Search results for: resource-limited care environments

Authors: Ravi Kant Anand, Nikkey Keshri

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The Great Barrier Reef of Australia is known for its beautiful landscapes and seascapes with ecological importance. This site was selected as a World Heritage site in 1981 and popularized internationally for tourism, recreational activities and fishing. But the major environmental hazards such as climate change, pollution, overfishing and shipping are making worst the site of marine ecosystem. Climate change is directly hitting on Great Barrier Reef through increasing level of sea, acidification of ocean, increasing in temperature, uneven precipitation, changes in the El Nino and increasing level of cyclones and storms. Apart from that pollution is second biggest factor which vanishing the coral reef ecosystem. Pollution including over increasement of pesticides and chemicals, eutrophication, pollution through mining, sediment runoff, loss of coastal wetland and oil spills. Coral bleaching is the biggest problem because of the environmental threatening agents. Acidification of ocean water reduced the formation of calcium carbonate skeleton. The floral ecosystem (including sea grasses and mangroves) of ocean water is the key source of food for fishes and other faunal organisms but the powerful waves, extreme temperature, destructive storms and river run- off causing the threat for them. If one natural system is under threat, it means the whole marine food web is affected from algae to whale. Poisoning of marine water through different polluting agents have been affecting the production of corals, breeding of fishes, weakening of marine health and increased in death of fishes and corals. In lieu of World Heritage site, tourism sector is directly affected and causing increasement in unemployment. Fishing sector also affected. Fluctuation in the temperature of ocean water affects the production of corals because it needs desolate place, proper sunlight and temperature up to 21 degree centigrade. But storms, El Nino, rise in temperature and sea level are induced for continuous reduction of the coral production. If we do not restrict the environmental problems of Great Barrier Reef than the best known ecological beauty with coral reefs, pelagic environments, algal meadows, coasts and estuaries, mangroves forests and sea grasses, fish species, coral gardens and the one of the best tourist spots will lost in upcoming years. My research will focus on the different environmental threats, its socio-economic impacts and different conservative measures.

Keywords: climate change, overfishing, acidification, eutrophication

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Authors: Mohamed Anwar Hammad, Khaled Mohamed Al Akhali, Yasmin Elsobky

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Board certification is a voluntary process that confirms a pharmacist's capability, competency, education, skills, and proficiency beyond what is essential for licensure. This analysis was intended to investigate the prevalence of board-certified pharmacists in the Arab countries and compare the Board of Pharmacy Specialties (BPS) between Egypt, Saudi Arabia, and Canada. A cross-sectional study was conducted. The data were mined from the BPS website. Data were managed by IBM SPSS Statistics 23.0 and presented as descriptive statistics. Of 36918 Board certified pharmacists (BCPs) until February 2018, only 4038 (10.9%) were from the outside United States of America. From 4038 BCPs, about 1782 (44.1%) were from Arab nations. Egypt has the top prevalence of the BPS among the Arab countries 937 (52.6%) BCPs. However, the Kingdom of Saudi Arabia comes in the second position 442 (24.8%). Pharmacotherapy (BCPS), nutrition support pharmacy (BCNSP), critical care pharmacy (BCCCP) and oncology pharmacy (BCOP) are the highest specialties by 1474 (82.7%), 114 (6.4%), 61 (3.42%) and 60 (3.37%) respectively, while, infectious diseases pharmacy (AQID), cardiology pharmacy (AQCD) and nuclear pharmacy (BCNP) are the lowest prevalence of specialties by 7 (0.4%), 6 (0.3%) and 1 (0.06%) respectively. Added qualifications were canceled and became a new specialty in BPS as the rest of the specialties. Both infectious diseases and cardiology specialties exams are not conducted yet all over the world from the beginning of 2018. Egypt has the second prevalence 937 (2.54%), before Canada 920 (2.49%) and after United States of America 32880 (89.06%) in the worldwide in terms of BCPs. In conclusion the BCPS is the uppermost specialty; however, there is still a need for all the other specialties. In a short period, BCCCP jumped to the third position. Cardiology and infectious disease will be new specialties. Egyptian pharmacists are in the top of Arab countries, and 2nd in worldwide BCPs.

Keywords: AQCD, AQID, Arab countries, BCACP, BCCCP, BCGP, BCNP, BCNSP, BCOP, BCPPS, BCPS, BCPP, Board of Pharmacy Specialties (BPS), Canada, Egypt, Saudi Arabia, USA

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Authors: Bhavishya Ramchandani

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A little electronic device that is worn on the finger is called a smart ring. It incorporates mobile technology and has features that make it simple to use the device. These gadgets, which resemble conventional rings and are usually made to fit on the finger, are outfitted with features including access management, gesture control, mobile payment processing, and activity tracking. A poor sleep pattern, an irregular schedule, and bad eating habits are all part of the problems with health that a lot of people today are facing. Diets lacking fruits, vegetables, legumes, nuts, and whole grains are common. Individuals in India also experience metabolic issues. In the medical field, smart rings will help patients with problems relating to stomach illnesses and the incapacity to consume meals that are tailored to their bodies' needs. The smart ring tracks all bodily functions, including blood sugar and glucose levels, and presents the information instantly. Based on this data, the ring generates what the body will find to be perfect insights and a workable site layout. In addition, we conducted focus groups and individual interviews as part of our core approach and discussed the difficulties they're having maintaining the right diet, as well as whether or not the smart ring will be beneficial to them. However, everyone was very enthusiastic about and supportive of the concept of using smart rings in healthcare, and they believed that these rings may assist them in maintaining their health and having a well-balanced diet plan. This response came from the primary data, and also working on the Emerging Technology Canvas Analysis of smart rings in healthcare has led to a significant improvement in our understanding of the technology's application in the medical field. It is believed that there will be a growing demand for smart health care as people become more conscious of their health. The majority of individuals will finally utilize this ring after three to four years when demand for it will have increased. Their daily lives will be significantly impacted by it.

Keywords: smart ring, healthcare, electronic wearable, emerging technology

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Authors: Franco Miguel Nodado, Adrienne Marie Bugayong Janagap, Allen Claire Arances, Kirsten Anne Gerez, Frances Catherine Rosario, Charise Alvyne Samaniego, Matt Andrew Secular, Rommel Gestuveo, Marilyn Sumayo, Joseph Arbizo, Philip Ian Padilla

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COVID-19 pandemic adversely affected the delivery of health care services, but its impacts on Maternal, Newborn, Child Health and Nutrition (MNCHN) programs in rural municipalities in the Philippines remains understudied. Thus, this study explored the effects of the pandemic on MNCHN indicators in the municipalities of Miagao, Iloilo and Sibunag, Guimaras. A cross-sectional design was employed to compare the MNCHN indicators before and during the pandemic, and between Miagao and Sibunag. Key informant interviews (KII) were performed to identify the factors affecting access to MNCHN programs. During the pandemic, Miagao had a significant increase in positive outcomes of eight out of ten maternal health indicators, while Sibunag showed a significant decrease in six indicators. For child health and nutrition, Miagao obtained significant improvements in five of seven indicators, while Sibunag showed a significant increase in positive outcomes for six. KII data showed that the primary concern of mothers in Miagao is accessibility, while mothers in Sibunag raised concerns on accessibility, availability, and affordability of these MNCHN services. Miagao MHO employed various strategies such as telemedicine, activation of barangay health workers, and decentralization of health services to Barangay Health Centers, which can explain the improvements in MNCHN indicators. Sibunag also decentralized its health services, but its limited resources might have led them to prioritize child health and nutrition services. The findings suggest that the impacts of the COVID-19 pandemic on MNCHN depend on local health measures employed by the municipality, while telemedicine is a very useful tool in mitigating the negative effects of disrupted health services.

