Search results for: guidance needs

Authors: Tyrus C. Torres, Michael Harris

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In a coastal town of Ecuador, the role of women is commonly defined as an ama de casa, a woman who works in the house, raises children, and contributes to the community. This project, under the guidance of Dr. Michael Harris from the Florida Atlantic University, seeks to understand how the role of an ama de casa provides a secure environment for men and women, coexists with economic and environmental constraints that explain the origins of how this environment has been formed. The coastal community aspects of familia (family), trabajo (work), relación (relationships), machismo (masculinity), feminista (femininity), and the culture of Ecuador define the ways of life in a coastal setting. This ethnographic research project included the following methodologies: environment mapping, conducting interviews, surveys, participant observation, direct and indirect observations, and integration into daily life. Immersion into the daily life and building relationships with the local people allowed the documentation of intricacies of both the cultural and social spheres. The findings of this research offer insight on how culture, economics, and environment can form female and male agency. Our investigation shows that occupations such as fishermen, laborers, ama de casas, and even students utilize occupational routes to create social agency in the face of economic and environmental constraints in Ecuador.

Keywords: Ecuador, ethnography, gender division of labor, gender roles

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Authors: Bheeshma B., Mathivanan N., Manoj Deepak M., Prabhu Thangaraju, K. Venkatachalam

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This study involves the effect of autologous blood injection for patients who had degeneration of the origin of extensor carpi radialis brevis which was confirmed radio logically and by ultrasound examination and failed cortisone injections to the lateral epicondylitis. In this prospective longitudinal series involves pre-injection assessment of grip strength, pain, and function, using the patient-rated tennis elbow evaluation. In this study, blood from the contralateral limb is taken and injected into the affected limb with the help of ultrasound guidance and then the patient wore a customized wrist support for five days, after which they were commenced with stretching, strengthening, and massage programme with an occupational therapist. In these patients assessment was done after six months and then finally at 12 months after injection, using the patient-rated tennis elbow evaluation. 50 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not. Our study thus concludes that autologous blood injection show significant improvement in pain and function in patients with chronic lateral epicondylitis, who did not have relief with cortisone injection.

Keywords: lateral epicondylitis, autologous blood injection, conservative treatment, plasma-rich proteins (PRPs)

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Authors: Mohamad Alnajem

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Purpose: To measure the readiness of the Kuwaiti small and medium sized manufacturing industries (K-SMMIs) to implement the lean system (LS) through an evaluation of their existing quality practices, and compare such readiness among different product sectors and ownership types. Design/methodology/approach: This study adopts the measurement framework developed by Al-Najem et al. (2013), which establishes six constructs related to lean quality practices, namely: process, planning and control, customer relations, suppliers relations, HR, and top management and leadership. Data were collected from a survey of 50 K-SMMIs operating in different industrial sectors. One research question and two hypotheses were developed and tested using t-test and Levene’s test, descriptive analysis, and one-way ANOVA. Findings: The results demonstrate that the K-SMMIs are far from being ready to implement lean. In addition, the study found that product sector and ownership type have no significant impact on the lean readiness in the K-SMMIs. Practical implications: This research provides insight into preparing Kuwaiti, and other SMMIs, to implement the LS by creating an assessment of their existing lean practices and readiness. Originality/value: This research is among a limited number of studies that have addressed lean within the Arab region, and only the second to examine the level of lean readiness of the K-SMMIs. It expands the literature on lean in developing countries, particularly in the Arab region, and can provide guidance to research within other countries in the region.

Keywords: Kuwaiti small and medium sized industries, lean system, lean readiness, manufacturing industries

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Authors: Ma Chaoyang

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This article starts from the perspective of environmental justice theory and analyzes the accessibility and regional equity of park green spaces in the central urban area of Chengdu in 2022 based on the improved Gaussian 2SFCA analysis method and Gini coefficient method. Then, according to the relevant analysis model, it further explores the correlation between the spatial distribution of park green spaces and the socio-economic conditions of residents in order to provide a reference for the construction and research of Chengdu's park city under the guidance of fairness and justice. The results show that: (1) Overall, the spatial distribution of parks and green spaces in Chengdu shows a significantly uneven distribution of extreme core edge, with a certain degree of unfairness; that is, there is an environmental injustice pattern. (2) The spatial layout of urban parks and green spaces is subject to strong guiding interference from the socio-economic level; that is, there is a high correlation between housing prices and the tendency of parks. (3) Green space resources Gini coefficient analysis shows that residents of the three modes of transportation in the study area have unequal opportunities to enjoy park and green space services, and the degree of unfairness in walking is much greater than that in cycling and cycling.

