Search results for: categories of practice

Authors: Marijana Ivanov, Roman Šubić

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The single rulebook together with the Single Supervisory Mechanism and the Single Resolution Mechanism - as two main pillars of the banking union, represent important steps towards completing the Economic and Monetary Union. It should provide a consistent application of common rules and administrative standards for supervision, recovery and resolution of banks – with the final aim that a former practice of the bail-out is replaced with the bail-in system through which bank failures will be resolved by their own funds, i.e. with minimal costs for taxpayers and real economy. It has to reduce the financial fragmentation recorded in the years of crisis as the result of divergent behaviors in risk premium, lending activities, and interest rates between the core and the periphery. In addition, it should strengthen the effectiveness of monetary transmission channels, in particular the credit channels and overflows of liquidity on the single interbank money market. However, contrary to all the positive expectations related to the future functioning of the banking union, low and unbalanced economic growth rates remain a challenge for the maintenance of financial stability in the euro area, and this problem cannot be resolved just by a single supervision. In many countries bank assets exceed their GDP by several times, and large banks are still a matter of concern because of their systemic importance for individual countries and the euro zone as a whole. The creation of the SSM and the SRM should increase transparency of the banking system in the euro area and restore confidence that have been disturbed during the depression. It would provide a new opportunity to strengthen economic and financial systems in the peripheral countries. On the other hand, there is a potential threat that future focus of the ECB, resolution mechanism and other relevant institutions will be extremely oriented to the large and significant banks (whereby one half of them operate in the core and most important euro area countries), while it is questionable to what extent the common resolution funds will be used for rescue of less important institutions.

Keywords: banking union, financial integration, single supervision mechanism (SSM)

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Authors: M. Vlahovic

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This paper presents a model of public finances, which combines three concepts: participatory budgeting, crowdfunding and blockchain technology. Participatory budgeting is defined as a process in which community members decide how to spend a part of community’s budget. Crowdfunding is a practice of funding a project by collecting small monetary contributions from a large number of people via an Internet platform. Blockchain technology is a distributed ledger that enables efficient and reliable transactions that are secure and transparent. In this hypothetical model, the government or authorities on local/regional level would set up a platform where they would propose public projects to citizens. Citizens would browse through projects and support or vote for those which they consider justified and necessary. In return, they would be entitled to a tax relief in the amount of their monetary contribution. Since the blockchain technology enables tracking of transactions, it can be used to mitigate corruption, money laundering and lack of transparency in public finances. Models of its application have already been created for e-voting, health records or land registries. By presenting a model of application of blockchain technology in public finances, this paper takes into consideration the potential of blockchain technology to disrupt governments and make processes more democratic, secure, transparent and efficient. The framework for this paper consists of multiple streams of research, including key concepts of direct democracy, public finance (especially the voluntary theory of public finance), information and communication technology, especially blockchain technology and crowdfunding. The framework defines rules of the game, basic conditions for the implementation of the model, benefits, potential problems and development perspectives. As an oversimplified map of a new form of public finances, the proposed model identifies primary factors, that influence the possibility of implementation of the model, and that could be tracked, measured and controlled in case of experimentation with the model.

Keywords: blockchain technology, distributed ledger, participatory budgeting, crowdfunding, direct democracy, internet platform, e-government, public finance

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Authors: Yi Huang

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Background: For the development of children, it is important for parents to encourage children not only on academic competence but also on children’s social competence. In the western cultural context, parents emphasize more heavily on female children’s social-behavioral development. However, whether the conclusion is correct in eastern culture and whether the parent’s gender affects such an emphasis remains unclear. And, more valuably, from the perspective of intervention, except for the nature factors - child’s gender and parent’s gender, it is also worth to probe whether the improvable factors, such as parent’s perspective taking, influence parent’s emphasis on child’s social competence. Aim: This study was aimed to investigate the impact of parent’s gender, child’s gender, and parent’s perspective-taking on parent’s attitudes of encouragement of the child’s social competence under the Chinese cultural context. Method: 461 Chinese parents whose children were in the first year of middle school during the research time participated in this study. Among all participants, there were 155 fathers and 306 mothers. The research adopted the self-report of perspective-taking, which is the sub-scale of the Interpersonal Reactivity Index and the self-report of the encouragement on a child’s social communication, which is the sub-scale of the Chinese version of The Children Rearing Practice Report. In this study, 291 parents reported regarding male children, and 170 parents reported regarding female children. Results: Contrary to the traditional western theory, which usually suggests parent puts more attention on social development and competence to girl the instead of the boy, in the Chinese context, parent emphasizes social competence more on the male child. Analogically, in China, compared to mother, father underscores the child’s social competence more heavily. By constructing the hierarchical regression model, the result indicated that after controlling the variables of the gender of child and the gender of parent, parent’s perspective-taking still explains for the variance of parent’s encouragement on child’s social competence, which means, parent’s perspective-taking predicts parent’s encouragement on child’s social competence after excluding the impact of the gender of parent and child. Conclusion: For Chinese parents, the ability of perspective-taking is beneficial to enhance their awareness of encouraging children’s social competence.

Keywords: parent; child, gender differences, perspective-taking, social development

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Authors: Mahera Abdulrahman, Satish Chandrasekhar Nair

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Growing demand for human health research in the United Arab Emirates (UAE) has prompted the need to develop a robust research ethics oversight, particularly given the large unskilled-worker immigrant population and the elderly citizens utilizing health services. Examination of the structure, function, practices and outcomes of the human research ethics committees (HREC) was conducted using two survey instruments, reliable and validated. Results indicate that in the absence of a national ethics regulatory body, the individual emirate’s governed 21 HRECs covering health facilities and academic institutions in the UAE. Among the HRECs, 86% followed International Council for Harmonization-Good Clinical Practice guidelines, 57% have been in operation for more than five years, 81% reviewed proposals within eight weeks, 48% reviewed for clinical and scientific merit apart from ethics, and 43% handled more than 50 research proposals per year. However, researcher recognition, funding transparency, adverse event reporting systems were widespread in less than one-third of all HRECs. Surprisingly, intellectual property right was not included as a research output. Research was incorporated into the vision and mission statements of many (62%) organizations and, mechanisms such as research publications, collaborations, and recognitions were employed as key performance indicators to measure research output. In spite, resources to generate research output such as dedicated budget (19%), support staff (19%) and continuous training and mentoring program for medical residents and HREC members were somehow lacking. HREC structure and operations in the UAE are similar to other regions of the world, resources allocation for efficient, quality monitoring, continuous training, and the creation of a clinical research network are needed to strengthen the clinical research enterprise to scale up for the future. It is anticipated that the results of this study will benefit investigators, regulators, pharmaceutical sponsors and the policy makers in the region.