Keywords: maternal, child, COVID-19, Miagao, Sibunag, nutrition

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Authors: Hyeon Sop Baek

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This paper will briefly investigate Jeong Do-jeon’s political philosophy. Jeong Do-jeon was a Korean Confucian philosopher and politician during the turbulent 14th Century who revolted against the old order, founded Joseon Dynasty, and significantly impacted the development of Korean culture. Jeong’s vision of an ideal state involved a polity that has its roots in the people -that is, an ideal government prioritizes caring for the welfare of the people, respecting and attending to the diverse opinions and concerns of the people, and relies on the genuine, voluntary support of the people. With the neo-Confucian worldview in mind -that every human being has the equal potential to become a moral person- Jeong sought to create a world suitable for everybody to contribute to the decision-making procedure and be able to realize their potential fully. This paper will first examine his works and present a quick overview of his vision of the ideal government. Then, it will examine the Confucian virtues of ren (仁) and yi (義) and how they formulate the basis of his philosophy, and then discuss the central features of his vision of government: popular mandate, equity of wealth, promoting freedom of expression and political participation, and elevating caring disposition as the paramount quality of the political leaders. Furthermore, this paper aims to analyze the element of care inherent within his political philosophy, namely his view on the dynamics of power, nurturing the people, and noncoercive justice. Finally, a discussion on why his philosophy is still relevant in the contemporary context will be provided. Jeong’s view aimed at building a sustainable model of government, by proposing that the people should be the foundation of a state and that they need to be carefully nurtured so they can realize their inborn potential and continue to contribute to the sustenance of the world, is the focal point of Jeong’s philosophy. Just as he sought to rebuild his world following the turmoils of the 14th Century, his philosophy still has a substantial implication on how we should strive to rebuild our society today.

Keywords: Korea, Confucianism, Jeong Do-jeon, Joseon, Korean philosophy, political philosophy

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Authors: M. Ahmadi, Sh. Damanabi, F. Sadoughi

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National Health Information System plays an important role in ensuring timely and reliable access to Health information which is essential for strategic and operational decisions that improve health, quality and effectiveness of health care. In other words, by using the National Health information system you can improve the quality of health data, information and knowledge used to support decision making at all levels and areas of the health sector. Since full identification of the components of this system for better planning and management influential factors of performance seems necessary, therefore, in this study, different attitudes towards components of this system are explored comparatively. Methods: This is a descriptive and comparative kind of study. The society includes printed and electronic documents containing components of the national health information system in three parts: input, process, and output. In this context, search for information using library resources and internet search were conducted and data analysis was expressed using comparative tables and qualitative data. Results: The findings showed that there are three different perspectives presenting the components of national health information system, Lippeveld, Sauerborn, and Bodart Model in 2000, Health Metrics Network (HMN) model from World Health Organization in 2008 and Gattini’s 2009 model. All three models outlined above in the input (resources and structure) require components of management and leadership, planning and design programs, supply of staff, software and hardware facilities, and equipment. In addition, in the ‘process’ section from three models, we pointed up the actions ensuring the quality of health information system and in output section, except Lippeveld Model, two other models consider information products, usage and distribution of information as components of the national health information system. Conclusion: The results showed that all the three models have had a brief discussion about the components of health information in input section. However, Lippeveld model has overlooked the components of national health information in process and output sections. Therefore, it seems that the health measurement model of network has a comprehensive presentation for the components of health system in all three sections-input, process, and output.

Keywords: National Health Information System, components of the NHIS, Lippeveld Model

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Authors: Andrew Kipp

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Student absenteeism is harmful to both the school and the absentee student. One approach to improving student absenteeism is targeting contextual factors within the students’ learning environment. However, contemporary literature has not taken an ecological agency approach to understanding student absenteeism. Ecological agency is a theoretical framework that magnifies the interplay between the environment and the actions of people within the environment. To elaborate, the person’s personal history and aspirations and the environmental conditions provide potential outlets or restrictions to their intended action. The framework provides the unique perspective of understanding absentee students’ decision-making through the affordances and constraints found in their learning environment. To that effect, the study was guided by the question, “Why do absentee students decide to engage in absenteeism in a suburban Kansas school?” A case study methodology was used to answer the research question. Four suburban, Kansas high school absentee students in the 2020-2021 school year were selected for the study. The fall 2020 semester was in a remote learning setting, and the spring 2021 semester was in an in-person learning setting. The study captured their decision-making with respect to school attendance throughsemi-structured interviews, prolonged observations, drawings, and concept maps. The data was analyzed through thematic analysis. The findings revealed that peer socialization opportunities, methods of instruction, shifts in cultural beliefs due to COVID-19, manifestations of anxiety and lack of space to escape their anxiety, social media bullying, and the inability to receive academic tutoring motivated the participants’ daily decision to either attend or miss school. The findings provided a basis to improve several institutional and classroom practices. These practices included more student-led instruction and less teacher-led instruction in both in-person and remote learning environments, promoting socialization through classroom collaboration and clubs based on emerging student interests, reducing instances of bullying through prosocial education, safe spaces for students to escape the classroom to manage their anxiety, and more opportunities for one-on-one tutoring to improve grades. The study provides an example of using the ecological agency approach to better understand the personal and environmental factors that lead to absenteeism. The study also informs educational policies and classroom practices to better promote student attendance. Further research should investigate other school contexts using the ecological agency theoretical framework to better understand the influence of the school environment on student absenteeism.

Keywords: student absenteeism, ecological agency, classroom practices, educational policy, student decision-making

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Authors: Mochache Vernon, Mwakusema Omar, Lakhani Amyn, El Busaidy Hajara, Temmerman Marleen, Gichangi Peter

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Background: Utilization of contraceptive methods has been associated with improved maternal and child health (MCH) outcomes. Unfortunately, there has been sub-optimal uptake of contraceptive services in the developing world despite significant resources being dedicated accordingly. It is imperative to granulate factors that could influence uptake and utilization of contraception. Methodology: Between March and December 2015, we conducted a mixed-methods cross-sectional study among women of reproductive age (18-45 years) from a pre-dominantly rural coastal Kenyan community. Qualitative approaches involved focus group discussions as well as a series of key-informant interviews. We also administered a sexual and reproductive health survey questionnaire at the household level. Results: We interviewed 745 women from 15 villages in Kwale County. The median (interquartile range, IQR) age was 29 (23-37) while 76% reported being currently in a marital union. Eighty-seven percent and 85% of respondents reported ever attending school and ever giving birth, respectively. Respondents who had ever attended school were more than twice as likely to be using contraceptive methods [Odds Ratio, OR = 2.1, 95% confidence interval, CI: 1.4-3.4, P = 0.001] while those who had ever given birth were five times as likely to be using these methods [OR = 5.0, 95% CI: 1.7-15.0, P = 0.004]. The odds were similarly high among women who reported attending antenatal care (ANC) [OR = 4.0, 95% CI: 1.1-14.8, P = 0.04] as well as those who expressly stated that they did not want any more children or wanted to wait longer before getting another child [OR = 6.7, 95% CI: 3.3-13.8, P<0.0001]. Interviewees reported deferring to the ‘wisdom’ of an older maternal figure in the decision-making process. Conclusions: Uptake and utilization of contraceptive methods among Digo women from Kwale, Kenya is positively associated with demand-side factors including educational attainment, previous birth experience, ANC attendance and a negative future fertility desire. Interventions to improve contraceptive services should focus on engaging dominant maternal figures in the community.

