Search results for: family care team
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7428

Search results for: family care team

3228 Wireless Based System for Continuous Electrocardiography Monitoring during Surgery

Authors: K. Bensafia, A. Mansour, G. Le Maillot, B. Clement, O. Reynet, P. Ariès, S. Haddab

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This paper presents a system designed for wireless acquisition, the recording of electrocardiogram (ECG) signals and the monitoring of the heart’s health during surgery. This wireless recording system allows us to visualize and monitor the state of the heart’s health during a surgery, even if the patient is moved from the operating theater to post anesthesia care unit. The acquired signal is transmitted via a Bluetooth unit to a PC where the data are displayed, stored and processed. To test the reliability of our system, a comparison between ECG signals processed by a conventional ECG monitoring system (Datex-Ohmeda) and by our wireless system is made. The comparison is based on the shape of the ECG signal, the duration of the QRS complex, the P and T waves, as well as the position of the ST segments with respect to the isoelectric line. The proposed system is presented and discussed. The results have confirmed that the use of Bluetooth during surgery does not affect the devices used and vice versa. Pre- and post-processing steps are briefly discussed. Experimental results are also provided.

Keywords: electrocardiography, monitoring, surgery, wireless system

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3227 Assessment of Dietary Intake of Pregnant Women

Authors: Tuleshova Gulnara, Abduldayeva Aigul

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The goal is based on the studying the prevalence of micronutrient deficiencies among children and women of reproductive age to develop evidence-based recommendations aimed at improving the effectiveness of programs to prevent micronutrient deficiency. Subject: In our study we used a representative, random sample, carried out with the cluster method in the precinct of the principle areas of medical care for children 5 years of old. If the site has at least 60 children under 5 years of old, each second child was sampled, and if more than 60 children - each third child (first child selected by random sampling). The total number of investigated persons was within 80-86 women of reproductive age and children - within 80-92 people. Results: The studies found that the average prevalence of anemia among children aged 6-59 months was 35.2%, with the most susceptible to iron deficiency anemia in infants aged 6-23 months (53.3%). The prevalence of anemia among non-pregnant women was 39.0% among pregnant women - 43.8%. In children, the prevalence of folate deficiency was the highest (27.6%). Among non-pregnant women, frequent prevalence of folic acid deficiency was 37.0%. The prevalence of vitamin A deficiency was higher among children living in Astana (37.4%) compared with the medium-republican level (23.2%).

Keywords: nutrition, pregnant women, micronutrients, macronutrients

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3226 Investigation of Suicide by Poison as a Result of Domestic Violence

Authors: Nazih Ramadan, Ghada Hassabo

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Background and Aims: Domestic violence and other forms of violence against women and other family members are known to be substantial and widespread, with women more likely than men to be abused mostly by their partner, which is known as gender-based violence. Domestic violence is a major precipitating factor for suicide in many communities especially in our Middle East area. The aim of the study is to show the real relation between suicidal attempts and domestic violence especially in female victims. We tried also through this study to know the most common age at which the abused person attempt suicide, the perpetrator, the educational level of the abused person, and the social level of them. Materials and Methods: In this study, we collect data from 150 victims of suicidal attempts who came to seek medical help at National Poisoning Center. They were asked to answer a preformed questionnaire after giving consent. Results: The study shows that women are at higher risk for suicidal behavior and that suicidal attempt is directly proportionate to low level of education and low social class situation. Conclusion: the study shows the strong relation between attempting suicide and exposure to domestic violence. At the end of this work, we recommend understanding the broad scope and tragic impact of domestic violence; further research is needed concerning domestic violence-related suicide.

Keywords: Cairo, domestic violence, domestic violence-related suicide, violence against women

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3225 Investigation of Stress and Its Effects on Health Workers in Federal Medical Centres in Nigeria

Authors: Chisom N. Nwaigwe, Blessing N. Egbulefu, Angela Uwakwem

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A study on Stress and its’ effect on the health of workers in Federal Medical Centres in Nigeria is presented. The aim is to evaluate how much stress related hazards health workers in our tertiary health institutions are exposed to and to create awareness and reduce the rate at which stress affect the health of the working population in Nigeria, using workers in Federal Medical Centre, Umuahia as a case study. The descriptive survey design was adopted with the aid of 100 questionnaires delivered to the respondents in order to obtain first-hand information. From the findings, the major causes of stress were identified as inadequate staffing, unresolved family problems and psychological/cultural factors like the return of a lactating mother to work after three months post-delivery. The effects of stress on the workers were identified as hypertension, poor job performances, depression, asthma, and peptic ulcers. The study recommended instituting counseling units for stress management, holding seminars on stress management and increasing the salary scale (remuneration) and proper roster planning as solutions to stress reduction in our hospitals. This study is important to management in planning staffing, roaster, and a rehabilitation programme for her staff.

Keywords: stress, causes, effects, workers

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3224 Investigation of the Factors Influencing the Construction Planning Process Using Participant Observation Method

Authors: Ashokkumar Subbiah

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This study investigates the impact of factors that influenced the success of construction planning for a major construction project in Qatar. An approach of participant observation is adopted which is informed by the principles of ethnography: one that reports the participants’ view of their world rather than imposing an artificial theoretical framework upon it. As participant observant, key factors were observed and identified that had an impact on the management and execution of the construction planning. It is found that a ‘shadow culture’ exists between the project participants which, it is argued, is only observable from the perspective of an embedded participant observer. The shadow culture acts to enable the management of the planning process, and its efficacy relates to the ‘quality’ of human inter-relationships amongst immediate stakeholders. Whilst this study uses the concept of shadow culture, it is treated as both a methodological stance and one of the findings of this research in the context of the major construction project in Qatar. The concept of shadow culture is not imposed upon the findings, but instead is used as a research tool: respondents report their own worldview and this is reported from the view of a participant observant in a manner that is understandable and useful to those who are not part of the construction project. The findings of this study identify similar factors influencing the planning process of the Qatar project, but the shadow culture predominantly influences these factors towards the failure of planning process. The research concludes by questioning the assumption that construction planning is a mechanistic process that has to be conducted solely by the planning team. Instead, it is a highly social phenomenon in which the seemingly mechanistic process is made workable by the quality of relationships that exist in the project. Drawing on this the final section provides a series of recommendations that may be helpful in enhancing the efficacy of project planning; these include better training/education at the pre-construction phase; recognition of the importance of shadow processes at management levels, and better appreciation of the impact of contract type and chosen procurement route.