Keywords: institutional review board, ethics committee, human research ethics, United Arab Emirates (UAE)

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Authors: Uchenna Egwu, Paul Jonathan Sallis

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Perennial ryegrass is an abundant renewable lignocellulosic biofuel feedstock for biomethane production through anaerobic digestion (AD). In this study, six anaerobic continuously stirred tank reactors (CSTRs) were set up in three pairs. Each pair of the CSTRs was then used to study the effects of operating temperatures – psychrophilic, mesophilic, and thermophilic, and optimum pH on the specific methane production (SMP) of the ryegrass during AD under discontinuous daily feeding conditions. The reactors were fed at an organic loading rate (OLR) ranging from 1-1.5 kgVS.L⁻¹d⁻¹ and hydraulic residence time, HRT=20 days for 140 days. The pH of the digesters was maintained at the range of 6.8-7.2 using 1 M NH₄HCO₃ solution, but this was replaced with biomass ash-extracts from day 105-140. The results obtained showed that the mean SMP of ryegrass measured between HRT 3 and 4 were 318.4, 425.4 and 335 N L CH₄ kg⁻¹VS.d⁻¹ for the psychrophilic (25 ± 2°C), mesophilic (40 ± 1°C) and thermophilic (60 ± 1°C) temperatures respectively. It was also observed that the buffering ability of the reactors increased with operating temperature, probably due to an increase in the solubility of ammonium bicarbonate (NH₄HCO₃) with temperature. The reactors also achieved a mean VS destruction of 61.9, 68.5 and 63.5%, respectively, which signifies that the mesophilic reactors achieved the highest specific methane production (SMP), while the psychrophilic reactors achieved the lowest. None of the reactors attained steady-state condition due to the discontinuous daily feeding times, and therefore, such feeding practice may not be the most effective for maximum biogas production over long periods of time. The addition of NH₄HCO₃ as supplement provided a good buffering condition in these AD digesters, but the digesters failed in the long run due to inhibition from the accumulation of free ammonia, which later led to decrease in pH, acidification, and souring of the digesters. However, the addition of biomass ash extracts was shown to potentially revive failed AD reactors by providing an adequate buffering and essential trace nutrient supplements necessary for optimal bacterial growth.

Keywords: anaerobic digestion, discontinuous feeding, perennial ryegrass, specific methane production, supplements, temperature

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Authors: Patience Oluchi Silas, Yemi Adeshina

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Financial transactions involving the use of the internet has become an important practice among commercial banks in Nigeria with the introduction of internet banking and this has improved banking efficiency in rending services to customers. However, customers in Lagos State are enslaved in the fear of insecurity, technical failure, inadequate operational facilities, including improper telecommunications and poor power supply. It is in line with this that this paper explores the obstacles faced by Lagosians, tourists, small scale business owners, companies, customers and the government's attitude in addressing the challenges associated with online banking system in Nigeria through relevant legislations. Internet banking has the potential to transform economic activity and achieve developmental goals. If the associated Challenges are addressed quickly, then it will have the desired impact on the Nigerian economy. In this study, Respondents, mostly bank employees and customers were issued well designed and structured questionnaires to effectively examine the new developments brought about by the introduction of Internet banking and the challenges inhibiting its adoption. Hypotheses were formulated to test assumptions and claims generated from the study. The results were statistically analyzed to address the issues of errors and chances, and at the end, the result of the statistical analysis shows that all especially insecurity, inadequate operational facilities and poor power supply are the significant factors affecting the adoption of internet banking services in Nigeria. The study recommends that for internet banking to assume a developmental dimension in Nigeria and for the country to be fully integrated and respected in global financial environment, the prevalent level of frauds in Lagos State and among Nigerians must first be addressed and the relevant local laws should be put in place and in consonance with international laws and conventions; get the citizens well educated on the intricacies of Internet usage and frauds.

Keywords: internet-banking, adoption, challenges, insecurity, legislation, fraud, Lagos state, statistics

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Authors: Noemia Bessa Vilela, Jose Caramelo Gomes

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All law student are familiarized, in the first years of their bachelor of laws with the concepts of “public goods” and “ private goods”; often, such legal concept does not exactly match such economic concept, and there are consequences are some sort of confusion being created. The list of goods that follow under each category is not exhaustive, nor are students given proper mechanisms to acknowledge that some legal fields can, on its own, be considered as a “public good”; this is the case of Competition. Legal authors consider that “competition law is used to promote public interest” and, as such, it is a “public good”; in economics theory, Competition is the first public good in a market economy, as the enabler of allocation efficiency. Competition law is the legal tool to support the proper functioning of the market economy and democracy itself. It is fact that Competition Law only applies to economic activities, still, competition is object of private litigation as an integral part of Public Law. Still, regardless of the importance of Competition Law in the economic activity and market regulation, most student complete their studies in law, join the Bar Associations and engage in their professional activities never having been given sufficient tools to deal with the increasing demands of a globalized world. The lack of knowledge of economics, market functioning and the mechanisms at their reach in order to ensure proper realization of their duties as lawyers/ attorneys-at-law would be tackled if Competition Law would be included as part of the curricula of Law Schools. Proper teaching of Competition Law would combine the foundations of Competition Law, doctrine, case solving and Case Law study. Students should to understand and apply the analytical model. Special emphasis should be given to EU Competition Law, namely the TFEU Articles 101 to 106. Damages Directive should also be part of the curriculum. Students must in the first place acquire and master the economic rationale as competition and the world of competition law are the cornerstone of sound and efficient market. The teaching of Competition Law in undergraduate programs in Law would contribute to fulfill the potential of the students who will deal with matters related to consumer protection, economic and commercial law issues both in private practice and as in-house lawyers for companies.

Keywords: higher education, competition law, legal education, law, market economy, industrial economics

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Authors: Ranjit Kumar Sahu, Ramakar Jha

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Urban Water Management is the practice of managing freshwater, waste water, and storm water as components of a basin-wide management plan. It builds on existing water supply and sanitation considerations within an urban settlement by incorporating urban water management within the scope of the entire river basin. The pervasive problems generated by urban development have prompted, in the present work, to study the spatial extent of urbanization in Golden Triangle of Odisha connecting the cities Bhubaneswar (20.2700° N, 85.8400° E), Puri (19.8106° N, 85.8314° E) and Konark (19.9000° N, 86.1200° E)., and patterns of periodic changes in urban development (systematic/random) in order to develop future plans for (i) urbanization promotion areas, and (ii) urbanization control areas. Remote Sensing, using USGS (U.S. Geological Survey) Landsat8 maps, supervised classification of the Urban Sprawl has been done for during 1980 - 2014, specifically after 2000. This Work presents the following: (i) Time series analysis of Hydrological data (ground water and rainfall), (ii) Application of SWMM (Storm Water Management Model) and other soft computing techniques for Urban Water Management, and (iii) Uncertainty analysis of model parameters (Urban Sprawl and correlation analysis). The outcome of the study shows drastic growth results in urbanization and depletion of ground water levels in the area that has been discussed briefly. Other relative outcomes like declining trend of rainfall and rise of sand mining in local vicinity has been also discussed. Research on this kind of work will (i) improve water supply and consumption efficiency (ii) Upgrade drinking water quality and waste water treatment (iii) Increase economic efficiency of services to sustain operations and investments for water, waste water, and storm water management, and (iv) engage communities to reflect their needs and knowledge for water management.

