Search results for: consumer travel experience

Authors: Zanib Nafees, Amir Razaghizad, Ibtisam Mahmoud, Abhinav Sharma, Renzo Cecere

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More than one million surgeries are performed each year in Canada, resulting in more than 100,000 associated serious adverse events (SAEs) per year. These are defined as unintended injuries or complications that adversely affect the well-being of patients. In recent years, there has been a proliferation of digital health interventions that have the potential to assist, monitor, and educate patients—facilitating self-care following post-operative discharge. Among digital health, interventions are interactive-voice response technologies (IVRs), which have been shown to be highly effective in certain medical settings. Although numerous IVR-based interventions have been developed, their effectiveness and utility remain unclear, notably in post-operative settings. To the best of our knowledge, no systematic or scoping reviews have evaluated this topic to date. Thus, the objective of this scoping review protocol is to systematically map and explore the literature and evidence describing and examining IVR tools, implementation, evaluation, outcome, and experience for post-operative patients. The focus will be primarily on the evaluation of baseline performance status, clinical assessment, treatment outcomes, and patient management, including self-management and self-monitoring. The objective of this scoping review is to assess the extent of the literature to direct future research efforts by identifying gaps and limitations in the literature and to highlight relevant determinants of positive outcomes in the emerging field of IVR monitoring for health outcomes in post-operative patients.

Keywords: digital healthcare technologies, post-surgery, interactive voice technology, interactive voice response

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Authors: M. Zezou

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This paper focuses on the design of a Massive Open Online Course (MOOC) about Content Language Integrated Learning (CLIL) and more specifically about how teachers can use CLIL as an educational approach incorporating technology in their teaching as well. All the four weeks of the MOOC will be presented and a step-by-step analysis of each lesson will be offered. Additionally, the paper includes detailed lesson plans about CLIL lessons with proposed CLIL activities and games in which technology plays a central part. The MOOC is structured based on certain criteria, in order to ensure success, as well as a positive experience that the learners need to have after completing this MOOC. It addresses to all language teachers who would like to implement CLIL into their teaching. In other words, it presents the methodology that needs to be followed so as to successfully carry out a CLIL lesson and achieve the learning objectives set at the beginning of the course. Firstly, in this paper, it is very important to give the definitions of MOOCs and LMOOCs, as well as to explore the difference between a structure-based MOOC (xMOOC) and a connectivist MOOC (cMOOC) and present the criteria of a successful MOOC. Moreover, the notion of CLIL will be explored, as it is necessary to fully understand this concept before moving on to the design of the MOOC. Onwards, the four weeks of the MOOC will be introduced as well as lesson plans will be presented: The type of the activities, the aims of each activity and the methodology that teachers have to follow. Emphasis will be placed on the role of technology in foreign language learning and on the ways in which we can involve technology in teaching a foreign language. Final remarks will be made and a summary of the main points will be offered at the end.

Keywords: CLIL, cMOOC, lesson plan, LMOOC, MOOC criteria, MOOC, technology, xMOOC

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Authors: Ana Paula Esteves, Diego S. Caetano, Louise L. B. Lomardo

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This paper presents an approach to the performance of the natural lighting, when the use of appropriated solar lighting systems on the roof is applied in cultural buildings such as museums and foundations. The roofs, as a part of contact between the building and the external environment, require special attention in projects that aim at energy efficiency, being an important element for the capture of natural light in greater quantity, but also for being the most important point of generation of photovoltaic solar energy, even semitransparent, allowing the partial passage of light. Transparent elements in roofs, as well as superior protection of the building, can also play other roles, such as: meeting the needs of natural light for the accomplishment of the internal tasks, attending to the visual comfort; to bring benefits to the human perception and about the interior experience in a building. When these resources are well dimensioned, they also contribute to the energy efficiency and consequent character of sustainability of the building. Therefore, when properly designed and executed, a roof light system can bring higher quality natural light to the interior of the building, which is related to the human health and well-being dimension. Furthermore, it can meet the technologic, economic and environmental yearnings, making possible the more efficient use of that primordial resource, which is the light of the Sun. The article presents the analysis of buildings that used zenith light systems in search of better lighting performance in museums and foundations: the Solomon R. Guggenheim Museum in the United States, the Iberê Camargo Foundation in Brazil, the Museum of Fine Arts in Castellón in Spain and the Pinacoteca of São Paulo.

Keywords: natural lighting, roof lighting systems, natural lighting in museums, comfort lighting

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Authors: Ayham Fattoum, Simos Chari, Duncan Shaw

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Volatile, uncertain, complex, and ambiguous (VUCA) conditions threaten systems viability with emerging and novel events requiring immediate and localized responses. Such responsiveness is only possible through devolved freedom and emancipated decision-making. The Viable System Model (VSM) recognizes the need and suggests maximizing autonomy to localize decision-making and minimize residual complexity. However, exercising delegated autonomy in VUCA requires confidence and knowledge to use intuition and guidance to maintain systemic coherence. This paper explores the role of intuition as an enabler of emancipated decision-making and autonomy under VUCA. Intuition allows decision-makers to use their knowledge and experience to respond rapidly to novel events. This paper offers three contributions to VSM. First, it designs a system model that illustrates the role of intuitive decision-making in managing complexity and maintaining viability. Second, it takes a black-box approach to theory development in VSM to model the role of autonomy and intuition. Third, the study uses a multi-stage discovery-oriented approach (DOA) to develop theory, with each stage combining literature, data analysis, and model/theory development and identifying further questions for the subsequent stage. We synthesize literature (e.g., VSM, complexity management) with seven months of field-based insights (interviews, workshops, and observation of a live disaster exercise) to develop a framework of intuitive complexity management framework and VSM models. The results have practical implications for enhancing the resilience of organizations and communities.

