and can facilitate the spread of western culture among villagers. On the other hand, the speed of expansion of ecotourism in Iran in the last ten years is owed to the development of the Internet in villages. In this regard, we pay attention to the dual role of the Internet in cultural assimilation and, at the same time, the platform that the online space has created for the growth and development of ecotourism accommodations as a source of stable income for local communities, focusing on the Iranian experience in the recent decade.

Keywords: tourism, globalization, internet, ecotourism in Iran, cultural assimilation

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Authors: M. Areekijseree, W. Pongsawat, M. Pumipaiboon, C. Thepsithar, S. Sengsai, T. Chuen-Im

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Morphological interaction of porcine cumulus-oocyte complexes (pCOCs) was investigated on in vitro condition using electron microscope (SEM and TEM). The totals of 1,923 oocytes were round in shape, surrounded by zona pellucida with layer of cumulus cells ranging between 59.29-202.14 µm in size. They were classified into intact-, multi-, partial cumulus cell layer oocyte, and completely denuded oocyte, at the percentage composition of 22.80% 32.70%, 18.60%, and 25.90 % respectively. The pCOCs classified as intact- and multi cumulus cell layer oocytes were further culturing at 37°C with 5% CO2, 95% air atmosphere and high humidity for 44 h in M199 with Earle’s salts supplemented with 10% HTFCS, 2.2 mg/mL NaHCO3, 1 M Hepes, 0.25 mM pyruvate, 15 µg/mL porcine follicle-stimulating hormone, 1 µg/mL LH, 1µg/mL estradiol with ethanol, and 50 µg/mL gentamycin sulfate. On electron microscope study, cumulus cells were found to stick their processes to secrete substance from the sac-shape end into zona pellucida of the oocyte and also communicated with the neighboring cells through their microvilli on the beginning of incubation period. It is believed that the cumulus cells communicate with the oocyte by inserting the microvilli through this gap and embedded in the oocyte cytoplasm before secreting substance, through the sac-shape end of the microvilli, to inhibit primary oocyte development at the prophase I. Morphological changes of the complexes were observed after culturing for 24-44 h. One hundred percentages of the cumulus layers were expanded and cumulus cells were peeling off from the oocyte surface. In addition, the round-shape cumulus cells transformed themselves into either an elongate shape or a columnar shape, and no communication between cumulus neighboring cells. After 44 h of incubation time, diameter of oocytes surrounded by cumulus cells was larger than 0 h incubation. The effect of hormones in culture medium is exerted by their receptors present in porcine oocyte. It is likely that all morphological changes of the complexes after hormone treatment were to allow maturation of the oocyte. This study demonstrated that the association of hormones in M199 could promote porcine follicle activation in 44 h in vitro condition. This culture system should be useful for studying the regulation of early follicular growth and development, especially because these follicles represent a large source of oocytes that could be used in vitro for cell technology.

Keywords: cumulus cells, electron microscopy, in vitro, porcine oocyte

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Authors: Nastja Utrosa, Matevz Juvancic

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Hospital buildings are complex public environments characterized by intricate functional arrangements and architectural layouts. Effective wayfinding is essential for patients, visitors, students, and staff. However, spatial orientation planning is often overlooked until after construction. While these environments meet functional needs, they frequently neglect the psychological aspects of user experience. This study investigates wayfinding within complex urban healthcare environments, focusing on the influences of spatial design, spatial cognition, and user experience. The inherent complexity of these environments, with extensive spatial dimensions and dispersed buildings, exacerbates the problem. Gradual expansions and additions contribute to disorientation and navigational difficulties for users. Effective route guidance in urban healthcare settings has become increasingly crucial. However, research on the environmental elements that influence wayfinding in such environments remains limited. To address this gap, we conducted a study at the University Medical Centre Ljubljana (UMCL), Slovenia's largest university hospital. Using a questionnaire, we assessed how individuals' perceptions and use of outdoor hospital spaces with a diverse sample (n=179). We evaluated the area’s usability by analyzing visit frequency, stops, modes of arrival, and parking patterns and examined the visitors' age distribution. Additionally, we investigated spatial aids and the use of color as an orientation element at three specific locations within the medical center. Our study explored the impact of color on entrance selection and the effectiveness of warm versus cool colors for wayfinding. Our findings highlight the significance of graphic adjustments in shaping perceptions of hospital outdoor spaces. Most participants preferred visually organized entrances, underscoring the importance of effective visual communication. Implementing these adaptations can substantially enhance the user experience, reducing stress and increasing satisfaction in hospital environments.

Keywords: hospital layout design, healthcare facilities, wayfinding, navigational aids, spatial orientation, color, signage

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Authors: Ahmed Elwaleed, Huiho Jeong, Ali H. Abdelbagi, Nguyen Thi Quynh, Koji Arizono, Yasuhiro Ishibashi

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Artisanal and small-scale gold mining (ASGM) poses substantial risks to both human health and the environment, particularly through contamination of soil, water, and air. Prolonged exposure to ASGM-contaminated soils can lead to acute or chronic mercury toxicity. This study assesses the human health risks associated with mercury-contaminated soils and tailings in the Alebediah mining community in Sudan. Soil samples were collected from various locations within Alebediah, including ASGM areas, farmlands, and residential areas, along with tailings samples commonly found within ASGM sites. The evaluation of potential health risks to humans included the computation of the estimated daily intake (AvDI), the hazard quotient (HQ), and the hazard index (HI) for both adults and children. The primary exposure route identified as potentially posing a significant health risk was the volatilization of mercury from tailings samples, where mercury concentrations reached up to 25.5 mg/kg. In contrast, other samples within the ASGM area showed elevated mercury levels but did not present significant health risks, with HI values below 1. However, all areas indicated HI values above 1 for the remaining exposure routes. The study observed a decrease in mercury concentration with increasing distance from the ASGM community. Additionally, soil samples revealed elevated mercury levels exceeding background values, prompting an assessment of contamination levels using the enrichment factor (EF). The findings indicated that farmlands and residential areas exhibited depleted EF, while areas surrounding the ASGM community showed none to moderate pollution. In contrast, ASGM areas exhibited significant to extreme pollution. A GIS map was generated to visually depict the extent of mercury pollution, facilitating communication with stakeholders and decision-makers.