Keywords: Storm Water Management Model (SWMM), uncertainty analysis, urban sprawl, land use change

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Authors: Ahmed Chouari

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Although research methods has been an integral part of the curriculum in Moroccan higher education for decades, it seems that the research methods teaching pedagogy that teachers use suffers from a serious absence of a body of literature in the field. Also, the various challenges that both teachers and students of research methods face have received little interest by researchers in comparison to other fields such as applied linguistics. Therefore, the main aim of this study is to remedy to this situation by exploring one of the major issues in teaching research methods – that is, the phenomenon of students’ dissatisfaction with the research methods course in higher education in Morocco. The aim is also to understand students’ attitudes and perceptions on how to make the research methods course more effective in the future. Three qualitative research questions were used: (1) To what extent are graduate students satisfied with the pedagogies used by the teachers of the research methods course in Moroccan higher education? (2) To what extent are graduate students satisfied with the approach used in assessing research methods in Moroccan higher education? (3) What are students’ perceptions on how to make the research methods course more effective in Moroccan higher education? In this study, a qualitative content analysis was adopted to analyze students’ views and perspectives about the major factors behind their dissatisfaction with the course at the School of Arts and Humanities – University of Moulay Ismail. A semi-structured interview was used to collect data from 14 respondents from two different Master programs. The results show that there is a general consensus among the respondents about the major factors behind the ineffectiveness of the course. These factors include theory-practice gap, heavy reliance on theoretical knowledge at the expense of procedural knowledge, and ineffectiveness of some teachers. The findings also reveal that teaching research methods in Morocco requires more time, better equipment, and more competent teachers. Above all, the findings indicate that today there is an urgent need in Morocco to shift from teacher-centered approaches to learner-centered approaches in teaching the research methods course. These findings, thus, contribute to the existing literature by unraveling the factors that impede the learning process, and by suggesting a set of strategies that can make course more effective.

Keywords: competencies, learner-centered teaching, research methods, student autonomy, pedagogy

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Authors: Subesh Panta

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The land is a one of the major boosting factors of production for the agricultural country like Nepal where access to land has been a major source of livelihood of tenants and small farmers. But there is an absence of secure land tenure arrangement which drastically affect the overall production of farmers leading towards food insecurity. Sharecropping is practiced in Nepal especially in tarai region from early period, but there is the gap in the academic study whether the sharecropping has benefitted tenant farmers and make them food sufficient or not. This study attempts to find out the food sufficiency among the tenant households. The research was carried in the three VDCs of Parsa district -Paterwa (Sugauli), Jitpur and Nirchuta. A total of 111 households were determined as the sample size from each of the three VDCs was randomly visited for interview in the study. The size of land rent-in was found to be very small and fragmented. At the same time, the land tenure security was not found to be secured among the tenants. Due to lack of land tenure security, on one hand tenants and small farmers were not found to be motivated to investment in agriculture as they need to share fifty percent of their production with the land owners, and on other hand land owners were also not interested in investing as they have other alternative sources of livelihood rather than agriculture. In conclusion, the study highpoint that the crop production and food sufficiency level of the tenants’ farmers of the Parsa district are decreasing. Many tenants’ farmers are seeking alternative opportunities for livelihood rather than sharecropping due to insecure land tenure, feudalistic practice, lack of storage for agriculture production, lack of proper agro-market. The situation is such that, if no action is taken timely, there may be a situation that we will have to depend on imports for all the food requirements. Thus, the study discloses that the sharecropping could act as catalyst for ensuring food sufficiency for all, if proper land tenure police are promoted to tenants/small farmers with legal titles to their land or promoted with sustainable agriculture methods.

Keywords: agriculture, food sufficiency, land, tenant farmes

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Authors: Lynette Sheridan Burns, Benjamin J. Matthews

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The context of post-industrial journalism is one in which the material circumstances of mechanical publication have been displaced by digital technologies, increasing the distance between the orthodoxy of the newsroom and the culture of journalistic writing. Content is, with growing frequency, created for delivery via the internet, publication on web-based ‘platforms’ and consumption on screen media. In this environment, the question is not ‘who is a journalist?’ but ‘what is journalism?’ today. The changes bring into sharp relief new distinctions between journalistic work and journalistic labor, providing a key insight into the current transition between the industrial journalism of the 20^th century, and the post-industrial journalism of the present. In the 20^th century, the work of journalists and journalistic labor went hand-in-hand as most journalists were employees of news organizations, whilst in the 21^st century evidence of a decoupling of ‘acts of journalism’ (work) and journalistic employment (labor) is beginning to appear. This 'decoupling' of the work and labor that underpins journalism practice is far reaching in its implications, not least for institutional structures. Under these conditions we are witnessing the emergence of expanded ‘entrepreneurial’ journalism, based on smaller, more independent and agile - if less stable - enterprise constructs that are a feature of creative industries. Entrepreneurial journalism is realized in a range of organizational forms from social enterprise, through to profit driven start-ups and hybrids of the two. In all instances, however, the primary motif of the organization is an ideological definition of journalism. An example is the Scoop Foundation for Public Interest Journalism in New Zealand, which owns and operates Scoop Publishing Limited, a not for profit company and social enterprise that publishes an independent news site that claims to have over 500,000 monthly users. Our paper demonstrates that this journalistic work meets the ideological definition of journalism; conducted within the creative industries using an innovative organizational structure that offers a new, viable post-industrial future for journalism.