Keywords: Intuition, complexity management, decision-making, viable system model

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Authors: Takhul Bakhtiar

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In South Sulawesi Province, there is an active Walanae Fault causing this area to frequently experience earthquakes. This study aims to determine the level of seismicity of the earthquake in order to obtain the potential for earthquakes in the future. The estimation of the potential for earthquakes is then made a scenario model determine the estimated level of shocks as an effort to mitigate earthquake disasters in the region. The method used in this study is the Gutenberg Richter Method through the statistical likelihood approach. This study used earthquake data in the South Sulawesi region in 1972 - 2022. The research location is located at the coordinates of 3.5° – 5.5° South Latitude and 119.5° – 120.5° East Longitude and divided into two segments, namely the northern segment at the coordinates of 3.5° – 4.5° South Latitude and 119,5° – 120,5° East Longitude then the southern segment with coordinates of 4.5° – 5.5° South Latitude and 119,5° – 120.5° East Longitude. This study uses earthquake parameters with a magnitude > 1 and a depth < 50 km. The results of the analysis show that the potential for earthquakes in the next ten years with a magnitude of M = 7 in the northern segment is estimated at 98.81% with an estimated shock level of VI-VII MMI around the cities of Pare-Pare, Barru, Pinrang and Soppeng then IV - V MMI in the cities of Bulukumba, Selayar, Makassar and Gowa. In the southern segment, the potential for earthquakes in the next ten years with a magnitude of M = 7 is estimated at 32.89% with an estimated VI-VII MMI shock level in the cities of Bulukumba, Selayar, Makassar and Gowa, then III-IV MMI around the cities of Pare-Pare, Barru, Pinrang and Soppeng.

Keywords: Gutenberg Richter, likelihood method, seismicity, shakemap and MMI scale

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Authors: Jackqueline Uy, Hannah Miriam Verano, Crysler Luis Verbo, Irene Gueco

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Educational tours are part of the curriculum of the College of Tourism and Hospitality Management, De La Salle University-Dasmarinas. They are highly significant to the students, especially Tourism students. The purpose of this study was to determine how effective educational tours were as a learning tool using the Experiential Learning Theory by David Kolb. This study determined the demographic profile of the third year tourism students in terms of gender, section, educational tours joined, and monthly family income and lastly, this study determined if there is a significant difference between the demographic profile of the respondents and their assessment of educational tours as a learning tool. The researchers used a historical research design with the third-year students of the bachelor of science in tourism management as the population size and used a random sampling method. The researchers made a survey questionnaire and utilized statistical tools such as weighted mean, frequency distribution, percentage, standard deviation, T-test, and ANOVA. The result of the study answered the profile of the respondents such as the gender, section, educational tour/s joined, and family monthly income. The findings of the study showed that the 3rd year tourism management students strongly agree that educational tours are a highly effective learning tool in terms of active experimentation, concrete experience, reflective observation, and abstract conceptualisation based on the data gathered from the respondents.

Keywords: CTHM, educational tours, experiential learning theory, De La Salle University Dasmarinas, tourism

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Authors: Kjellgren Maria, Lilliehorn Sara, Markström Urban

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This article describes the counselling practice of school social workers (SSWs) with individual children. SSWs work in the school system’s pupil health team, whose primary task is health promotion and prevention. The work of SSWs is about helping children and adolescents who, for various reasons, suffer from mental ill-health, school absenteeism, or stress that make them unable to achieve their intended goals. SSWs preferably meet these children in individual counselling sessions. The aim of this article is to describe and analyse SSWs’ experience of counselling with children and to examine the characteristics of counselling practice. The data collection was conducted through four semi-structured focus group interviews with a total of 22 SSWs in four different regions in Sweden. SSWs provide counselling to children in order to bring about improved feelings or behavioural changes. It can be noted that SSWs put emphasis on both the counselling process and the alliance with the child. The interviews showed a common practice among SSWs regarding the structure of the counselling sessions, with certain steps and approaches being employed. However, the specific interventions differed and were characterised by an eclectic standpoint in which SSWs utilise a broad repertoire of therapeutic schools and techniques. Furthermore, a relational perspective emerged as a most prominent focus for the SSWs by re-emerging throughout the material. We believe that SSWs could benefit from theoretical perspectives on ‘contextual model’ and ‘attachment theory’ as ‘models of the mind’. Being emotionally close to the child and being able to follow their development requires a lot from SSWs, as both professional caregivers and as “safe havens”.