Keywords: mercury pollution, artisanal and small-scale gold mining, health risk assessment, hazard index, soil and tailings, enrichment factor

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Authors: Jiradeach Kalayaruan, Tosawat Seetawan

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This paper studied the energy of the nature systems by looking at the overall image throughout the universe. The energy of the nature systems was developed from the Einstein’s energy equation. The researcher used the new ideas called even 2n and odd 3n light dimension energy states systems, which were developed from Einstein’s relativity energy theory equation. In this study, the major methodology the researchers used was the basic principle ideas or beliefs of some religions such as Buddhism, Christianity, Hinduism, Islam, or Tao in order to get new discoveries. The basic beliefs of each religion - Nivara, God, Ether, Atman, and Tao respectively, were great influential ideas on the researchers to use them greatly in the study to form new ideas from philosophy. Since the philosophy of each religion was alive with deep insight of the physical nature relative energy, it connected the basic beliefs to light dimension energy states systems. Unfortunately, Einstein’s original relative energy equation showed only even 2n light dimension energy states systems (if n = 1,…,∞). But in advance ideas, the researchers multiplied light dimension energy by Einstein’s original relative energy equation and get new idea of theoritical physics in odd 3n light dimension energy states systems (if n = 1,…,∞). Because from basic principle ideas or beliefs of some religions philosophy of each religion, you had to add the media light dimension energy into Einstein’s original relative energy equation. Consequently, the simple meaning picture in deep insight showed that you could touch light dimension energy of Nivara, God, Ether, Atman, and Tao by light dimension energy. Since light dimension energy was transferred by Nivara, God, Ether, Atman and Tao, the researchers got the new equation of odd 3n light dimension energy states systems. Moreover, the researchers expected to be able to solve overview problems of all light dimension energy in all nature relative energy, which are developed from Eistein’s relative energy equation.The finding of the study was called 'super nature relative energy' ( in odd 3n light dimension energy states systems (if n = 1,…,∞)). From the new ideas above you could do the summation of even 2n and odd 3n light dimension energy states systems in all of nature light dimension energy states systems. In the future time, the researchers will expect the new idea to be used in insight theoretical physics, which is very useful to the development of quantum mechanics, all engineering, medical profession, transportation, communication, scientific inventions, and technology, etc.

Keywords: 2n light dimension energy states systems effect, Ether, even 2n light dimension energy states systems, nature relativity, Nivara, odd 3n light dimension energy states systems, perturbation points energy, relax point energy states systems, stress perturbation energy states systems effect, super relative energy

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Authors: Tsung Chin Wu, Yu Chen Tsai, Rhay Hung Weng, Weir Sen Lin

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In recent years, nursing staff’s lower job satisfaction has led to higher turnover rates, and high turnover rates not only cause medical institution costs to increase but also the quality of medical care to decrease. From the perspective of internal marketing, institution staffs are internal customers, and institutions should focus and meet the needs of staff, so that staff will strive to meet the needs of external customers and provide them with the required care. However, few previous studies have investigated the impact of internal staff satisfaction on external customers. Therefore, this study aimed to conduct job satisfaction surveys on internal staff to investigate the relationship between job satisfaction and quality of medical care through statistical analysis of the study results. The related study results may serve as a reference for healthcare managers. This study was conducted using a questionnaire and the subjects were nursing staff from four hospitals. A total of 600 questionnaires were distributed and 577 valid questionnaires were returned with a response rate of 96.1%. After collecting the data, the reliability and validity of the study variables were confirmed by confirmatory factor analysis. The impact of internal marketing and job satisfaction on turnover intention of nursing staff was analyzed using descriptive analysis, one-way ANOVA, Pearson correlation analysis and multiple regression analysis. The study results showed that there was a significant difference between nursing staff’s job title and ‘professional participation’ and ‘shifts’. There was a significant difference between salary and ‘shifts’ and ‘turnover intention’, as well as between marriage and ‘remuneration’ and ‘turnover intention’. A significant difference was found between professional advancement and ‘professional growth’ and ‘type of leave’, as well as between division of service and ‘shifts’ and ‘turnover intention’. Pearson correlation analysis revealed a significant negative correlation between turnover intention and ‘internal marketing’, ‘interaction’, ‘professional participation’, ‘grasp of environment’, ‘remuneration’ and ‘shifts’, meaning that the higher the satisfaction, the lower the turnover intention. It is recommended that hospitals establish a comprehensive internal marketing mechanism to enhance staff satisfaction and in turn, reduce intention to resign, and the key to increasing job satisfaction is by establishing effective methods of internal communication.

Keywords: internal marketing, job satisfaction, turnover intention, nursing staff

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Authors: Enes Caliskan, Hatice Camgoz Akdag

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There is no doubt that humanity needs to realize the sustainability problems in the world and take serious action regarding that. All members of the United Nations adopted the 2030 Agenda for Sustainable Development, the most comprehensive study on sustainability internationally, in 2015. The summary of the study is 17 sustainable development goals. It covers everything about sustainability, such as environment, society and governance. The use of Information and Communication Technology (ICT), such as the Internet, mobile phones, and satellites, is essential for tackling the main issues facing sustainable development. Hence, the contributions of 3 major ICT companies to the sustainable development goals are assessed in this study. Quality Function Deployment (QFD) is utilized as a methodology for this study. Since QFD is an excellent instrument for comparing businesses on relevant subjects, a House of Quality must be established to complete the QFD application. In order to develop a House of Quality, the demanded qualities (voice of the customer) and quality characteristics (technical requirements) must first be determined. UN SDGs are used as demanded qualities. Quality characteristics are derived from annual sustainability and corporate social responsibility reports of ICT companies. The companies' efforts, as indicated by the QFD results, are concentrated on the use of recycled raw materials and recycling, reducing GHG emissions through energy saving and improved connectivity, decarbonizing the value chain, protecting the environment and water resources by collaborating with businesses that have completed CDP water assessments and paying attention to reducing water consumption, ethical business practices, and reducing inequality. The evaluations of the three businesses are found to be very similar when they are compared. The small differences between the companies are usually about the region they serve. Efforts made by the companies mostly concentrate on responsible consumption and production, life below water, climate action, and sustainable cities and community goals. These efforts include improving connectivity in needed areas for providing access to information, education and healthcare.

