Search results for: structured radiology report

Authors: Jill Stephenson, Marie Vaganay, Robert Cameron, Caoimhe McGurk, Neil Hewitt

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Purpose: The key aim of the research was to identify the secondary stressors experienced by businesses affected by single or repeated flooding and to determine to what extent businesses were affected by these stressors, along with any resulting impact on health. Additionally, the research aimed to establish the likelihood of businesses being re-exposed to the secondary stressors through assessing awareness of flood risk, implementation of property protection measures and level of community resilience. Design/methodology/approach: The chosen research method involved the distribution of a questionnaire survey to businesses affected by either single or repeated flood events. The questionnaire included the Impact of Event Scale (a 15-item self-report measure which assesses subjective distress caused by traumatic events). Findings: 55 completed questionnaires were returned by flood impacted businesses. 89% of the businesses had sustained internal flooding while 11% had experienced external flooding. The results established that the key secondary stressors experienced by businesses, in order of priority, were: flood damage, fear of reoccurring flooding, prevention of access to the premise/closure, loss of income, repair works, length of closure and insurance issues. There was a lack of preparedness for potential future floods and consequent vulnerability to the emergence of secondary stressors among flood affected businesses, as flood resistance or flood resilience measures had only been implemented by 11% and 13% respectively. In relation to the psychological repercussions, the Impact of Event scores suggested that potential prevalence of post-traumatic stress disorder (PTSD) was noted among 8 out of 55 respondents (l5%). Originality/value: The results improve understanding of the enduring repercussions of flood events on businesses, indicating that not only residents may be susceptible to the detrimental health impacts of flood events and single flood events may be just as likely as reoccurring flooding to contribute to ongoing stress. Lack of financial resources is a possible explanation for the lack of implementation of property protection measures among businesses, despite 49% experiencing flooding on multiple occasions. Therefore it is recommended that policymakers should consider potential sources of financial support or grants towards flood defences for flood impacted businesses. Any form of assistance should be made available to businesses at the earliest opportunity as there was no significant association between the time of the last flood event and the likelihood of experiencing PTSD symptoms.

Keywords: flood event, flood resilience, flood resistance, PTSD, secondary stressors

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Authors: Annette Cosgrove

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The objectives of this research study is to examine the impact of professional development in Technology Enhanced Learning (TEL) and the digitisation of learning in teaching communities across multiple higher education sites in the ATU (Atlantic Technological University *) ( 2020-2025), including the proposal of an evidence based digital teaching model for use in a future pandemic. The research strategy undertaken for this PhD Study is a multi-site study using mixed methods. Qualitative & quantitative methods are being used in the study to collect data. A pilot study was carried out initially , feedback collected and the research instrument was edited to reflect this feedback, before being administered. The purpose of the staff questionnaire is to evaluate the impact of professional development in the area of TEL, and to capture the practitioners views on the perceived impact on their teaching practice in the higher education sector across ATU (West of Ireland – 5 Higher education locations ). The phenomenon being explored is ‘ the impact of professional development in the area of technology enhanced learning and on teaching practice in a higher education institution.’ The research methodology chosen for this study is an Action based Research Study. The researcher has chosen this approach as it is a prime strategy for developing educational theory and enhancing educational practice . This study includes quantitative and qualitative methods to elicit data which will quantify the impact that continuous professional development in the area of digital teaching practice and technologies has on the practitioner’s teaching practice in higher education. The research instruments / data collection tools for this study include a lecturer survey with a targeted TEL Practice group ( Pre and post covid experience) and semi-structured interviews with lecturers.. This research is currently being conducted across the ATU multisite campus and targeting Higher education lecturers that have completed formal CPD in the area of digital teaching. ATU, a west of Ireland university is the focus of the study , The research questionnaire has been deployed, with 75 respondents to date across the ATU - the primary questionnaire and semi- formal interviews are ongoing currently – the purpose being to evaluate the impact of formal professional development in the area of TEL and its perceived impact on the practitioners teaching practice in the area of digital teaching and learning . This paper will present initial findings, reflections and data from this ongoing research study.

Keywords: TEL, DTL, digital teaching, digital assessment

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Authors: Jeremy Dixon

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Safeguarding adults forms a core part of social work practice. The Government in England and Wales has made efforts to standardise practices through The Care Act 2014. The Act states that local authorities have duties to make inquiries in cases where an adult with care or support needs is experiencing or at risk of abuse and is unable to protect themselves from abuse or neglect. Despite the importance given to safeguarding adults within law there remains little research about how social workers conduct such decisions on the ground. This presentation reports on findings from a pilot research study conducted within two social work teams in a Local Authority in England. The objective of the project was to find out how social workers interpreted safeguarding duties as laid out by The Care Act 2014 with a particular focus on how workers assessed and managed risk. Ethnographic research methods were used throughout the project. This paper focusses specifically on decisions made by workers in the assessment team. The paper reports on qualitative observation and interviews with five workers within this team. Drawing on governmentality theory, this paper analyses the techniques used by workers to manage risk from a distance. A high proportion of safeguarding referrals came from care workers or managers in residential care homes. Social workers conducting safeguarding assessments were aware that they had a duty to work in partnership with these agencies. However, their duty to safeguard adults also meant that they needed to view them as potential abusers. In making judgments about when it was proportionate to refer for a safeguarding assessment workers drew on a number of common beliefs about residential care workers which were then tested in conversations with them. Social workers held the belief that residential homes acted defensively, leading them to report any accident or danger. Social workers therefore encouraged residential workers to consider whether statutory criteria had been met and to use their own procedures to manage risk. In addition social workers carried out an assessment of the workers’ motives; specifically whether they were using safeguarding procedures as a shortcut for avoiding other assessments or as a means of accessing extra resources. Where potential abuse was identified social workers encouraged residential homes to use disciplinary policies as a means of isolating and managing risk. The study has implications for understanding risk within social work practice. It shows that whilst social workers use law to govern individuals, these laws are interpreted against cultural values. Additionally they also draw on assumptions about the culture of others.

Keywords: adult safeguarding, governmentality, risk, risk assessment

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Authors: Zarina Chokparova, Ighor Uzhinsky

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Carbon dioxide emissions resulting from burning of the fossil fuels on large scales, such as oil industry or power plants, leads to a plenty of severe implications including global temperature raise, air pollution and other adverse impacts on the environment. Besides some precarious and costly ways for the alleviation of CO₂ emissions detriment in industrial scales (such as liquefaction of CO₂ and its deep-water treatment, application of adsorbents and membranes, which require careful consideration of drawback effects and their mitigation), one physically and commercially available technology for its capture and disposal is supersonic system for inertial extraction of CO₂ in after-combustion streams. Due to the flue gas with a carbon dioxide concentration of 10-15 volume percent being emitted from the combustion system, the waste stream represents a rather diluted condition at low pressure. The supersonic system induces a flue gas mixture stream to expand using a converge-and-diverge operating nozzle; the flow velocity increases to the supersonic ranges resulting in rapid drop of temperature and pressure. Thus, conversion of potential energy into the kinetic power causes a desublimation of CO₂. Solidified carbon dioxide can be sent to the separate vessel for further disposal. The major advantages of the current solution are its economic efficiency, physical stability, and compactness of the system, as well as needlessness of addition any chemical media. However, there are several challenges yet to be regarded to optimize the system: the way for increasing the size of separated CO₂ particles (as they are represented on a micrometers scale of effective diameter), reduction of the concomitant gas separated together with carbon dioxide and provision of CO₂ downstream flow purity. Moreover, determination of thermodynamic conditions of the vapor-solid mixture including specification of the valid and accurate equation of state remains to be an essential goal. Due to high speeds and temperatures reached during the process, the influence of the emitted heat should be considered, and the applicable solution model for the compressible flow need to be determined. In this report, a brief overview of the current technology status will be presented and a program for further evaluation of this approach is going to be proposed.