Keywords: school social conselling, school social workers, contextual model, attachment thory

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Authors: Timothy Mossman

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The number of adolescent children accompanying their immigrant parents to Canada has steadily increased since the 1990s. Much of the applied linguistics literature on these so-called ‘Generation 1.5’ youth has focused on their deficiencies as academic writers in US Rhetoric and Composition and ESL contexts in higher education and the stigma of ESL in US K-12 contexts. However, the literature on Generation 1.5 students and identity in Canadian higher education is limited. This qualitative study investigates the processes of identity construction of three Generation 1.5 students studying at a university in Metro Vancouver to find out what types of identities and representations of self and other they make relevant, the meanings they attribute to their identities, and what motivates them to construct these identities. The study analyzes the accounts and experiences of the participants in interviews, focus groups, and texts and as ‘culture-in-action,’ positing that they constructed identities as social categories associated with the languages and social practices of their countries of birth, in liminal spaces among a continuum between Canada and their countries of birth, and a spectrum of related cultural representations. Ideas and beliefs associated with broader ‘macro’ social structures in Canadian society related to language, culture, legitimacy, immigration, power, distinction, and racism were shown to be transcended in and through their representations of themselves and others. Data suggest that moving to Canada caused participants to experience discontinuities between their cultures, languages, and social practices, and in some cases a conflicting sense of self. The study brings implications for finding ways to understand the complexity of immigrant students, avoid reifying and generalizing about them, and not see them as stuck-in-between or lacking.

Keywords: culture-in-action, generation 1.5, identity, membership categorization analysis

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Authors: Irene Oluwatosin Uwabor

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Climate change is a global phenomenon which affects the environment and undermines agricultural activities, in particular, cocoa production in Nigeria. This study, therefore, assessed the farmers ‘coping strategies to climate change effects in Ilaro Local Government Area of Ogun State, Nigeria. A simple random sampling technique was used to select twenty-five cocoa farmers from each of the selected six wards to make up 150 cocoa farmers as sample size for this study. Descriptive statistics and chi-square analysis were used for the data analysis. The results showed that the average age of the respondents was 43.8 years and male dominated (80.00%) cocoa production. Most of the respondents had some level of formal education (93.4%). The mean of household and year of experience in cocoa farming were eight people and 11.6 years respectively. Family and Hired labour (41.3%) was the common source of labour to the respondents and majority (86.0%) of the respondents were aware of climate change. The study concluded that respondents experienced low yield and high rate of deformed beans in the pods due to climate change. The adjustment strategies used were planting of diseases and pest resistant cocoa varieties, using of heavy mulching, diversification into other non- agricultural income generating activities and tree crops cultivation to provide shade. Also, significant relationships existed between personal characteristics (χ²= 62.24, df = 6, p = 0.00), adjustment strategies (χ²= 103.1, df = 4, p = 0.00) and effect of climate change. It is hereby recommend that extension service providers should intensify more effort and advocating for improved agronomic practices to increase cocoa productivity in the study area.

Keywords: cocoa farmers, coping strategies, climate change, ilaro

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Authors: Karen V. Lee

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The background and significance of this study involves research about a music teacher discovering how language development and learning can help her overcome harmful and lasting consequences from sexual violence. Education about intervention resources from language development that helps her cope with consequences influencing her career as teacher. Basic methodology involves the qualitative method of research as theoretical framework where the author is drawn into a deep storied reflection about political issues surrounding teachers who need to overcome social, psychological, and health risk behaviors from violence. Sub-themes involve available education from learning resources to ensure teachers receive social, emotional, physical, spiritual, and intervention resources that evoke visceral, emotional responses from the audience. Major findings share how language development and learning provide helpful resources to victims of violence. It is hoped the research dramatizes an episodic yet incomplete story that highlights the circumstances surrounding the protagonist’s life. In conclusion, the research has a reflexive storied framework that embraces harmful and lasting consequences from sexual violence. The reflexive story of the sensory experience critically seeks verisimilitude by evoking lifelike and believable feelings from others. Thus, the scholarly importance of using language development and learning for intervention resources can provide transformative aspects that contribute to social change. Overall, the circumstance surrounding the story about sexual violence is not uncommon in society. Language development and learning supports the moral mission to help teachers overcome sexual violence that socially impacts their professional lives as victims.

Keywords: intervention, language development and learning, sexual violence, story

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Authors: Yeaji Seok, Myung Kyung Lee

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Background: Even if patients survive after a stroke, stroke patients may experience disability in mobility, sensation, cognition, and speech and language. Stroke patients require rehabilitation for functional recovery and daily life for a considerable time. During rehabilitation, the role of caregivers is important. However, the stroke patients’ quality of life may deteriorate due to family caregivers’ non-preparedness and increased role burden. Purpose: To investigate the prediction of caregivers' preparedness and role burden on stroke patients’ quality of life. Methods: The target population was stroke patients who were hospitalized for rehabilitation and their family care providers. A total of 153 patient-family caregiver dyads were recruited from June to August 2021. Data were collected from self-reported questionnaires and analyzed using descriptive statistics, t-tests, chi-squared test, one-way analysis of variance, Pearson’s correlation coefficients, and multiple regression with SPSS statistics 28 programs. Results: Family caregivers’ preparedness affected stroke patients’ mobility (β = .20, p < 0.05) and character (β = -.084, p < 0.05) and production activities (β = -.197, p < 0.05) in quality of life. The role burden of family caregivers affected language skills (β = .310, p<0.05), visual functions (β=-.357, p < 0.05), thinking skills (β = 0.443, p = 0.05), mood conditions (β = 0.565, p < 0.001), family roles (β = -0.361, p < 0.001), and social roles (β = -0.304, p < 0.001), while the caregivers’ burden of performing self-protection negatively affected patients’ social roles (β = .180, p=.048). In addition, caregivers’ role burden of personal life sacrifice affected patients’ mobility (β = .311, p < 0.05), self-care (β =.232, p < 0.05) and energy (β = .239, p < 0.05). Conclusion: This study indicated that family caregivers' preparedness and role burden affected stroke patients’ quality of life. The results of this study suggested that intervention to improve family caregivers’ preparedness and to reduce role burden should be required for quality of life in stroke patients.