Keywords: multi-criteria decision-making, sustainable supply chain risk, supply chain agility, quality function deployment, Sustainable development goals

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Authors: Marinel Dayawon

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Student participation in classroom activities is vital in the teaching- learning the process as it develops self-confidence, social relationships and good academic performance of students. It is the teacher’s empathetic manner and creativity to create solutions that encourage teamwork and mutual support while dropping the academic competition within the class that hinder every shy student to walk with courage and talk with conviction because they consider their ideas, weak, as compared to the bright students. This study aimed to explore the different design thinking strategies that will change the mindset of shy students in classroom activities, maximizing their participation in all given tasks while sharing their views through ideation and providing them a wider world through compromise agreement within the members of the group, sensitivity to one’s idea, thus, arriving at a collective decision in the development of a prototype that indicates improvement in their classroom involvement. The study used the qualitative type of research. Triangulation is done through participant observation, focus group discussion and interview, documented through photos and videos. The respondents were the second- year Bachelor of Secondary Education students of the Institute of Teacher Education at Isabela State University- Cauayan City Campus. The result of the study revealed that reticent students when involved in game activities through a slap and tap method, writing their clustered ideas, using sticky notes is excited in sharing ideas as it doesn’t use oral communication. It is also observed after three weeks of using the design thinking strategies; shy students volunteer as secretary, rapporteur or group leader in the team- building activities as it represents the ideas of the heterogeneous group, removing the individual identity of the ideas. Superior students learned to listen to the ideas of the reticent students and involved them in the prototyping process of designing a remediation program for high school students showing reticence in the classroom, making their experience as a benchmark. The strategies made a 360- degrees transformation of the shy students, producing their journal log, in their journey to being open. Thus, faculty members are now adopting the design thinking approach.

Keywords: design thinking activities, qualitative, reticent students, Isabela, Philippines

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Authors: Michael Wagner, Philipp Steinbauer, Andrea Katharina Lietz, Alexander Hoffelner, Johannes Fessler

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Background: Cardiopulmonary resuscitations are stressful situations in which vital decisions must be made within seconds. Lack of routine due to the infrequency of pediatric emergencies can lead to serious medical and communication errors. Virtual reality can fundamentally change the way simulation training is conducted in the future. It appears to be a useful learning tool for technical and non-technical skills. It is important to investigate the use of VR in providing a strong sense of presence within simulations. Methods: In this randomized study, we will enroll doctors and medical students from the Medical University of Vienna, who will receive learning material regarding the resuscitation of a one-year-old child. The study will be conducted in three phases. In the first phase, 20 physicians and 20 medical students from the Medical University of Vienna will be included. They will perform simulation-based training with a standardized scenario of a critically ill child with a hypovolemic shock. The main goal of this phase is to establish a baseline for the following two phases to generate comparative values regarding cognitive load and stress. In phase 2 and 3, the same participants will perform the same scenario in a VR setting. In both settings, on three set points of progression, one of three predefined events is triggered. For each event, three different stress levels (easy, medium, difficult) will be defined. Stress and cognitive load will be analyzed using the NASA Task Load Index, eye-tracking parameters, and heart rate. Subsequently, these values will be compared between VR training and traditional simulation-based training. Hypothesis: We hypothesize that the VR training and the traditional training groups will not differ in physiological response (cognitive load, heart rate, and heart rate variability). We further assume that virtual reality training can be used as cost-efficient additional training. Objectives: The aim of this study is to measure cognitive load and stress level during a real-life simulation training and compare it with VR training in order to show that VR training evokes the same physiological response and cognitive load as real-life simulation training.

Keywords: virtual reality, cognitive load, simulation, adaptive virtual reality training

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Authors: Aditi Taunk, George Iskander, Kitty Ka Kit Ho, Mark Willcox, Naresh Kumar

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Bacterial infections on biomaterial implants and medical devices accounts for 60-70% of all hospital acquired infections (HAIs). Treatment or removal of these infected devices results in high patient mortality and morbidity along with increased hospital expenses. In addition, with no effective strategies currently available and rapid development of antibacterial resistance has made device-related infections extremely difficult to treat. Therefore, in this project we have developed biomaterial surfaces using antibacterial compounds that inhibit biofilm formation by interfering with the bacterial communication mechanism known as quorum sensing (QS). This study focuses on covalent attachment of potent quorum sensing (QS) inhibiting compounds, halogenated furanones (FUs) and dihydropyrrol-2-ones (DHPs), onto glass surfaces. The FUs were attached by photoactivating the azide groups on the surface, and the acid functionalized DHPs were immobilized on amine surface via EDC/NHS coupling. The modified surfaces were tested in vitro against pathogenic organisms such as Staphylococcus aureus and Pseudomonas aeruginosa using confocal laser scanning microscopy (CLSM). Successful attachment of compounds on the substrates was confirmed by X-ray photoelectron spectroscopy (XPS) and contact angle measurements. The antibacterial efficacy was assessed, and significant reduction in bacterial adhesion and biofilm formation was observed on the FU and DHP coated surfaces. The activity of the coating was dependent upon the type of substituent present on the phenyl group of the DHP compound. For example, the ortho-fluorophenyl DHP (DHP-2) exhibited 79% reduction in bacterial adhesion against S. aureus and para-fluorophenyl DHP (DHP-3) exhibited 70% reduction against P. aeruginosa. The results were found to be comparable to DHP coated surfaces prepared in earlier study via Michael addition reaction. FUs and DHPs were able to retain their in vitro antibacterial efficacy after covalent attachment via azide chemistry. This approach is a promising strategy to develop efficient antibacterial biomaterials to reduce device related infections.