Keywords: unmet need, utilization of contraceptive methods, women, Digo community

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Authors: Raphael Palucci Rosa, Giuseppe Rosace

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Stereolithography (SLA) is one of the 3D-printing technologies that has been steadily growing in popularity for both industrial and personal applications due to its versatility, high accuracy, and low cost. Its printing process consists of using a light emitter to solidify photosensitive liquid resins layer-by-layer to produce solid objects. However, the majority of the resins used in SLA are derived from petroleum and characterized by toxicity, stability, and recalcitrance to degradation in natural environments. Aiming to develop an eco-friendly resin, in this work, different combinations of a standard commercial SLA resin (Peopoly UV professional) with a vegetable-based resin were investigated. To reach this goal, different mass concentrations (varying from 10 to 50 wt%) of acrylated epoxidized soybean oil (AESO), a vegetable resin produced from soyabean oil, were mixed with a commercial acrylate-based resin. 1.0 wt% of Diphenyl(2,4,6-trimethylbenzoyl) phosphine oxide (TPO) was used as photo-initiator, and the samples were printed using a Peopoly moai 130. The machine was set to operate at standard configurations when printing commercial resins. After the print was finished, the excess resin was drained off, and the samples were washed in isopropanol and water to remove any non-reacted resin. Finally, the samples were post-cured for 30 min in a UV chamber. FT-IR analysis was used to confirm the UV polymerization of the formulated resin with different AESO/Peopoly ratios. The signals from 1643.7 to 1616, which corresponds to the C=C stretching of the AESO acrylic acids and Peopoly acrylic groups, significantly decreases after the reaction. The signal decrease indicates the consumption of the double bonds during the radical polymerization. Furthermore, the slight change of the C-O-C signal from 1186.1 to 1159.9 decrease of the signals at 809.5 and 983.1, which corresponds to unsaturated double bonds, are both proofs of the successful polymerization. Mechanical analyses showed a decrease of 50.44% on tensile strength when adding 10 wt% of AESO, but it was still in the same range as other commercial resins. The elongation of break increased by 24% with 10 wt% of AESO and swelling analysis showed that samples with a higher concentration of AESO mixed absorbed less water than their counterparts. Furthermore, high-resolution prototypes were printed using both resins, and visual analysis did not show any significant difference between both products. In conclusion, the AESO resin was successful incorporated into a commercial resin without affecting its printability. The bio-based resin showed lower tensile strength than the Peopoly resin due to network loosening, but it was still in the range of other commercial resins. The hybrid resin also showed better flexibility and water resistance than Peopoly resin without affecting its resolution. Finally, the development of new types of SLA resins is essential to provide new sustainable alternatives to the commercial petroleum-based ones.

Keywords: 3D-printing, bio-based, resin, soybean, stereolithography

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Authors: Tuula Nygard

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This study contributes to the pedagogical discussion on how to promote adolescents’ multiliteracies with the emphasis on information seeking and evaluation skills in contemporary media environments. The study is conducted in the school environment utilizing perspectives of educational sciences and information studies to health communication and teaching. The research focus is on the teacher role as a trusted person, who guides students to choose and use credible information sources. Evaluating the credibility of information may often be challenging. Specifically, children and adolescents may find it difficult to know what to believe and who to trust, for instance, in health and well-being communication. Thus, advanced multiliteracy skills are needed. In the school environment, trust is based on the teacher’s subject content knowledge, but also the teacher’s character and caring. Teacher’s benevolence and approachability generate trustworthiness, which lays the foundation for good interaction with students and further, for the teacher’s pedagogical authority. The study explores teachers’ perceptions of their pedagogical authority and the role of a trustee. In addition, the study examines what kind of multiliteracy practices teachers utilize in their teaching. The data will be collected by interviewing secondary school health education teachers during Spring 2019. The analysis method is a nexus analysis, which is an ethnographic research orientation. Classroom interaction as the interviewed teachers see it is scrutinized through a nexus analysis lens in order to expound a social action, where people, places, discourses, and objects are intertwined. The crucial social actions in this study are information seeking and evaluation situations, where the teacher and the students together assess the credibility of the information sources. The study is based on the hypothesis that a trustee’s opinions of credible sources and guidance in information seeking and evaluation affect students’, that is, trustors’ choices. In the school context, the teacher’s own experiences and perceptions of health-related issues cannot be brushed aside. Furthermore, adolescents are used to utilize digital technology for day-to-day information seeking, but the chosen information sources are often not very high quality. In the school, teachers are inclined to recommend familiar sources, such as health education textbook and web pages of well-known health authorities. Students, in turn, rely on the teacher’s guidance of credible information sources without using their own judgment. In terms of students’ multiliteracy competences, information seeking and evaluation tasks in health education are excellent opportunities to practice and enhance these skills. To distinguish the right information from a wrong one is particularly important in health communication because experts by experience are easy to find and their opinions are convincing. This can be addressed by employing the ideas of multiliteracy in the school subject health education and in teacher education and training.

Keywords: multiliteracies, nexus analysis, pedagogical authority, trust

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Authors: Shih-Chieh Liao, Cheng-Yan Shuai

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"Party game" is a game mode that enables players to maintain a good social and interactive experience. The common game modes include Teamwork, Team competitive, Independent competitive, Battle Royale. Party games are defined as a game with easy rules, easy to play, quickly spice up a party, and support four to six players. It also needs to let the player feel satisfied no matter victory or defeat. However, players may feel negative or angry when the game is imbalanced, especially when they play with teammates. Some players care about winning or losing, and they will blame it on the game mechanics. What is more serious is that the player will cause the argument, which is unnecessary. These behaviors that trigger quarrels and negative emotions often originate from the player's determination of the victory and the ratio of victory during the competition. In view of this, our research invited a group of subjects to the experiment, which is going to inspect player’s emotions by Electromyography (EMG) and Electrodermal Activity (EDA) when they are playing party games with others. When a player wins or loses, the negative and positive feeling will be recorded from the game beginning to the end. At the same time, physiologic and emotional reactions are also being recorded in each part of the game. The game will be designed as telling the interaction when players are in the quest of a party game. The experiment content includes the emotional changes affected by the physiological values of game victory and defeat between “player against friend” and “player against stranger.” Through this experiment, the balance between winners and losers lies in the basis of good game interaction and game interaction in the game and explore the emotional positive and negative effects caused by the result of the party game. The result shows that “player against friend” has a significant negative emotion and significant positive emotion at “player against stranger.” According to the result, the player's experience will be affected with winning rate or form when they play the party game. We suggest the developer balance the game with our experiment method to let players get a better experience.