Keywords: construction planning, participant observation, project participants, shadow culture

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3223 Antioxidant Activity of Essential Oils and Ethanolic Extracts of Four Medicinal Plants Alone and in Combination

Authors: Fatiha Bedjou, Meriem Meddas, Tadjajikt Chekkal

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The present work aims to evaluate the antioxidant activity of ethanolic extracts and essential oils of aromatic plants of the Lamiaceae family: Thymus algeriensis and Salvia rosmarinus, and Anacardiaceae: Pistacia lentiscus, Myrtaceae: Eucalyptus polybracetea. The polyphenols were measured using the Folin-Ciocalteu method; the results showed that the essential oils studied as well as the ethanolic extracts are relatively rich in polyphenols. Their antioxidant properties were tested by the synthetic DPPH radical trapping method. The IC50 values were determined according to the graph representing the percentage of inhibition of the DPPH radical by essential oils and by ethanolic extracts, according to our results there is a correlation between the level of polyphenols present in the different essential oils and different ethanolic extracts and their ability to neutralize free radicals. Several combinations were carried out between the essential oils and also between the ethanolic extracts in order to determine the type of interactions existing between the combined substances, the results were represented in the form of isobolograms. Additive and super-additive effects were observed in combinations of essential oils, and super-additive and sub-additive effects were observed for combinations of ethanolic extracts.

Keywords: essential oils, ethanolic extracts, DPPH, combination

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3222 Assessing Measures and Caregiving Experiences of Thai Caregivers of Persons with Dementia

Authors: Piyaorn Wajanatinapart, Diane R. Lauver

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The number of persons with dementia (PWD) has increased. Informal caregivers are the major providing care. They can have perceived gains and burdens. Caregivers who reported high in perceived gains may report low in burdens and better health. Gaps of caregiving literature were: no report psychometrics in a few studies and unclear definitions of gains; most studies with no theory-guided and conducting in Western countries; not fully described relationships among caregiving variables: motivations, satisfaction with psychological needs, social support, gains, burdens, and physical and psycho-emotional health. Those gaps were filled by assessing psychometric properties of selected measures, providing clearly definitions of gains, using self-determination theory (SDT) to guide the study, and developing the study in Thailand. The study purposes were to evaluate six measures for internal consistency reliability, content validity, and construct validity. This study also examined relationships of caregiving variables: motivations (controlled and autonomous motivations), satisfaction with psychological needs (autonomy, competency, and relatedness), perceived social support, perceived gains, perceived burdens, and physical and psycho-emotional health. This study was a cross-sectional and correlational descriptive design with two convenience samples. Sample 1 was five Thai experts to assess content validity of measures. Sample 2 was 146 Thai caregivers of PWD to assess construct validity, reliability, and relationships among caregiving variables. Experts rated questionnaires and sent them back via e-mail. Caregivers answered questionnaires at clinics of four Thai hospitals. Data analysis was used descriptive statistics and bivariate and multivariate analyses using the composite indicator structural equation model to control measurement errors. For study results, most caregivers were female (82%), middle age (M =51.1, SD =11.9), and daughters (57%). They provided care for 15 hours/day with 4.6 years. The content validity indices of items and scales were .80 or higher for clarity and relevance. Experts suggested item revisions. Cronbach’s alphas were .63 to .93 of ten subscales of four measures and .26 to .57 of three subscales. The gain scale was acceptable for construct validity. With controlling covariates, controlled motivations, the satisfaction with three subscales of psychological needs, and perceived social support had positive relationships with physical and psycho-emotional health. Both satisfaction with autonomy subscale and perceived social support had negative relationship with perceived burdens. The satisfaction with three subscales of psychological needs had positive relationships among them. Physical and psycho-emotional health subscales had positive relationships with each other. Furthermore, perceived burdens had negative relationships with physical and psycho-emotional health. This study was the first use SDT to describe relationships of caregiving variables in Thailand. Caregivers’ characteristics were consistent with literature. Four measures were valid and reliable except two measures. Breadth knowledge about relationships was provided. Interpretation of study results was cautious because of using same sample to evaluate psychometric properties of measures and relationships of caregiving variables. Researchers could use four measures for further caregiving studies. Using a theory would help describe concepts, propositions, and measures used. Researchers may examine the satisfaction with psychological needs as mediators. Future studies to collect data with caregivers in communities are needed.

Keywords: caregivers, caregiving, dementia, measures

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3221 Malaria Menace in Pregnancy; Hard to Ignore

Authors: Nautiyal Ruchira, Nautiyal Hemant, Chaudhury Devnanda, Bhargava Surbhi, Chauhan Nidhi

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Introduction: South East Asian region contributes 2.5 million cases of malaria each year to the global burden of 300 to 500 million of which 76% is reported from India. Government of India launched a national program almost half a century ago, still malaria remains a major public health challenge. Pregnant women are more susceptible to severe malaria and its fetomaternal complications. Inadequate surveillance and under-reporting underestimates the problem. Aim: Present study aimed to analyze the clinical course and pattern of malaria during pregnancy and to study the feto-maternal outcome. Methodology: This is a prospective observational study carried out at Himalayan Institute of Medical Sciences – a tertiary care center in the sub-Himalayan state of Uttarakhand, Northern India. All the pregnant women with malaria and its complications were recruited in the study during 2009 to 2014 which included referred cases from the state of western Uttar Pradesh. A thorough history and clinical examination were carried out to assess maternal and fetal condition. Relevant investigations including haemogram, platelet count, LFT, RFT, and USG was done. Blood slides and rapid diagnostic tests were done to diagnose the type of malaria.The primary outcomes measured were the type of malaria infection, maternal complications associated with malaria, outcome of pregnancy and effect on the fetus. Results: 67 antenatal cases with malaria infection were studied. 71% patients were diagnosed with plasmodium vivax infection, 25% cases were plasmodium falciparum positive and in 3% cases mixed infection was found. 38(56%) patients were primigravida and 29(43%) were multiparous. Most of the patients had already received some treatment from their local doctors and presented with severe malaria with the complications. Thrombocytopenia was the commonest manifestation seen in 35(52%) patients, jaundice in 28%, severe anemia in 18%, and severe oligohydramnios in 10% and renal failure in 6% cases. Regarding pregnancy outcome there were 44 % preterm deliveries, 22% had IUFD and abortions in 6% cases.20% of newborn were low birth weight and 6% were IUGR. There was only one maternal death which occurred due to ARDS in falciparum malaria. Although Plasmodium vivax was the main parasite considering the severity of clinical presentation, all the patients received intensive care. As most of the patients had received chloroquine therapy hence they were treated with IV artesunate followed by oral artemesinin combination therapy. Other therapies in the form of packed RBC’s and platelet transfusions, dialysis and ventilator support were provided when required. Conclusion: Even in areas with annual parasite index (API) less than 2 like ours, malaria in pregnancy could be an alarming problem. Vivax malaria cannot be considered benign in pregnancy because of high incidence of morbidity. Prompt diagnosis and aggressive treatment can reduce morbidity and mortality significantly. Increased community level research, integrating ANC checkups with the distribution of insecticide-treated nets in areas of high endemicity, imparting education and awareness will strengthen the existing control strategies.