Keywords: antibacterial biomaterials, biomedical device-related infections, quorum sensing, surface functionalization

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Authors: Chante Van Tonder, Bart Bossink, Chris Schachtebeck, Cecile Nieuwenhuizen

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Small and Medium-Sized Enterprises (SMEs) play a key role in national economies around the world, being contributors to economic and social well-being. Due to this, the success, growth and competitiveness of SMEs are critical. However, there are many factors that undermine this, such as resource constraints, poor information communication infrastructure (ICT), skills shortages and poor management. The Fourth Industrial Revolution offers new tools and opportunities such as digital transformation and business model innovation (BMI) to the SME sector to enhance its competitiveness. Adopting and leveraging digital technologies such as cloud, mobile technologies, big data and analytics can significantly improve business efficiencies, value proposition and customer experiences. Digital transformation can contribute to the growth and competitiveness of SMEs. However, SMEs are lagging behind in the participation of digital transformation. Extant research lacks conceptual and empirical research on how digital transformation drives BMI and the impact it has on the growth and competitiveness of SMEs. The purpose of the study is, therefore, to close this gap by developing and empirically validating a conceptual model to determine if SMEs are achieving BMI through digital transformation and how this is impacting the growth, competitiveness and overall business performance. An empirical study is being conducted on 300 SMEs, consisting of 150 South-African and 150 Dutch SMEs, to achieve this purpose. Structural equation modeling is used, since it is a multivariate statistical analysis technique that is used to analyse structural relationships and is a suitable research method to test the hypotheses in the model. Empirical research is needed to gather more insight into how and if SMEs are digitally transformed and how BMI can be driven through digital transformation. The findings of this study can be used by SME business owners, managers and employees at all levels. The findings will indicate if digital transformation can indeed impact the growth, competitiveness and overall performance of an SME, reiterating the importance and potential benefits of adopting digital technologies. In addition, the findings will also exhibit how BMI can be achieved in light of digital transformation. This study contributes to the body of knowledge in a highly relevant and important topic in management studies by analysing the impact of digital transformation on BMI on a large number of SMEs that are distinctly different in economic and cultural factors

Keywords: business models, business model innovation, digital transformation, SMEs

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Authors: Mohd. Ashik Shahrier, Hiromi Wada

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Prenatal ethanol exposure has potential to induce difficulties in the social behavior of rats and can alter pup-dam communication suggesting that deficits in pups could result in altered dam behavior, which in turn could result in more aberrant behavior in the pup. Ultrasonic vocalization (USV) is a sensitive tool for investigating social behavior between rat pups and their dam. Rat pups produce USVs on separation from their dam. This signals the dam to locate her pups and retrieve them back to the nest. In this study, it was predicted that prenatal ethanol exposure cause alterations on the acoustic characteristics of USVs in rat pups. Thirteen pregnant rats were purchased and randomly assigned into three groups: high-ethanol (n = 4), low-ethanol (n = 5), and control (n = 4) groups. Laboratory ethanol (purity = 99.5%) was dissolved in tap water and administered to the high- and low-ethanol groups as drinking water from gestational days (GD) 8-20. Ethanol-containing water was administered to the animals in three stages by gradually increasing the concentration between GDs 8–20. From GDs 8–10, 10% and 5%, from GDs 11–13, 20% and 10%, and from GDs 14–20, 30% and 15% ethanol-containing water (v/v) was administered to the high- and low-ethanol groups, respectively. Tap water without ethanol was given to the control group throughout the experiment. The day of birth of the pups was designated as postnatal day (PND) 0. On PND 4, each litter was culled to four male and four female pups. For the present study, two male and two female pups were randomly sampled from each litter as subjects. Thus, eight male and eight female pups from the high-ethanol and control groups and another 10 male and 10 female pups from the low-ethanol group, were sampled. An ultrasonic microphone and the Sonotrack system version 2.4.0 (Metris, Hoofddorp, The Netherlands) were used to record and analyze USVs of the pups. On postnatal days 4, 8, 12 and 16, the resultant pups were individually isolated from their dams and littermates, and USVs were recorded for 5 min in a sound-proof box. Pups in the high-ethanol group produced greater number of USVs compared with that in both low-ethanol and control groups on PND 12. Rat pups in the high-ethanol group also produced higher mean, minimum, and maximum fundamental frequencies of USVs compared with that in both low-ethanol and control groups. Male pups in the high-ethanol group had higher USV amplitudes than in those in low-ethanol and control groups on PND 12. These results suggest that pups in the high-ethanol group relatively experienced more negative emotionality due to the ethanol-induced neuronal activation in the core limbic system and tegmental structures and accordingly, produced altered USVs as distress calls.

Keywords: emotionality, ethanol, maternal separation, ultrasonic vocalization

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Authors: Mahtab Makaremi Masouleh, Günter Wozniak

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This research is part of an interdisciplinary project, promoting the design of a light temporary installable textile defence system against flood. In case river water levels increase abruptly especially in winter time, one can expect massive extra load on a textile protective structure in term of impact as a result of floating debris and even tree trunks. Estimation of this impulsive force on such structures is of a great importance, as it can ensure the reliability of the design in critical cases. This fact provides the motivation for the numerical analysis of a fluid structure interaction application, comprising flexible slender shaped and free-surface water flow, where an accelerated heavy flotsam tends to approach the membrane. In this context, the analysis on both the behavior of the flexible membrane and its interaction with moving flotsam is conducted by finite elements based solvers of the explicit solver and implicit Abacus solver available as products of SIMULIA software. On the other hand, a study on how free surface water flow behaves in response to moving structures, has been investigated using the finite volume solver of Star CCM+ from Siemens PLM Software. An automatic communication tool (CSE, SIMULIA Co-Simulation Engine) and the implementation of an effective partitioned strategy in form of an implicit coupling algorithm makes it possible for partitioned domains to be interconnected powerfully. The applied procedure ensures stability and convergence in the solution of these complicated issues, albeit with high computational cost; however, the other complexity of this study stems from mesh criterion in the fluid domain, where the two structures approach each other. This contribution presents the approaches for the establishment of a convergent numerical solution and compares the results with experimental findings.