Keywords: party games, biofeedback, emotional responses, user experience, game design

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Authors: Xiao Wen Xu

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There exists a challenge of accommodating/integrating people at risk and those from various backgrounds in urban areas. The success of interdependence as a tool for survival largely rests on the mutually beneficial relationships amongst individuals within a given society. One approach to meeting this challenge has been written by Ivan Illich in his book, Tools for Conviviality, where he defines 'conviviality' as interactions that help individuals. With the goal of helping the community and applying conviviality as a principle to actors in both natural and social realms of Moss Park in Toronto, the proposal involves redesigning the park and buildings as a series of different health care, extended learning, employment support, armoury, and recreation facilities that integrate the exterior landscape as treatment, teaching, military, and recreation areas; in other words, the proposal links services with access to park space. While buildings are traditionally known to physically provide shelter, parks embody shelter and act as service, as people often find comfort and relief from being in nature, and Moss Park, in particular, is home to many people at risk. This landscape is not only an important space for the homeless community but also the rest of the neighborhood. The thesis proposes that the federal government rebuilds the current armoury, as it is an obsolete building while acknowledging the extensive future developments proposed by developers and its impact on public space. The neighbourhood is an underserved area, and the new design develops not just a new armoury, but also a complex of interrelated services, which are completely integrated into the park. The armoury is redesigned as an integral component of the community that not only serves as training facilities for reservists but also serves as an emergency shelter in sub-zero temperatures for the homeless community. This paper proposes a new design for Moss Park through examining how 'park buildings', interconnected buildings and parks, can foster empowering relationships that create a supportive public realm.

Keywords: conviviality, natural, social, Ivan Illich

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Authors: Van Truong Pham

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Background: Self-management was described as a potential strategy for blood pressure control in patients with hypertension. However, the effects of self-management interventions on blood pressure, self-efficacy, medication adherence, and body mass index (BMI) in older adults with hypertension have not been systematically evaluated. We evaluated the effects of self-management interventions on systolic blood pressure (SBP) and diastolic blood pressure (DBP), self-efficacy, medication adherence, and BMI in hypertensive older adults. Methods: We followed the recommended guidelines of preferred reporting items for systematic reviews and meta-analyses. Searches in electronic databases including CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, Web of Science, and other sources were performed to include all relevant studies up to April 2019. Studies selection, data extraction, and quality assessment were performed by two reviewers independently. We summarized intervention effects as Hedges' g values and 95% confidence intervals (CI) using a random-effects model. Data were analyzed using Comprehensive Meta-Analysis software 2.0. Results: Twelve randomized controlled trials met our inclusion criteria. The results revealed that self-management interventions significantly improved blood pressure control, self-efficacy, medication adherence, whereas the effect of self-management on BMI was not significant in older adult patients with hypertension. The following Hedges' g (effect size) values were obtained: SBP, -0.34 (95% CI, -0.51 to -0.17, p < 0.001); DBP, -0.18 (95% CI, -0.30 to -0.05, p < 0.001); self-efficacy, 0.93 (95%CI, 0.50 to 1.36, p < 0.001); medication adherence, 1.72 (95%CI, 0.44 to 3.00, p=0.008); and BMI, -0.57 (95%CI, -1.62 to 0.48, p = 0.286). Conclusions: Self-management interventions significantly improved blood pressure control, self-efficacy, and medication adherence. However, the effects of self-management on obesity control were not supported by the evidence. Healthcare providers should implement self-management interventions to strengthen patients' role in managing their health care.

Keywords: self-management, meta-analysis, blood pressure control, self-efficacy, medication adherence, body mass index

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Authors: Marta Skwarecka, Patrycja Bloch, Rafal Walkusz, Oliwia Urbanowicz, Grzegorz Zielinski, Sabina Zoledowska, Dawid Nidzworski

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Upper respiratory tract infections are one of the most common reasons for visiting a general doctor. Streptococci are the most common bacterial etiological factors in these infections. There are many different types of Streptococci and infections vary in severity from mild throat infections to pneumonia. For example, S. pyogenes mainly contributes to acute pharyngitis, palatine tonsils and scarlet fever, whereas S. Streptococcus pneumoniae is responsible for several invasive diseases like sepsis, meningitis or pneumonia with high mortality and dangerous complications. There are only a few diagnostic tests designed for detection Streptococci from the infected throat of patients. However, they are mostly based on lateral flow techniques, and they are not used as a standard due to their low sensitivity. The diagnostic standard is to culture patients throat swab on semi selective media in order to multiply pure etiological agent of infection and subsequently to perform antibiogram, which takes several days from the patients visit in the clinic. Therefore, the aim of our studies is to develop and implement to the market a Point of Care device for the rapid identification of Streptococcus pyogenes and Streptococcus pneumoniae with simultaneous identification of antibiotic resistance genes. In the course of our research, we successfully selected genes for to-species identification of Streptococci and genes encoding antibiotic resistance proteins. We have developed a reaction to amplify these genes, which allows detecting the presence of S. pyogenes or S. pneumoniae followed by testing their resistance to erythromycin, chloramphenicol and tetracycline. What is more, the detection of β-lactamase-encoding genes that could protect Streptococci against antibiotics from the ampicillin group, which are widely used in the treatment of this type of infection is also developed. The test is carried out directly from the patients' swab, and the results are available after 20 to 30 minutes after sample subjection, which could be performed during the medical visit.

Keywords: antibiotic resistance, Streptococci, respiratory infections, diagnostic test

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Authors: Pibool Waijittragum

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The purpose of this research is to analyze the marketing strategies of Thai Halal products which related to the way of life for Thai Muslims. The expected benefit is the marketing strategy for brand building process for Halal products in Thailand. 4 elements of marketing strategies which necessary for the brand identity creation is the research framework: Consists of Attributes, Benefits, Values and Personality. The research methodology was applied using qualitative and quantitative; 19 marketing experts with dynamic roles in Thai consumer products were interviewed. In addition, a field survey of 122 Thai Muslims selected from 175 Muslim communities in Bangkok was studied. Data analysis will be according to 5 categories of Thai Halal product: 1) Meat 2) Vegetable and Fruits 3) Instant foods and Garnishing ingredient 4) Beverages, desserts and snacks 5) Hygienic daily products; such as soap, shampoo and body lotion. The results will explain some suitable representation in the marketing strategies of Thai Halal products as are: 1) Benefit; the characteristics of the product with its benefit. Consumers will purchase this product with the reason of; it is beneficial nutrients product, there are no toxic or chemical residues. Fresh and clean materials 2) Attribute; the exterior images that attract to consumer. Consumers will purchase this product with the reason of; there is a standard proof mark, food and drug secure proof mark and Halal products mark. Packaging and its materials should be draw attention. Use an attractive graphic. Use outstanding images of product, material or ingredients. 3) Value; the value of products that affect to consumers perception; it is healthy products. Accumulate quality of life. It is a product of expertise, manufacturing of research result. Consumers are important. It’s sincere, honest and reliable to all. 4) Personality; reflection of consumers thought. The personality feedback to them after they were consumes this product; they are health care persons. They are the rational person, moral person, justice person and thoughtful person like a progressive thinking.