Keywords: severe malaria, pregnancy, plasmodium vivax, plasmodium falciparum

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3220 Screening for Women with Chorioamnionitis: An Integrative Literature Review

Authors: Allison Herlene Du Plessis, Dalena (R.M.) Van Rooyen, Wilma Ten Ham-Baloyi, Sihaam Jardien-Baboo

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Introduction: Women die in pregnancy and childbirth for five main reasons—severe bleeding, infections, unsafe abortions, hypertensive disorders (pre-eclampsia and eclampsia), and medical complications including cardiac disease, diabetes, or HIV/AIDS complicated by pregnancy. In 2015, WHO classified sepsis as the third highest cause for maternal mortalities in the world. Chorioamnionitis is a clinical syndrome of intrauterine infection during any stage of the pregnancy and it refers to ascending bacteria from the vaginal canal up into the uterus, causing infection. While the incidence rates for chorioamnionitis are not well documented, complications related to chorioamnionitis are well documented and midwives still struggle to identify this condition in time due to its complex nature. Few diagnostic methods are available in public health services, due to escalated laboratory costs. Often the affordable biomarkers, such as C-reactive protein CRP, full blood count (FBC) and WBC, have low significance in diagnosing chorioamnionitis. A lack of screening impacts on effective and timeous management of chorioamnionitis, and early identification and management of risks could help to prevent neonatal complications and reduce the subsequent series of morbidities and healthcare costs of infants who are health foci of perinatal infections. Objective: This integrative literature review provides an overview of current best research evidence on the screening of women at risk for chorioamnionitis. Design: An integrative literature review was conducted using a systematic electronic literature search through EBSCOhost, Cochrane Online, Wiley Online, PubMed, Scopus and Google. Guidelines, research studies, and reports in English related to chorioamnionitis from 2008 up until 2020 were included in the study. Findings: After critical appraisal, 31 articles were included. More than one third (67%) of the literature included ranked on the three highest levels of evidence (Level I, II and III). Data extracted regarding screening for chorioamnionitis was synthesized into four themes, namely: screening by clinical signs and symptoms, screening by causative factors of chorioamnionitis, screening of obstetric history, and essential biomarkers to diagnose chorioamnionitis. Key conclusions: There are factors that can be used by midwives to identify women at risk for chorioamnionitis. However, there are a paucity of established sociological, epidemiological and behavioral factors to screen this population. Several biomarkers are available to diagnose chorioamnionitis. Increased Interleukin-6 in amniotic fluid is the better indicator and strongest predictor of histological chorioamnionitis, whereas the available rapid matrix-metalloproteinase-8 test requires further testing. Maternal white blood cells count (WBC) has shown poor selectivity and sensitivity, and C-reactive protein (CRP) thresholds varied among studies and are not ideal for conclusive diagnosis of subclinical chorioamnionitis. Implications for practice: Screening of women at risk for chorioamnionitis by health care providers providing care for pregnant women, including midwives, is important for diagnosis and management before complications arise, particularly in resource-constraint settings.

Keywords: chorioamnionitis, guidelines, best evidence, screening, diagnosis, pregnant women

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3219 Thidiazuron's Role in Murraya paniculata and Fortunella hindsii's in vitro Flowering

Authors: Hasan Basri Jumin, Mardaleni

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Fortunella hindsii and Muraya paniculata are family members of Rutaceae and have potentially improved genetic diversity. Isolated protoplasts were cultured with media supplemented with 2.0 % glucose and 0.0, 0.001, 0.01, 0.1 or 1.0. 10.0 mg/1 thidiazuron (TDZ) and, thickened with 0.9% gelrite, and maintained under 16 h photoperiod at 52.9 μmol/m²/s light intensity. The media supplemented with 0.00 mg/l TDZ yielded the maximum plating efficiency, while 0.001 mg/l TDZ produced the highest percentage of shoot formation, approximately 80%. After being cultured on the same TDZ concentration for 12 days, the protoplasts that survived developed cell walls. Ninety days following the culture of protoplasts, Fortunella hindsii and Murraya paniculata underwent somatic embryogenesis to grow into plantlets. Thidiazuron has demonstrated efficacy in forming flower buds that grow normally. Fortunella hindsii and Murraya paniculata shoots that emerged from branch internodes flowered in vitro on half-strength MT basal media containing 0.001 to 0.01 mg/l TDZ and 2-3% sucrose after two months of culture, and they eventually went on to flower. Seventy five percent of the plants displayed flowering on medium supplemented with 0.001 mg/l TDZ. Among the segments of Fortunella hindsii and Murraya paniculata generated from branch internodes, a possible precocious and floral gradient was found.

Keywords: Fortunella-hindsii, in-vitro flowering, Murraya-paniculata, protoplast, thidiazuron

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3218 CMT4G: Rare Form of Charcot-Marie-Tooth Disease in Slovak Roma Patient

Authors: Dana Gabriková, Martin Mistrík, Jarmila Bernasovská, Iveta Tóthová, Jana Kisková

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The Roma (Gypsies) is a transnational minority with a high degree of consanguineous marriages. Similar to other genetically isolated founder populations, the Roma harbor a number of unique or rare genetic disorders. This paper discusses about a rare form of Charcot-Marie-Tooth disease – type 4G (CMT4G), also called Hereditary Motor and Sensory Neuropathy type Russe, an autosomal recessive disease caused by mutation private to Roma characterized by abnormally increased density of non-myelinated axons. CMT4G was originally found in Bulgarian Roma and in 2009 two putative causative mutations in the HK1 gene were identified. Since then, several cases were reported in Roma families mainly from Bulgaria and Spain. Here we present a Slovak Roma family in which CMT4G was diagnosed on the basis of clinical examination and genetic testing. This case is a further proof of the role of the HK1 gene in pathogenesis of the disease. It confirms that mutation in the HK1 gene is a common cause of autosomal recessive CMT disease in Roma and should be considered as a common part of a diagnostic procedure.