Keywords: parks and green spaces, environmental justice, two step mobile search method, Gini coefficient, spatial distribution

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Authors: Toni Buterin, Robert Doričić

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Mainstream bioethics, narrowed down mainly to human medicine and research, can hardly be expected to efficiently face modern challenges related to environmental issues. Departing from the interpretation of "European Bioethics" as a discipline considering ethical duties not only toward fellow humans, but to all living beings, this paper presents the results of a study conducted in three communities in Croatian Northern Adriatic region, selected for their recent experience of ecological threats (Labin – thermo-electric power plant; Bakar – cokery), or representing a highly-valuable and vulnerable natural insular pocket (Mali Lošinj – health tourism, dolphin wildlife refuge, fragrant gardens programme, etc.). After targeted workshops and interviews had been organised in those communities, the results of the obtained insights were combined with experts' opinion and a list of around hundred “bioethical standards” was formed. "Bioethical standards" represent a set of principles and measures of the correct attitude of people towards their own health, animals, plants, and the eco-system as a whole. "Bioethical standards" charter might improve the level of local community environmental consciousness, and provide direct guidance for its sustainable development (including its tourism-advertising ace card). The present paper discusses the standards' potential benefits and some implementational risks.

Keywords: bioethical standards, croatia, European bioethics, local communities

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Authors: Ferdinando Montemari, Antonio Vitale, Nicola Genito, Luca Garbarino, Urbano Tancredi, Domenico Accardo, Michele Grassi, Giancarmine Fasano, Anna Elena Tirri

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The development of guidance, navigation and control algorithms and avionic procedures requires the disposability of suitable analysis and verification tools, such as simulation environments, which support the design process and allow detecting potential problems prior to the flight test, in order to make new technologies available at reduced cost, time and risk. This paper presents a simulation environment for avionic software development and qualification, especially aimed at equipment for general aviation aircrafts and unmanned aerial systems. The simulation environment includes models for short and medium-range radio-navigation aids, flight assistance systems, and ground control stations. All the software modules are able to simulate the modeled systems both in fast-time and real-time tests, and were implemented following component oriented modeling techniques and requirement based approach. The paper describes the specific models features, the architectures of the implemented software systems and its validation process. Performed validation tests highlighted the capability of the simulation environment to guarantee in real-time the required functionalities and performance of the simulated avionics systems, as well as to reproduce the interaction between these systems, thus permitting a realistic and reliable simulation of a complete mission scenario.

Keywords: ADS-B, avionics, NAVAIDs, real-time simulation, TCAS, UAS ground control station

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Authors: Eftah Bte. Moh Hj Abdullah, Abd Aziz Bin Abd Shukor, Norazilawati Binti Abdullah, Rahimah Adam, Othman Bin Lebar

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The competency and integrity required for better understanding and practice of School-based Assessment (PBS) comes not only from the process, but also in providing the support or ‘scaffolding’ for teachers to recognize the student as a learner, improve their self-assessment skills, understanding of the daily teaching plan and its constructive alignment of the curriculum, pedagogy and assessment. The cultivation of integrity in PBS among the teachers is geared towards encouraging them to become committed and dedicated in implementing assessments in a serious, efficient manner, thus moving away from the usual teacher-focused approach to the student-focused approach. The teachers show their integrity via their professional commitment, responsibility and actions. The module based on the cultivation of integrity in PBS among Malaysian teachers aims to broaden the guidance support for teachers (embedded in the training), which consists of various domains to enable better evaluation of complex assessment tasks and the construction of suitable instrument for measuring the relevant cognitive, affective and psychomotor domains to describe the students’ achievement. The instrument for integrity cultivation in PBS has been developed and validated for measuring the effectiveness of the module constructed. This module is targeted towards assisting the staff in the Education Ministry, especially the principal trainers, teachers, headmasters and education officers to acquire effective intervention for improving the PBS assessors’ integrity and competency.

Keywords: school-based assessment, assessment competency integrity cultivation, professional commitment, module

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Authors: Lina Yang, Mao Wen, Jianhong Chen, Kan Zhang

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Molybdenum disulfide (MoS₂) represents a highly sought lubricant for reducing friction based on intrinsic layered structure, but for this reason, practical applications have been greatly restricted due to the fact that its low hardness would cause severe wear. Here, a novel TiMoN/MoSₓ composite coatings with TiMoN solid solution grains embedded into MoSₓ-based amorphous matrix has been successfully designed and synthesized, through magnetron co-sputtering technology. Desirably, in virtue of such special microstructure, superhardness and excellent toughness can be well achieved, along with an ultra-low wear rate at ~2×10⁻¹¹ mm³/Nm in the air environment, simultaneously, low friction at ~0.1 is maintained. It should be noted that this wear level is almost two orders of magnitude lower than that of pure TiN coating, and is, as we know, the lowest wear rate in dry sliding. Investigations of tribofilm reveal that it is amorphous MoS₂ in nature, and its formation arises directly from the MoSₓ amorphous matrix. Which contributes to effective lubrication behavior, coupled with excellent mechanical performances of such composite coating, exceptionally low wear can be guaranteed. The findings in this work suggest that the special composite structure makes it possible for the synthesis of super-hard and super-durable lubricative coating, offering guidance to synthesize ultrahigh performance protective coating for industrial application.