Keywords: marketing strategies, product identity, branding, Thai Halal products

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Authors: Sameer Masood, Lucas Chartier

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Head injuries are a commonly encountered presentation in emergency departments (ED) and the Choosing Wisely Canada (CWC) campaign was released in June 2015 in an attempt to decrease imaging utilization for patients with minor head injuries. The impact of the CWC campaign on imaging utilization for head injuries has not been explored in the ED setting. In our study, we describe the characteristics of patients with head injuries presenting to a tertiary care academic ED and the impact of the CWC campaign on CT head utilization. This retrospective cohort study used linked databases from the province of Ontario, Canada to assess emergency department visits with a primary diagnosis of head injury made between June 1, 2014 and Aug 31, 2016 at the University Health Network in Toronto, Canada. We examined the number of visits during the study period, the proportion of patients that had a CT head performed before and after the release of the CWC campaign, as well as mode of arrival, and disposition. There were 4,322 qualifying visits at our site during the study period. The median presenting age was 44.12 years (IQR 27.83,67.45), the median GCS was 15 (IQR 15,15) and the majority of patients presenting had intermediate acuity (CTAS 3). Overall, 43.17% of patients arrived via ambulance, 49.24 % of patients received a CT head and 10.46% of patients were admitted. Compared to patients presenting before the CWC campaign release, there was no significant difference in the rate of CT heads after the CWC (50.41% vs 47.68%, P = 0.07). There were also no significant differences between the two groups in mode of arrival (ambulance vs ambulatory) (42.94% vs 43.48%, P = 0.72) or admission rates (9.85% vs 11.26%, P = 0.15). However, more patients belonged to the high acuity groups (CTAS 1 or 2) in the post CWC campaign release group (12.98% vs 8.11% P <0.001). Visits for head injuries make up a significant proportion of total ED visits and approximately half of these patients receive CT imaging in the ED. The CWC campaign did not seem to impact imaging utilization for head injuries in the 14 months following its launch. Further efforts, including local quality improvement initiatives, are likely needed to increase adherence to its recommendation and reduce imaging utilization for head injuries.

Keywords: choosing wisely, emergency department, head injury, quality improvement

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Authors: Ramanish Ravishankar, Azar Hussain, Mahmoud Loubani, Mubarak Chaudhry

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Background and Aims: Currently, there are no strict guidelines in cardiopulmonary bypass temperature management in cardiac surgery not involving the aortic arch. This study aims to compare patient outcomes undergoing mild hypothermia and normothermia. The aim of this study was to compare patient outcomes between mild hypothermia and normothermia undergoing on-pump cardiac surgery not involving the aortic arch. Methods: This was a retrospective cohort study from January 2015 until May 2023. Patients who underwent cardiac surgery with cardiopulmonary bypass temperatures ≥32oC were included and stratified into mild hypothermia (32oC – 35oC) and normothermia (>35oC) cohorts. Propensity matching was applied through the nearest neighbour method (1:1) using the risk factors detailed in the EuroScore using RStudio. The primary outcome was mortality. Secondary outcomes included post-op stay, intensive care unit readmission, re-admission, stroke, and renal complications. Patients who had major aortic surgery and off-pump operations were excluded. Results: Each cohort had 1675 patients. There was a significant increase in overall mortality with the mild hypothermia cohort (3.59% vs. 2.32%; p=0.04912). There was also a greater stroke incidence (2.09% vs. 1.13%; p=0.0396) and transient ischaemic attack (TIA) risk (3.1% vs. 1.49%; p=0.0027). There was no significant difference in renal complications (9.13% vs. 7.88%; p=0.2155). Conclusions: Patient’s who underwent mild hypothermia during cardiopulmonary bypass have a significantly greater mortality, stroke, and transient ischaemic attack incidence. Mild hypothermia does not appear to provide any benefit over normothermia and does not appear to provide any neuroprotective benefits. This shows different results to that of other major studies; further trials and studies need to be conducted to reach a consensus.

Keywords: cardiac surgery, therapeutic hypothermia, neuroprotection, cardiopulmonary bypass

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Authors: P. V. Pramila , V. Mahesh

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Pulmonary Function Tests are important non-invasive diagnostic tests to assess respiratory impairments and provides quantifiable measures of lung function. Spirometry is the most frequently used measure of lung function and plays an essential role in the diagnosis and management of pulmonary diseases. However, the test requires considerable patient effort and cooperation, markedly related to the age of patients esulting in incomplete data sets. This paper presents, a nonlinear model built using Multivariate adaptive regression splines and Random forest regression model to predict the missing spirometric features. Random forest based feature selection is used to enhance both the generalization capability and the model interpretability. In the present study, flow-volume data are recorded for N= 198 subjects. The ranked order of feature importance index calculated by the random forests model shows that the spirometric features FVC, FEF 25, PEF,FEF 25-75, FEF50, and the demographic parameter height are the important descriptors. A comparison of performance assessment of both models prove that, the prediction ability of MARS with the `top two ranked features namely the FVC and FEF 25 is higher, yielding a model fit of R2= 0.96 and R2= 0.99 for normal and abnormal subjects. The Root Mean Square Error analysis of the RF model and the MARS model also shows that the latter is capable of predicting the missing values of FEV1 with a notably lower error value of 0.0191 (normal subjects) and 0.0106 (abnormal subjects). It is concluded that combining feature selection with a prediction model provides a minimum subset of predominant features to train the model, yielding better prediction performance. This analysis can assist clinicians with a intelligence support system in the medical diagnosis and improvement of clinical care.

Keywords: FEV, multivariate adaptive regression splines pulmonary function test, random forest

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Authors: Jared Cheves, Amanda DeChent, Joyce Pan

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Total knee replacements (TKAs) are one of the most common but painful surgical procedures performed in the United States. Currently, the gold standard for postoperative pain management is the utilization of opioids. However, in the wake of the opioid epidemic, the healthcare system is attempting to reduce opioid consumption by trialing innovative opioid sparing analgesic techniques such as continuous peripheral nerve blocks (CPNB) and continuous periarticular infiltration (CPAI). The alleviation of pain, particularly during the first 72 hours postoperatively, is of utmost importance due to its association with delayed recovery, impaired rehabilitation, immunosuppression, the development of chronic pain, the development of rebound pain, and decreased patient satisfaction. While both CPNB and CPAI are being used today, there is limited evidence comparing the two to the current standard of care or to each other. An extensive literature review was performed to explore the safety profiles and effectiveness of CPNB and CPAI in reducing reported pain scores and decreasing opioid consumption. The literature revealed the usage of CPNB contributed to lower pain scores and decreased opioid use when compared to opioid-only control groups. Additionally, CPAI did not improve pain scores or decrease opioid consumption when combined with a multimodal analgesic (MMA) regimen. When comparing CPNB and CPAI to each other, neither unanimously lowered pain scores to a greater degree, but the literature indicates that CPNB decreased opioid consumption more than CPAI. More research is needed to further cement the efficacy of CPNB and CPAI as standard components of MMA in TKA procedures. In addition, future research can also focus on novel catheter-free applications to reduce the complications of continuous catheter analgesics.

Keywords: total knee arthroplasty, continuous peripheral nerve blocks, continuous periarticular infiltration, opioid, multimodal analgesia

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Authors: Alejandra Torres-Landa López