Keywords: co-simulation, flexible thin structure, fluid-structure interaction, implicit coupling algorithm, moving flotsam

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Authors: Cristiane R. Magalhaes

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Advances in Information and Communication Technologies (ICT) have led to changes in different sectors particularly in architecture, engineering, construction, and operation (AECO) industry. In this context, the advent of BIM (Building Information Modeling) has brought a number of opportunities in the field of the digital architectural design process bringing integrated design concepts that impact on the development, elaboration, coordination, and management of ventures. The project scope has begun to contemplate, from its original stage, the third dimension, by means of virtual environments (VEs), composed of models containing different specialties, substituting the two-dimensional products. The possibility to simulate the construction process of a venture in a VE starts at the beginning of the design process offering, through new technologies, many possibilities beyond geometrical digital modeling. This is a significant change and relates not only to form, but also to how information is appropriated in architectural and engineering models and exchanged among professionals. In order to achieve the main objective of this work, the Design Science Research Method will be adopted to elaborate an artifact containing strategies for the application and use of ICTs from BIM flows, with pre-construction cut-off to the execution of the building. This article intends to discuss and investigate how BIM can be extended to the site acting as a protagonist and link between the Virtual Environments and the Real-World, as well as its contribution to the integration of the value chain and the consequent increase of efficiency in the production of the building. The virtualization of the design process has reached high levels of development through the use of BIM. Therefore it is essential that the lessons learned with the virtual models be transposed to the actual building production increasing precision and efficiency. Thus, this paper discusses how the Fourth Industrial Revolution has impacted on property developments and how BIM could be the propellant acting as the main fuel and link between the virtual environment and the real production for the structuring of flows, information management and efficiency in this process. The results obtained are partial and not definite up to the date of this publication. This research is part of a doctoral thesis development, which focuses on the discussion of the impact of digital transformation in the construction of residential buildings in Brazil.

Keywords: building information modeling, building production, digital transformation, ICT

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Authors: Xiaoshuang Jia, Huiling Feng, Li Niu, Wei Hai

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Led by Humanistic Beijing Studies Center in Renmin University of China, My Peking Memory Project(MPMP) is a long-time digital memory project under guarantee of public participation to enable the cultural and intellectual memory of Beijing to be collected, organized, preserved and promoted for discovery and research. Taking digital memory as a new way, MPMP is an important part of Peking Memory Project(PMP) which is aimed at using digital technologies to protect and (re)present the cultural heritage in Beijing. The key outcome of MPMP is the co-building of a total digital collection of knowledge assets about Beijing. Institutional memories are central to Beijing’s collection and consist of the official published documentary content of Beijing. These have already fall under the archival collection purview. The advances in information and communication technology and the knowledge form social memory theory have allowed us to collect more comprehensively beyond institutional collections. It is now possible to engage citizens on a large scale to collect private memories through crowdsourcing in digital formats. Private memories go beyond official published content to include personal narratives, some of which are just in people’s minds until they are captured by MPMP. One aim of MPMP is to engage individuals, communities, groups or institutions who have formed memories and content about Beijing, and would like to contribute them. The project hopes to build a culture of remembering and it believes ‘Every Memory Matters’. Digital memory contribution was achieved through the development of the MPMP. In reducing barriers to digital contribution and promoting high public Participation, MPMP has taken explored the harvesting of transcribe service for digital ingestion, mobile platform and some off-line activities like holding social forum. MPMP has also cooperated with the ‘Implementation Plan of Support Plan for Growth of Talents in Renmin University of China’ to get manpower and intellectual support. After six months of operation, now MPMP have more than 2000 memories added and 7 Special Memory Collections now online. The work of MPMP has ultimately helped to highlight the important role in safeguarding the documentary heritage and intellectual memory of Beijing.

Keywords: digital memory, public participation, MPMP, cultural heritage, collection

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Authors: Rui Zhang

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Translation has been elevated to one of the key notions in contemporary cultural discourse for a wide range of fields. It focuses not only on communication or transmission of meaning between different languages, but also on ways in which the very act of translation can be understood as a metaphor for cultural process. In recent years, the notion of translation is employed by some contemporary Chinese artists in a conceptual way, whose works contribute to constructing/deconstructing global/local cultural discourse and their own cultural identities. This study examines two artworks by contemporary Chinese artist Gu Wenda from a translational perspective, namely Forest of Stone Steles - Retranslation & Rewriting of Tang Poetry and United Nations - China Monument: Temple of Heaven, aiming to broaden the scope of Translation Studies to investigate visual culture and enrich methodological approach to contemporary Chinese art. Focusing on the relationship between translation, visuality and materiality in these two works, this study explores the nature of translation as part of the production of cultural discourse in the age of globalization as well as a way of establishing cultural identity. Gu Wenda, one of the most prestigious artists in contemporary China, is considered a pioneer in ‘85 Art Movement of China, and thereafter he went abroad for his artistic pursuits. His transnational experience enriches his cultural identity and the underlying discourse constructed/deconstructed in many of his works. In the two works already mentioned, the concept of translation is deployed by Gu Wenda on both linguistic level and metaphorical level for artistic expression. These two works produce discourses in which the artist’s perception of cultural identity in a transnational context is articulated by the tension between source text and target text. Based on the conceptual framework of cultural identity proposed by Stuart Hall, analyses of Gu Wenda’s cultural identity revealed through translation in these two works are centred on two axes, i.e., the axis of similarity and continuity with Chinese intellectual culture and the axis of difference and rupture with it, and the dialogic relationship between these two vectors. It argues that besides serving as a means of constructing visuality in the two works, translation metaphorizes Gu Wenda’s journey from overcoming his cultural identity anxiety to re-establishing a transcultural identity embedded in the underlying discourse.