Keywords: hardness, MoS₂-containing composite coatings, toughness, tribological properties

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Authors: Bachir Nora

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Integrating vegetation into urban environments is crucial for enhancing quality of life, particularly through microclimate regulation and the reduction of urban heat islands. This study investigates the impact of different street tree species on the urban microclimate in the El-Houria neighborhood of Mostaganem, Algeria, using the ENVI-met software for advanced environmental simulations. it focused on three tree species—Robinia pseudo-acacia, Populus alba, and Jacaranda mimosifolia—to evaluate their effectiveness in influencing key meteorological parameters, including air temperature, mean radiant temperature, surface temperature, and the predicted percentage of dissatisfied (PPD) thermal comfort index. Statistical analyses were conducted to compare these parameters across different tree species, ensuring the robustness of our findings. Our results indicate that Robinia pseudo-acacia is the most effective species, capable of reducing air temperature by up to 1°C and surface temperature by up to 12°C. These findings underscore the importance of strategically selecting tree species to mitigate the effects of climate change, improve thermal comfort, and reduce energy consumption in urban settings. The study offers valuable insights for urban planners and policymakers, providing practical guidance for sustainable urban design practices tailored to the Algerian context.

Keywords: heat islands, microclimate simulation, street tree alignment, sustainable urban design, thermal comfort.

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Authors: Orla McConnell, Cormac MacMahon, Jen Harvey

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Ireland’s national professional development framework for those who teach in higher education, aims to provide guidance and leadership in the planning, developing and engaging in professional development practices. A series of pilot projects have been initiated to help explore the framework’s likely utility and acceptance by educators and their institutions. These projects require engagement with staff in the interpretation and adaption of the framework within their working contexts. The purpose of this paper is to outline the development of one such project with engineering educators at three Institutes of Technology seeking designation as a technological university. The initiative aims to gain traction in the acceptance of the framework with the engineering education community by linking core and discipline-specific teaching and learning competencies with professional development activities most valued by engineering educators. Informed by three strands of literature: professional development in higher education; engineering education; and teaching and learning training provisions, the project begins with a survey of all those involved in teaching and learning in engineering across the three institutes. Based on engagement with key stakeholders, subsequent qualitative research informs the contextualization of the national framework for discipline-specific and institutional piloting. The paper concludes by exploring engineering educator perceptions of the national framework’s utility based on their engagement with the pilot process. Feedback from the pilot indicates that there is a significant gap between the professional development needs of engineering educators and the current professional development provision in teaching and learning.

Keywords: engineering education, pilot, professional development, teaching and learning

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Authors: Mubeshera Tufail

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The purpose of the study was to explore the experiences and challenges faced by teachers and students with Flipped Classroom Instruction (FCI) for an undergraduate course at university level. The Flipped Classroom lesson plan consisted of two components: one was out-of-class component consisting of learning material for reading for students and other was within-class component involving a class quiz, class activity and the feedback/further reading task. Besides, experiences, the research study also covered the adaptations made to improve their experiences with Flipped Classroom during the study. The phenomenological research strategy was used for this research study. The data consisted of weekly reflective journals documented by class teacher and students. The reflective journals were recorded by teacher and students while working in Flipped Classroom for an undergraduate course at university level. The main challenges highlighted by teacher were related to effort and time required for planning, time management and students' guidance for shift of their role from passive to independent learner. The main challenges found in reflective journals of students were personal computers issue, electricity and internet speed issue. It is recommended to adapt to some locally useful lesson planning and classroom management techniques to enhance the effectiveness of Flipped Classroom Instruction in an undergraduate university level course.

Keywords: flipped classroom instruction, undergraduate students, independent learner, technology-integrated classroom

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Authors: Miriam Corrado, Roberta Ciccola, Maria Serena Chiucchi

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SDGs represent the last edge in the sustainability corporate practices, including the supply chain management. Supply chains are becoming more global and complex, can create more inclusive markets and make contribution to the advance of the sustainable development. In corporate practices, the presence of sustainability criteria in supply chain management could offer an opportunity to increase competitiveness and to meet stakeholders’ expectations in terms of sustainability and corporate accountability. The research aims to understand how focal companies can integrate SDGs in their supply chain and how they can measure and assess their impacts on SDGs. The study adopts a multiple case study methodology based on four case studies referred to companies committed in measuring SDGs’ performance in their supply chains. Preliminary findings demonstrate the willingness and the need of companies to commit under a supply-chain perspective for the achievement of SDGs. Companies recognize their role in impacting the SDGs through their procurement choices by defining and implementing an SDGs scoring system. The contribution of the study is twofold: first, given the lack of research and studies addressing the integration of SDGs in the supply chain and in the performance measurement systems, the research provides a contribution to the current academic literature in relation to these emerging gaps; second, the research provides a practical guidance to implement a sustainable supply chain and advance towards the achievement of SDGs.