Keywords: CO₂ sequestration, converging diverging nozzle, fossil fuel power plant emissions, inertial CO₂ extraction, supersonic post-combustion carbon dioxide capture

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Authors: Atefeh Abdollahi, Maryam Bahreini, Babak Choobi Anzali, Fatemeh Rasooli

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Introduction: Triage becomes the main part of organization of care in Emergency department (ED)s. It is used to describe the sorting of patients for treatment priority in ED. The accurate triage of injured patients has reduced fatalities and improved resource usage. Besides, the nurses’ knowledge and skill are important factors in triage decision-making. The ability to define an appropriate triage level and their need for intervention is crucial to guide to a safe and effective emergency care. Methods: This is a prospective cross-sectional study designed for emergency nurses working in four public university hospitals. Five triage workshops have been conducted every three months for emergency nurses based on a standard triage Emergency Severity Index (ESI) IV slide set - approved by Iranian Ministry of Health. Most influential items on triage performance were discussed through brainstorming in workshops which then, were peer reviewed by five emergency physicians and two head registered nurses expert panel. These factors that might distract nurse’ attention from proper decisions included patients’ past medical diseases, the natural tricks of triage and system failure. After permission had been taken, emergency nurses participated in the study and were given the structured questionnaire. Data were analysed by SPSS 21.0. Results: 92 emergency nurses enrolled in the study. 30 % of nurses reported the past history of chronic disease as the most influential confounding factor to ascertain triage level, other important factors were the history of prior admission, past history of myocardial infarction and heart failure to be 20, 17 and 11 %, respectively. Regarding the concept of difficulties in triage practice, 54.3 % reported that the discussion with patients and family members was difficult and 8.7 % declared that it is hard to stay in a single triage room whole day. Among the participants, 45.7 and 26.1 % evaluated the triage workshops as moderately and highly effective, respectively. 56.5 % reported overcrowding as the most important system-based difficulty. Nurses were mainly doubtful to differentiate between the triage levels 2 and 3 according to the ESI VI system. No significant correlation was found between the work record of nurses in triage and the uncertainty in determining the triage level and difficulties. Conclusion: The work record of nurses hardly seemed to be effective on the triage problems and issues. To correct the deficits, training workshops should be carried out, followed by continuous refresher training and supportive supervision.

Keywords: assessment, education, nurse, triage

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Authors: Priyanka V. Janbandhu, Santosh B. Phad, Dhananjay W. Bansod

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The current changing scenario of the family is a compelling aged group not only to be alone in a nuclear family but also to join the old age institutions. The consequences of it are feeling of neglected or left alone by the children, adding a touch of helpless in the absence of lack of expected care and support. The accretion of all these feelings and unpleasant events ignite a question in their mind that – who is there for me? The efforts have taken to highlight the issues of the elderly after joining the old age home and their perception about the current life as an institutional inmate. This attempt to cover up the condition, adjustment, changed lifestyle and perspective in the association with several issues of the elderly, which have an essential effect on their well-being. The present research piece has collected the information about institutionalized elderly with the help of a semi-structured questionnaire. This study interviewed 500 respondents from 22 old age homes of Pune city of Maharashtra State, India. This data collection methodology consists of Multi-stage random sampling. In which the stratified random sampling adopted for the selection of old age homes and sample size determination, sample selection probability proportional to the size and simple random sampling techniques implemented. The study provides that around five percent of the elderly shifted to old age home along with their spouse, whereas ten percent of the elderly are staying away from their spouse. More than 71 percent of the elderly have children, and they are an involuntary inmate of the old age institution, even less than one-third of the elderly consulted to the institution before the joining it. More than sixty percent of the elderly have children, but they joined institution due to the unpleasant response of their children only. Around half of the elderly responded that there are issues while adjusting to this environment, many of them are still persistent. At least one elderly out of ten is there who is suffering from the feeling of loneliness and left out by children and other family members. In contrast, around 97 percent of the elderly are very happy or satisfied with the institutional facilities. It illustrates that the issues are associated with their children and other family members, even though they left their home before a year or more. When enquired about this loneliness feeling few of them are suffering from it before leaving their homes, it was due to lack of interaction with children, as they are too busy to have time for the aged parents. Additionally, the conflicts or fights within the family due to the presence of old persons in the family contributed to establishing another feeling of insignificance among the elderly parents. According to these elderly, have more than 70 percent of the share, the children are ready to spend money indirectly for us through these institutions, but not prepared to provide some time and very few amounts of all this expenditure directly for us.

Keywords: elderly, old age homes, life style changes and adjustment, India

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Authors: Po-Chien Li

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Despite the extant literature has hosted a wide-range of knowledge about trade shows, this knowledge base deserves to be further expanded and extended because there exist many unclear issues and overlooked topics. One area that needs much research attention is regarding the behavior and performance of booth workers at the exhibition site. Booth staffs play many key roles in interacting with booth visitors. Their exhibiting-related attitudes and motivations might have significant consequences on a firm’s exhibition results. However, to date, little research, if any, has studied how booth workers are affected and behave in the context of trade fair. The primary purpose of the current study is to develop and test a research model, derived from role theory and resource-based viewpoint, that depicts the effects of a firm’s pre-exhibition resource investment behavior on booth staff’s role perceptions and work behavior during the exhibition period. The author collects data with two survey questionnaires at two trade shows in 2016. One questionnaire is given to the booth head of an exhibiting company, asking about the firm’s resource commitment behavior prior to the exhibition period. In contrast, another questionnaire is provided for a booth worker of the same firm, requesting the individual staff to report his/her own role perceptions, degree of exhibition goal acceptance, and level of work effort during the exhibition period. The study has utilized the following analytic methods, including descriptive statistics, exploratory factor analysis, reliability analysis, and regression analysis. The results of a set of regression analyses show that a firm’s pre-exhibition resource investment behavior has significant effects on a booth staff’s exhibiting perceptions and attitudes. Specifically, an exhibitor’s resource investment behavior has impacts on the factors of booth staff’s role clarity and role conflict. In addition, a booth worker’s role clarity is related to the degree of exhibition goal acceptance, but his/her role conflict is not. Finally, a booth worker’s exhibiting effort is significantly related to the individual’s role clarity, role conflict and goal acceptance. In general, the major contribution of the current research is that it offers insight into and early evidence on the links between an exhibiting firm’s resource commitment behavior and the work perceptions and attitudes of booth staffs during the exhibition period. The current research’s results can benefit the extant literature of exhibition marketing.

Keywords: exhibition resource investment, role perceptions, goal acceptance, work effort

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Authors: S. Surapa Raju

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In Andhra Pradesh, the symptoms of climate variations in coastal villages can be observed from various studies. The Andhra Pradesh coast is known its frequent tropical cyclones and associated floods and tidal surges causing loss of life and property in the region. In the last decade alone, the state experienced 18 devastating storms causing huge loss to coastal people. The year 2007 was the fourth warmest year on record since 1901 and 2009 witnessed the heat wave conditions prevailing over the coastal Andhra Pradesh. With regarding to sea level rise (SLR), 43 percent of the coastal areas considered to be at high risk. The main objectives of the study are: to know the perceptions of fisher people on climate variations and to find out the awareness of the fisher people on climate variations and its effects at village and on fishing households. Altogether 150 households were chosen purposively for this study and collected information from the households based on semi-structured schedule. The present field-based study observed that most of the fisher people are experienced about the changes in climate variations in their villages. The first generation fisher people expressed that the at least 1/2km of sea erosion taken place from the last 20 years and most of them displaced. With regard to fishing activities, first generation fisher people revealed that 20 years back they were fishing in near-shore areas, but now availability of near shore is decreased at a large extent. The present study observed the lot of variations in growth of species in marine districts of Andhra Pradesh from the year 2005-2010. Some species like Silver pomfret, Sole (flat fish), Chriocentrus, Thrisocies, Stakes, Rays etc. are in decaling. The results of the study indicate that huge variation observed in growth rates of fish species. Small and traditional fishers have drastically effected in El NiNo years than the normal years as they have not own suitable equipment such as crafts and nets. The study discovered that many changes taken place in the fishing activities and they are: go for long distance for fishing which increases the cost of fishing operations; decrease in fish catches. Need to take up in-depth studies in the marine villages and tackle the situation by creating more awareness about the negative effects of climate variations among fishing households. Suitable fish craft technology is to be supplied and create more employment opportunities for the fishers in other than fishery.