Keywords: gypsies, HK1, HSMN-Russe, rare disease

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3217 Effectuating Theology of Culture: The Only Weapon to Confront 21st Century Global Godless Culture

Authors: Hram Bik

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This is an analytical paper on how to apply theology to the global godless culture. The paper will analyze and materialize theology of culture and come up with theo-cultural principles which will enable Christians to properly engage with today godless culture. If theology and daily life are in any way split apart, Christians will lose the authenticity essential to their calling. Living out godliness in the ungodly culture requires materializing theology into daily life. To do that has become an unbeatable challenge for Christians in 21st century with the overtaking in of global godless culture enforced by Information Technology resulting in rapid and chaotic change of global lifestyles wherein Christianity stands in danger of being swallowed up. Staying away from the culture will rob Christianity of its mission to witness and staying with and like it will rob Christianity of its effectiveness. Thus the question is how should today Christians apply theology to the culture wherein what are said to be sins in the Bible no longer look like sins? Should we forge an all-out war against it or should distance ourselves away from it? The extreme response to it could fruit Christian Jihadism on the right and the apathetic response would let it booming with no one attempting to stop it on the left. This paper calls for global Christians to essentially make theology a part of their daily lives to form a united global force to influence the godless global culture by influencing our own family and community.

Keywords: Christians, global culture, godliness, theology

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3216 Business Intelligence Dashboard Solutions for Improving Decision Making Process: A Focus on Prostate Cancer

Authors: Mona Isazad Mashinchi, Davood Roshan Sangachin, Francis J. Sullivan, Dietrich Rebholz-Schuhmann

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Background: Decision-making processes are nowadays driven by data, data analytics and Business Intelligence (BI). BI as a software platform can provide a wide variety of capabilities such as organization memory, information integration, insight creation and presentation capabilities. Visualizing data through dashboards is one of the BI solutions (for a variety of areas) which helps managers in the decision making processes to expose the most informative information at a glance. In the healthcare domain to date, dashboard presentations are more frequently used to track performance related metrics and less frequently used to monitor those quality parameters which relate directly to patient outcomes. Providing effective and timely care for patients and improving the health outcome are highly dependent on presenting and visualizing data and information. Objective: In this research, the focus is on the presentation capabilities of BI to design a dashboard for prostate cancer (PC) data that allows better decision making for the patients, the hospital and the healthcare system related to a cancer dataset. The aim of this research is to customize a retrospective PC dataset in a dashboard interface to give a better understanding of data in the categories (risk factors, treatment approaches, disease control and side effects) which matter most to patients as well as other stakeholders. By presenting the outcome in the dashboard we address one of the major targets of a value-based health care (VBHC) delivery model which is measuring the value and presenting the outcome to different actors in HC industry (such as patients and doctors) for a better decision making. Method: For visualizing the stored data to users, three interactive dashboards based on the PC dataset have been developed (using the Tableau Software) to provide better views to the risk factors, treatment approaches, and side effects. Results: Many benefits derived from interactive graphs and tables in dashboards which helped to easily visualize and see the patients at risk, better understanding the relationship between patient's status after treatment and their initial status before treatment, or to choose better decision about treatments with fewer side effects regarding patient status and etc. Conclusions: Building a well-designed and informative dashboard is related to three important factors including; the users, goals and the data types. Dashboard's hierarchies, drilling, and graphical features can guide doctors to better navigate through information. The features of the interactive PC dashboard not only let doctors ask specific questions and filter the results based on the key performance indicators (KPI) such as: Gleason Grade, Patient's Age and Status, but may also help patients to better understand different treatment outcomes, such as side effects during the time, and have an active role in their treatment decisions. Currently, we are extending the results to the real-time interactive dashboard that users (either patients and doctors) can easily explore the data by choosing preferred attribute and data to make better near real-time decisions.

Keywords: business intelligence, dashboard, decision making, healthcare, prostate cancer, value-based healthcare

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3215 A Comparative Study of Natural Language Processing Models for Detecting Obfuscated Text

Authors: Rubén Valcarce-Álvarez, Francisco Jáñez-Martino, Rocío Alaiz-Rodríguez

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Cybersecurity challenges, including scams, drug sales, the distribution of child sexual abuse material, fake news, and hate speech on both the surface and deep web, have significantly increased over the past decade. Users who post such content often employ strategies to evade detection by automated filters. Among these tactics, text obfuscation plays an essential role in deceiving detection systems. This approach involves modifying words to make them more difficult for automated systems to interpret while remaining sufficiently readable for human users. In this work, we aim at spotting obfuscated words and the employed techniques, such as leetspeak, word inversion, punctuation changes, and mixed techniques. We benchmark Named Entity Recognition (NER) using models from the BERT family as well as two large language models (LLMs), Llama and Mistral, on XX_NER_WordCamouflage dataset. Our experiments evaluate these models by comparing their precision, recall, F1 scores, and accuracy, both overall and for each individual class.

Keywords: natural language processing (NLP), text obfuscation, named entity recognition (NER), deep learning

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3214 From Vertigo to Verticality: An Example of Phenomenological Design in Architecture

Authors: E. Osorio Schmied

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Architects commonly attempt a depiction of organic forms when their works are inspired by nature, regardless of the building site. Nevertheless it is also possible to try matching structures with natural scenery, by applying a phenomenological approach in terms of spatial operations, regarding perceptions from nature through architectural aspects such as protection, views, and orientation. This method acknowledges a relationship between place and space, where intentions towards tangible facts then become design statements. Although spaces resulting from such a process may present an effective response to the environment, they can also offer further outcomes beyond the realm of form. The hypothesis is that, in addition to recognising a bond between architecture and nature, it is also plausible to associate such perceptions with the inner ambient of buildings, by analysing features such as daylight. The case study of a single-family house in a rainforest near Valdivia, Chilean Patagonia is presented, with the intention of addressing the above notions through a discussion of the actual effects of inhabiting a place by way of a series of insights, including a revision of diagrams and photographs that assist in understanding the implications of this design practice. In addition, figures based on post-occupancy behaviour and daylighting performance relate both architectural and environmental issues to a decision-making process motivated by the observation of nature.