Keywords: sustainable supply chains, sustainable development goals, performance measurement, performance management

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Authors: H. Noureddine, P. Rao, R. Guru, A. Chandratreya

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The nice guidance for elective total knee replacements states that patients should be given mechanical thrombo-prophylaxis, and if no contraindications chemical thromboprophylaxis in the form of Dabigatran etexilate, Rivaroxiban, UFH, LMWH, or Fondaparinux sodium (CG92, 1.5.14, January 2010). In Practice administering oral agents has been the dominant practice as it reduces the nursing needs, and shortens hospital stay and is generally received better by patients. However, there are well documented associated bleeding risks, and their effects are difficult to reverse in case of major bleeding. Our experience with oral factor 10 inhibitors used for thromboprophylaxis was marked with several patients developing complications necessitating return to the theatre for wound washouts. This has led us to try a different protocol for thromboprophylaxis that we applied on our patients undergoing total and unicondylar knee replacements. We applied mechanical thromboprophylaxis in the form of intermittent pneumatic pressure devices, and chemical thromboprophylaxis in the form of a dose of prophylactic LMWH pre-op, then 150 mg of Aspirin to start 24 hours after the surgery and to continue for 6 weeks, alongside GI cover with PPIs or antihistamines. We also administered local anaesthetics intra-operatively in line with the ERAS protocol thus encouraging early mobilization. We have identified a cohort of 133 patients who underwent one of the aforementioned procedures in the same trust, and by the same surgeon, where this protocol was applied and examined their medical notes retrospectively with a mean follow-up period of 14 months, to identify the rate and percentage of patients who had thrombo-embolic events in the post-operative period.

Keywords: aspirin, heparin, knee arthroplasty, thromboprophylaxis

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Authors: Bishwa Nath Oli

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Nepal is highly impacted by climate change and adaptation has been a major focus. This paper investigates the gaps and coherence in national policies across water, forestry, local development and agriculture sectors, identifies their links to climate change adaptation and national development plans and analyzes the effectiveness of climate change policy on adaptation. The study was based on a content analysis of relevant policy documents on the level of attention given to adaptation and key informant interviews. Findings show that sectoral policies have differing degrees of cross thematic coherence, often with mismatched priorities and differing the paths towards achieving climate change goal. They are somewhat coherent in addressing immediate disaster management issues rather than in climate adaptation. In some cases, they are too broad and complicated and the implementation suffers from barriers and limits due to lack of capacity, investment, research and knowledge needed for evidence-based policy process. They do not adequately provide operational guidance in supporting communities in adapting to climate change. The study recommends to a) embrace longer-term cross-sectoral planning within government structures to foster greater policy coherence and integrated adaptation planning, b) increase awareness and flow of information on the potential role of communities in climate change, c) review the existing development sectors from the climate change perspectives, and d) formulate a comprehensive climate change legislation based on the need to implement the new Constitution.

Keywords: agriculture, climate change adaptation, forestry, policies

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Authors: Shaolan Zou, Kullapa Soratana

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Construction industry faces tremendous challenges in sustainability issue in recent years. Building materials, generally, are non-recyclable with short service life time, leading to economic loss. Building sites also cause social issues, e.g. noise, hazardous substances, and particulate matters. Sustainable supply chain management (SSCM) has been recognized as an appropriate method to balance three pillars of sustainability: environment, economy, and society. However, most of construction companies cannot successfully adopt SSCM due to numerous challenges. In this study, a list of challenges in implementing SSCM was collected from peer-reviewed literature on sustainable implementation. A building materials company in Thailand, which has successfully adopted SSCM for almost two decades and established the sustainable development committee since 1995, was used as a case study. Management-level representatives in sustainability department of the company were interviewed, mainly, to examine which challenges on the list complies with the company’s condition when adopting SSCM. The interview result was analyzed by interpretive structural model (ISM) with sustainability experts’ opinions to identify top 5 influential challenges. The results could assist a building construction company in assigning appropriate strategies to overcome most influential barriers, as well as in using as a reference or guidance for other construction companies adopting SSCM.