Keywords: contemporary Chinese art, cultural identity, transculturality, translation

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Authors: Josée Charette

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The academic and educational success of immigrant students is a current issue in education, especially in western societies such in the province of Quebec, in Canada. For people who immigrate with school-age children, the success of the family’s migratory project is often measured by the benefits drawn by children from the educational institutions of their host society. In order to support the academic achievement of their children, immigrant parents try to develop practices that derive from their representations of school and related challenges inspired by the socio-cultural context of their country of origin. These findings lead us to the following question: How does strategies implemented by immigrant parents to manage the representational distance between school of their country of origin and school of the host society support or not the academic and educational success of their child? In the context of a qualitative exploratory approach, we have made interviews in the French-, English- and Spanish-languages with 32 newly immigrated parents and 10 of their children. Parents were invited to complete a network of free associations about «School in Quebec» as a premise for the interview. The objective of this communication is to present strategies implemented by immigrant parents to manage the distance between their representations of schools in their country of origin and in the host society, and to explore the influence of this management on their child’s academic and educational trajectories. Data analysis led us to develop various types of strategies, such as continuity, adaptation, resources mobilization, compensation and "return to basics" strategies. These strategies seem to be part of a continuum from oppositional-conflict scenario, in which parental strategies act as a risk factor, to conciliator-integrator scenario, in which parental strategies act as a protective factor for immigrant students’ academic and educational success. In conclusion, we believe that our research helps in providing a more efficient support to immigrant parents and contributes to develop a wider portrait of immigrant students’ academic achievement. In addition, we think that by improving the experience of immigrant families in Quebec schools, a greater number of migratory projects will be effective.

Keywords: immigrant students, family’s migratory project, school of origin and school of host society, immigrants parental strategies

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Authors: Sana Zia

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One of the most important questions for research on Muslim women's representation is the relationship between Islam and women’s situation in Islamic countries. In this context, certain questions can be raised like is it possible to analyze women’s situation in Islamic countries like Pakistan? Or what is the relationship between Islam and patriarchy? So this paper will examine all these questions by analysing Muslim women's representation in Pakistani Cinema. It is also significant to note that despite political and religious constraints in Muslim countries, in particular, Pakistan, women have not only been part of the film industry for long, but they also have chosen films as their feminist tool to question and expose the effects of patriarchy, religious fundamentalism, and gender-specific socio-cultural oppression. The religious-cultural ethos that could include gender-specific restrictions and limitations on their creative expression as Muslim women in an Islamic society. A new wave of Pakistani cinema is pivoting around strong Muslim female characters and opened up a new thought about Islamic women.Their contributions and success through this medium emphasized the need to investigate the significance and effectiveness of contemporary cinema as a tool of resistance and cross-cultural communication in a Muslim society. So this research can also provide a better understanding about Islam that needs to be modernized and reclaimed from the clutches of fundamentalism and extremism. This paper thus investigates the interrelation of women's representation and Pakistani cinema by analysing two films ‘Bol: To speak up’ and ‘Dukhter: Daughter’. The feminist analysis of these films not only helps to understand the new trends and dimensions in representation of Muslim women in Pakistani cinema, but this also helps to raise awareness globally regarding the depiction of Muslim women. So to foreground the above mentioned discussion, the films under study helps to evaluate their significance, the role they play towards activism, resistance, and global awareness in terms of what could be termed as a Muslim woman. The paper thus provides a valuable insight that how and why Islam is being used as a mechanism to merge social, political and economic factors to define the rights and conditions of Pakistani Muslim women and highlight the cinematic struggle of the film maker’s which by using films as an awareness tool are going to highlight the problems and issues of Muslim women in the global world.

Keywords: Muslim women, Pakistani cinema, patriarchy, religious fundamentalism

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Authors: Ann Devitt, Mairead Brady, Markus Lamest, Stephen Gomez

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This study set out to explore the use of an online collaborative serious game for student learning in a postgraduate introductory marketing module. The simulation game aimed to bridge the theory-practice divide in marketing by allowing students to apply theory in a safe, simulated marketplace. This study addresses the following research questions: Does an online marketing simulation game engage students higher order cognitive skills? Does collaborative activity required develop students’ “soft” skills, such as communication and negotiation? What specific affordances of the online simulation promote learning? This qualitative case study took place in 2014 with 40 postgraduate students on a Business Masters Programme. The two-week intensive module combined lectures with collaborative activity on a marketing simulation game, MMX from Pearsons. The game requires student teams to compete against other teams in a marketplace and design a marketing plan to maximize key performance indicators. The data for this study comprise essays written by students after the module reflecting on their learning on the module. A thematic analysis was conducted of the essays using the following a priori theme sets: 6 levels of the cognitive domain of Blooms taxonomy; 5 principles of Cooperative Learning; affordances of simulation environments including experiential learning; motivation and engagement; goal orientation. Preliminary findings would strongly suggest that the game facilitated students identifying the value of theory in practice, in particular for future employment; enhanced their understanding of group dynamics and their role within that; and impacted very strongly, both positively and negatively on motivation. In particular the game mechanics of MMX, which hinges on the correct identification of a target consumer group, was identified as a key determinant of extrinsic and intrinsic motivation for learners. The findings also suggest that the situation of the simulation game within a broader module which required post-game reflection was valuable in identifying key learning of marketing concepts in both the positive and the negative experiences of the game.

Keywords: simulation, marketing, serious game, cooperative learning, bloom's taxonomy

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Authors: Masami Usui

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After 9/11, the American literary scene was confronted with new perspectives that enabled both writers and readers to recognize the hidden aspects of their political, economic, legal, social, and cultural phenomena. There appeared an argument over new and challenging multicultural aspects after 9/11 and this argument is presented by a tension of space related to 9/11. In Amy Waldman’s the Submission (2011), designing both the memorial park and the family network has a significant meaning in establishing the progress of understanding from multiple perspectives. The most intriguing and controversial topic of racism is reflected in the Submission, where one young architect’s blind entry to the competition for the memorial of Ground Zero is nominated, yet he is confronted with strong objections and hostility as soon as he turns out to be a Muslim named Mohammad Khan. This ‘Khan’ issue, immediately enlarged into a social controversial issue on American soil, causes repeated acts of hostility to Muslim women by ignorant citizens all over America. His idea of the park is to design a new concept of tracing the cultural background of the open space. Against his will, his name is identified as the ‘ingredient’ of the networking of the resistant community with his supporters: on the other hand, the post 9/11 hysteria and victimization is presented in such family associations as the Angry Family Members and Grieving Family Members. These rapidly expanding networks, whether political or not, constructed by the internet, embody the contemporary societal connection and representation. The contemporary quest for the significance of human relationships is recognized as a quest for global peace. Designing both the memorial park and the communication networks strengthens a process of facing the shared conflicts and healing the survivors’ trauma. The tension between the idea and networking of the Garden for the memorial site and the collapse of Ground Zero signifies the double mission of the site: to establish the space to ease the wounded and to remember the catastrophe. Reading the design of these icons of 9/11 in the Submission means that decoding the myth of globalization and its representations in this century.