Keywords: quality of life, preparedness, role burden, caregivers, stroke

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Authors: Makrina Tindangen

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The problems faced by participants of teacher profession program in Faculty of teaching and education Mulawarman University is professional and pedagogic competence. Professional competence related to the mastery of teaching materials, while pedagogic competence related with the ability to plan and to implement learning. Based on the problems, the purpose of the research is to maximize the role of companion teacher for the achievement of professional and pedagogic competencies in the workshop of the participants of teacher professional education in the Faculty of Teaching and Education of Mulawarman University. Qualitative research method with interview guidance and document to get in-depth data on how to maximize the role of companion teachers in the achievement of professional and pedagogic competencies in the workshop participants of professional education participants. Location of this research is on the Faculty of Teaching and Education of Mulawarman University, Samarinda City, East Kalimantan Province. Research respondents were 12 teachers of workshop facilitator. Descriptive data analysis is through interpretation of interview data. The conclusion of the research result, how to maximize the role of assistant teachers in workshop activities for the professional competence and pedagogic competence of professional teacher training program participants, through facilitation activities conducted by teachers of companion related to real problems faced by students in school, so that the workshop participants have professional competence and pedagogic as an initial competence before carrying out practical activities of field experience in school.

Keywords: companion teacher, professional and pedagogical competence, activities, workshop participants

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Authors: Mohd Noah A. Rahman, Afzaal H. Seyal, Sharul T. Tajuddin, Hartiny Md Azmi

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Taking into consideration the real time situation specifically the higher academic institutions, small, medium to large companies, public to private sectors and the remaining sectors, do experience the inventory or asset shrinkages due to theft, loss or even inventory tracking errors. This happening is due to a zero or poor security systems and measures being taken and implemented in their organizations. Henceforth, implementing the Radio Frequency Identification (RFID) technology into any manual or existing web-based system or web application can simply deter and will eventually solve certain major issues to serve better data retrieval and data access. Having said, this manual or existing system can be enhanced into a mobile-based system or application. In addition to that, the availability of internet connections can aid better services of the system. Such involvement of various technologies resulting various privileges to individuals or organizations in terms of accessibility, availability, mobility, efficiency, effectiveness, real-time information and also security. This paper will look deeper into the integration of mobile devices with RFID technologies with the purpose of asset tracking and control. Next, it is to be followed by the development and utilization of MongoDB as the main database to store data and its association with RFID technology. Finally, the development of a web based system which can be viewed in a mobile based formation with the aid of Hypertext Preprocessor (PHP), MongoDB, Hyper-Text Markup Language 5 (HTML5), Android, JavaScript and AJAX programming language.

Keywords: RFID, asset tracking system, MongoDB, NoSQL

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Authors: Jessica Hemberg, Mikaela Miller

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Unreasonable workload and work-related stress can reduce nurse leaders’ job satisfaction and productivity and can increase absence and burnout. Nurse leaders’ workload in public healthcare settings is relatively unresearched. The aim of this study was to investigate nurse leaders’ perceptions of workload and task distribution with relation to leading work tasks in public healthcare. A qualitative explorative design was used. The data material consisted of texts from interviews with nurse leaders in public healthcare (N=8). The method was inspired by content analysis. The COREQ checklist was used. Informed consent was sought from the participants regarding study participation and the storage and handling of data for research purposes. Six main themes were found: Increased and unreasonable workload, Length of work experience as nurse leader affects perception of workload, Number of staff and staff characteristics affect perception of workload, Versatile and flexible task distribution, Working overtime as a way of managing high workload, and Insufficient time for leadership mission. The workload for nurse leaders in a public healthcare setting was perceived to be unreasonable. Common measures for managing high workload included working overtime, delegating work tasks and organizing more staff resources in the form of additional staff. How nurse leaders perceive their workload was linked to both the number of staff and staff characteristics. These should both be considered equally important when determining staff levels and measuring nurse leaders’ workload. Future research should focus on investigating workload and task distribution from nurses’ perspectives.

Keywords: nurse leaders, workload, task distribution, public healthcare, qualitative

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Authors: Dorothy I. Riddle

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Limited mobility (or an inability to walk more than 15 meters without sitting down to rest) restricts full community participation for 13 percent of Canadian adults or 4.2 million persons), yet Canadian accessibility standards are silent on distance to be walked as an accessibility barrier to be addressed. Instead, they focus on ensuring access for the wheeled mobility devices used regularly by le The Accessible Canada Act mandates that Canada be barrier free by 2040, which will necessitate eliminating distance to be walked as a barrier in federal programs and services. This paper details the results of a multi-year research project funded by Accessibility Standards Canada to document the lived experience of those struggling with limited mobility and make recommendations regarding how to ensure accessibility for those with limited mobility. Over 2,600 Canadians from across Canada participated in an online survey and follow-up focus groups. The results underscored the importance of providing not only mobility supports in public facilities but also the information necessary for planning access to federal programs and services. As numerous participants indicated, if they weren’t sure how far they would have to walk, they simply stayed home and depended on friends and relatives for help with errands or appointments. This included failing to participate in civic activities, such as voting, for fear of having to walk too far and stand unsupported for too long. Types of information that were deemed critical included whether or not mobility aids were available, where seating to rest was located throughout the facility, what alternatives to standing while waiting for service and having to walk to the service provider (rather than the provider coming to the customer) were available, and diagrams of accessible parking and its relationship to elevators and services.