Keywords: climate, Andhra Pradesh, El nino years, India

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Authors: Pisut Boonkaew, Jatuporn Thongsri

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In hard disk drive manufacturing industry, the process of reducing an unnecessary part and qualifying the quality of part before assembling is important. Thus, clamp was designed and fabricated as a fixture for holding in testing process. Basically, testing by trial and error consumes a long time to improve. Consequently, the simulation was brought to improve the part and reduce the time taken. The problem is the present clamp has a low life expectancy because of the critical stress that occurred. Hence, the simulation was brought to study the behavior of stress and compressive force to improve the clamp expectancy with all probability of designs which are present up to 27 designs, which excluding the repeated designs. The probability was calculated followed by the full fractional rules of six sigma methodology which was provided correctly. The six sigma methodology is a well-structured method for improving quality level by detecting and reducing the variability of the process. Therefore, the defective will be decreased while the process capability increasing. This research focuses on the methodology of stress and fatigue reduction while compressive force still remains in the acceptable range that has been set by the company. In the simulation, ANSYS simulates the 3D CAD with the same condition during the experiment. Then the force at each distance started from 0.01 to 0.1 mm will be recorded. The setting in ANSYS was verified by mesh convergence methodology and compared the percentage error with the experimental result; the error must not exceed the acceptable range. Therefore, the improved process focuses on degree, radius, and length that will reduce stress and still remain in the acceptable force number. Therefore, the fatigue analysis will be brought as the next process in order to guarantee that the lifetime will be extended by simulating through ANSYS simulation program. Not only to simulate it, but also to confirm the setting by comparing with the actual clamp in order to observe the different of fatigue between both designs. This brings the life time improvement up to 57% compared with the actual clamp in the manufacturing. This study provides a precise and trustable setting enough to be set as a reference methodology for the future design. Because of the combination and adaptation from the six sigma method, finite element, fatigue and linear regressive analysis that lead to accurate calculation, this project will able to save up to 60 million dollars annually.

Keywords: clamp, finite element analysis, structural, six sigma, linear regressive analysis, fatigue analysis, probability

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Authors: Paolo Guzzini, Emad Samuel M. Ebeid

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Bridges and Railways are critical infrastructures. Ensuring safety for transports using such assets is a primary goal as it directly impacts the lives of people. By the way, improving safety could require increased investments in O&M, and therefore optimizing resource usage for asset maintenance becomes crucial. Drones4Safety (D4S), a European project funded under the H2020 Research and Innovation Action (RIA) program, aims to increase the safety of the European civil transport by building a system that relies on 3 main pillars: • Drones operating autonomously in swarm mode; • Drones able to recharge themselves using inductive phenomena produced by transmission lines in the nearby of bridges and railways assets to be inspected; • Data acquired that are analyzed with AI-empowered algorithms for defect detection This paper describes the business model behind this disruptive project. The Business Model is structured in 2 parts: • The first part is focused on the design of the business model Canvas, to explain the value provided by the Drone4safety project; • The second part aims at defining a detailed financial analysis, with the target of calculating the IRR (Internal Return rate) and the NPV (Net Present Value) of the investment in a 7 years plan (2 years to run the project + 5 years post-implementation). As to the financial analysis 2 different points of view are assumed: • Point of view of the Drones4safety company in charge of designing, producing, and selling the new system; • Point of view of the Utility company that will adopt the new system in its O&M practices; Assuming the point of view of the Drones4safety company 3 scenarios were considered: • Selling the drones > revenues will be produced by the drones’ sales; • Renting the drones > revenues will be produced by the rental of the drones (with a time-based model); • Selling the data acquisition service > revenues will be produced by the sales of pictures acquired by drones; Assuming the point of view of a utility adopting the D4S system, a 4th scenario was analyzed taking into account the decremental costs related to the change of operation and maintenance practices. The paper will show, for both companies, what are the key parameters affecting most of the business model and which are the sustainable scenarios.

Keywords: a swarm of drones, AI, bridges, railways, drones4safety company, utility companies

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Authors: Fulufhelo Oscar Maphiri-Makananise

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The main purpose of this paper is to explore and provide substantiated evidence based on the usage patterns of Information and Communication Technologies (ICTs) by females in the Vhembe District in Limpopo-Province, South Africa. The study presents a broader picture and understanding about the usage of ICTs from female’s perspective. The significance of this study stems from the need to discover the role, relevance and usage patterns of ICTs such as smartphones, computers, laptops, and iPods, internet and social networking sites among females following the trends of new media technologies in the society. The main objective of the study was to investigate the usability and accessibility of ICTs to empower the Vhembe District females in South Africa. The study used quantitative research method together with elements of qualitative research to determine the major ideas, perceptions and usage patterns of ICTs by females in the District. Data collection involved structured and self-administered questionnaire with both closed-ended and open-ended questions. Two groups of respondents participated in this study. Media Studies female students (n=50) at the University of Venda provided their ideas and perceptions about the usefulness and usage patterns of ICTs such as smartphones, internet and computers at the university level, while the second group were (n=50) Makhado comprehensive school learners who also provided their perceptions and ideas about the use of ICTs at the high school level. Also, the study provides a more balanced, accurate and rational results on the pertinent issues that concern the use of ICTs by females in the Vhembe District. The researcher also believes that the findings of the study are useful as a guideline and model for ICT intervention that work as an empowerment to women in South Africa. The study showed that the main purpose of using ICTs by females was to search information for writing assignments, conducting research, dating, exchanging ideas and networking with friends and relatives that are also members of social networking sites and maintaining existing friends in real life. The study further revealed that most females were using ICTs for social purposes and accessing the internet than entertaining themselves. The finding also indicated a high number of females that used ICTs for e-learning (62%) and social purposes (85%). Moreover, the study centred on providing strong insightful information on the females’ usage patterns and their perceptions of ICTs in the Vhembe district of Limpopo province.

Keywords: female users, information and communication technologies, internet, usage patterns

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Authors: H.C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

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Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological wellbeing, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes. Hopefully it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

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Authors: Muhammad Arif Khan, Haroon Idrees, Imran Aziz, Sidra Mushtaq

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The purpose of this study is to investigate the current level of knowledge mapping skills of the public sector employees in Pakistan. National Institute of Management is one of the premiere public sector training organization for mid-career public sector employees in Pakistan. This study is conducted on participants of fourteen weeks long training course called Mid-Career Management Course (MCMC) which is mandatory for public sector employees in order to ascertain how to enhance their knowledge mapping skills. Methodology: Researcher used both qualitative and quantitative approach to conduct this study. Primary data about current level of participants’ understanding of knowledge mapping was collected through structured questionnaire. Later on, Participant Observation method was used where researchers acted as part of the group to gathered data from the trainees during their performance in training activities and tasks. Findings: Respondents of the study were examined for skills and abilities to organizing ideas, helping groups to develop conceptual framework, identifying critical knowledge areas of an organization, study large networks and identifying the knowledge flow using nodes and vertices, visualizing information, represent organizational structure etc. Overall, the responses varied in different skills depending on the performance and presentations. However, generally all participants have demonstrated average level of using both the IT and Non-IT K-mapping tools and techniques during simulation exercises, analysis paper de-briefing, case study reports, post visit presentation, course review, current issue presentation, syndicate meetings, and daily synopsis. Research Limitations: This study is conducted on a small-scale population of 67 public sector employees nominated by federal government to undergo 14 weeks extensive training program called MCMC (Mid-Career Management Course) at National Institute of Management, Peshawar, Pakistan. Results, however, reflects only a specific class of public sector employees i.e. working in grade 18 and having more than 5 years of work. Practical Implications: Research findings are useful for trainers, training agencies, government functionaries, and organizations working for capacity building of public sector employees.