Keywords: sustainable supply chain management, challenges, construction industry, interpretive structural model

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Authors: Pachawo Bisani, Goodall Nyirenda

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The Malawi National Antiretroviral Therapy (NART) Electronic Medical Record (EMR) system was designed and developed with guidance from the Ministry of Health through the Department of HIV and AIDS (DHA) with the aim of supporting the management of HIV patient data and reporting in high prevalence ART clinics. As of 2021, the system has been scaled up to over 206 facilities across the country. The system is integrated with the clinical decision support system (CDSS) to assist healthcare providers in making a decision about an individual patient at a particular point in time. Despite NART EMR undergoing several evaluations and assessments, little has been done to evaluate the clinical decision support system in the NART EMR system. Hence, the study aimed to evaluate the use of CDSS in the NART EMR system in Malawi. The study adopted a mixed-method approach, and data was collected through interviews, observations, and questionnaires. The study has revealed that the CDSS tools were integrated into the ART clinic workflow, making it easy for the user to use it. The study has also revealed challenges in system reliability and information accuracy. Despite the challenges, the study further revealed that the system is effective and efficient, and overall, users are satisfied with the system. The study recommends that the implementers focus more on the logic behind the clinical decision-support intervention in order to address some of the concerns and enhance the accuracy of the information supplied. The study further suggests consulting the system's actual users throughout implementation.

Keywords: clinical decision support system, electronic medical record system, usability, antiretroviral therapy

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Authors: Ender Su, Kai Wen Wong, I-Ling Ju, Ya-Ling Wang

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In this study, the systemic risk change of Taiwan’s banking sector is analyzed during the financial crisis. The risk expose of each financial institutions to the whole Taiwan banking systemic risk or vice versa under financial distress are measured by conditional Value-at-Risk (CoVaR) and conditional coherent expected shortfall (CoES). The CoVaR and CoES are estimated by using vector quantile autoregression (MVMQ-CaViaR) with the daily stock returns of each banks included domestic and foreign banks in Taiwan. The daily in-sample data covered the period from 05/20/2002 to 07/31/2007 and the out-of-sample period until 12/31/2013 spanning the 2008 U.S. subprime crisis, 2010 Greek debt crisis, and post risk duration. All banks in Taiwan are categorised into several groups according to their size of market capital, leverage and domestic/foreign to find out what the extent of changes of the systemic risk as the risk changes between the individuals in the bank groups and vice versa. The final results can provide a guidance to financial supervisory commission of Taiwan to gauge the downside risk in the system of financial institutions and determine the minimum capital requirement hold by financial institutions due to the sensibility changes in CoVaR and CoES of each banks.

Keywords: bank financial distress, vector quantile autoregression, CoVaR, CoES

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Authors: Ibraheem Husain, Abul Kalam Najmi, Karishma Chester

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First-in-human (FIH) studies are a critical step in clinical development of any molecule that has shown therapeutic promise in preclinical evaluations, since preclinical research and safety studies into clinical development is a crucial step for successful development of monoclonal antibodies for guidance in pharmaceutical industry for the treatment of human diseases. Therefore, comparison between USFDA and nine pharmacologically guided approaches (PGA) (simple allometry, maximum life span potential, brain weight, rule of exponent (ROE), two species methods and one species methods) were made to determine maximum recommended starting dose (MRSD) for first in human clinical trials using four drugs namely Denosumab, Bevacizumab, Anakinra and Omalizumab. In our study, the predicted pharmacokinetic (pk) parameters and the estimated first-in-human dose of antibodies were compared with the observed human values. The study indicated that the clearance and volume of distribution of antibodies can be predicted with reasonable accuracy in human and a good estimate of first human dose can be obtained from the predicted human clearance and volume of distribution. A pictorial method evaluation chart was also developed based on fold errors for simultaneous evaluation of various methods.

Keywords: clinical pharmacology (CPH), clinical research (CRE), clinical trials (CTR), maximum recommended starting dose (MRSD), clearance and volume of distribution

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Authors: Chen Yong, Bi Wangyang, Zang Libin, Li Jinkai, Cheng Xiaowei, Liu Jinmin, Yu Miao

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New energy vehicle power transmission systems continue to develop in the direction of high torque, high speed, and high efficiency. The cooling and lubrication of the motor and the transmission system are integrated, and new requirements are placed on the lubricants for the transmission system. The effects of traditional lubricants and special lubricants for new energy vehicles on transmission efficiency were studied through experiments and simulation methods. A mathematical model of the transmission efficiency of the lubricating oil in the gearbox was established. The power loss of each part was analyzed according to the working conditions. The relationship between the speed and the characteristics of different lubricating oil products on the power loss of the stirring oil was discussed. The minimum oil film thickness was required for the life of the gearbox. The accuracy of the calculation results was verified by the transmission efficiency test conducted on the two-motor integrated test bench. The results show that the efficiency increases first and then decreases with the increase of the speed and decreases with the increase of the kinematic viscosity of the lubricant. The increase of the kinematic viscosity amplifies the transmission power loss caused by the high speed. New energy vehicle special lubricants have less attenuation of transmission efficiency in the range above mid-speed. The research results provide a theoretical basis and guidance for the evaluation and selection of transmission efficiency of gearbox lubricants for new energy vehicles.