Keywords: creative industries, digital communication, journalism, post industrial

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Authors: Eunjoo Lee

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Background: As the number of surgeries increases, the incidence of adverse events is likely to become more prevalent. Patients who are somewhat knowledgeable about surgery-related adverse events are more likely to engage in safety initiatives to prevent them. Objectives: To evaluate the impact of a smartphone application developed during the study to enhance patients’ knowledge of surgery-related adverse events during hospitalization. Design: Non-randomized, one group, measured pre- and post-intervention. Participants: Thirty-six hospitalized patients admitted to the orthopedics unit of a general hospital in South Korea. Methods. First, a smartphone application to enhance patients’ knowledge of surgery-related adverse events was developed through an iterative process, which included a literature review, expert consultation, and pilot testing. The application was installed on participants’ smartphones, and research assistants taught the participants to use it. Twenty-five true/false questions were used to assess patients’ knowledge of preoperative precautions (eight items), surgical site infection (five items), Foley catheter management (four items), drainage management (four items), and anesthesia-related complications (four items). Results: Overall, the percentage of correct answers increased significantly, from 57.02% to 73.82%, although answers related to a few specific topics did not increase that much. Although the patients’ understanding of drainage management and the Foley catheter did increase substantially after they used the smartphone application, it was still relatively low. Conclusions: The smartphone application developed during this study enhanced the patients’ knowledge of surgery-related adverse events during hospitalization. However, nurses must make an additional effort to help patients to understand certain topics, including drainage and Foley catheter management. Relevance to clinical practice: Insufficient patient knowledge increases the risk of adverse events during hospitalization. Nurses should take active steps to enhance patients’ knowledge of a range of safety issues during hospitalization, in order to decrease the number of surgery-related adverse events.

Keywords: patient education, patient participation, patient safety, smartphone application, surgical errors

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Authors: L. Bernabeo, T. Loftus

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Many children often experience phases of picky eating, food aversions and/or avoidance. For families with children who have special needs, these experiences are often exacerbated, which can lead to feelings that negatively impact a caregiver’s relationship with their child. Within the scope of speech language pathology practice, knowledge of both emotional and feeding development is key. This paper will explore the significance of “messy play” within typical feeding development, and the challenges that may arise if a child does not have the opportunity to engage in this type of exploratory play. This paper will consider several contributing factors that can result in a “picky eater.” Further, research has shown that individuals with special needs, including autism, possess a neurological makeup that differs from that of a typical individual. Because autism is a disorder of relating and communicating due to differences in the limbic system, an individual with special needs may respond to a typical feeding experience as if it is a traumatic event. As a result, broadening one’s dietary repertoire may seem to be an insurmountable challenge. This paper suggests that introducing new foods through exploratory play can help broaden and strengthen diets, as well as improve the feeding experience, of individuals with autism. The DIRFloortimeⓇ methodology stresses the importance of following a child's lead. Within this developmental model, there is a special focus on a person’s individual differences, including the unique way they process the world around them, as well as the significance of therapy occurring within the context of a strong and motivating relationship. Using this child-centered approach, we can support our children in expanding their diets, while simultaneously building upon their cognitive and creative development through playful and respectful interactions that include exposure to foods that differ in color, texture, and smell. Further, this paper explores the importance of exploration, self-feeding and messy play on brain development, both in the context of typically developing individuals and those with disordered development.

Keywords: development, feeding, floortime, sensory

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Authors: Emmanuel Olasope Bamigboye, Ismail Oladeji Oladosu

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Local people of south-western Nigeria like in other climes, continue to be confronted with the vagaries of changing environments. Through the modification of existing practice and shifting resource base, their strategies for coping with change have enabled them to successfully negotiate the shifts in climate change and the environment. This article analyses indigenous adaptation strategies for climate change with a view to enhancing sustainable crop farming in south –western Nigeria. Multi-stage sampling procedure was used to select 340 respondents from the two major ecological zones (Forest and Derived Savannah) for good geographical spread. The article draws on mixed methods of qualitative research, literature review, field observations, informal interview and multinomial logit regression to capture choice probabilities across the various options of climate change adaptation options among arable crop farmers. The study revealed that most 85.0% of the arable crop farmers were males. It also showed that the use of local climate change adaptation strategies had no relationship with the educational level of the respondents as 77.3% had educational experiences at varying levels. Furthermore, the findings showed that seven local adaptation strategies were commonly utilized by arable crop farmers. Nonetheless, crop diversification, consultation with rainmakers and involvement in non-agricultural ventures were prioritized in the order of 1-3, respectively. Also, multinomial logit analysis result showed that at p ≤ 0.05 level of significance, household size (P<0.08), sex (p<0.06), access to loan(p<0.16), age(p<0.07), educational level (P<0.17) and functional extension contact (P<0.28) were all important in explaining the indigenous climate change adaptation utilized by the arable crops farmers in south-western Nigeria. The study concluded that all the identified local adaptation strategies need to be integrated into the development process for sustainable climate change adaptation.

Keywords: crop diversification, climate change, adaptation option, sustainable, small farmers

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Authors: Dalma Varga, Nora Hubayne H.

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Nowadays, among the measures taken to offset the consequences of climate change, water resources management is one of the key tools, which can include excess water management. As a result of climate change’s effects and as a result of the frequent inappropriate landuse, more and more areas are affected by the excess water inundation. Hungary is located in the deepest part of the Pannonian Basin, which is exposed to water damage – especially lowland areas that are endangered by floods or excess waters. The periodical presence of excess water creates specific habitats in a given area, which have ecological, functional, and aesthetic values. Excess water inundation affects approximately 74% of Hungary’s lowland areas, of which about 46% is also under nature protection (such as national parks, protected landscape areas, nature conservation areas, Natura 2000 sites, etc.). These data prove that areas exposed to excess water inundation – which are predominantly characterized by agricultural land uses – have an important ecological role. Other research works have confirmed the presence of numerous rare and endangered plant species in drainage canals, on grasslands exposed to excess water, and on special agricultural fields with mud vegetation. The goal of this research is to define and analyze ecosystem services of areas exposed to excess water inundation. In addition to this, it is also important to determine the quantified indicators of these areas’ natural and landscape values besides the presence of protected species and the naturalness of habitats, so all in all, to analyze the various nature protections related to excess water. As a result, a practice-orientated assessment method has been developed that provides the ecological water demand, assimilates to ecological and habitat aspects, contributes to adaptive excess water management, and last but not least, increases or maintains the share of the green infrastructure network. In this way, it also contributes to reduce and mitigate the negative effects of climate change.