Keywords: American literature, cultural studies, globalization, literature of catastrophe

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Authors: Maryam Nzari

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Today, with the advancement of Internet technology, one of the tools used by humans is a tool that allows them to do what they need easily. Online platforms in different forms and by providing different services make it possible for users to communicate with each other and users with platforms. Audience communication with mass media is not the same as in the past. Today the conditions are different; With online platforms that provide the latest news minute by minute, he has access to all the content and can choose more quickly and easily. According to professionals Galloway, Apple, Amazon, Facebook and Google companies create a wide range. They are among the products and services that are connected with the daily life of billions of people all over the planet. Over time, platforms gain high economic value and in this way gain power that will influence the social, cultural, economic and political aspects of people’s lives. As a result of the effects of the process of platformization on all areas of individual and collective life, we now live in a platform society, which communicates It is close to “platform politics”. Nowadays, with social media platforms, users can interact with many people and people can share their data on various topics with others in this space. In this research, what will be investigated is the role of these online platforms in economic growth and the introduction of local culture areas in tourist areas. Tourism in a region is linked with various factors; One of the important factors that attract tourists to a region is its culture, and on the other hand, this culture can also affect economic growth. Without a proper understanding of the culture of these tourist areas, it is not possible to plan properly for the growth of the tourism industry and the subsequent increase in economic growth. The interaction of local people and tourists will have social and cultural effects on each other and will give them the opportunity to get to know each other. Therefore, the purpose of this research is to examine issues such as the role that online platforms play in cultural interaction in tourist areas and to understand that online platforms are only seeking to show the good aspects of a region and then generate enough extra income or that platforms can They play a role beyond what we imagine and introduce the culture of a region in a proper way so that we don’t see disagreements in the tourism planning of that region. in this article It has been tried by using library and field methods Answer the questions.

Keywords: online platforms, economic growth, culture Indigenous, tourism

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Authors: Bintou Jobe

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The construction sector, both in the United Kingdom (UK) and developing Anglophone West African countries, specifically The Gambia, is facing significant health and safety challenges. While the UK has established legislation and regulations to support Occupational Health and Safety (OHS) in the industry, the same level of support is lacking in developing countries. The significance of this review is to assess the extent and effectiveness of OHS legislation and regulatory reform in the construction industry, with a focus on understanding the challenges faced by both the UK and developing Anglophone West African countries. It aims to highlight the benefits of implementing an OHS management system, specifically ISO 45001. This study uses a literature review approach, synthesizing publications from the past decade and identifying common themes and best practices related to Occupational Health and Safety in the construction industry. Findings were analysed, compared, and conclusions and recommendations were drawn after developing research questions and addressing them. This comprehensive review of the literature allows for a detailed understanding of the challenges faced by the industry in both contexts. The findings of the study indicate that while the UK has established robust health and safety legislation, many UK construction companies have not fully met the standards outlined in ISO 45001. These challenges faced by the UK include poor data management, inadequate communication of best practices, insufficient training, and a lack of safety culture mirroring those observed in the developing Anglophone countries. Therefore, compliance with OHS management systems has been shown to yield benefits, including injury prevention and centralized health and safety documentation. In conclusion, the effectiveness of OHS legislation for developing Anglophone West African countries should consider the positive impact experienced by the UK. The implementation of ISO 45001 can serve as a benchmark standard and potentially inform recommendations for developing countries. The selection criteria for literature include search keywords and phrases, such as occupational health and safety challenges, The Gambia, developing countries management systems, ISO 45001, and impact and effectiveness of OHS legislation. The literature was sourced from Google Scholar, the UK Health and Safety Executive websites, and Google Advanced Search.

Keywords: ISO 45001, developing countries, occupational health and safety, UK

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Authors: Akriti Kafle Baral, Ruixing Zhang, Dzifa K Lalit, Manthar M Alli

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Introduction: Hemodialysis is the most common type of dialysis globally approximately million are reported to receive this type of dialysis. Psychosocial issues in hemodialysis are the psychological and socioeconomic burdens emanating from the initiation and course of treatment and have the potential for gross deterioration in the quality of life and general well-being of patients. Understanding the psychosocial issues and needs of patients undergoing hemodialysis could pave the way for comprehensive support and therapies designed to reduce stress, improve social support, and foster mental resilience. Objectives: The aim of this study was to explore the psychosocial issues and support needs of patients undergoing hemodialysis at a tertiary care center in Nepal. Methods: A qualitative descriptive study was conducted among 20 purposefully selected patients attending hemodialysis treatment at Pokhara Academy of Health Sciences, Nepal. Data was analyzed via thematic analysis. Results: The study resulted in three major themes which included Emotional, psychological, and spiritual struggles, Social and economic impacts, and Support and information needs. Moreover, 16 sub-themes emerged which are Frustration with daily life, Constant fear of death, Thoughts of self-harm, Perceived Burden on Family, Sense of Divine Punishment, Sense of Unfairness, Fear about future uncertainties, Social avoidance, Social stigmatization, Loss of employment, Financial strain, Transportation challenges, Need for early, clear and comprehensive information, Need for support and reassurance from family, Support through peer connections, and Reassurance from healthcare providers. Conclusion: The findings of this study indicate that patients undergoing hemodialysis in Nepal experience numerous hardships and multifaceted struggles that require support from different dimensions. Establishing robust support systems that include family involvement, peer networks, and effective communication from healthcare professionals can significantly mitigate feelings of anxiety and isolation.