Keywords: accessibility standards, distance to be walked, limited mobility, mobility aids, service to customer

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Authors: Chih-Yi Ho, Tzu-Fang Chang, Chih-Chia Huang, Chia-Yen Lee

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In dental clinics, the dentists use the periapical radiography image to assess the effectiveness of endodontic treatment of teeth with chronic apical periodontitis. Periapical radiography images are taken at different times to assess alveolar bone variation before and after the root canal treatment, and furthermore to judge whether the treatment was successful. Current clinical assessment of apical tissue recovery relies only on dentist personal experience. It is difficult to have the same standard and objective interpretations due to the dentist or radiologist personal background and knowledge. If periapical radiography images at the different time could be registered well, the endodontic treatment could be evaluated. In the image registration area, it is necessary to assign representative control points to the transformation model for good performances of registration results. However, detection of representative control points (feature points) on periapical radiography images is generally very difficult. Regardless of which traditional detection methods are practiced, sufficient feature points may not be detected due to the low-contrast characteristics of the x-ray image. Barnard detector is an algorithm for feature point detection based on grayscale value gradients, which can obtain sufficient feature points in the case of gray-scale contrast is not obvious. However, the Barnard detector would detect too many feature points, and they would be too clustered. This study uses the local extrema of clustering feature points and the suppression radius to overcome the problem, and compared different feature point detection methods. In the preliminary result, the feature points could be detected as representative control points by the proposed method.

Keywords: feature detection, Barnard detector, registration, periapical radiography image, endodontic treatment

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Authors: Lisa Winstead, Penny Congcong Wang

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This two-year multiple case study of eight Spanish-English speaking teachers explores bilingual-bicultural Latino teachers’ lived experiences as English Language Learners and, more recently, as adult teachers who work with English Language Learners in mainstream schools. Research questions explored include: How do bilingual-bicultural teachers perceive their native language use and sense of self within society from childhood to adulthood? Correspondingly, what are bilingual teachers’ perceptions of how their own language learning experience might affect teaching students of similar linguistic and cultural backgrounds? This study took place in an urban area in the Pacific Southwest of the United States. Participants were K-8 teachers and enrolled in a Spanish-English bilingual authorization program. Data were collected from journals, focus group interviews, field notes, and class artifacts. Within case and cross-case analysis revealed that the participants were shamed about their language use as children which contributed to their primary language loss. They similarly reported how experiences of mainstream educator and administrator language shaming invalidated their ability to provide support for Latino heritage ELLs, despite their bilingual-bicultural expertise. However, participants reported that counter-narratives from the bilingual authorization program, parents, community and church organizations, and cultural responsive teachers were effective in promoting their language retention, pride, and feelings of well-being.

Keywords: teacher education, bilingual education, English language learners, emergent bilinguals, social justice, language shame, language loss, translanguaging

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Authors: Devendra Gupta, Sushilk K. Agarwal, Amit Kesari, P. K. Singh

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Objectives: Pediatric patients often may experience persistent respiratory failure that requires tracheostomy placement in Pediatric ICU. We have designed a technique of tracheostomy in pediatric patients with S-shaped incision on the tracheal wall with higher success rate and lower complication rate. Technique: Following general anesthesia and positioning of the patient, the trachea was exposed in midline by a vertical skin incision. In order to make S-shaped tracheostoma, second tracheal ring was identified. The conventional vertical incision was made in second tracheal ring and then extended at both its ends laterally in the inter-cartilaginous space parallel to the tracheal cartilage in the opposite direction to make the incision S-shaped. The trachea was dilated with tracheal dilator and appropriate size of tracheostomy tube was then placed into the trachea. Results: S-shaped tracheostomy was performed in 20 children with mean age of 6.25 years (age range is 2-7) requiring tracheostomy placement. The tracheostomy tubes were successfully placed in all the patients in single attempt. There was no incidence of significant intra-operative bleeding, subcutaneous emphysema, vocal cord palsy or pneumothorax. Two patients developed pneumonia and expired within a year. However, there was no incidence of tracheo-esophageal fistula, suprastomal collapse or difficulty in decannulation on one year of follow up related to our technique. One patient developed late trachietis managed conservatively. Conclusion: S-shaped tracheoplasty was associated with high success rate, reduced risk of the early and late complications in pediatric patients requiring tracheostomy.

Keywords: peatrics, tracheostomy, ICU, tracheostoma

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Authors: Saman Naqvi

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Introduction: Telemedicine is the practise of providing remote healthcare to patients via the utilisation of communication technologies. Its application has become increasingly important since the Coronavirus Disease 2019 (COVID-19) pandemic. It is essential to determine the knowledge and attitudes of healthcare professionals concerning its use in order to maximise its application. Purpose: We aim to examine and evaluate the current understanding and perceptions of medical staff toward the use of telemedicine. Methods: In this cross-sectional study, we surveyed 1091 healthcare professionals worldwide. Following an extensive review of the literature, data were gathered using a questionnaire. To depict the participant profile, frequency, percentages, and cumulative percentages were determined. Results: The majority of respondents had either heard of (90.9%), seen (65.3%), or were familiar with (74.6%) how telemedicine is implemented in practice. 72.2% of people were familiar with the tools that could be applied to this technology. Those with a medical degree and experience of under five years were found to be more familiar with telemedicine. Additionally, opinions on providing healthcare remotely were largely favorable, with 80% of respondents stating that it reduced staff burden and 80.6% thinking that it eliminated unnecessary transportation costs. Furthermore, 83% expressed that it saves clinicians' time. However, 20% of participants believed telemedicine adds to staff workload and 40% of healthcare professionals felt it compromises patient privacy and information confidentiality. Conclusion: Despite being a new and developing practice in many countries, telemedicine appears to have a bright future. This is crucial during a pandemic as it provides effective healthcare while maintaining social isolation measures. Moreover, the majority of the participants in this study demonstrated a good understanding and a favorable attitude toward telemedicine.