Keywords: ecosystem services, landscape architecture, excess water management, green infrastructure planning

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Authors: Faith Eweluegim Enahoro-Ofagbe

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Water is essential for sustaining life. As a limited resource, effective water management is vital. Water scarcity has become more common due to the effects of climate change, land degradation, deforestation, and population growth, especially in rural communities, which are more susceptible to water-related issues such as water shortage, water-borne disease, et c., due to the unsuccessful implementation of water policies and projects in Nigeria. Since rural communities generate the majority of agricultural products, they significantly impact on water management for sustainability. The development of methods to advance this goal for residential and agricultural usage in the present and the future is a challenge for rural residents. This study evaluated rural water supply systems and irrigation management techniques to conserve water in Kwara State, North-Central Nigeria. Suggesting some measures to conserve water resources for sustainability, off-season farming, and socioeconomic security that will remedy water degradation, unemployment which is one of the causes of insecurity in the country, by considering the use of fabricated or locally made irrigation equipment, which are affordable by rural farmers, among other recommendations. Questionnaires were distributed to respondents in the study area for quantitative evaluation of irrigation methods practices. For physicochemical investigation, samples were also gathered from their available water sources. According to the study's findings, 30 percent of farmers adopted intelligent irrigation management techniques to conserve water resources, saving 45% of the water previously used for irrigation. 70 % of farmers practice seasonal farming. Irrigation water is drawn from river channels, streams, and unlined and unprotected wells. 60% of these rural residents rely on private boreholes for their water needs, while 40% rely on government-supplied rural water. Therefore, the government must develop additional water projects, raise awareness, and offer irrigation techniques that are simple to adapt for water management, increasing socio-economic productivity, security, and water sustainability.

Keywords: water resource management, sustainability, irrigation, rural water management, irrigation management technique

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Authors: Yukiko Fujiwara

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As a language learning methodology, Content and Language Integrated Learning (CLIL) has become increasingly prevalent in Japan. Most CLIL classroom practice and its research are conducted in EFL fields. However, much less research has been done in the Japanese language learning setting. Therefore, there are still many issues to work out using CLIL in the Japanese language teaching (JLT) setting. it is expected that more research will be conducted on both authentically and academically. Under such circumstances, this is one of the few classroom-based CLIL researches experiments in JLT and aims to find an effective course design for a class with students at different proficiency levels. The class was called ‘Japanese culture A’. This class was offered as one of the elective classes for International exchange students at a Japanese university. The Japanese proficiency level of the class was above the Japanese Language Proficiency Test Level N3. Since the CLIL approach places importance on ‘authenticity’, the class was designed with materials and activities; such as books, magazines, a film and TV show and a field trip to Kyoto. On the field trip, students experienced making traditional Japanese desserts, by receiving guidance directly from a Japanese artisan. Through the course, designated task sheets were used so the teacher could get feedback from each student to grasp what the class proficiency gap was. After reading an article on Japanese culture, students were asked to write down the words they did not understand and what they thought they needed to learn. It helped both students and teachers to set learning goals and work together for it. Using questionnaires and interviews with students, this research examined whether the attempt was effective or not. Essays they wrote in class were also analyzed. The results from the students were positive. They were motivated by learning authentic, natural Japanese, and they thrived setting their own personal goals. Some students were motivated to learn Japanese by studying the language and others were motivated by studying the cultural context. Most of them said they learned better this way; by setting their own Japanese language and culture goals. These results will provide teachers with new insight towards designing class materials and activities that support students in a multilevel CLIL class.

Keywords: authenticity, CLIL, Japanese language and culture, multilevel class

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Authors: Asma AlQahtani, Jumana AlHadad, Maryam AlQallaf, Shoug AlHasan

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New product development (NPD) is the complete process of bringing a new product to the customer by integrating the two broad divisions; one involving the idea generation, product design and detail engineering; and the other involving market research and marketing analysis. It is a common practice for companies to undertake some of these tasks simultaneously (concurrent engineering) and also consider them as an ongoing process (continuous development). The current study explores the framework and methodology for a new product development process utilizing the Quality Function Deployment (QFD) tool for bringing the customer opinion into the product development process. An elaborate customer survey with focus groups in the region was carried out to ensure that customer requirements are integrated into new products as early as the design stage including identifying the recognition of need for the new product. A QFD Matrix (House of Quality) was prepared that links customer requirements to product engineering requirements and a feasibility study and risk assessment exercise was carried out for a Small and Medium Enterprise (SME) in Kuwait for development of the new product. SMEs in Kuwait, particularly in manufacturing sector are mainly focused on serving the local demand, and often lack of product quality adversely affects the ability of the companies to compete on a regional/global basis. Further, lack of focus on identifying customer requirements often deters SMEs to envisage the idea of a New Product Development. The current study therefore focuses in utilizing QFD Matrix right from the conceptual design to detail design and to some extent, extending the link this to design of the manufacturing system. The outcome of the project resulted in a development of the prototype for a new molded product which can ensure consistency between the customer’s requirements and the measurable characteristics of the product. The Engineering Economics and Cost studies were also undertaken to analyse the viability of the new product, the results of which was also linked to the successful implementation of the initial QFD Matrix.

Keywords: Quality Function Deployment, QFD Matrix, new product development, NPD, Kuwait SMEs, prototype development

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Authors: Xiaoqing Peng, Aijing Luo, Yang Chen

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Background: Cyberchondria, as an "emerging risk" accompanied by the information era, is a new abnormal pattern characterized by excessive or repeated online searches for health-related information and escalating health anxiety, which endangers people's physical and mental health and poses a huge threat to public health. Objective: To explore and discuss the research status, hotspots and trends of Cyberchondria. Methods: Based on a total of 77 articles regarding "Cyberchondria" extracted from Web of Science from the beginning till October 2019, the literature trends, countries, institutions, hotspots are analyzed by bibliometric analysis, the concept definition of Cyberchondria, instruments, relevant factors, treatment and intervention are discussed as well. Results: Since "Cyberchondria" was put forward for the first time in 2001, the last two decades witnessed a noticeable increase in the amount of literature, especially during 2014-2019, it quadrupled dramatically at 62 compared with that before 2014 only at 15, which shows that Cyberchondria has become a new theme and hot topic in recent years. The United States was the most active contributor with the largest publication (23), followed by England (11) and Australia (11), while the leading institutions were Baylor University(7) and University of Sydney(7), followed by Florida State University(4) and University of Manchester(4). The WoS categories "Psychiatry/Psychology " and "Computer/ Information Science "were the areas of greatest influence. The concept definition of Cyberchondria is not completely unified in the world, but it is generally considered as an abnormal behavioral pattern and emotional state and has been invoked to refer to the anxiety-amplifying effects of online health-related searches. The first and the most frequently cited scale for measuring the severity of Cyberchondria called “The Cyberchondria Severity Scale (CSS) ”was developed in 2014, which conceptualized Cyberchondria as a multidimensional construct consisting of compulsion, distress, excessiveness, reassurance, and mistrust of medical professionals which was proved to be not necessary for this construct later. Since then, the Brazilian, German, Turkish, Polish and Chinese versions were subsequently developed, improved and culturally adjusted, while CSS was optimized to a simplified version (CSS-12) in 2019, all of which should be worthy of further verification. The hotspots of Cyberchondria mainly focuses on relevant factors as follows: intolerance of uncertainty, anxiety sensitivity, obsessive-compulsive disorder, internet addition, abnormal illness behavior, Whiteley index, problematic internet use, trying to make clear the role played by “associated factors” and “anxiety-amplifying factors” in the development of Cyberchondria, to better understand the aetiological links and pathways in the relationships between hypochondriasis, health anxiety and online health-related searches. Although the treatment and intervention of Cyberchondria are still in the initial stage of exploration, there are kinds of meaningful attempts to seek effective strategies from different aspects such as online psychological treatment, network technology management, health information literacy improvement and public health service. Conclusion: Research on Cyberchondria is in its infancy but should be deserved more attention. A conceptual consensus on Cyberchondria, a refined assessment tool, prospective studies conducted in various populations, targeted treatments for it would be the main research direction in the near future.