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Introduction: Can architecture students be creative in spaces conformed by an educational infrastructure build with paradigms of the past?, this question and others related are answered in this paper as it presents the PhD research: An anthropic conflict in Mexican Higher Education Institutes, problems and challenges of the educational infrastructure in teaching and learning History of Architecture. This research was finished in 2013 and is one of the first studies conducted nationwide in Mexico that analysis the educational infrastructure impact in learning architecture; its objective was to identify which elements of the educational infrastructure of Mexican Higher Education Institutes where architects are formed, hinder or contribute to the teaching and learning of History of Architecture; how and why it happens. The methodology: A mixed methodology was used combining quantitative and qualitative analysis. Different resources and strategies for data collection were used, such as questionnaires for students and teachers, interviews to architecture research experts, direct observations in Architecture classes, among others; the data collected was analyses using SPSS and MAXQDA. The veracity of the quantitative data was supported by the Cronbach’s Alpha Coefficient, obtaining a 0.86, figure that gives the data enough support. All the above enabled to certify the anthropic conflict in which Mexican Universities are. Major findings of the study: Although some of findings were probably not unknown, they haven’t been systematized and analyzed with the depth to which it’s done in this research. So, it can be said, that the educational infrastructure of most of the Higher Education Institutes studied, is a barrier to the educational process, some of the reasons are: the little morphological variation of space, the inadequate control of lighting, noise, temperature, equipment and furniture, the poor or none accessibility for disable people; as well as the absence, obsolescence and / or insufficiency of information technologies are some of the issues that generate an anthropic conflict understanding it as the trouble that teachers and students have to relate between them, in order to achieve significant learning). It is clear that most of the educational infrastructure of Mexican Higher Education Institutes is anchored to paradigms of the past; it seems that they respond to the previous era of industrialization. The results confirm that the educational infrastructure of Mexican Higher Education Institutes where architects are formed, is perceived as a "closed container" of people and data; infrastructure that becomes a barrier to teaching and learning process. Conclusion: The research results show it's time to change the paradigm in which we conceive the educational infrastructure, it’s time to stop seen it just only as classrooms, workshops, laboratories and libraries, as it must be seen from a constructive, urban, architectural and human point of view, taking into account their different dimensions: physical, technological, documental, social, among others; so the educational infrastructure can become a set of elements that organize and create spaces where ideas and thoughts can be shared; to be a social catalyst where people can interact between each other and with the space itself.

Keywords: educational infrastructure, impact of space in learning architecture outcomes, learning environments, teaching architecture, learning architecture

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Authors: Getenet Shumet Birhan, Biruk Lelisa Eticha, Gizachew Tilahun Belete, Fisseha Admassu Ayele

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Context: Glaucoma is a significant public health concern globally, being the second leading cause of blindness. This study focuses on adult glaucoma patients in Ethiopia, specifically at the University of Gondar. Research Aim: The main objective is to assess the prevalence of visual impairment and identify associated factors among adult glaucoma patients at the University of Gondar. Methodology: The study used an institution-based cross-sectional design, collecting data from 423 glaucoma patients through interviews and medical chart reviews. Descriptive statistics and logistic regression were employed for analysis. Findings: The study found a high prevalence of visual impairment (77.6%) among adult glaucoma patients, with factors such as female sex, rural residence, glaucoma type, disease stage, and duration of diagnosis significantly associated with visual impairment. Theoretical Importance: This research adds valuable insights into the prevalence and determinants of visual impairment among glaucoma patients in Ethiopia, contributing to the existing literature on eye health in low-resource settings. Data Collection: Data were collected through face-to-face interviews and medical chart reviews at the University of Gondar, utilizing a structured questionnaire. Analysis Procedures: Descriptive statistics, frequency analysis, and binary logistic regression were employed to analyze the data and identify factors associated with visual impairment in adult glaucoma patients. Question Addressed: The study sought to answer the question of the prevalence of visual impairment and its associated factors among adult glaucoma patients at the University of Gondar in Northwest Ethiopia. Conclusion: The research concludes that visual impairment is significantly high among adult glaucoma patients in this setting, with several factors playing a role in its occurrence.

Keywords: visual impairment, glaucoma, Ethiopia, Gondar

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Authors: Yuan Yue, Wen-Wei Wang

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The objective of this research is to comprehensively evaluate the impact of alkaline environments on the durability of Glass Fiber Reinforced Polymer (GFRP) reinforcements in concrete structures and further explore their potential value within the construction industry. Specifically, we investigate the effects of two widely used high-performance concrete (HPC) materials on the durability of GFRP bars when embedded within them under varying temperature conditions. A total of 279 GFRP bar specimens were manufactured for microcosmic and mechanical performance tests. Among them, 270 specimens were used to test the residual tensile strength after 120 days of immersion, while 9 specimens were utilized for microscopic testing to analyze degradation damage. SEM techniques were employed to examine the microstructure of GFRP and cover concrete. Unidirectional tensile strength experiments were conducted to determine the remaining tensile strength after corrosion. The experimental variables consisted of four types of concrete (engineering cementitious composite (ECC), ultra-high-performance concrete (UHPC), and two types of ordinary concrete with different compressive strengths) as well as three acceleration temperatures (20, 40, and 60℃). The experimental results demonstrate that high-performance concrete (HPC) offers superior protection for GFRP bars compared to ordinary concrete. Two types of HPC enhance durability through different mechanisms: one by reducing the pH of the concrete pore fluid and the other by decreasing permeability. For instance, ECC improves embedded GFRP's durability by lowering the pH of the pore fluid. After 120 days of immersion at 60°C under accelerated conditions, ECC (pH=11.5) retained 68.99% of its strength, while PC1 (pH=13.5) retained 54.88%. On the other hand, UHPC enhances FRP steel's durability by increasing porosity and compactness in its protective layer to reinforce FRP reinforcement's longevity. Due to fillers present in UHPC, it typically exhibits lower porosity, higher densities, and greater resistance to permeation compared to PC2 with similar pore fluid pH levels, resulting in varying degrees of durability for GFRP bars embedded in UHPC and PC2 after 120 days of immersion at a temperature of 60°C - with residual strengths being 66.32% and 60.89%, respectively. Furthermore, SEM analysis revealed no noticeable evidence indicating fiber deterioration in any examined specimens, thus suggesting that uneven stress distribution resulting from interface segregation and matrix damage emerges as a primary causative factor for tensile strength reduction in GFRP rather than fiber corrosion. Moreover, long-term prediction models were utilized to calculate residual strength values over time for reinforcement embedded in HPC under high temperature and high humidity conditions - demonstrating that approximately 75% of its initial strength was retained by reinforcement embedded in HPC after 100 years of service.

Keywords: GFRP bars, HPC, degeneration, durability, residual tensile strength.

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Authors: D. Scarpanti, M. Brondino, M. Pasini

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Background: the present study explores the role of light and restorativeness on work. According with the Attention Restoration Theory (ART) and a Model of Work Environment, the main idea is that some features of environment, i.e., lighting, influences the direct attention, and so, the performance. Restorativeness refers to the presence/absence level of all the characteristics of physical environment that help to regenerate direct attention. Specifically, lighting can affect level of fascination and attention in one hand; and in other hand promotes several biological functions via pineal gland. Different reviews on this topic show controversial results. In order to bring light on this topic, the hypotheses of this study are that lighting can affect the construct of restorativeness and, in the second time, the restorativeness can affect the performance. Method: the participants are 30 workers of a mechatronic company in the North Italy. Every subject answered to a questionnaire valuing their subjective perceptions of environment in a different way: some objective features of environment, like lighting, temperature and air quality; some subjective perceptions of this environment; finally, the participants answered about their perceived performance. The main attention is on the features of light and his components: visual comfort, general preferences and pleasantness; and the dimensions of the construct of restorativeness; fascination, coherence and being away. The construct of performance per se is conceptualized in three level: individual, team membership and organizational membership; and in three different components: proficiency, adaptability, and proactivity, for a total of 9 subcomponents. Findings: path analysis showed that some characteristics of lighting respectively affected the dimension of fascination; and, as expected, the dimension of fascination affected work performance. Conclusions: The present study is a first pilot step of a wide research. These first results can be summarized with the statement that lighting and restorativeness contribute to explain work performance variability: in details perceptions of visual comfort, satisfaction and pleasantness, and fascination respectively. Results related to fascination are particularly interesting because fascination is conceptualized as the opposite of the construct of direct attention. The main idea is, in order to regenerate attentional capacity, it’s necessary to provide a lacking of attention (fascination). The sample size did not permit to test simultaneously the role of the perceived characteristics of light to see how they differently contribute to predict fascination of the work environment. However, the results highlighted the important role that light could have in predicting restorativeness dimensions and probably with a larger sample we could find larger effects also on work performance. Furthermore, longitudinal data will contribute to better analyze the causal model along time. Applicative implications: the present pilot study highlights the relevant role of lighting and perceived restorativeness in the work environment and the importance to focus attention on light features and the restorative characteristics in the design of work environments.