Keywords: healthcare system, global survey, knowledge, attitude, covid 19, telemedicine

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Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

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Bile spillage occurs frequently during laparoscopic cholecystectomy yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact, might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visits, with subsequent readmission and additional procedures. While some authors found no increase in SSI following bile spillage (BS) compared to non-bile spillage cases, others found bile spillage to be associated with SSI. Therefore we sought to examine whether bile spillage is indeed associated with an increased risk of postoperative wound infections after laparoscopic cholecystectomy. I hypothesize that patients who experience BS during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing Laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per CDC-defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non-bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and was absent in the rest i.e.92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in nonbile spillage cases, SSI was found in 8 cases (8.7%). However, it was statistically not significant (p-value>0.05). Eleven (92%) cases were superficial SSI and one was an organ-space infection. No mortality or 30-day readmission. Spillage of Gallbladder content does not lead to an increase in SSIs. However as the rate of SSI is still higher, Surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage thorough peritoneal irrigation with normal saline should be done.

Keywords: organ space infection, Laparoscopic cholecystectomy, biliary spillage, surgical site infection

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Authors: Simon Mwima, Evans Jennifer Mann, Agnes Nzomene, Edson Chipalo, Eusebius Small, Moses Okumu, Bosco Mukuba

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Introduction: In Uganda, sexual minorities experience exacerbated intersectional stigma and discrimination that exposes them to elevated HIV infections and impedes access to HIV testing and PrEP with low treatment adherence. We contribute to the lack of information about sexual minorities living with HIV in Uganda by using modified social-ecological theory to explore social influences impacting HIV services engagement. Findings from focused group discussion (FGD) involving 31 sexual minorities, ages 18-25, recruited through urban HIV clinics in Kampala reveal the protective and promotive social influence within the individual and interpersonal relationships (sexual partners and peers). Further, inhibitive social influences were found within family, community, societal, and healthcare settings. During the COVID-19 pandemic, these adolescents strategically used promotive social influences to increase their engagement with HIV care services. Interviews were recorded in English, transcribed verbatim, and analyzed using Dedoose. Conclusions: The findings revealed that young people (identified as sexual minorities) strategically used promotive social influences and supported each other to improve engagement with HIV care in the context of restrictive laws in Uganda during the COVID-19-Pandemic. Future HIV prevention, treatment, and care responses could draw on how peers support each other to navigate the heavily criminalized and stigmatized settings to access healthcare services.

Keywords: HIV/AIDS services, intersectional stigma, discrimination, adolescents, sexual minorities, COVID-19 pandemic Uganda

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Authors: Nounamo Nguedie Yann Harold

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The factors behind the debt have been the subject of several studies in the literature. Pioneering studies based on the 'double deficit' approach linked indebtedness to the imbalance between savings and investment, the budget deficit and the current account deficit. Most studies on identifying factors that may stimulate or reduce the level of external public debt agree that the following variables are important explanatory variables in leveraging debt: the budget deficit, trade opening, current account and exchange rate, import, export, interest rate, term variation exchange rate, economic growth rate and debt service, capital flight, and over-indebtedness. Few studies addressed the impact of political factors on the level of external debt. In general, however, the IMF's stabilization programs in developing countries following the debt crisis have resulted in economic recession and the advent of political crises that have resulted in changes in governments. In this sense, political institutions are recognised as factors of accumulation of external debt in most developing countries. This paper assesses the role of political factors on the external debt level of African countries in the Franc Zone over the period 1985-2016. Data used come from World Bank and ICRG. Using a logit in panel, the results show that the more a country is politically stable, the lower the external debt compared to the gross domestic product. Political stability multiplies 1.18% the chances of being in the sustainable debt zone. For example, countries with good political institutions experience less severe external debt burdens than countries with bad political institutions.

Keywords: African countries, external debt, Franc Zone, political factors

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Authors: Avneet Kaur

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India is a nation of villages. Traditionally, women had enjoyed a high social status in India. Our mythology, folklore and history are full of women who were epitomes of virtue, wisdom, power, and position. The important concern about their entry into the politics is of great importance all over the world. Women have performed excellently in social, economic and political sphere. However, the fact remains that despite constituting half of the population their representation among elected post continue to remain negligible in Panchayati Raj Institutions. Women in India suffered from many social economic handicaps such as illiteracy, economically dependent, social customs, traditions and rituals that are the main causes of their inactive participation in local governance. There is still widespread patriarchal outlook in the villages and the lack of experience on the part of women leadership are some of the major issues of debate. The implementation of the 73rd Amendment Act of the Indian Constitution in 1992 reserved 1/3 rd of the seats for women empowerment. It was a major step to encourage them to take part in the village politics. This kind of revolution was the beginning of women leadership in villages. The paper intends to study the role and importance of women leadership in Panchayati Raj Institutions in India. The paper is divided into four sections. First section deals with the introduction by taking into account the available research on this particular subject. Second section talks about the role played by women leadership in these institutions after the passing of 73rd Amendment Act. Third section deals with some of the critical insights of the study by discussing the problems faced by the active women’s leadership at the grassroots. Finally, the paper concludes with policy suggestions.