Keywords: knowledge management, km in public sector, knowledge management and professional development, knowledge management in training, knowledge mapping

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Authors: Ali Alahmari

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Urban drainage in Saudi Arabia is an increasingly challenging issue due to factors such as climate change and rapid urban expansion. The existing infrastructure, based on traditional drainage systems, is not always able to cope with the increased precipitation, sometimes leading to rainwater runoff and floods causing disturbances and damage to property. Therefore, there is a need to find new ways of managing drainage, such as Sustainable Urban Drainage Systems (SUDS). The research has highlighted the main driving forces behind the need for change, revealed by the participants, to the need to adopt new ideas and approaches for urban drainage. However, while moving towards this, certain factors that may hinder the aim of using the experiences of other countries and taking advantage of innovative solutions. The research illustrates an initial conceptual model for these factors emerging from the analysis. It identifies some of the fundamental issues affecting the resistance to change towards the adoption of the concept of sustainability in Saudi Arabia, with Riyadh city as a case study. This was by using a qualitative approach, whereby, through two phases of fieldwork during 2013 and 2014, twenty-six semi-structured interviews were conducted with a number of representative officials and professionals from key government departments and organisations related to urban drainage management. Grounded Theory approach was followed to analyse the qualitative data obtained. Resistance to change was classified to: firstly: individual inertia (e.g. familiarity with the conventional solutions and approaches, lack of awareness, and considering sustainability as a marginal matter in urban planning). This resulted in not paying the desired attention, and impact on planning and setting priorities for development. Secondly: institutionalised inertia (e.g. lack of technical and design specifications for other unconventional drainage solutions, lack of consideration by decision makers in other disciplines such as contributions from environmental and geographical studies, and routine work and bureaucracy). This contributes to the weakness of decision-making, weakness in the role of research, and a lack of human resources. It seems that attitudes towards change may have reduced the ability to move forward towards sustainable development, in addition to contributing towards difficulties in some aspects of the decision-making process. Thus, the chapter provides insights into the current situation in Saudi Arabia and contributes to understanding the decisions that are made regarding change.

Keywords: climate change, new knowledge and approaches, resistance to change, Saudi Arabia, SUDS, urban drainage, urban expansion

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Authors: Bridgette Merriman, Wen Fan

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Background: Existing cancer survivorship literature explores varying physical, psychosocial, and psychological late effects experienced by survivors of childhood cancer. However, adolescent and young adult (AYA) survivors of childhood cancer are understudied compared to their adult and pediatric cancer counterparts. Furthermore, existing quality of life (QoL) research fails to account for how cancer survivorship affects survivors across the lifespan. Given that prior research suggests positive cognitive appraisals of adverse events - such as cancer - mitigate detrimental psychosocial symptomologies later in life; it is crucial to understand cancer’s impacts on AYA survivors of childhood malignancies across the life course in order to best support these individuals and prevent maladaptive psychosocial outcomes. Methods: This qualitative study adopted the life-course perspective to investigate the experiences of AYA survivors of childhood malignancies. Eligible patients included AYA 21-30 years old who were diagnosed with cancer <18 years old and off active treatment for >2 years. Participants were recruited through social media posts. Study fulfillment included taking part in one semi-structured video interview to explore areas of survivorship previously identified as being specific to AYA survivors. Interviews were transcribed, coded, and analyzed in accordance with narrative analysis and life-course theory. This study was approved by the Boston College Institutional Review Board. Results: Of 28 individuals who met inclusion criteria and expressed interest in the study, nineteen participants (12 women, 7 men, mean age 25.4 years old) completed the study. Life course theory analysis revealed that events relating to childhood cancer are interconnected throughout the life course rather than isolated events. This “trail of survivorship” includes age at diagnosis, transitioning to life after cancer, and relationships with other childhood survivors. Despite variability in objective characteristics surrounding these events, participants recalled positive experiences regarding at least one checkpoint, ultimately finding positive meaning from their cancer experience. Conclusions: These findings suggest that favorable subjective experiences at these checkpoints are critical in fostering positive conceptions of childhood malignancy for AYA survivors of childhood cancer. Ultimately, healthcare professionals and communities may use these findings to guide support resources and interventions for childhood cancer patients and AYA survivors, therein minimizing detrimental psychosocial effects and maximizing resiliency.

Keywords: medical sociology, pediatric oncology, survivorship, qualitative, life course perspective

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Authors: Anthea Carol Nefdt

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In this article, observations are drawn from a number of interviews conducted with female executives in the South African Oil Industry in 2017. Globally, the oil industry represents one of the most male-dominated organisational structures as well as cultures in the business world. Some of the remarkable women, who hold upper management positions, have not only emerged from the science and finance spheres (equally gendered organisations) but also navigated their way through an aggressive, patriarchal atmosphere of rivalry and competition. We examine various mythology associated with the industry, such as the cowboy myth, the frontier ideology and the queen bee syndrome directed at female executives. One of the themes to emerge from my interviews was the almost unanimous rejection of the ‘glass ceiling’ metaphor favoured by some Feminists. The women of the oil industry rather affirmed a picture of their rise to leadership positions through a strategic labyrinth of challenges and obstacles both in terms of gender and race. This article aims to share the insights of women leaders in a complex industry through both their reflections and a theoretical Feminist lens. The study is located within the South African context and given our historical legacy, it was optimal to use an intersectional approach which would allow issues of race, gender, ethnicity and language to emerge. A qualitative research methodological approach was employed as well as a thematic interpretative analysis to analyse and interpret the data. This research methodology was used precisely because it encourages and acknowledged the experiences women have and places these experiences at the centre of the research. Multiple methods of recruitment of the research participants was utilised. The initial method of recruitment was snowballing sampling, the second method used was purposive sampling. In addition to this, semi-structured interviews gave the participants an opportunity to ask questions, add information and have discussions on issues or aspects of the research area which was of interest to them. One of the key objectives of the study was to investigate if there was a difference in the leadership styles of men and women. Findings show that despite the wealth of literature on the topic, to the contrary some women do not perceive a significant difference in men and women’s leadership style. However other respondents felt that there were some important differences in the experiences of men and women superiors although they hesitated to generalise from these experiences Further findings suggest that although the oil industry provides unique challenges to women as a gendered organization, it also incorporates various progressive initiatives for their advancement.