Keywords: architecture, design statements, nature, perception

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3213 A phytochemical and Biological Study of Viscum schemperi Engl. Growing in Saudi Arabia

Authors: Manea A. I. Alqrad, Alaa Sirwi, Sabrin R. M. Ibrahim, Hossam M. Abdallah, Gamal A. Mohamed

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Phytochemical study of the methanolic extract of the air dried powdered of the parts of Viscum schemperi Engl. (Family: Viscaceae) using different chromatographic techniques led to the isolation of five compounds: -amyrenone (1), betulinic acid (2), (3β)-olean-12-ene-3,23-diol (3), -oleanolic acid (4), and α-oleanolic acid (5). Their structures were established based on physical, chemical, and spectral data. Anti-inflammatory and anti-apoptotic activities of oleanolic acid in a mouse model of acute hepatorenal damage were assessed. This study showed the efficacy of oleanolic acid to counteract thioacetamide-induced hepatic and kidney injury in mice through the reduction of hepatocyte oxidative damage, suppression of inflammation, and apoptosis. More importantly, oleanolic acid suppressed thioacetamide-induced hepatic and kidney injury by inhibiting NF-κB/TNF-α-mediated inflammation/apoptosis and enhancing SIRT1/Nrf2/Heme-oxygenase signalling pathway. These promising pharmacological activities suggest the potential use of oleanolic acid against hepatorenal damage.

Keywords: oleanolic acid, viscum schimperi, thioacetamide, SIRT1/Nrf2/NF-κB, hepatorenal damage

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3212 Antioxidant Activity of Launaea nudicaulis Growing in Southwest of Algeria

Authors: Abdelkrim Cheriti, Mebarka Belboukhari, Nasser Belboukhari

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Launaea Cass. is a small genus of the family Asteraceae (tribe Lactuceae, subtribe Sonchinae), consisting of 54 species, of which 9 are presented in the flora of Algeria and is mainly distributed in the South Mediterranean, Africa and SW Asia. Plants in the Launaea genus have been used ethnobotanically as bitter stomachic, for treating diarrhea, gastrointestinal tracts, as anti-inflammatory, for skin diseases, treatment of infected wounds, hepatic pains, children fever, as soporific, lactagogue, diuretic and as insecticidal. Antioxidants are vital substances, which possess the ability to protect the body from damages caused by free radical induced oxidative stress. A variety of free radical scavenging antioxidants is found in a number of dietary sources. The main objective of this study focused on the screening of antioxidant activity of Launaea nudicaulis (Asteraceae) extracts. The in vitro antioxidant activity was investigated with DPPH radical scavenging assay. The quantitative evaluation of DPPH scavenging activity showed that n-BuOH and EtOAc extracts are the most active extracts with a percentage of antiradical activity of 89,62% and 71,57% respectively.

Keywords: Launaea, phytochemical, South Algeria, Sahara, endemic specie

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3211 Driving towards Sustainability with Shared Electric Mobility: A Case Study of Time-Sharing Electric Cars on University’s Campus

Authors: Jiayi Pan, Le Qin, Shichan Zhang

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Following the worldwide growing interest in the sharing economy, especially in China, innovations within the field are rapidly emerging. It is, therefore, appropriate to address the under-investigated sustainability issues related to the development of shared mobility. In 2019, Shanghai Jiao Tong University (SJTU) introduced one of the first on-campus Time-sharing Electric Cars (TEC) that counts now about 4000 users. The increasing popularity of this original initiative highlights the necessity to assess its sustainability and find ways to extend the performance and availability of this new transport option. This study used an online questionnaire survey on TEC usage and experience to collect answers among students and university staff. The study also conducted interviews with TEC’s team in order to better understand its motivations and operating model. Data analysis underscores that TEC’s usage frequency is positively associated with a lower carbon footprint, showing that this scheme contributes to improving the environmental sustainability of transportation on campus. This study also demonstrates that TEC provides a convenient solution to those not owning a car in situations where soft mobility cannot satisfy their needs, this contributing to a globally positive assessment of TEC in the social domains of sustainability. As SJTU’s TEC project belongs to the non-profit sector and aims at serving current research, its economical sustainability is not among the main preoccupations, and TEC, along with similar projects, could greatly benefit from this study’s findings to better evaluate the overall benefits and develop operation on a larger scale. This study suggests various ways to further improve the TEC users’ experience and enhance its promotion. This research believably provides meaningful insights on the position of shared transportation within transport mode choice and how to assess the overall sustainability of such innovations.

Keywords: shared mobility, sharing economy, sustainability assessment, sustainable transportation, urban electric transportation

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3210 2021 Study of 529 Donor-Conceived Adults

Authors: Wendy Kramer

Abstract:

How and when a donor-conceived person (DCP) learns about their conception significantly affects their experiences and choices, including whether they'd consider using a donor or donating their own gametes. Objective: We sought to identify factors that positively and negatively impact the experience of being a DCP. We sought to determine if DCP would consider utilizing donor gametes themselves, if unable to conceive spontaneously and if DCP were likely to be donors themselves. Materials and Methods: A cross-sectional survey of adult DCP was disseminated to members of the Donor Sibling Registry. The survey consisted of 31 items including whether experience as DCP was positive or negative, the willingness to use donor gametes if spontaneous conception was not an option, and questions regarding donating gametes. Results: 529 people (81.7% female) completed the survey, the median age was 28 years (range 18-77 years) and 94.7% were conceived via donor sperm. Most felt "neutral" (31.6%), "positive" (26.3%) or "very positive" (20.8%) about being a DCP regardless of donor type. While most found out about being a DCP after age 18 (63.4%), those with a positive experience were more likely to "have always known" (40.7%). Conclusions: People conceived by donor-assisted reproduction are more likely to have neutral to positive overall feelings surrounding their conception if they are told at a very young age about their donor-conceived origins by a family member. The majority of DCP are willing to adopt but would not consider using donated gametes themselves if unable to conceive spontaneously. DCP are not likely to become donors themselves despite the majority of DCP having a high positive feeling regarding being donor-conceived.