Keywords: new energy vehicles, lubricants, transmission efficiency, kinematic viscosity, test and simulation

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Authors: Menouni Aziza, Chbihi Kaoutar, Duca Radu Corneliu, Gilissen Liesbeth, Bounou Salim, Godderis Lode, El Jaafari Samir

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In Africa, environmental and occupational health risks are mostly underreported. The aim of this research is to develop and implement a sentinel surveillance system comprising training and guidance of occupational physicians (OC) who will report new work-related diseases in African countries. A group of 30 OC are recruited and trained in each of the partner countries (Morocco, Benin and Ethiopia). Each committed OC is asked to recruit 50 workers during a consultation in a time-frame of 6 months (1500 workers per country). Workers are asked to fill out an online questionnaire about their health status and work conditions, including exposure to 20 chemicals. Urine and blood samples are then collected for human biomonitoring of common exposures. Some preliminary results showed that 92% of the employees surveyed are exposed to physical constraints, 44% to chemical agents, and 24% to biological agents. The most common physical constraints are manual handling of loads, noise pollution and thermal pollution. The most frequent chemical risks are exposure to pesticides and fuels. This project will allow a better understanding of effective sentinel systems as a promising method to gather high quality data, which can support policy-making in terms of preventing emerging work-related diseases.

Keywords: sentinel system, occupational diseases, human biomonitoring, Africa

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Authors: Aditya Manna

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Introduction: As in any developing countries state of West Bengal in India has a huge burden of cancer patients in advanced stage coming from rural area where awareness regarding the usefulness of palliative care in rather poor. Objective: Our goal is to give a pain free good quality of life in these advanced stage cancer patients. Objective of this study is to identify the main difficulties in achieving the above goal in a rural village setting in India. Method: Advanced cancer patients in need of palliative care in various villages in of rural India were selected for this study. Their symptoms and managements in that rural surroundings were evaluated by an NGO (under the guidance of a senior palliative care specialist) working in that area. An attempt was made to identify the main obstacles in getting proper palliative care in a rural setting. Results: Pain, fatigue are the main symptoms effecting these patients. In most patients pain and other symptoms control were grossly inadequate due to lack of properly trained manpower in the rural India. However regular homecare visits by a group of social workers were of immense help in the last few months of life. NGO team was well guided by a palliative care specialist. Conclusion: There is a wide gap of trained manpower in this filled in rural areas of India. Dedicated groups from rural area itself need encouragement and proper training, so that difficult symptoms can be managed locally along with necessary social and psychological support to these patients.

Keywords: palliative care, NGO, rural India, home care

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Authors: Waqas Ahmad, Eisha Tahir, Shahper Aqeel, Imran Khalid Niazi, Amjad Iqbal

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Background: Breast conservation surgery applies a number of techniques for accurate localization of lesions. Wire localization remains the method of choice in non-palpable breast cancers post-neoadjuvant chemotherapy. Objective: The aim of our study was to determine the accuracy of wire localization procedures in our department and compare it with internationally set protocols as per the Royal College of Radiologists. Post wire mammography, as well as the margin status of the postoperative specimen, assessed the accuracy of the procedure. Methods: We retrospectively reviewed the data of 225 patients who presented to our department from May 2014 to June 2015 post neoadjuvant chemotherapy with non-palpable cancers. These patients are candidates for wire localized lumpectomies either under ultrasound or stereotactic guidance. Metallic marker was placed in all the patients at the time of biopsy. Post wire mammogram was performed in all the patients and the distance of the wire tip from the marker was calculated. The presence or absence of the metallic clip in the postoperative specimen, as well as the marginal status of the postoperative specimen, was noted. Results: 157 sonographic and 68 stereotactic wire localization procedures were performed. 95% of the wire tips were within 1 cm of the metallic marker. Marginal status was negative in 94% of the patients in histopathological specimen. Conclusion: Our audit report declares more than 95% accuracy of image guided wire localization in successful excision of non-palpable breast lesions.

Keywords: breast, cancer, non-palpable, wire localization

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Authors: Nashalla Gwyn Nyinda

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The ancient system of Tibetan Medicine, known as Sowa Rigpa across the Himalayan regions, is a systematic system of healing encouraging balance primarily through diet and behavior modifications. With the rise of the popularity of Tibetan Medicine, compliance is critical to successful treatment outcomes. As patients learn more about who they are as individuals and how their elemental balances or imbalances affect disorders and mental-emotional balance, they develop faith and dedication to their healing process. Specifically, regarding diet and behavior and the basic principles of the medical system, patient compliance increases dramatically in all treatment areas when they understand why a treatment or dietary prescription guidance is effective. Successful responses to Tibetan treatment rely on a buy-in from the patient. Trust between the slower process of Traditional medicine treatments, the Tibetan physician and the patient is a cornerstone of treatment. The resulting decrease in the use of allopathic medicine and better health outcomes for acute and chronic disorders are well documented. This paper addresses essential points of the Tibetan Medicine system, dialogue between doctor and patient focused on appropriate and seasonal changing dietetics. Such fluctuating treatment approaches, based on external elemental factors, dramatically increase treatment outcomes. Specifically, this work addresses why allopathic medicine models may need more trust development between practitioner and patient.