Keywords: hemodialysis, psychosocial issues, support needs, chronic kidney disease, end stage renal disease, Nepal

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Authors: Manahil Alfuraydan, Jodie Croxall, Lisa Hurt, Mike Kerr, Sinead Brophy

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Autism Spectrum Disorder (ASD) is a developmental condition characterised by impairment in terms of social communication, social interaction, and a repetitive or restricted pattern of interest, behaviour, and activity. There is a significant delay between seeking help and a confirmed diagnosis of ASD. This may result in delay in receiving early intervention services, which are critical for positive outcomes. The long wait times also cause stress for the individuals and their families. Telehealth potentially offers a way of improving the diagnostic pathway for ASD. This review of the literature aims to examine which telehealth approaches have been used in the diagnosis and assessment of autism in children and adults, whether they are feasible and acceptable, and how they compare with face-to-face diagnosis and assessment methods. A comprehensive search of following databases- MEDLINE, CINAHL Plus with Full text, Business Sources Complete, Web of Science, Scopus, PsycINFO and trail and systematic review databases including Cochrane Library, Health Technology Assessment, Database of Abstracts and Reviews of Effectiveness and NHS Economic Evaluation was conducted, combining the terms of autism and telehealth from 2000 to 2018. A total of 10 studies were identified for inclusion in the review. This review of the literature found there to be two methods of using telehealth: (a) video conferencing to enable teams in different areas to consult with the families and to assess the child/adult in real time and (b) a video upload to a web portal that enables the clinical assessment of behaviours in the family home. The findings were positive, finding there to be high agreement in terms of the diagnosis between remote methods and face to face methods and with high levels of satisfaction among the families and clinicians. This field is in the very early stages, and so only studies with small sample size were identified, but the findings suggest that there is potential for telehealth methods to improve assessment and diagnosis of autism used in conjunction with existing methods, especially for those with clear autism traits and adults with autism. Larger randomised controlled trials of this technology are warranted.

Keywords: assessment, autism spectrum disorder, diagnosis, telehealth

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Authors: Min Wei

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Objectives: Experience tourism represents an advanced stage of tourism compared with sightseeing tourism and relaxation tourism. Experience tourism reflects the full respect of experience economy to the human natures. This paper chose one of the most popular ocean tourism products in Zhoushan, as a subject and investigated the constructive elements in tourist experience based on the needs of tourists. Methods: This paper started with the influences of tourism product innovation on tourist experience, then proposed a model of the relationship between tourist experience, tourist satisfaction, and the following behavior of tourists, and concluded that tourist experience improves tourist satisfaction and thereby enhances tourist loyalty based on the developmental pathway of experience tourism. To ensure the accuracy of the collected data of the research results, the sample of this questionnaire survey is chosen by the method of occasional sampling, combined with the judgment of the investigators and the convenience of the questionnaire survey, the survey objects are selected from the scenic spots of Putuo Mountain, Zhujiajian, Taohua Island, waiting room of passenger terminal, etc. Before filling in the questionnaire, the author and the respondents have a short communication. On the premise that the respondents can fully understand the purpose and content of the questionnaire, tourists fill in the questionnaire independently and collect it on the spot. Results: The research results of this paper are mainly embodied in the following aspects: it is concluded that there are many constructive factors of tourists' experience in Zhoushan tourism products. Based on Zhoushan tourism products, this paper explores the constructive factors of tourists' experience in Zhoushan tourism products from three aspects: attracting object experience, facility experience and service experience. At present, there are still big differences between Zhoushan tourism products, tourists’ expectations and tourists' experience, mainly in the aspects of transportation, publicity and tour guide service. Corresponding measures should be taken to improve tourists' experience quality and satisfaction. Conclusions: The influence factors of island tourism products are discriminated, and established a structural model of tourist experience, which includes three basic elements: attractions, facilities, and services. This model was further verified by questionnaires and analyses in Putuo Shan, Zhujia Jian, and Taohua Island. Finally, we combined this model and made some suggestions on boost the satisfaction of Zhoushan islands.

Keywords: experience tourism, tourists’ expectations, tourists' experience, tourism products

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Authors: F. DelGaudio, H. Gill

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Resuscitation during cardiopulmonary (CPA) arrest is dynamic, high stress, high acuity situation, which can easily lead to communication breakdown, and errors. The care of these high acuity patients has also been shown to increase physiologic stress and task saturation of providers, which can negatively impact the care being provided. These difficulties are further complicated during a global pandemic and pose a significant safety risk to bedside providers. Nurse-led codes are a relatively new concept that may be a potential solution for alleviating some of these difficulties. An experienced nurse who has completed advanced cardiac life support (ACLS), and additional training, assumed the responsibility of directing the mechanics of the appropriate ACLS algorithm. This was done in conjunction with a physician who also acted as a physician leader. The additional nurse-led code training included a multi-disciplinary in situ simulation of a CPA on a suspected COVID-19 patient. During the CPA, the nurse leader’s responsibilities include: ensuring adequate compression depth and rate, minimizing interruptions in chest compressions, the timing of rhythm/pulse checks, and appropriate medication administration. In addition, the nurse leader also functions as a last line safety check for appropriate personal protective equipment and limiting exposure of staff. The use of nurse-led codes for CPA has shown to decrease the cognitive overload and task saturation for the physician, as well as limiting the number of staff being exposed to a potentially infectious patient. The real-world application has allowed physicians to perform and oversee high-risk procedures such as intubation, line placement, and point of care ultrasound, without sacrificing the integrity of the resuscitation. Nurse-led codes have also given the physician the bandwidth to review pertinent medical history, advanced directives, determine reversible causes, and have the end of life conversations with family. While there is a paucity of research on the effectiveness of nurse-led codes, there are many potentially significant benefits. In addition to its value during a pandemic, it may also be beneficial during complex circumstances such as extracorporeal cardiopulmonary resuscitation.

Keywords: cardiopulmonary arrest, COVID-19, nurse-led code, task saturation

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