Keywords: donor conception, donor offspring, sperm donation, egg donation, donor-conceived people

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3209 Effect of Retinoic Acid Treatment on the Retinoic Acid Signaling Pathway in a siRNA-Based Aniridia Limbal Epithelial Cell Model, in Vitro

Authors: Shao-Lun Hsu, Tanja Stachon, Fabian N. Fries, Zhen Li, Shuailin Li, Shanhe Liu, Berthold Seitz, Swarnali Kundu, Maryam Amini, Shweta Suiwal, Nóra Szentmáry

Abstract:

Purpose: Congenital aniridia is characterized by PAX6 haploinsufficiency, and aniridia-associated keratopathy (AAK). In AAK, limbal stem cell deficiency and impaired wound healing are wiPurpose: Congenital aniridia is characterized by PAX6 haploinsufficiency and aniridia-associated keratopathy (AAK). In AAK, limbal stem cell deficiency and impaired wound healing are widely observed in patients, which might be associated with an imbalanced retinoic acid (RA) signaling pathway. In the previous studies, we demonstrated the relationship between PAX6 and the altered expression levels of key markers in the RA signaling pathway to retinol treatment. The present study evaluates the gene and protein expression levels in an in vitro small interfering RNA (siRNA) PAX6 knockdown aniridia limbal epithelial cell model following retinoic acid treatment. This study targets the direct effects of active RA products and their association with key regulators of the RA signaling pathway in siRNA PAX6 knockdown LECs. Methods: Primary human limbal epithelial cells (LECs) were knocked down by siRNA treatment to mimic PAX6 deletion in congenital aniridia (n=8). This was followed by 0µM, 1µM, and 5µM retinoic acid treatment applied in both siRNA PAX6 control and knockdown groups. After 48h incubation, paired box 6 (PAX6), alcohol dehydrogenase 7 (ADH7), aldehyde dehydrogenase 1 family member A1 (ALDH1A1), cytochrome P450 family 26 subfamilies A member 1 (CYP26A1), retinol-binding protein 1 (RBP1), cellular retinoic acid binding protein 2 (CRABP2), fatty acid binding protein 5 (FABP5), retinoid X receptor alpha (RXRA), retinoid X receptor beta (RXRB), retinoic acid receptor alpha (RARA), retinoic acid receptor beta (RARB), peroxisome proliferator-activated receptor gamma (PPARG), vascular endothelial growth factor A (VEGFA) mRNA levels have been determined using qPCR and protein levels by ELISA or western blot. Results: PAX6, ADH7, ALDH1A1, FABP5 mRNA levels and PAX6, ADH7, FABP5, PPARG2 protein levels were significantly lower in the PAX6 knockdown group, than in controls (p<0.001, p=0.018, p=0.015, p<0.001; p<0.001, p=0.003, p<0.001, p=0.007). PPARG mRNA level was significantly higher in the PAX6 knockdown group than in controls (p=0.012). CYP26A1 mRNA expression was upregulated using 1 µM and 5 µM RA treatment in both the PAX6 control (p<0.001; p<0.001) and the PAX6 knockdown group (p=0.001; p=0.002). CRABP2 mRNA expression in the PAX6 knockdown group (p=0.02) and protein expression in both groups were downregulated using to 5 µM RA concentration (p=0.003; p=0.02). RARA mRNA expression in the PAX6 knockdown group (p=0.023), RARB mRNA expression in both groups (p=0.006, p=0.001), and RXRA protein expression in controls (p=0.007), were downregulated using 5 µM RA concentration. VEGFA mRNA expression in PAX6 controls was upregulated using 5 µM RA (p=0.041). FABP5 to CRAP2 ratio was higher in PAX6 controls than in the PAX6 knockdown group (p<0.001). Additionally, the FABP5 to CRAP2 ratio was only upregulated in PAX6 controls using 5 µM RA concentration but not in the PAX6 knockdown group (p<0.001). Conclusions: These results reveal a less-responsive FABP5 to CRABP2 ratio in PAX6 knockdown LECs following increased RA concentration, as well as altered expression of key regulators in the RA signaling pathway. Further investigations into the regulatory processes are required to elucidate the role of RA signaling in the development of AAK.

Keywords: congenital aniridia, paired box 6 gene, aniridia-associated keratopathy, retinoic acid signaling pathway

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3208 Ecobiological Study of Olivier in the Northern Slopes of the Mountains of Tlemcen, Western Algeria

Authors: Hachemi Nouria

Abstract:

The olive tree is a Mediterranean tree, which belongs to the family Oleaceae. The Olea genus contains various species and subspecies, and the only species bearing edible fruit is Olea europaea. The desired issue in this study is to provide the current status of plant cover and especially the training in Olea europaea currently existing in the major centers of the region of Tlemcen. While based on the flora and biometric aspect of this plant germplasm. In order to make an assessment of the phytomass, we made measurements of the four parameters of the aerial part of the taxon: height, diameter, and canopy density to ten feet of the olive tree per station. The floristic analysis shows a certain floristic difference between the different stations. The vegetal formations reflect the biotic and abiotic conditions including climate affecting the ecosystem. Biometric study on the feet of Olea in the six study sites, has led us to conclude that the four measured parameters provides insight on the development or degradation of Olea feet depending on the layout of the stations and the factors environmental. We find that the terrains are havens for these assets. Also the local microclimate (Oued Thalweg) promotes the healthy development of this species.

Keywords: olivier, ecology, biometrics, Tlemcen, Algeria

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3207 An Analysis of Fertility Decline in India: Evidences from Tamil Nadu and Uttar Pradesh

Authors: Ajay Kumar

Abstract:

Using data from census of India, sample registration system and national family health survey (NFHS-3), this paper traces spatial pattern, trends and the factors which have played their role differently in fertility transition in Uttar Pradesh and Tamil Nadu. For the purpose spatial variation analysis, trend line and binary logistic regression analysis has been carried out. There exist considerable regional disparities in terms of fertility decline in northern and southern states. The pace of fertility decline has been faster in southern and coastal regions, and at a slow pace in backward northern state. In Tamil Nadu fertility declined substantially among the women of lower and higher age groups in comparison to Uttar Pradesh characterized by low literacy, low female age at marriage, poor health infrastructure and low status of women. The Study shows that Fertility rates have been higher among the most vulnerable and deprived sections of the society like Illiterate women, women belong to scheduled caste, scheduled tribe and women residing in rural areas.