Keywords: petroleum industry, gender, feminism, leadership

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Authors: Abdelmanie Suleimat, Nagham Abu Shaqra, Sawsan Majali, Issam Adawi, Heba Abo Shindi, Anas Al Mohtaseb

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The Government of Jordan recognizes that maternal mortality constitutes a grave public health problem. Over the past two decades, there has been significant progress in improving the quality of maternal health services, resulting in improved maternal and child health outcomes. Despite these efforts, measurement and analysis of maternal mortality remained a challenge, with significant discrepancies from previous national surveys that inhibited accuracy. In response with support from USAID, the Jordan Maternal Mortality Surveillance Response (JMMSR) System was established to collect, analyze, and equip policymakers with data for decision-making guided by interdisciplinary multi-levelled advisory groups aiming to eliminate preventable maternal deaths, A 2016 Public Health Bylaw required the notification of deaths among women of reproductive age. The JMMSR system was launched in 2018 and continues annually, analyzing data received from health facilities, to guide policy to prevent avoidable deaths. To date, there have been four annual national maternal mortality reports (2018-2021). Data is collected, reviewed by advisory groups, and then consolidated in an annual report to inform and guide the Ministry of Health (MOH); JMMSR collects the necessary information to calculate an accurate maternal mortality ratio and assists in identifying leading causes and contributing factors for each maternal death. Based on this data, national response plans are created. A monitoring and evaluation plan was designed to define, track, and improve implementation through indicators. Over the past four years, one of these indicators, ‘percent of facilities notifying respective health directorates of all deaths of women of reproductive age,’ increased annually from 82.16%, 92.95%, and 92.50% to 97.02%, respectively. The Government of Jordan demonstrated commitment to the JMMSR system by designating the MOH to primarily host the system and lead the development and dissemination of policies and procedures to standardize implementation. The data was translated into practical and evidence-based recommendations. The successful impact of results deepened the understanding of maternal mortality in Jordan, which convinced the MOH to amend the Bylaw now mandating electronic reporting of all births and neonatal deaths from health facilities to empower the JMMSR system, by developing a stillbirths and neonatal mortality surveillance and response system.

Keywords: maternal health, maternal mortality, preventable maternal deaths, maternal morbidity

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Authors: Dawit Hoyiso, Abinet Arega, Terefe Markos

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Background: - In spite of all the various programs and strategies to promote the use of research finding there is still gap between theory and practice. Difference in outcomes, health inequalities, and poorly performing health service continue to present a challenge to all nurses. A number of studies from various countries have reported that nurses’ experience of evidence-based practice is low. In Ethiopia there is an information gap on the extent of evidence based nursing practice and its associated factors. Objective: - the study aims to assess the implementation of evidence based nursing practice and associated factors among nurses in Jimma zone public hospitals. Method: - Institution based cross-sectional study was conducted from March 1-30/2015. A total of 333 sampled nurses for quantitative and 8 in-depth interview of key informants were involved in the study. Semi-structured questionnaire was adapted from funk’s BARRIER scale and Friedman’s test. Multivariable Linear regression was used to determine significance of association between dependent and independent variables. Pretest was done on 17 nurses of Bedele hospital. Ethical issue was secured. Result:-Of 333 distributed questionnaires 302 were completed, giving 90.6% response rate. Of 302 participants 245 were involved in EBP activities to different level (from seldom to often). About forty five(18.4%) of the respondents had implemented evidence based practice to low level (sometimes), one hundred three (42 %) of respondents had implemented evidence based practice to medium level and ninety seven (39.6 %) of respondents had implemented evidence based practice to high level(often). The first greatest perceived barrier was setting characteristic (mean score=26.60±7.08). Knowledge about research evidence was positively associated with implementation of evidence based nursing practice (β=0.76, P=0.008). Similarly, Place where the respondent graduated was positively associated with implementation of evidence based nursing practice (β=2.270, P=0.047). Also availability of information resources was positively associated with implementation of evidence based practice (β=0.67, P= 0.006). Conclusion: -Even though larger portion of nurses in this study were involved in evidence-based practice whereas small number of participants had implemented frequently. Evidence-based nursing practice was positively associated with knowledge of research, place where respondents graduated, and the availability of information resources. Organizational factors were found to be the greatest perceived barrier. Intervention programs on awareness creation, training, resource provision, and curriculum issues to improve implementation of evidence based nursing practice by stakeholders are recommended.

Keywords: evidence based practice, nursing practice, research utilization, Ethiopia

Procedia PDF Downloads 96

Authors: Liane J. Ioannou, Jonathan Serpell, Joanne Dean, Cino Bendinelli, Jenny Gough, Dean Lisewski, Julie Miller, Win Meyer-Rochow, Stan Sidhu, Duncan Topliss, David Walters, John Zalcberg, Susannah Ahern

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Background: The occurrence of thyroid cancer is increasing throughout the developed world, including Australia and New Zealand, and since the 1990s has become the fastest increasing malignancy. Following the success of a number of institutional databases that monitor outcomes after thyroid surgery, the Australian and New Zealand Endocrine Surgeons (ANZES) agreed to auspice the development of a bi-national thyroid cancer registry. Objectives: To establish a bi-national population-based clinical quality registry with the aim of monitoring and improving the quality of care provided to patients diagnosed with thyroid cancer in Australia and New Zealand. Patients and Methods: The Australian and New Zealand Thyroid Cancer Registry (ANZTCR) captures clinical data for all patients, over the age of 18 years, diagnosed with thyroid cancer, confirmed by histopathology report, that have been diagnosed, assessed or treated at a contributing hospital. Data is collected by endocrine surgeons using a web-based interface, REDCap, primarily via direct data entry. Results: A multi-disciplinary Steering Committee was formed, and with operational support from Monash University the ANZTCR was established in early 2017. The pilot phase of the registry is currently operating in Victoria, New South Wales, Queensland, Western Australia and South Australia, with over 30 sites expected to come on board across Australia and New Zealand in 2018. A modified-Delphi process was undertaken to determine the key quality indicators to be reported by the registry, and a minimum dataset was developed comprising information regarding thyroid cancer diagnosis, pathology, surgery, and 30-day follow up. Conclusion: There are very few established thyroid cancer registries internationally, yet clinical quality registries have shown valuable outcomes and patient benefits in other cancers. The establishment of the ANZTCR provides the opportunity for Australia and New Zealand to further understand the current practice in the treatment of thyroid cancer and reasons for variation in outcomes. The engagement of endocrine surgeons in supporting this initiative is crucial. While the pilot registry has a focus on early clinical outcomes, it is anticipated that future collection of longer-term outcome data particularly for patients with the poor prognostic disease will add significant further value to the registry.

Keywords: thyroid cancer, clinical registry, population health, quality improvement

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Authors: John Acire, Wilfred Lajul, Ogwang Tom

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Using a qualitative research technique, this study investigates the influence of Early Childhood Education (ECE) on learning outcomes in lower primary schools in Gulu City, Uganda. The study, which is based on Vygotsky's sociocultural theory of human learning, fills gaps in the current literature on the influence of ECE on learning outcomes. The aims of the study include analyzing the state of learning outcomes, investigating ECE practices, and determining the influence of these practices on learning outcomes in lower primary schools. The findings highlight the critical significance of ECE in promoting children's overall development. Nursery education helps children improve their handwriting, reading abilities, and general cognitive development. Children who have received nursery education have improved their abilities to handle pencils, form letters, and engage in social interactions, highlighting the significance of fine motor skills and socializing. Despite the good elements, difficulties in implementing ECE practices were found, such as differences in teaching styles, financial limits, and potential weariness due to prolonged school hours. The study suggests focused interventions to improve the effectiveness of ECE practices, ensure their connection with educational goals and maximize their influence on children's development. The study's findings show that respondents agree on the importance of nursery education in supporting holistic development, socialization, language competency, and conceptual comprehension. Challenges in nursery education, such as differences in teaching techniques and insufficient resources, highlight the need for comprehensive measures to address these challenges. Furthermore, parental engagement in home learning activities was revealed as an important factor affecting early education outcomes. Children who were engaged at home performed better in lower primary, emphasizing the value of a supportive family environment. Finally, the report suggests measures to enhance parental participation, changes in teaching methods through retraining, and age-appropriate enrolment. Future studies might concentrate on the involvement of parents, ECE policy practice, and the influence of ECE teachers on lower primary school learning results. These ideas are intended to help create a more favorable learning environment by encouraging holistic development and preparing children for success in succeeding academic levels.