Keywords: lighting, performance, restorativeness, workplace

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Authors: Sushma Tejwani, Shoruba Dinakaran, Kushal Kacha, K. Bhujang Shetty

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Introduction and aim: It is not unusual to find patients with glaucomatous damage and normal intraocular pressure, and to label a patient as Normal tension glaucoma (NTG) majority of clinicians depend on office Intraocular pressures (IOP) recordings; hence, the concern is that whether we are missing the late night or early morning spikes in this group of patients. Also, ischemia to the optic nerve is one of the presumed causes of damage in these patients, however demonstrating the same has been a challenge. The aim of this study was to evaluate IOP variations and patterns in a series of patients with open angles, glaucomatous discs or fields but normal office IOP, and in addition to identify ischemic factors for true NTG patients. Materials & Methods: This was an observational cross- sectional study from a tertiary care centre. The patients that underwent full day DVT from Jan 2012 to April 2014 were studied. All patients underwent IOP measurement on Goldmann applanation tonometry every 3 hours for 24 hours along with a recording of the blood pressure (BP). Further patients with normal IOP throughout the 24- hour period were evaluated with a cardiologist for echocardiography and carotid Doppler. Results: There were 47 patients and a maximum number of patients studied was in the age group of 50-70 years. A biphasic IOP peak was noted for almost all the patients. Out of the 47 patients, 2 were excluded from analysis as they were on treatment.20 patients (42%) were diagnosed on DVT to have an IOP spike and were then diagnosed as open angle glaucoma and another 25 (55%) were diagnosed to have normal tension glaucoma and were subsequently advised a carotid Doppler and a cardiologists consult. Another interesting finding was that 9 patients had a nocturnal dip in their BP and 3 were found to have carotid artery stenosis. Conclusion: A continuous 24-hour monitoring of the IOP and BP is a very useful albeit mildly cumbersome tool which provides a wealth of information in cases of glaucoma presenting with normal office pressures. It is of great value in differentiating between normal tension glaucoma patients & open angle glaucoma patients. It also helps in timely diagnosis & possible intervention due to referral to a cardiologist in cases of carotid artery stenosis.

Keywords: carotid artery disease in NTG, diurnal variation of IOP, ischemia in glaucoma, normal tension glaucoma

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Authors: Maria Fontenele, Claude-Gilles Dussap, Vincent Dumouilla, Baptiste Boit

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Roquette Frères is a producer of plant-based ingredients that employs many processes to extract relevant molecules and often transforms them through chemical and physical processes to create desired ingredients with specific functionalities. In this context, Roquette encounters numerous multi-component complex systems in their processes, including fibers, proteins, and carbohydrates, in an aqueous environment. To develop, control, and optimize both new and old processes, Roquette aims to develop new in silico tools. Currently, Roquette uses process modelling tools which include specific thermodynamic models and is willing to develop computational methodologies such as molecular dynamics simulations to gain insights into the complex interactions in such complex media, and especially hydrogen bonding interactions. The issue at hand concerns aqueous mixtures of polyols with high dry matter content. The polyols mannitol and sorbitol molecules are diastereoisomers that have nearly identical chemical structures but very different physicochemical properties: for example, the solubility of sorbitol in water is 2.5 kg/kg of water, while mannitol has a solubility of 0.25 kg/kg of water at 25°C. Therefore, predicting liquid-solid equilibrium properties in this case requires sophisticated solution models that cannot be based solely on chemical group contributions, knowing that for mannitol and sorbitol, the chemical constitutive groups are the same. Recognizing the significance of solvation phenomena in polyols, the GePEB (Chemical Engineering, Applied Thermodynamics, and Biosystems) team at Institut Pascal has developed the COSMO-UCA model, which has the structural advantage of using quantum mechanics tools to predict formation and phase equilibrium properties. In this work, we use molecular dynamics simulations to elucidate the behavior of polyols in aqueous solution. Specifically, we employ simulations to compute essential metrics such as radial distribution functions and hydrogen bond autocorrelation functions. Our findings illuminate a fundamental contrast: sorbitol and mannitol exhibit disparate hydrogen bond lifetimes within aqueous environments. This observation serves as a cornerstone in elucidating the divergent physicochemical properties inherent to each compound, shedding light on the nuanced interplay between their molecular structures and water interactions. We also present a methodology to predict the physicochemical properties of complex solutions, taking as sole input the three-dimensional structure of the molecules in the medium. Finally, by developing knowledge models, we represent some physicochemical properties of aqueous solutions of sorbitol and mannitol.

Keywords: COSMO models, hydrogen bond, molecular dynamics, thermodynamics

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Authors: Noor Ashikin Omar

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The rapid growth and advancement in information and communication technology (ICT) at a global scene has greatly influenced and revolutionised interaction amongst society. The use of ICT has become second nature in managing everyday lives, particularly in the education environment. Traditional learning methods of using blackboards and chalks have been largely improved by the use of ICT devices such as interactive whiteboards and computers in school. This paper aims to explore the impacts of virtual learning environments (VLE) on teacher’s pedagogy and student’s learning in primary school settings. The research was conducted in two phases. Phase one of this study comprised a short interview with the school’s senior assistants to examine issues and challenges faced during planning and implementation of FrogVLE in their respective schools. Phase two involved a survey of a number of questionnaires directed to three major stakeholders; the teachers, students and parents. The survey intended to explore teacher’s and student’s perspective and attitude towards the use of VLE as a teaching and learning medium and as a learning experience as a whole. In addition, the survey from parents provided insights on how they feel towards the use of VLE for their child’s learning. Collectively, the two phases enable improved understanding and provided observations on factors that had affected the implementation of the VLE into primary schools. This study offers the voices of the students which were frequently omitted when addressing innovations as well as teachers who may not always be heard. It is also significant in addressing the importance of teacher’s pedagogy on students’ learning and its effects to enable more effective ICT integration with a student-centred approach. Finally, parental perceptions in the implementation of VLE in supporting their children’s learning have been implicated as having a bearing on educational achievement. The results indicate that the all three stakeholders were positive and highly supportive towards the use of VLE in schools. They were able to understand the benefits of moving towards the modern method of teaching using ICT and accept the change in the education system. However, factors such as condition of ICT facilities at schools and homes as well as inadequate professional development for the teachers in both ICT skills and management skills hindered exploitation of the VLE system in order to fully utilise its benefits. Social influences within different communities and cultures and costs of using the technology also has a significant impact. The findings of this study are important to the Malaysian Ministry of Education because it informs policy makers on the impact of the Virtual Learning Environment (VLE) on teacher’s pedagogy and learning of Malaysian primary school children. The information provided to policy makers allows them to make a sound judgement and enables an informed decision making.