Keywords: compliancy in treatment, diet and lifestyle medicine, nature and elements as medicine, seasonal diets, Sowa Rigpa, traditional Tibetan medicine, treatment outcomes

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Authors: Pablo Cardozo Herrera

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In a dynamic market of Information Technology (IT) Service and with high quality demands and high performance requirements in decreasing costs, it is imperative that IT companies invest organizational effort in order to increase the effectiveness of their Information Technology Service Management (ITSM) processes through the improvement of ITSM project management and through solid support to the strategic decision-making process of IT directors. In this article, the author presents an analysis of common issues of IT companies around the world, with strategic needs of information unmet that provoke their ITSM processes and projects management that do not achieve the effectiveness and efficiency expected of their results. In response to the issues raised, the author proposes a framework consisting of an innovative theoretical framework model of ITSM management and a technological solution aligned to the Information Technology Infrastructure Library (ITIL) good practices guidance and ISO/IEC 20000-1 requirements. The article describes a research that proves the proposed framework is able to integrate, manage and coordinate in a holistic way, measurable and auditable, all ITSM processes and projects of IT organization and utilize the effectiveness assessment achieved for their strategic decision-making process increasing the process maturity level and improving the capacity of an efficient management.

Keywords: innovation in IT services, ITSM processes, ITIL and ISO/IEC 20000-1, IT service management, IT service excellence

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Authors: Nuo Duan, Yi Pik Cheng

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This paper presents the data of a series of two-dimensional Discrete Element Method (DEM) simulations of a large-diameter rigid monopile subjected to cyclic loading under a high gravitational force. At present, monopile foundations are widely used to support the tall and heavy wind turbines, which are also subjected to significant from wind and wave actions. A safe design must address issues such as rotations and changes in soil stiffness subject to these loadings conditions. Design guidance on the issue is limited, so are the availability of laboratory and field test data. The interpretation of these results in sand, such as the relation between loading and displacement, relies mainly on empirical correlations to pile properties. Regarding numerical models, most data from Finite Element Method (FEM) can be found. They are not comprehensive, and most of the FEM results are sensitive to input parameters. The micro scale behaviour could change the mechanism of the soil-structure interaction. A DEM model was used in this paper to study the cyclic lateral loads behaviour. A non-dimensional framework is presented and applied to interpret the simulation results. The DEM data compares well with various set of published experimental centrifuge model test data in terms of lateral deflection. The accumulated permanent pile lateral displacements induced by the cyclic lateral loads were found to be dependent on the characteristics of the applied cyclic load, such as the extent of the loading magnitudes and directions.

Keywords: cyclic loading, DEM, numerical modelling, sands

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Authors: Irfan Ahmad, Raza Ghafoor, Hammad Raza Ahmad, Muhammad Asif, Farrakh Nawaz, M. Tahir Siddiqui

Abstract:

Due to the exploding population of Pakistan the pressure on natural forests is increasing to meet the demands of wood and wood based products. Agroforestry is being practiced throughout the world on scientific basis but unfortunately the farmers of Pakistan are reluctant in its adoption. The presents study was designed to assess the adoption of agroforestry practices in Faisalabad with respect to land holdings of farmers and future suitability by using Geographic information system (GIS). Faisalabad is the third largest city of the country and is famous due to the textile industry. A comprehensive survey from target villages of the Lyallpur town of Faisalabad district was carried out. Out of total 65 villages, 40 were selected for study. From each selected village, one farmer who was actively engaged in farming activities was selected. It was observed that medium sized farmers having 10-20 acre were more in number as compared to small and large farmers. Number of trees was found maximum in large farm lands, ratio of diseased trees was almost similar in all categories with maximum in small farmlands (24.1%). Regarding the future prospects 35% farmer were interested in agroforestry practices 65% were not interested in the promotion of trees due to the non-availability of technical guidance and proper markets. Geographic images of the study site can further help the researchers and policy makers in the promotion of agroforestry.

Keywords: agroforestry trends, adoption, Faisalabad, geographic information system (GIS)

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Authors: Xia Fang

Abstract:

Arid and semiarid areas of China (ASAC) have experienced significant land-use/cover changes (LUCC), along with intensified climate change. However, LUCC and climate changes and their individual and interactive effects on carbon stocks have not yet been fully understood in the ASAC. This study analyses the carbon stocks in the ASAC during 1980 - 2020 using the specific arid ecosystem model (AEM), and investigates the effects of LUCC and climate change on carbon stock trends. The results indicate that in the past 41 years, the ASAC carbon pool experienced an overall growth trend, with an increase of 182.03 g C/m2. Climatic factors (+291.99 g C/m2), especially the increase in precipitation, were the main drivers of the carbon pool increase. LUCC decreased the carbon pool (-112.27 g C/m2), mainly due to the decrease in grassland area (-2.77%). The climate-induced carbon sinks were distributed in northern Xinjiang, on the Ordos Plateau, and in Northeast China, while the LUCC-induced carbon sinks mainly occurred on the Ordos Plateau and the North China Plain, resulting in a net decrease in carbon sequestration in these regions according to carbon pool measurements. The study revealed that the combination of climate variability, LUCC, and increasing atmospheric CO2 concentration resulted in an increase of approximately 182.03 g C/m2, which was mainly distributed in eastern Inner Mongolia and the western Qinghai-Tibet Plateau. Our findings are essential for improving theoretical guidance to protect the ecological environment, rationally plan land use, and understand the sustainable development of arid and semiarid zones.