Keywords: early childhood education, learning outcomes in lower primary schools, early childhood education practices, how ECE practices influence learning outcomes in lower primary schools

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Authors: Anis Al-Yakhiri

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Introduction: The World Health Organization (WHO) classifies malignant epithelial thyroid tumors into four major groups (papillary, follicular, medullar and undifferentiated) . Papillary thyroid carcinoma (PTC) is the most common type, for about eight out of ten thyroid cancers belong to this histological type. Radioactive iodine (RAI) is considered effective for patients with total or nearly total thyroidectomy, but the beneficial effects of RAI are still controversial. War conditions forced us to study alternative methods of using radioactive iodine in the treatment of patients with PTC. Material and methods: Between January 2014 and June 2021, in Al-Yakhiri hospital, 57 Total Thyroidectomy with Radical BilateralNeckDissection (RBND) were performed, 50 for malignant disease,7 for false positive cytology.RBND involves surgical clearance of Levels II-VI. Mean age was 40.7 years old and 92% of the patients were female. 7(14%) patients had hypothyroidism which required preoperative thyroid hormone treatment. The Thyroid Stimulating Hormone- Suppression Therapy (TSH-ST) immediately started after RBND for mostpatients on the first day. It consisted in reducing the level of TSH< 0.1 mIU/L. Results: The Apron flap was used on most operations (40)80% and with lateral extensions had 10(20%). RBND involves surgical clearance of Levels II-VI performed in all operated patients, besides that, 4(8%) of them had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV) withclearance of Levels IB. The PTC was the most common 80.9% (38 patients from 47)by histopathological report. and 4(8%) patients of 50 had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV). The postoperative mortality rate not observed (0%). The postoperative morbidity rate was 22.8% (n =13).Seroma(8.7%),Hypocalcimia(7%), Wound infection(5.3%), Bleeding(1.8%). To suppress TSH and growth of any residual thyroid theTSH-ST (levothyroxine150 – 600mcg)was performed in all patients 57(100%) on the first day afterRBND. We tracked the results of treatment for two years in 30 patients with PTC, only 3 of them received radioactive iodine abroad. Biennial Recurrence rate for PTC appeared in one woman (2%), who had RAI postoperatively in the form of neck lymph nodes metastasis. Conclusion: For patients with PTC, thyroidectomy plus prophylacticRBND is a safe and efficient procedure and it results in lower recurrence rate. Postoperative treatment with exogenous thyroid hormone in doses sufficient to suppress TSH (not less than 150mcg), decreases incidence of recurrence. Total Thyroidectomy with RBND followed by TSH-ST, in our opinion, applicable optimal treatment scheme care for this patient population.

Keywords: thyroid cancer, Yemen war, absence of radioactive iodine, neck dissection, surgery results

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Authors: Bing Xu, Kerry Lee, Jason M. Stephen

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Collaborative learning (CL) has been regarded as a way to facilitate students to gain knowledge and improve social skills. In China, lecturers in higher education institutions have commonly adopted CL in their daily practice. However, such a strategy could not be effective when it is designed and applied in an inappropriate way. Previous research hardly focused on how CL was applied in Chinese universities. This present study aims to gain a deep understanding of how Chinese lecturers design and implement CL tasks. The researchers interviewed ten lecturers from different faculties in various universities in China and usedGroup Learning Activity Instructional Design (GLAID) framework to analyse the data. We found that not all lecturers pay enough attention to eight essential components (proposed by GLAID) when they designed CL tasks, especially the components of Structure and Guidance. Meanwhile, only a small part of lecturers made formative assessment to help students improve learning. We also discuss the strengths and limitations and CL design and further provide suggestions to the lecturers who intend to use CL in class. Research Objectives: The aims of the present research are threefold. We intend to 1) gain a deep understanding of how Chinese lecturers design and implement collaborative learning (CL) tasks, 2) find strengths and limitations of CL design in higher education, and 3) give suggestions about how to improve the design and implement. Research Methods: This research adopted qualitative methods. We applied the semi-structured interview method to interview ten Chinese lecturers about how they designed and implemented CL tasks in their courses. There were 9 questions in the interview protocol focusing on eight components of GLAID. Then, underpinning the GLAID framework, we utilized the coding reliability thematic analysis method to analyse the research data. The coding work was done by two PhD students whose research fields are CL, and the Cohen’s Kappa was 0.772 showing the inter-coder reliability was good. Contribution: Though CL has been commonly adopted in China, few studies have paid attention to the details about how lecturers designed and implemented CL tasks in practice. This research addressed such a gap and found not lecturers were aware of how to design CL and felt it difficult to structure the task and guide the students on collaboration, and further ensure student engagement in CL. In summary, this research advocates for teacher training; otherwise, students may not gain the expected learning outcomes.

Keywords: collaborative learning, higher education, task design, GLAID framework

Procedia PDF Downloads 99

Authors: Babatope David Omoniyi, Fiona Lalor, Sinead Furey

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This ongoing project investigates the impact of Brexit on consumer perceptions of trust in the food industry. Brexit has significantly impacted the food industry, triggering a paradigm shift in the movement of food/agricultural produce, regulations, and cross-border collaborations between Great Britain, Northern Ireland, and the Republic of Ireland. In a world where the dynamics have shifted because of regulatory changes that impact trade and the free movement of foods and agricultural produce between these three countries, monitoring and controlling every stage of the food supply chain have become challenging, increasing the potential for food fraud and food safety incidents. As consumers play a pivotal role in shaping the market, understanding any shifts in trust post-Brexit enables them to navigate the market with confidence and awareness. This study aims to explore the complexities of consumer perceptions, focusing on trust as a cornerstone of consumer confidence in the post-Brexit food landscape. The objectives include comparing trust in official controls pre- and post-Brexit, determining consumer awareness of food fraud, and devising recommendations that reflect the evidence from this primary research regarding consumer trust in food authenticity post-Brexit. The research design follows an exploratory sequential mixed methods approach, incorporating qualitative methods such as focus groups and structured interviews, along with quantitative research through a large-scale survey. Participants from UCD and Ulster University campuses, comprising academic and non-academic staff, students, and researchers, will provide insights into the impact of Brexit on consumer trust. Preliminary findings from focus groups and interviews highlight changes in labelling, reduced quantity and quality of foods in both Northern Ireland and the Republic of Ireland, fewer food choices, and increased food prices since Brexit. The study aims to further investigate and quantify these impacts through a comprehensive large-scale survey involving participants from Northern Ireland and the Republic of Ireland. The results will inform official controls and consumer-facing messaging contributing valuable insights to navigate the evolving post-Brexit food landscape.