Keywords: cyberchondria, hypochondriasis, health anxiety, online health-related searches

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Authors: Mohammed Sani Abdulai

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Public sector budgeting, all over the world, is underpinned by some universally accepted principles of sound budget management such as budget unity, universality, annuality, and a balanced budget. These traditional principles, though fundamental, had, in recent years, been augmented by the more modern principles of budgeting within fiscal objective, alignment with medium-term strategic plans as well as the observance of such related concepts as transparency, openness and accessibility. In this paper, we have endeavored to shed light, from literature and practice, on the meaning and purposes of such fundamental budgeting principles. We have also assessed the extent to which the Government of Ghana’s budget complies with the four traditional principles of budget unity, universality, annuality, and a balanced budget and the three out of the ten modern principles of budgetary governance of Organisation for Economic Co-operation and Development (OECD). We did so by using a qualitative method of review and analysis of existing documents and the performance assessment reports on Ghana’s Public Financial Management (PFM) measured using such frameworks as the Public Expenditure and Financial Accountability (PEFA), the Open Budget Survey (OBS) and its Index (OBI), the reports and action plans of Open Government Partnership (OGP) and the Global Initiative for Fiscal Transparency (GIFT). Other performance assessment reports that were relied on included, but not limited to, the Joint Evaluation Report of PFM in Ghana, 2001-2010, and the Joint Evaluation of Budget Support to Ghana, 2005-2015. We have, through this paper, brought to the fore the lessons that could be learned on how those budgetary principles undergird the Government of Ghana’s budget formulation, execution, accounting, control, and oversight. These lessons include, but are not limited to, the need for both scholars and practitioners in the PFM space to be aware of the impact of those principles on public sector budgeting.

Keywords: annulaity, balanced budget, budget unity, budgetary principles, OECD’s principles on budgetary governance, open budget index, public expenditure and financial accountability, universality

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Authors: Jeounghee Kim

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Objective: To describe the incidence of complication, according to the stage of Traumatic Spinal Cord Injury (TSCI) which was treated at Asan Medical Center (AMC), Korea. Hereafter, it should be developed in nursing management protocol of traumatic SCI. Methods. Retrospectively reviewed hospital records about the patients who were admitted AMC Patients with traumatic spinal cord injury until January 2005 and December 2016 were analyzed (n=97). AMC is a single institution of 2,700 beds where patients with trauma and severe trauma can be treated. Patients who were admitted to the emergency room due to spinal cord injury and who underwent intensive care unit, general ward, and rehabilitation ward. To identify long-term complications, we excluded patients who were operated on to other hospitals after surgery. Complications such as respiratory(pneumonia, atelectasis, pulmonary embolism, and others), cardiovascular (hypotension), urinary (autonomic dysreflexia, urinary tract infection (UTI), neurogenic bladder, and others), and skin systems (pressure ulcers) from the time of admission were examined through medical records and images. Results: SCI was graded according to ASIA scale. The initial grade was checked at admission. (grade A 55(56.7%), grade B 14(14.4)%, grade C 11(11.3%), grade D 15(15.5%), and grade E 2(2.1%). The grade was rechecked when the patient was discharged after treatment. (grade A 43(44.3%), grade B 15(15.5%), grade C 12(12.4%), grade D 21(21.6%), and grade E 6(6.2%). The most common complication after SCI was UTI 24cases (mean 36.5day), sore 24cases (40.5day), and Pneumonia which was 23 cases after 10days averagely. The other complications after SCI were neuropathic pain 19 cases, surgical site infection 4 cases. 53.6% of patient who had SCI were educated about intermittent catheterization at discharge from hospital. The mean hospital stay of all SCI patients was 61days. Conclusion: The Complications after traumatic SCI were developed at various stages from acute phase to chronic phase. Nurses need to understand fully the time-course of complication in traumatic SCI to provide evidence-based practice.

Keywords: spinal cord injury, complication, nursing, rehabilitation

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Authors: Sadiah Baharom, Che Nidzam Che Ahmad, Saipol Barin Ramli, Asmayati Yahaya, Sopia Md Yassin

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The early childhood care and education (ECCE) in Malaysia aspire to develop children who are intellectually, emotionally, physically and spiritually balanced. This aspiration can only materialise if the early childhood program developed comprehensive and is of high quality comparable to international standards. As such, there is a pressing need to assess the quality of the program in an all-encompassing manner. The overall research project aims at developing a comprehensive and integrated model of high-quality Malaysian ECCE. One of the major objectives of this project is to assess and evaluate the scope and quality of the existing ECCE programs in Malaysia. To this end, a specific aspect of this objective is to develop and validate an instrument to assess and evaluate the ECCE curriculum of the country. Thus this paper describes the development and validation of an instrument to explore the quality of early childhood care and education curriculum currently implemented in the country’s ECCE centres. The generation of the constructs and items were based on a set of criteria mapped against existing ECCE practice, document analyses, expert interviews and panel discussions. The items went through expert validation and were field tested on 597 ECCE teachers. The data obtained went through an exploratory factor analysis to validate the constructs of the instrument followed by reliability studies on internal consistency based on the Cronbach Alpha values. The final set of items for the ECCE curriculum instrument, earmarked for the main study, consists of four constructs namely philosophy and core values, curriculum content, curriculum review and unique features. Each construct consists of between 21 to 3 items with a total of 36 items in all. The reliability coefficients for each construct range from 0.65 to 0.961. These values are within the acceptable limits for a reliable instrument to be used in the main study.