Keywords: AEM, climate change, LUCC, carbon stocks

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Authors: Xue Wang, Li-Wei Fan

Abstract:

The technology innovation has become the driving force of social and economic development and transformation. The guidance and support of public policies is an important condition to promote the realization of technology innovation goals. Policy effectiveness evaluation is instructive in policy learning and adjustment. This paper reviews existing studies and systematically evaluates the effectiveness of policy-driven technological innovation. We used 167 articles from WOS and CNKI databases as samples to clarify the measurement of technological innovation indicators and analyze the classification and application of policy evaluation methods. In general, technology innovation input and technological output are the two main aspects of technological innovation index design, among which technological patents are the focus of research, the number of patents reflects the scale of technological innovation, and the quality of patents reflects the value of innovation from multiple aspects. As for policy evaluation methods, statistical analysis methods are applied to the formulation, selection and evaluation of the after-effect of policies to analyze the effect of policy implementation qualitatively and quantitatively. The bibliometric methods are mainly based on the public policy texts, discriminating the inter-government relationship and the multi-dimensional value of the policy. Decision analysis focuses on the establishment and measurement of the comprehensive evaluation index system of public policy. The economic analysis methods focus on the performance and output of technological innovation to test the policy effect. Finally, this paper puts forward the prospect of the future research direction.

Keywords: technology innovation, index, policy effectiveness, evaluation of policy, bibliometric analysis

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Authors: Emily J. Winnall

Abstract:

It is understood that China has the largest population of people living with dementia in the world; however, little is known about this culturally diverse community, specifically the Chinese Communities, which has been poorly represented in past British research Literature. Further research is needed to gain a greater understanding of the support needs of caregivers caring for a relative living with dementia from the Chinese background. Dementia care and caregivers in Chinese communities are less investigated. The study is a case study of two Chinese community centers and one housing support service. Semi-structured one-to-one interviews and a pilot questionnaire were used as the methods for the study. A toolkit will also be created as a document that provides guidance and signposting to health and social care services for Chinese communities. The findings identified three main themes. Caregivers do not receive any formal support from the UK health and social services, and they felt they would have benefited from getting advice on what support they could access. Furthermore, the data also identified that Chinese organisations do not have the knowledge of dementia, to be able to support those living with dementia and their families. Also, people living with dementia and their families rarely present to Chinese organisations and UK health and social care services, meaning they are not receiving the support they are entitled to or need. Additionally, the community center would like to see workshops/courses around dementia for people from Chinese backgrounds. The study concludes that people from Chinese cultural backgrounds do not have sufficient access to support from UK health and social care services. More information needs to be published that will benefit Chinese communities.

Keywords: Chinese, Chinese organisations, Dementia, family caregivers, social care

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Authors: Kholood Baron

Abstract:

Radiologic interventional studies use fluoroscopy imaging guidance to perform both diagnostic and therapeutic procedures. These could result in high radiation doses being delivered to the patients and also to the radiology team. This is due to the prolonged fluoroscopy time and the large number of images taken, even when dose-minimizing techniques and modern fluoroscopic tools are applied. Hence, these procedures are part of the everyday routine of interventional radiology doctors, assistant nurses, and radiographers. Thus, it is important to estimate the radiation exposure dose they received in order to give objective advice and reduce both patient and radiology team radiation exposure dose. The aim of this study was to find out the total radiation dose reaching the radiologist and the patient during an interventional procedure and to determine the impact of certain parameters on the patient dose. Method: The radiation dose was measured by TLD devices (thermoluminescent dosimeter; radiation dosimeter device). Physicians, patients, nurses, and radiographers wore TLDs during 12 interventional radiology procedures performed in two hospitals, Mubarak and Chest Hospital. This study highlights the need for interventional radiologists to be mindful of the radiation doses received by both patients and medical staff during interventional radiology procedures. The findings emphasize the impact of factors such as fluoroscopy duration and the number of images taken on the patient dose. By raising awareness and providing insights into optimizing techniques and protective measures, this research contributes to the overall goal of reducing radiation doses and ensuring the safety of patients and medical staff.

Keywords: dosimetry, radiation dose, interventional radiology procedures, patient radiation dose

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