Keywords: Brexit, consumer trust, food fraud, food authenticity, food safety, food industry

Procedia PDF Downloads 47

Authors: Pratima Thapa

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Background: It is very critical to understand that awareness of family planning and proper utilization of contraceptives is an important indicator for reducing maternal and neonatal mortality and morbidity. It also plays an important role in promoting reproductive health of the women in an underdeveloped country like ours. Objective: To assess knowledge, attitude and practices of contraception among married women of reproductive age group in selected wards of Dharan Sub-Metropolitan City. Materials and methods: A cross-sectional descriptive study was conducted among 209 married women of reproductive age. Simple random sampling was used to select the wards, population proportionate sampling for selecting the sample numbers from each wards and purposive sampling for selecting each sample. Semi-structured questionnaire was used to collect data. Descriptive and inferential statistics were used to interpret the data considering p-value 0.05. Results: The mean ± SD age of the respondents was 30.01 ± 8.12 years. Majority 92.3% had ever heard of contraception. Popular known method was Inj. Depo (92.7%). Mass media (85.8%) was the major source of information. Mean percentage score of knowledge was 45.23%.less than half (45%) had adequate knowledge. Majority 90.4% had positive attitude. Only 64.6% were using contraceptives currently. Misbeliefs and fear of side effects were the main reason for not using contraceptives. Education, occupation, and total income of the family was associated with knowledge regarding contraceptives. Results for Binary Logistic Regression showed significant correlates of attitude with distance to the nearest health facility (OR=7.97, p<0.01), education (OR=0.24, p<0.05) and age group (0.03, p<0.01). Regarding practice, likelihood of being current user of contraceptives increased significantly by being literate (OR=5.97, p<0.01), having nuclear family (OR=4.96, p<0.01), living in less than 30 minute walk distance from nearest health facility (OR=3.34, p<0.05), women’s participation in decision making regarding household and fertility choices (OR=5.23, p<0.01) and husband’s support on using contraceptives (OR=9.05, p<0.01). Significant and positive correlation between knowledge-attitude, knowledge-practice and attitude-practice were observed. Conclusion: Results of the study indicates that there is need to increase awareness programs in order to intensify the knowledge and practices of contraception. The positive correlation indorses that better knowledge can lead to positive attitude and hence good practice. Further, projects aiming to increase better counselling about contraceptives, its side effects and the positive effects that outweighs the negative aspects should be enrolled appropriately.

Keywords: attitude, contraceptives, knowledge, practice

Procedia PDF Downloads 269

Authors: Serag El Hegazi

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The development of an assessment methodological framework for local and institutional sustainability is a key factor for future development plans and visions. This paper develops an approach to local and institutional sustainability assessment (ALISA). The ALISA methodology is a methodological framework that assists in the clarification, formulation, preparation, selection, and ranking of key indicators to facilitate the assessment of the level of sustainability at the local and institutional levels in North African and Middle Eastern cities. According to the literature review, this paper formulates a methodological framework, ALISA, which is a combination of the UNCSD (2001) Theme Indicators Framework and the issue-based Framework illustrated by McLaren (1996). The methodological framework has been implemented to formulate, select, and prioritise key indicators that most directly reflect the issues of a case study at the local community and institutional level. Yet, in the meantime, there is a lack of clear indicators and frameworks that can be developed to apply successfully at the local and institutional levels in the MENA Region, particularly in the cities of Benghazi and Amman. This is an essential issue for sustainability development estimation. Therefore, a conceptual framework was developed to be tested as a methodology to collect and classify data. The Approach to Local and Institutional Sustainability Assessment (ALISA) is a methodological framework that was developed to apply to certain cities in the MENA region. The main goal is to develop the ALISA framework to formulate, choose, and prioritize sustainability key indicators, which then can assist in guiding an assessment progress to improve decisions and policymakers towards the development of sustainable cities at the local and institutional level in the city of Benghazi. The conceptual, methodological framework, which supports this research with joint documentary and analysed data in two case studies, including focus-group discussions, semi-structured interviews, and questionnaires, reflects the approach required to develop a combined framework that assists the development of sustainability indicators. To achieve this progress and reach the aim of this paper, which is developing a practical approach for sustainability indicators framework that could be used as a tool to develop local and institutional sustainability indicators, appropriate stages must be applied to propose a set of local and institutional sustainability indicators as follows: Step one: issues clarifications, Step two: objectives formation/analysing of issues and boundaries, Step three: indicators preparation, First list of proposed indictors, Step four: indicator selection, Step five: indicator rating/ranking.

Keywords: sustainability indicators, approach to local and institutional level, ALISA, policymakers

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Authors: Jason Hoellwarth, Atiya Oomatia, Anuj Chavan, Kevin Tetsworth, Munjed Al Muderis

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Introduction: Percutaneous EndoProsthetic Osseointegration for Limbs (PEPOL) facilitates improved quality of life (QOL) and objective mobility for most amputees discontent with their traditional socket prosthesis (TSP) experience. Some amputees desiring PEPOL have residual bone much shorter than the currently marketed press-fit implant lengths of 14-16 cm, potentially a risk for failure to integrate. We report on the techniques used, complications experienced, the management of those complications, and the overall mobility outcomes of seven patients who had femur distraction osteogenesis (DO) with a Freedom nail followed by PEPOL. Method: Retrospective evaluation of a prospectively maintained database identified nine patients (5 females) who had transfemoral DO in preparation for PEPOL with two years of follow-up after PEPOL. Six patients had traumatic causes of amputation, one had perinatal complications, one was performed to manage necrotizing fasciitis and one was performed as a result of osteosarcoma. Result: The average age at which DO commenced was 39.4±15.9 years, and seven patients had their amputation more than ten years prior (average 25.5±18.8 years). The residual femurs, on average, started at 102.2±39.7 mm and were lengthened 58.1±20.7 mm, 98±45% of the goal (99±161% of the original bone length). Five patients (56%) had a complication requiring additional surgery: four events of inadequate regeneration were managed with continued lengthening to the desired goal followed by autograft placement harvested from contralateral femur reaming; one patient had the cerclage wires break, which required operative replacement. All patients had osseointegration performed at 355±123 days after the initial lengthening nail surgery. One patient had K-level >2 before DO, at a mean of 3.4±0.6 (2.6-4.4) years following osseointegration. Six patients had K-level >2. The 6-Minute Walk Test remained unchanged (267±56 vs. 308 ± 117 meters). Patient self-rating of prosthesis function, problems, and amputee situation did not significantly change from before DO to after osseointegration. Six patients required additional surgery following osseointegration: six to remove fixation plates placed to maintain distraction osteogenesis length at osseointegration; two required irritation and debridement for infection. Conclusion: Extremely short residual femurs, which make TSP use troublesome, can be lengthened with externally controlled telescoping nails and successfully achieve osseointegration. However, it is imperative to counsel patients that additional surgery to address inadequate regeneration or to remove painful hardware used to maintain fixation may be necessary. This may improve the amputee’s expectations before beginning a potentially arduous process.

Keywords: osseointegration, limb lengthening, quality of life, amputation

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Authors: Chia-Wen Wang, Patou Masika Musumari, Teeranee Techasrivichien, S. Pilar Suguimoto, Chang-Chuan Chan, Masako Ono-Kihara, Masahiro Kihara

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Background: In recent years, a particular form of bullying, referred to as 'cyberbullying' has emerged along with the rapid expansion of the Internet, social network services (SNSs) and smart phones. Many Asian countries, including Taiwan, are faced with both the cyberbullying and the traditional form of bullying. This study aims to explore Taiwanese adolescents’ experiences, perceptions and opinions regarding cyberbullying and traditional bullying through the perspective of victim, perpetrator, or witness. Method: This is a qualitative study using face-to-face in-depth interviews guided by a semi-structured questionnaire among high school students -aged 16 to 18 years- in Taipei, Taiwan. The participants were recruited through convenience sampling from five high schools between June and November 2016. Interviews were digitally recorded, transcribed, and analyzed using the thematic analysis approach. Results: Forty-eight participants were recruited, of which, 14 (29.2%) reported had ever experienced bullying. Specifically, 7 participants (14.6%) reported had ever been victims of cyberbullying, 1 (2%) had been victims of traditional bullying, and 6 (12.5%) had been victims of both cyber and traditional bullying. The majority (70.8%) reported had ever witnessed acts of bullying; however, none of the participants recognized had ever been a perpetrator of bullying. Cyberbullying mostly happens on social media (Facebook and Instagram) or LINE instant messaging application, and included upload and sharing of degrading pictures and videos of victims, as well as gossip and mean messages by the perpetrators. The anonymous and public nature of social media groups in schools made it easier to perpetrate bullying. The victim of traditional bullying reported being the target of verbal attack because of his physical appearance. Regardless of the type of bullying, victims reported feeling bad, angry, or depressed as a result of being bullied. Witnesses of both cyber- and traditional bullying cited physical appearance (e.g. having the big/flat bust or big butt, or overweight or obese) and disability as the most reasons of being a bullying victim. Conclusion: Both cyberbullying and traditional bullying had negative emotional and psychological impacts on victims. This study warrants further research to assess the extent of this phenomenon and understand the characteristics of perpetrators, victims, and witnesses to inform the design of tailored interventions using appropriate channels of dissemination.