Keywords: women, leadership, grassroots, Panchayati Raj

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Authors: Claude Takenga, Rolf-Dietrich Berndt, Erling Si, Markus Diem, Guohui Qiao, Melanie Gau, Michael Brandstoetter, Martin Kampel, Michael Dworzak

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In patients with acute lymphoblastic leukaemia (ALL), treatment response is increasingly evaluated with minimal residual disease (MRD) analyses. Flow Cytometry (FCM) is a fast and sensitive method to detect MRD. However, the interpretation of these multi-parametric data requires intensive operator training and experience. This paper presents a pipeline-software, as a ready-to-use FCM-based MRD-assessment tool for the daily clinical practice for patients with ALL. The new tool increases accuracy in assessment of FCM-MRD in samples which are difficult to analyse by conventional operator-based gating since computer-aided analysis potentially has a superior resolution due to utilization of the whole multi-parametric FCM-data space at once instead of step-wise, two-dimensional plot-based visualization. The system developed as a telemedical network reduces the work-load and lab-costs, staff-time needed for training, continuous quality control, operator-based data interpretation. It allows dissemination of automated FCM-MRD analysis to medical centres which have no established expertise for the benefit of an even larger community of diseased children worldwide. We established a telemedical network system for analysis and clinical follow-up and treatment monitoring of Leukaemia. The system is scalable and adapted to link several centres and laboratories worldwide.

Keywords: data security, flow cytometry, leukaemia, telematics platform, telemedicine

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Authors: Ndukwe, Chinedu O.

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Background: There are only a few epidemiological studies published on skin disorders in the elderly within the Nigerian context and none from the Southeast Region of the country. In addition, none of these studies has considered the pattern and frequency of histopathologically diagnosed geriatric skin lesions. Hence, we attempted to determine the frequency as well as the age and gender distributions of histologically diagnosed dermatological diseases in the geriatric population from skin biopsies submitted to the histopathology department of a tertiary care hospital in Southeast Nigeria. Material and methods: This is a cross-sectional retrospective hospital-based study involving all skin biopsies of patients 60 years and above, received at the Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria from January 2004 to December 2019. Results: During the study period, 751 skin biopsies were received in the histopathology department. Of these, 142 were from patients who were older than 60 years. Thus, the overall share of geriatric patients was 18.9%. The mean age at presentation was 71.1 ± 8.6 years. The M: F was 1:1 and most of the patients belonged to the age group of 60–69 years (69 cases, 48.6%). The mean age of the male patients was 72.1±9.5 years. In the female patients, it was 70.1±7.5 years. The commonest disease category was neoplasms (91, 64.1%). Most neoplasms were malignant. There were 67/142 (47.2%) malignant lesions. Commonest was Squamous cell carcinoma (SCC) (30 cases) which is 21.1% of all geriatric skin biopsies and 44.8% of malignant skin biopsies. This is closely followed by melanoma (29 cases). Conclusion: Malignant neoplasms, benign neoplasms and papulosquamous disorders are the three commonest histologically diagnosed skin lesions in our geriatric population. The commonest skin malignancies in this group of patients are squamous cell carcinoma and malignant melanoma.

Keywords: geriatric, skin, Nigeria, histopathology

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Authors: Broto Seno

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This study aims to describe and examine more in the implementation of educational partnerships for undergraduate students at Yogyakarta State University (YSU), which is more focused on educational partnerships abroad. This study used descriptive qualitative approach. The study subjects consisted of a vice-rector, two staff education partnerships, four vice-dean, nine undergraduate students and three foreign students. Techniques of data collection using interviews and document review. Validity test of the data source using triangulation. Data analysis using flow models Miles and Huberman, namely data reduction, data display, and conclusion. Results of this study showed that the implementation of educational partnerships abroad for undergraduate students at YSU meets six of the nine indicators of the success of strategic partnerships. Six indicators are long-term, strategic, mutual trust, sustainable competitive advantages, mutual benefit for all the partners, and the separate and positive impact. The indicator has not been achieved is cooperative development, successful, and world class / best practice. These results were obtained based on the discussion of the four formulation of the problem, namely: 1) Implementation and development of educational partnerships abroad has been running good enough, but not maximized. 2) Benefits of the implementation of educational partnerships abroad is providing learning experiences for students, institutions of experience in comparison to each faculty, and improving the network of educational partnerships for YSU toward World Class University. 3) The sustainability of educational partnerships abroad is pursuing a strategy of development through improved management of the partnership. 4) Supporting factors of educational partnerships abroad is the support of YSU, YSU’s partner and society. Inhibiting factors of educational partnerships abroad is not running optimally management.