Keywords: age specific fertility rate, fertility transition, replacement level, total fertility rate

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3206 A Fuzzy Logic Based Health Assesment Platform

Authors: J. Al-Dmour, A. Sagahyroon, A. Al-Ali, S. Abusnana

Abstract:

Radio Frequency Based Identification Systems have emerged as one of the possible valuable solutions that can be utilized in healthcare systems. Nowadays, RFID tags are available with built-in human vital signs sensors such as Body Temperature, Blood Pressure, Heart Rate, Blood Sugar level and Oxygen Saturation in Blood. This work proposes the design, implementation, and testing of an integrated mobile RFID-based health care system. The system consists of a wireless mobile vital signs data acquisition unit (RFID-DAQ) integrated with a fuzzy-logic–based software algorithm to monitor and assess patients conditions. The system is implemented and tested in ‘Rashid Center for Diabetes and Research’, Ajman, UAE. System testing results are compared with the Modified Early Warning System (MEWS) that is currently used in practice. We demonstrate that the proposed and implemented system exhibits an accuracy level that is comparable and sometimes better than the widely adopted MEWS system.

Keywords: healthcare, fuzzy logic, MEWS, RFID

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3205 Health Inequalities in the Global South: Identification of Poor People with Disabilities in Cambodia to Generate Access to Healthcare

Authors: Jamie Lee Harder

Abstract:

In the context of rapidly changing social and economic circumstances in the developing world, this paper analyses access to public healthcare for poor people with disabilities in Cambodia. Like other countries of South East Asia, Cambodia is developing at rapid pace. The historical past of Cambodia, however, has set former social policy structures to zero. This past forces Cambodia and its citizens to implement new public health policies to align with the needs of social care, healthcare, and urban planning. In this context, the role of people with disabilities (PwDs) is crucial as new developments should and can take into consideration their specific needs from the beginning onwards. This paper is based on qualitative research with expert interviews and focus group discussions in Cambodia. During the field work it became clear that the identification tool for the poorest households (HHs) does not count disability as a financial risk to fall into poverty neither when becoming sick nor because of higher health expenditures and/or lower income because of the disability. The social risk group of poor PwDs faces several barriers in accessing public healthcare. The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about their rights and negative social and cultural beliefs. Shortened budgets and the lack of prioritizations lead to the need for reorientation of local communities, international and national non-governmental organizations and social policy. The poorest HHs are identified with a questionnaire, the IDPoor program, for which the Ministry of Planning is responsible. The identified HHs receive an ‘Equity Card’ which provides access free of charge to public healthcare centers and hospitals among other benefits. The dataset usually does not include information about the disability status. Four focus group discussions (FGD) with 28 participants showed various barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The contents of the FGDs were ratified and repeated during the expert interviews with the local Ministries, NGOs, international organizations and private persons working in the field. The participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence in their lives. When discussing their health situation, we identified, a huge difference between those who are identified and hold an Equity Card and those who do not. Participants reported high costs without IDPoor identification, positive experiences when going to the health center in terms of attitude and treatment, low satisfaction with specific capacities for treatments, negative rumors, and discrimination with the consequence of fear to seek treatment in many cases. The problem of accessing public healthcare by risk groups can be adapted to situations in other countries.

Keywords: access, disability, health, inequality, Cambodia

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3204 Attitude of Youth Farmers to Climate Change Adaptation and Mitigation in Benue State, Nigeria

Authors: Cynthia E. Nwobodo, A. E. Agwu

Abstract:

The study was carried out in Benue State, Nigeria. Multi-stage sampling technique was used to select 120 respondents from two agricultural zones in the State. Data was collected using interview schedule. Descriptive statistics was used in data analysis. Findings showed that youth farmers in the area had positive attitude to climate change adaptation and mitigation as shown by their response to a set of positive and negative statement including: the youth are very important stakeholders in climate change issues (M= 2.91), youths should be encouraged to be climate change conscious (2.90), everybody should be involved in planting trees not just the government (M= 2.89), I will be glad to participate in climate change seminars (M= 2.89) among others. Findings on information seeking behavior indicate that majority (80.8 %) of the respondents sought climate change information from radio at an average of 19.78 times per month, 53.3 % sought from friends and neighbours at an average of 12.55 times per month and 42.5 % sought from family members at an average of 12.55 times per month among others. It was recommended that Youth farmers should be made important stakeholders in climate change policies and programmes since they have a very positive attitude to climate change adaptation and mitigation.

Keywords: adaptation, mitigation, attitude, climate change, youth farmers

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3203 Recovery of Waste Acrylic Fibers for the Elimination of Basic Dyes

Authors: N. Ouslimani, M. T. Abadlia

Abstract:

Environment protection is a precondition for sustained growth and a better quality of life for all people on earth. Aqueous industrial effluents are the main sources of pollution. Among the compounds of these effluents, dyes are particularly resistant to discoloration by conventional methods, and discharges present many problems that must be supported. The scientific literature shows that synthetic organic dyes are compounds used in many industrial sectors. They are found in the chemical, car, paper industry and particularly the textile industry, where all the lines and grades of the chemical family are represented. The affinity between the fibers and dyes vary depending on the chemical structure of dyes and the type of materials to which they are applied. It is not uncommon to find that during the dyeing operation from 15 to 20 % of sulfur dyes, and sometimes up to 40 % of the reactants are discharged with the effluent. This study was conducted for the purpose of fading basics dyes from wastewater using as adsorbent fiber waste material. This technique presents an interesting alternative to usual treatment, as it allows the recovery of waste fibers, which can find uses as raw material for the manufacture of cleaning products or in other sectors In this study the results obtained by fading fiber waste are encouraging, given the rate of color removal which is about 90%.This method also helps to decrease BOD and suspended solids MES in an effective way.

Keywords: adsorption, dyes, fiber, valorization, wastewater

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3202 The Iconic Pink Donut Box: An Analysis of Memory and Identity Amongst Cambodian Refugees in California

Authors: Basmah Arshad

Abstract:

In the aftermath of the Cambodian genocide, many refugees resettled in America. They carved out a distinctively Cambodian-American space in California with donut shops, establishing a tight-knit community that worked to achieve ‘the American dream’. Urged by traumatic memories of the genocide and American society directly encouraging (if not demanding) cultural assimilation, these refugees and successive generations continuously worked to re-identify themselves as Americans. Artist Phung Huynh grew up in this context of family-owned donut shops and the frantic scramble for stability and security. It is this community that she depicts in her artwork series from the late 2010s, ‘Khmerican: Drawing on Pink Donut Boxes’. Huynh's artwork challenges dominant Western narratives about the Cambodian genocide by pushing forward images of resilience, resistance, and joy, while also allowing for a discussion about issues of assimilation, identity, and nostalgia in the Cambodian-American community. It also provokes deeply relevant questions about how refugees and immigrants deliberately appropriate elements of the Americana (eg, donuts) to assimilate and re-fashion their identity as a tactic for financial stability and social survival.