Keywords: cyberbullying, traditional bullying, social media, adolescents

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Authors: Susumu Fukita, Hiromi Kawasaki, Satoko Yamasaki, Kotomi Yamashita, Tomoko Iki

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The increase in the number of workers with mental health problems has become an issue. Many workers work in small- and medium-sized enterprises, which often support local employment and economy, especially in underpopulated mountainous areas. It is important for managers to take mental health measures for employees since there is no budget to hire health staff in small- and medium-sized enterprises. It is necessary to understand the manager's attitude toward the mental health of employees and to publicly support the manager in promoting mental health measures for employees. The purpose of this study was to study the awareness of managers of small- and medium-sized enterprises regarding the mental health of employees and to consider support for managers to take measures for the mental health of employees. Semi-structured interviews were conducted with six managers of small- and medium-sized enterprises in underpopulated mountainous areas in November 2019. Managers were asked about their awareness of the mental health of their employees. Qualitative descriptive analysis was used, and subcategories and categories were extracted. Four categories emerged. Regarding the mental health of employees, the managers acknowledged that if the appearance and behavior of the employees do not interfere with their lives, the manager judges that the employees’ mental health is normal. It was also found that the managers acknowledged that there is a comfortable working environment due to the characteristics of the underpopulated mountainous area. On the other hand, the managers acknowledged that employees are dissatisfied with salaries and management systems. In addition, it was found the manager acknowledged that some employees retire due to mental health problems. Although managers recognized that employees may be dissatisfied with salaries, they also recognized that there was a comfortable working environment due to the characteristics of the areas, with good interpersonal relationships. Economic challenges are difficult to solve in underpopulated mountainous areas. It is useful to consider measures that take advantage of the characteristics of the areas where it is easy to work because of good relations with each other, for example, to create a family-like workplace culture where managers and employees can engage in daily conversation. The managers judged that the employees were in good health if there was no interference with their lives. However, it is too late to take measures at the stage when it becomes an obstacle to life. Therefore, it is necessary to provide training for managers to learn observation techniques by which they quickly notice changes in the situation of employees and give appropriate responses; and to set up a contact point for managers to consult. Local governments should actively provide public support such as training for managers and establishing consultation desks to maintain valuable employment and local economics in underpopulated mountainous areas.

Keywords: employer, mental health, small- and medium- sized enterprises, underpopulated areas

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Authors: Jinming Du

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With the COVID-19 pandemic beginning in 2020, many higher education institutions and education systems are turning to hybrid or fully distance online courses to maintain social distance and provide a safe virtual space for learning and teaching. However, the majority of faculty members were not well prepared for the shift to blended or distance learning. Communication frustrations are prevalent in both hybrid and full-distance courses. A systematic literature review was conducted by a comprehensive analysis of 1688 publications that focused on the application of the adoption of chatbots in education. This study aimed to explore instructors' experiences with chatbots in online and blended undergraduate English courses. Language learners are overwhelmed by the variety of information offered by many online sites. The recently emerged chatbots (e.g.: ChatGPT) are slightly superior in performance as compared to those traditional through previous technologies such as tapes, video recorders, and websites. The field of chatbots has been intensively researched, and new methods have been developed to demonstrate how students can best learn and practice a new language in the target language. However, it is believed that among the many areas where chatbots are applied, while chatbots have been used as effective tools for communicating with business customers, in consulting and targeting areas, and in the medical field, chatbots have not yet been fully explored and implemented in the field of language education. This issue is challenging enough for language teachers; they need to study and conduct research carefully to clarify it. Pedagogical chatbots may alleviate the perception of a lack of communication and feedback from instructors by interacting naturally with students through scaffolding the understanding of those learners, much like educators do. However, educators and instructors lack the proficiency to effectively operate this emerging AI chatbot technology and require comprehensive study or structured training to attain competence. There is a gap between language teachers’ perceptions and recent advances in the application of AI chatbots to language learning. The results of the study found that although the teachers felt that the chatbots did the best job of giving feedback, the teachers needed additional training to be able to give better instructions and to help them assist in teaching. Teachers generally perceive the utilization of chatbots to offer substantial assistance to English language instruction.

Keywords: artificial intelligence in education, chatbots, education and technology, education system, pedagogical chatbot, chatbots and language education

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Authors: Yi-Ting Chen, Yu-Fang Huang, Pei-Wei Wang, Hai-Wei Liang, Chun-Hao Lai, Mei-Lien Chen

Abstract:

Background: Bisphenol A (BPA) is commonly used in consumer products, such as inner coatings of cans and polycarbonated bottles. BPA is considered to be an endocrine disrupting substance (EDs) that affects normal human hormones and may cause adverse effects on human health. Pregnant women and fetuses are susceptible groups of endocrine disrupting substances. Prenatal exposure to BPA has been shown to affect the fetus through the placenta. Therefore, it is important to evaluate the potential health risk of fetal exposure to BPA during pregnancy. The aims of this study were (1) to determine the urinary concentration of BPA in pregnant women, and (2) to investigate the association between BPA exposure during pregnancy and birth outcomes. Methods: This study recruited 117 pregnant women and their fetuses from 2012 to 2014 from the Taiwan Maternal- Infant Cohort Study (TMICS). Maternal urine samples were collected in the third trimester and questionnaires were used to collect socio-demographic characteristics, eating habits and medical conditions of the participants. Information about birth outcomes of the fetus was obtained from medical records. As for chemicals analysis, BPA concentrations in urine were determined by off-line solid-phase extraction-ultra-performance liquid chromatography coupled with a Q-Tof mass spectrometer. The urinary concentrations were adjusted with creatinine. The association between maternal concentrations of BPA and birth outcomes was estimated using the logistic regression model. Results: The detection rate of BPA is 99%; the concentration ranges (μg/g) from 0.16 to 46.90. The mean (SD) BPA levels are 5.37(6.42) μg/g creatinine. The mean ±SD of the body weight, body length, head circumference, chest circumference and gestational age at birth are 3105.18 ± 339.53 g, 49.33 ± 1.90 cm, 34.16 ± 1.06 cm, 32.34 ± 1.37 cm and 38.58 ± 1.37 weeks, respectively. After stratifying the exposure levels into two groups by median, pregnant women in higher exposure group would have an increased risk of lower body weight (OR=0.57, 95%CI=0.271-1.193), smaller chest circumference (OR=0.70, 95%CI=0.335-1.47) and shorter gestational age at birth newborn (OR=0.46, 95%CI=0.191-1.114). However, there are no associations between BPA concentration and birth outcomes reach a significant level (p < 0.05) in statistics. Conclusions: This study presents prenatal BPA profiles and infants in northern Taiwan. Women who have higher BPA concentrations tend to give birth to lower body weight, smaller chest circumference or shorter gestational age at birth newborn. More data will be included to verify the results. This report will also present the predictors of BPA concentrations for pregnant women.

Keywords: bisphenol A, birth outcomes, biomonitoring, prenatal exposure

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