Keywords: early childhood and care education, instrument development, reliability studies, validity studies

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Authors: R. Bužgová, R. Kozáková, M. Škutová, M. Bar, P. Ressner, P. Bártová

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Introduction: Currently, there has been an increasing concern about the provision of palliative care in non-oncological patients in both professional literature and clinical practice. However, there is not much scientific information on how to provide neurological and palliative care together. The main objective of the project is to create and to verify a concept of neuro-palliative and rehabilitative care for patients with selected neurological diseases in an advanced stage of the disease and also to evaluate bio-psychosocial and spiritual needs of these patients and their caregivers related to the quality of life using created standardized tools. Methodology: Triangulation of research methods (qualitative and quantitative) will be used. A concept of care and assessment tools will be developed by analyzing interviews and focus groups. Qualitative data will be analyzed using grounded theory. The concept of care will be tested in the context of the intervention study. Using quantitative analysis, we will assess the effect of an intervention provided on the saturation of needs, quality of life, and quality of care. A research sample will be made up of the patients with selected neurological diseases (Parkinson´s syndrome, motor neuron disease, multiple sclerosis, Huntington’s disease), together with patients´ family members. Based on the results, educational materials and a certified course for health care professionals will be created. Findings: Based on qualitative data analysis, we will propose the concept of integrated care model combining neurological, rehabilitative and specialist palliative care for patients with selected neurological diseases in different settings of care and services. Patients´ needs related to quality of life will be described by newly created and validated measuring tools before the start of intervention (application of neuro-palliative and palliative approach) and then in the time interval. Conclusion: Based on the results, educational materials and a certified course for doctors and health care professionals will be created.

Keywords: multidisciplinary approach, neuropalliative care, research, quality of life

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Authors: Anne N. Heirman, Lisette van der Molen, Richard Dirven, Gyorgi B. Halmos, Michiel W.M. van den Brekel

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Background: Due to the rising incidence of oropharyngeal squamous cell cancer (OPSCC), many patients are challenged with choosing between transoral(robotic) surgery and radiotherapy, with equal survival and oncological outcomes. Also, functional outcomes are of little difference over the years. With this study, the wants and needs of patients and caregivers are identified to develop a comprehensible patient decision aid (PDA). Methods: The development of this PDA is based on the International Patient Decision Aid Standards criteria. In phase 1, relevant literature was reviewed and compared to current counseling papers. We interviewed ten post-treatment patients and ten doctors from four head and neck centers in the Netherlands, which were transcribed verbatim and analyzed. With these results, the first draft of the PDA was developed. Phase 2 beholds testing the first draft for comprehensibility and usability. Phase 3 beholds testing for feasibility. After this phase, the final version of the PDA was developed. Results: All doctors and patients agreed a PDA was needed. Phase 1 showed that 50% of patients felt well-informed after standard care and 35% missed information about treatment possibilities. Side effects and functional outcomes were rated as the most important for decision-making. With this information, the first version was developed. Doctors and patients stated (phase 2) that they were satisfied with the comprehensibility and usability, but there was too much text. The PDA underwent text reduction revisions and got more graphics. After revisions, all doctors found the PDA feasible and would contribute to regular counseling. Patients were satisfied with the results and wished they would have seen it before their treatment. Conclusion: Decision-making for OPSCC should focus on differences in side-effects and functional outcomes. Patients and doctors found the PDA to be of great value. Future research will explore the benefits of the PDA in clinical practice.

Keywords: head-and-neck oncology, oropharyngeal cancer, patient decision aid, development, shared decision making

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Authors: Celeste Lawson

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Learning to embrace and value teamwork assessment at a university level is critical for students, as graduates enter a real-world working environment where teamwork is likely to occur virtually. Student disdain for teamwork exercises is an area often overlooked or disregarded by academics. This research explored the implementation of an online teamwork assessment approach at a regional Australian university with a significant cohort of Distance Education students. Students had disliked teamwork for three reasons: it was not relevant to their study, the grading was unfair amongst team members, and managing the task was challenging in a virtual environment. Teamwork assessment was modified so that the task was an authentic task that could occur in real-world practice; team selection was based on the task topic rather than randomly; grading was based on the individual’s contribution to the task, and students were provided virtual team management skills as part of a the assessment. In this way, management of the team became an output of the task itself. Data was gathered over three years from student satisfaction surveys, failure rates, attrition figures, and unsolicited student comments. In one unit where this approach was adopted (Advanced Public Relations), student satisfaction increased from 3.6 (out of 5) in 2012 to 4.6 in 2016, with positive comments made about the teamwork approach. The attrition rate for another unit (Public Relations and the Media) reduced from 20.7% in 2012 to 2.2% in 2015. In 2012, criticism of teamwork assessment made up 50% of negative student feedback in Public Relations and the Media. By 2015, following the successful implementation of the teamwork assessment approach, only 12.5% of negative comments on the student satisfaction survey were critical of teamwork, while 33% of positive comments related to a positive teamwork experience. In 2016, students explicitly nominated teamwork as the best part of this unit. The approach is transferable to other disciplines and was adopted by other academics within the institution with similar results.

Keywords: assessment, distance education, teamwork, virtual

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Authors: Ningfei Xiao, Simon Twose, Hannah Hopewell

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In urban settings worldwide, artists and researchers have drawn from shamanic healing, providing insightful responses to the environment. This project is a transdisciplinary creative research project where architecture and art practice draw from shamanic healing and provide the potential to expand knowledge of public space and inspire more aesthetic explorations of public spatial visions. The research started from the encounters with the Ewengki/Evenki shaman tribe in settlement areas of northern China in 2019 and extended through the partnerships with Maori artists in Poneke Aotearoa, New Zealand, in 2023. Based on the learnings and collaborations with female indigenous tradition practitioners and the healing that the researcher received from the land, a spatial installation exhibition was developed in this project. Indigenous practices are intricately woven with contemporary technology, merging visuals, soundscapes, and other non-visual aesthetics influenced by the researcher's personal experiences of embodied shamanic healing with brainwave generative technology. This synthesis seeks to ritualize and reimagine future public spaces, encompassing streetscapes and greenscapes from China to Aotearoa, and fostering connections between urbanized human body, mind, spirit, and land. In doing so, the project presents a feminist posthuman inquiry into how individuals perceive materiality within the context of a future city. Grounded in creative research and embodied methodologies, this paper focuses on the conceptual and autoethnographic aspects of visual-non-visual aesthetics and their creative representation. Through the exploration of aesthetics beyond the visual realm within urban and spatial contexts, this project showcases the spatial installation exhibition as an example of shamanic influence and related response to public space through embodied artistry and transdisciplinary creative inquiry.