Keywords: Cambodian diaspora, cultural identity, assimilation, food, artwork

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3201 Constraints Women Academician's Participation at Administrative Positions in Higher Education of Developing Countries

Authors: Bahieh Mohajeri, Mohamad Sharif Mustaf, Mahani Mokhtar

Abstract:

Purpose: This paper attempts to set the stage for the exploration of female participation in administrative positions within non-western countries by reviewing the studies on female in administrative positions within non-western countries and suggesting guidelines for future studies in this area in developing countries. Methodology: The paper is based on a systematic review of papers that have been published in journals. Findings: The review focuses on constraints to female’s participation in higher education of developing countries (e.g. strong family responsibility, low levels of women faculty members, social values and gendered cultural factors). Practical Implications: Further guidelines for future examination of this field of study are suggested (e.g. adopting a different theoretical view).Value: The article is an initial attempt to gather knowledge about constraints of female administrators in higher education of developing countries. The subject has received less attention in studies on administration and gender. In addition, the article provides suggestions for future studies in order to understand women administrators’ experiences in different educational and cultural settings.

Keywords: administrative position, female administrator, developing countries, participation

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3200 Psychological Capital: Convergent and Discriminant Validity of a Reconfigured Measure

Authors: Anton Grobler

Abstract:

Background: Psychological capital (PsyCap), consisting of Hope, Optimism, Resilience, and Self-efficacy, is a popular positive organisational behaviour construct utilised in the studying employee work and behavioral attitudes. Various scholars believe however that further validity research should be conducted on the PsyCap questionnaire (PCQ), outside of the founding research team and in more diverse settings, for the purpose of this paper, within the diverse South African (SA) context. Aim: The purpose of this study was to investigate the construct validity of the PCQ with specific reference to its psychometric properties within the diverse SA context. Setting: The sample includes a total of 1 749 respondents, ± 60 each from 30 organisations in South Africa. Method: This study utilised a cross-sectional design and quantitative analysis. The sample is relatively representative (in terms of race, gender) of the South African workforce. A multi-factorial model was statistically explored and confirmed (with exploratory factor analysis [EFA] and confirmatory factor analysis [CFA] respectively). Results: The study yielded a three-factor solution, with Hope and Optimism as a combined factor and Resilience and Self-efficacy made up of a reconfigured set of substantively justifiable items. Three items of the original 24 items were found not to be suitable. The three factors showed good psychometric properties, good fit (in support of construct validity) and acceptable levels of convergent and discriminant validity. Conclusion: The results support the original conceptualisation of PsyCap, although with a unique structural configuration. This resonates with the notion of scholars that further research should be conducted within diverse settings. This is necessary to ensure the valid measurement of the construct, which is considered to be one of the four criteria for a construct to be categorised as a positive organisational behaviour construct.

Keywords: positive organisational behaviour, psychological capital, hope, optimism, resilience, self-efficacy, construct validity

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3199 Active Learning through a Game Format: Implementation of a Nutrition Board Game in Diabetes Training for Healthcare Professionals

Authors: Li Jiuen Ong, Magdalin Cheong, Sri Rahayu, Lek Alexander, Pei Ting Tan

Abstract:

Background: Previous programme evaluations from the diabetes training programme conducted in Changi General Hospital revealed that healthcare professionals (HCPs) are keen to receive advance diabetes training and education, specifically in medical, nutritional therapy. HCPs also expressed a preference for interactive activities over didactic teaching methods to enhance their learning. Since the War on Diabetes was initiated by MOH in 2016, HCPs are challenged to be actively involved in continuous education to be better equipped to reduce the growing burden of diabetes. Hence, streamlining training to incorporate an element of fun is of utmost importance. Aim: The nutrition programme incorporates game play using an interactive board game that aims to provide a more conducive and less stressful environment for learning. The board game could be adapted for training of community HCPs, health ambassadors or caregivers to cope with the increasing demand of diabetes care in the hospital and community setting. Methodology: Stages for game’s conception (Jaffe, 2001) were adopted in the development of the interactive board game ‘Sweet Score™ ’ Nutrition concepts and topics in diabetes self-management are embedded into the game elements of varying levels of difficulty (‘Easy,’ ‘Medium,’ ‘Hard’) including activities such as a) Drawing/ sculpting (Pictionary-like) b)Facts/ Knowledge (MCQs/ True or False) Word definition) c) Performing/ Charades To study the effects of game play on knowledge acquisition and perceived experiences, participants were randomised into two groups, i.e., lecture group (control) and game group (intervention), to test the difference. Results: Participants in both groups (control group, n= 14; intervention group, n= 13) attempted a pre and post workshop quiz to assess the effectiveness of knowledge acquisition. The scores were analysed using paired T-test. There was an improvement of quiz scores after attending the game play (mean difference: 4.3, SD: 2.0, P<0.001) and the lecture (mean difference: 3.4, SD: 2.1, P<0.001). However, there was no significance difference in the improvement of quiz scores between gameplay and lecture (mean difference: 0.9, 95%CI: -0.8 to 2.5, P=0.280). This suggests that gameplay may be as effective as a lecture in terms of knowledge transfer. All the13 HCPs who participated in the game rated 4 out of 5 on the likert scale for the favourable learning experience and relevance of learning to their job, whereas only 8 out of 14 HCPs in the lecture reported a high rating in both aspects. 16. Conclusion: There is no known board game currently designed for diabetes training for HCPs.Evaluative data from future training can provide insights and direction to improve the game format and cover other aspects of diabetes management such as self-care, exercise, medications and insulin management. Further testing of the board game to ensure learning objectives are met is important and can assist in the development of awell-designed digital game as an alternative training approach during the COVID-19 pandemic. Learning through gameplay increases opportunities for HCPs to bond, interact and learn through games in a relaxed social setting and potentially brings more joy to the workplace.

Keywords: active learning, game, diabetes, nutrition

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