Keywords: partnership, education, YSU, institutions and faculties

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Authors: Jalal Maqbool, Gyu Myoung Lee

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Using smart devices for context aware mobile learning is becoming increasingly popular. This has led to mobile learning technology becoming an indispensable part of today’s learning environment and platforms. However, some fundamental issues remain - namely, mobile learning still lacks the ability to truly understand human reaction and user behaviour. This is due to the fact that current mobile learning systems are passive and not aware of learners’ changing contextual situations. They rely on static information about mobile learners. In addition, current mobile learning platforms lack the capability to incorporate dynamic contextual situations into learners’ preferences. Thus, this thesis aims to address these issues highlighted by designing a context aware framework which is able to sense learner’s contextual situations, handle data dynamically, and which can use contextual information to suggest bespoke learning content according to a learner’s preferences. This is to be underpinned by a robust recommendation system, which has the capability to perform these functions, thus providing learners with a truly context-aware mobile learning experience, delivering learning contents using smart devices and adapting to learning preferences as and when it is required. In addition, part of designing an algorithm for the recommendation engine has to be based on learner and application needs, personal characteristics and circumstances, as well as being able to comprehend human cognitive processes which would enable the technology to interact effectively and deliver mobile learning content which is relevant, according to the learner’s contextual situations. The concept of this proposed project is to provide a new method of smart learning, based on a capable recommendation engine for providing an intuitive mobile learning model based on learner actions.

Keywords: aware, context, learning, mobile

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Authors: Y. N. Shashidhara, B. S. Shakuntala

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Introduction: Nursing practice is undergoing tremendous changes and challenges. In order to meet social challenges and needs, nursing practice must be research based. Research is needed to evaluate the effectiveness of nursing treatment modalities, to determine the impact of nursing care on the health of the patients or to test the theory of nursing practice. Objective of the study to explore the attitude of staff nurses on Nursing research and its utilization Methodology: The descriptive study design was adopted and 300 staff nurses were selected by systematic random sampling technique from eight hospitals. The attitude on nursing research was assessed by validated and reliable self-administered attitude scale which consists of 40 items. Results: The overall attitude mean score 130.2 (SD 11.5) regarding attitude on Nursing research and its utilization. Some of the findings are the majority of staff nurses (51% agreed and 18.3% strongly agreed) that they have all the motivation to use research findings if they get support. Nearly 25.3 percent of staff nurses agreed and 10.7 percent strongly agreed that they do not have time to conduct research. The majority of staff nurses 53.7 percent agreed that research will help in updating Nursing profession. Nearly 32.6 percent of staff nurses agreed and 20.5 percent strongly agreed that being able to use will make them better nurses. About 45.3 percent and 17.3 percent agreed and strongly agreed that knowledge gained through experience is more useful than research. Most (40%) of nurses agreed that thy do not have the authority to change the patient care practice. The majority of staff nurses (45.7 percent agreed and 13 percent strongly agreed) feel the research will consume their personal time. Majority, 50 percent of staff nurses agreed and 16.7 percent strongly agreed that to conduct and utilize research findings requires financial support. Majority 50 percent of staff nurses agreed and 12 percent strongly agreed that physicians will cooperate and value nursing research findings. Majority 67.3 percent of staff nurses had moderate positive and 32.7 percent of staff nurses had highly positive attitude towards Nursing research and its utilization. Conclusion: With this study we understanding that, the staff nurses have positive attitude regarding nursing research. If the nurses are supported and motivated for research utilization we can improve the patient care.

Keywords: nurses, attitude, nursing research, research utilization

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Authors: Agoston Restas

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Introduction: In case of managing disasters decision makers can face many times such a special situation where any pre-sign of the drastically change is missing therefore the improvised decision making can be required. The complexity, ambiguity, uncertainty or the volatility of the situation can require many times the improvisation as decision making. It can be taken at any level of the management (strategic, operational and tactical) but at tactical level the main reason of the improvisation is surely time pressure. It is certainly the biggest problem during the management. Methods: The author used different tools and methods to achieve his goals; one of them was the study of the relevant literature, the other one was his own experience as a firefighting manager. Other results come from two surveys that are referred to; one of them was an essay analysis, the second one was a word association test, specially created for the research. Results and discussion: This article proves that, in certain situations, the multi-criteria, evaluating decision-making processes simply cannot be used or only in a limited manner. However, it can be seen that managers, directors or commanders are many times in situations that simply cannot be ignored when making decisions which should be made in a short time. The functional background of decisions made in a short time, their mechanism, which is different from the conventional, was studied lately and this special decision procedure was given the name recognition-primed decision. In the article, author illustrates the limits of the possibilities of analytical decision-making, presents the general operating mechanism of recognition-primed decision-making, elaborates on its special model relevant to managers at tactical level, as well as explore and systemize the factors that facilitate (catalyze) the processes with an example with fire managers.

Keywords: decision making, disaster managers, recognition primed decision, model for making decisions in emergencies

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Authors: Getaneh Berie Tarekegn, Li-Chia Tai

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With the rapid advancement of artificial intelligence, low-power built-in sensors on Internet of Things devices, and communication technologies, location-aware services have become increasingly popular and have permeated every aspect of people’s lives. Global navigation satellite systems (GNSSs) are the default method of providing continuous positioning services for ground and aerial vehicles, as well as consumer devices (smartphones, watches, notepads, etc.). However, the environment affects satellite positioning systems, particularly indoors, in dense urban and suburban cities enclosed by skyscrapers, or when deep shadows obscure satellite signals. This is because (1) indoor environments are more complicated due to the presence of many objects surrounding them; (2) reflection within the building is highly dependent on the surrounding environment, including the positions of objects and human activity; and (3) satellite signals cannot be reached in an indoor environment, and GNSS doesn't have enough power to penetrate building walls. GPS is also highly power-hungry, which poses a severe challenge for battery-powered IoT devices. Due to these challenges, IoT applications are limited. Consequently, precise, seamless, and ubiquitous Positioning, Navigation and Timing (PNT) systems are crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarms, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. We also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

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