Keywords: aesthetic, embodiment, visual and/or non-visual, spatial installation, shamanic healing, public space

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Authors: Sher Ali

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Organic agriculture has gained significant momentum globally as a sustainable and environmentally friendly farming practice. In Pakistan, amidst growing concerns about food security, environmental degradation, and health issues related to conventional farming methods, the adoption of organic agriculture presents a promising pathway for agricultural development. This abstract aims to provide an overview of the status, opportunities, challenges, and future directions of organic agriculture in Pakistan. It delves into the current state of organic farming practices, including the extent of adoption, key crops cultivated, and the regulatory framework governing organic certification. Furthermore, the abstract discusses the unique opportunities that Pakistan offers for organic agriculture, such as its diverse agro-climatic zones, rich biodiversity, and traditional farming knowledge. It highlights successful initiatives and case studies that showcase the potential of organic farming to improve rural livelihoods, enhance food security, and promote sustainable agricultural practices. However, the abstract also addresses the challenges hindering the widespread adoption of organic agriculture in Pakistan, ranging from limited awareness and technical know-how among farmers to inadequate infrastructure and market linkages. It emphasizes the need for supportive policies, capacity-building programs, and investment in research and extension services to overcome these challenges and promote the growth of the organic agriculture sector. Lastly, the abstract outlines future directions and recommendations for advancing organic agriculture in Pakistan, including strategies for scaling up production, strengthening certification mechanisms, and fostering collaboration among stakeholders. By shedding light on the opportunities, challenges, and potential of organic agriculture in Pakistan, this abstract aims to contribute to the discourse on sustainable farming practices at the upcoming Agro Conference in the USA. It invites participants to engage in dialogue, share experiences, and explore avenues for collaboration toward promoting organic agriculture for a healthier, more resilient food system.

Keywords: agriculture, challenges, organic, Pakistan

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Authors: Canan Duzan

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For most language learners, mastery of the speaking skill is the proof of the mastery of the foreign language. On the other hand, the speaking skill is considered as the most difficult aspect of language learning to develop for both learners and teachers. Especially in countries like Turkey where exposure to the target language is minimum and resources and opportunities provided for language practice are scarce, teaching and learning to speak the language become a real struggle for teachers and learners alike. Data collected from students, instructors, faculty members and the business sector in needs analysis studies conducted previously at Middle East Technical University (METU) consistently revealed the need for addressing the problem of lack of confidence in speaking English. Action was taken during the design of the only EAP speaking course offered in Modern Languages Department since lack of confidence is considered to be a serious barrier for effective communication and causes learners to suffer from insecurity, uncertainty and fear. “Confidence building” served as the guiding principle in the syllabus design, nature of the tasks created for the course and the assessment procedures to help learners become more confident speakers of English. In order to see the effectiveness of the decisions made during the design phase of the course and whether students become more confident speakers upon completion of the course, a case study was carried out with 100 students at METU. A questionnaire including both Likert-Scale and open-ended items were administered to students to collect data and this data were analyzed using the SPSS program. Group interviews were also carried out to gain more insight into the effectiveness of the course in terms of building speaking confidence. This presentation will explore the specific actions taken to develop students’ confidence based on the findings of program evaluation studies and to what extent the students believe these actions to be effective in improving their confidence. The unique design of this course and strategies adopted for confidence building are highly applicable in other EAP contexts and may yield similar positive results.

Keywords: confidence, EAP, speaking, strategy

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Authors: Eva Kirzner

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Based on outcome studies published over the past two decades, in 2018, the ACC/AHA published new guidelines for the management of hypercholesterolemia that incorporate the use of coronary artery calcium (CAC) scanning as a decision tool for ascertaining which patients may benefit from statin therapy. This use is based on the recognition that the absence of calcium on CAC scanning (i.e., a CAC score of zero) usually signifies the absence of significant atherosclerotic deposits in the coronary arteries. Specifically, in patients with a high risk for atherosclerotic cardiovascular disease (ASCVD), initiation of statin therapy is generally recommended to decrease ASCVD risk. However, among patients with intermediate ASCVD risk, the need for statin therapy is less certain. However, there is a need for new outcome studies that provide evidence that the management of hypercholesterolemia based on these new ACC/AHA recommendations is safe for patients. Based on a Pub-Med and Google Scholar literature search, four relevant population-based or patient-based cohort studies that studied the relationship between CAC scanning, risk assessment or mortality, and statin therapy that were published between 2017 and 2021 were identified (see references). In each of these studies, patients were assessed for their baseline risk for atherosclerotic cardiovascular disease (ASCVD) using the Pooled Cohorts Equation (PCE), an ACC/AHA calculator for determining patient risk based on assessment of patient age, gender, ethnicity, and coronary artery disease risk factors. The combined findings of these four studies provided concordant evidence that a zero CAC score defines patients who remain at low clinical risk despite the non-use of statin therapy. Thus, these new studies confirm the use of CAC scanning as a safe tool for reducing the potential overuse of statin therapy among patients with zero CAC scores. Incorporating these new data suggest the following best practice: (1) ascertain ASCVD risk according to the PCE in all patients; (2) following an initial attempt trial to lower ASCVD risk with optimal diet among patients with elevated ASCVD risk, initiate statin therapy for patients who have a high ASCVD risk score; (3) if the ASCVD score is intermediate, refer patients for CAC scanning; and (4) and if the CAC score is zero among the intermediate risk ASCVD patients, statin therapy can be safely withheld despite the presence of an elevated serum cholesterol level.

Keywords: cholesterol, cardiovascular disease, statin therapy, coronary calcium

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Authors: Laïd Boukraâ

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Complementary and Alternative Medicine is an inclusive term that describes treatments, therapies, and modalities that are not accepted as components of mainstream education or practice, but that are performed on patients by some practitioners. While these treatments and therapies often form part of post-graduate education, study and writing, they are generally viewed as alternatives or complementary to more universally accepted treatments. Ancient civilizations used bee products and medicinal plants, but modern civilization and ‘education’ have seriously lessened our natural instinctive ability and capability. Despite the fact that the modern Western establishment appears to like to relegate apitherapy and aromatherapy to the status of 'folklore' or 'old wives' tales', they contain a vast spread of pharmacologically-active ingredients and each one has its own unique combination and properties. They are classified in modern herbal medicine according to their spheres of action. Bee products and medicinal plants are well-known natural product for their healing properties and their increasing popularity recently as they are widely used in wound healing. Honey not only has antibacterial properties which can help as an antibacterial agent but also has chemical properties which may further help in the wound healing process. A formulation with honey as its main component was produced into a honey gel. This new formulation has enhanced texture and is more user friendly for usage as well. This new formulation would be better than other formulas as it is hundred percent consisting of natural products and has been made into a better formulation. In vitro assay, animal model study and clinical trials have shown the effectiveness of LEADERMAX for the treatment of diabetic foot, burns, leg ulcer and bed sores. This one hundred percent natural product could be the best alternative to conventional products for wound and burn management. The advantages of the formulation are: 100% natural, affordable, easy to use, strong power of absorption, dry surface on the wound making a film, will not stick to the wound bed; helps relieve wound pain, inflammation, edema and bruising while improving comfort.

Keywords: bed sore bee products, burns, diabetic foot, medicinal plants, leg ulcer, wounds

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