Keywords: attitudes towards virtual learning environment (VLE), parental perception, student's learning, teacher's pedagogy

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Authors: Elif Berna Var

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Cultural, physical, socio-economic, or politic changes occurred in urban areas might be resulted in the decaying period which may cause social problems. As a solution to that, urban renewal projects have been used in European countries since World War II whereas they have gained importance in Turkey after the 1980s. The first attempts were mostly related to physical or economic aspects which caused negative effects on social pattern later. Thus, social concerns have also started to include in renewal processes in developed countries. This integrative approach combining social, physical, and economic aspects promotes creating more sustainable neighbourhoods for both current and future generations. However, it is still a new subject for developing countries like Turkey. Concentrating on Trabzon-Turkey, this study highlights the importance of socially sustainable urban renewal processes especially in historical neighbourhoods where protecting the urban identity of the area is vital, as well as social structure, to create sustainable environments. Being in the historic city centre and having remarkable traditional houses, Ortahisar is an important image for Trabzon. Because of the fact that architectural and historical pattern of the area is still visible but need rehabilitations, it is preferred to use 'urban rehabilitation' as a way of urban renewal method for this study. A project is developed by the local government to create a secondary city centre and a new landmark for the city. But it is still ambiguous if this project can provide social sustainability of area which is one of the concerns of the research. In the study, it is suggested that social sustainability of an area can be achieved by several factors. In order to determine the factors affecting the social sustainability of an urban rehabilitation project, previous studies have been analysed and some common features are attempted to define. To achieve this, firstly, several analyses are conducted to find out social structure of Ortahisar. Secondly, structured interviews are implemented to 150 local people which aims to measure satisfaction level, awareness, the expectation of them, and to learn their demographical background in detail. Those data are used to define the critical factors for a more socially sustainable neighbourhood in Ortahisar. Later, the priority of those factors is asked to 50 experts and 150 local people to compare their attitudes and to find common criterias. According to the results, it can be said that social sustainability of Ortahisar neighbourhood can be improved by considering various factors like quality of urban areas, demographical factors, public participation, social cohesion and harmony, proprietorial factors, facilities of education and employment. In the end, several suggestions are made for Ortahisar case to promote more socially sustainable urban neighbourhood. As a pilot study highlighting the importance of social sustainability, it is hoped that this attempt might be the contributory effect on achieving more socially sustainable urban rehabilitation projects in Turkey.

Keywords: urban rehabilitation, social sustainability, Trabzon, Turkey

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Authors: Emma S. Bowers

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Perturbations in global environments and temperatures have heightened the urgency of creating cost-efficient, energy-neutral building techniques. Structural responses to this thermal crisis have included designs (including those of the building standard PassivHaus) with airtightness, window placement, insulation, solar orientation, shading, and heat-exchange ventilators as potential solutions or interventions. Limitations in the predictability of the circulation of cooled air through the ambient temperature gradients throughout a structure are one of the major obstacles facing these enhanced building methods. A diverse range of air-cooling devices utilizing varying technologies is implemented around the world. Many of them worsen the problem of climate change by consuming energy. Using natural ventilation principles of air buoyancy and density to circulate fresh air throughout a building with no energy input can combat these obstacles. A unique prototype of an energy-neutral air-circulation system was constructed in order to investigate potential temperature and pressure gradients related to the stack effect (updraft of air through a building due to changes in air pressure). The stack effect principle maintains that since warmer air rises, it will leave an area of low pressure that cooler air will rush in to fill. The result is that warmer air will be expelled from the top of the building as cooler air is directed through the bottom, creating an updraft. Stack effect can be amplified by cooling the air near the bottom of a building and heating the air near the top. Using readily available, mostly recyclable or biodegradable materials, an insulated building module was constructed. A tri-part construction model was utilized: a subterranean earth-tube heat exchanger constructed of PVC pipe and placed in a horizontally oriented trench, an insulated, airtight cube aboveground to represent a building, and a solar chimney (painted black to increase heat in the out-going air). Pressure and temperature sensors were placed at four different heights within the module as well as outside, and data was collected for a period of 21 days. The air pressures and temperatures over the course of the experiment were compared and averaged. The promise of this design is that it represents a novel approach which directly addresses the obstacles of air flow and expense, using the physical principle of stack effect to draw a continuous supply of fresh air through the structure, using low-cost and readily available materials (and zero manufactured energy). This design serves as a model for novel approaches to creating temperature controlled buildings using zero energy and opens the door for future research into the effects of increasing module scale, increasing length and depth of the earth tube, and shading the building. (Model can be provided).

Keywords: air circulation, PassivHaus, stack effect, thermal gradient

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Authors: Nada Basset

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Problem Statement: The study examines the important role of leading change inside start-ups and highlights the challenges faced by an entrepreneur during the startup phase of the business. Research Methods/Procedures/Approaches: A qualitative research approach is taken, using the case study analysis method. A comparative study was made between two day care nurseries in Greater Cairo. Non-probability purposive sampling was used and a triangulation of semi-structured interviews, document analysis and participant-observation were applied simultaneously. The in-depth case study analysis took place over a longitudinal study of four calendar months. Results/Findings: Findings demonstrated that leading change in an entrepreneurial setup must be initiated by the entrepreneur, who must also be the owner of the change process. Another important finding showed that the culture of change, although created by the entrepreneur, needs the support and engagement of followers, who should be sharing the same value system and vision of the entrepreneur. Conclusions and Implications: An important implication suggests that during the first year of a start-up lifecycle, special emphasis must be made to the recruitment and selection of personnel, who should play a role into setting the new start-up culture and help it grow or shrink. Another drawn conclusion is that the success of the change must be measured in both quantitative and qualitative terms. Increasing revenues and customer attrition rates -as quantitative KPIs- must be aligned with other qualitative KPIs like customer satisfaction, employee satisfaction, and organizational commitment and business reputation. Originality of Paper: The paper addresses change management in an entrepreneurial concept, with an empirical application on an Egyptian start-up model providing a service to both adults and children. This privileges the research as the constructs measured merged together the level of satisfaction of employees, decision-makers (parents of children), and the users (children).

Keywords: leadership, change management, entrepreneurship, startup business

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Authors: Hossein Afzali

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Increasingly, decision analytic models are used to inform decisions about whether or not to publicly fund new health technologies. It is well noted that the accuracy of model predictions is strongly influenced by the appropriateness of model structuring. However, there is relatively inadequate methodological guidance surrounding this issue in guidelines developed by national funding bodies such as the Australian Pharmaceutical Benefits Advisory Committee (PBAC) and The National Institute for Health and Care Excellence (NICE) in the UK. This presentation aims to discuss issues around model structuring within decision making with a focus on (1) the need for a transparent and evidence-based model structuring process to inform the most appropriate set of structural aspects as the base case analysis; (2) the need to characterise structural uncertainty (If there exist alternative plausible structural assumptions (or judgements), there is a need to appropriately characterise the related structural uncertainty). The presentation will provide an opportunity to share ideas and experiences on how the guidelines developed by national funding bodies address the above issues and identify areas for further improvements. First, a review and analysis of the literature and guidelines developed by PBAC and NICE will be provided. Then, it will be discussed how the issues around model structuring (including structural uncertainty) are not handled and justified in a systematic way within the decision-making process, its potential impact on the quality of public funding decisions, and how it should be presented in submissions to national funding bodies. This presentation represents a contribution to the good modelling practice within the decision-making process. Although the presentation focuses on the PBAC and NICE guidelines, the discussion can be applied more widely to many other national funding bodies that use economic evaluation to inform funding decisions but do not transparently address model structuring issues e.g. the Medical Services Advisory Committee (MSAC) in Australia or the Canadian Agency for Drugs and Technologies in Health.

Keywords: decision-making process, economic evaluation, good modelling practice, structural uncertainty

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