Search results for: decision criteria

Authors: Ahmad Haidar

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This research paper investigates the concept of modern management, concentrating on the development of managerial practices and the adoption of innovative strategies in response to the fast-changing business landscape caused by Artificial Intelligence (AI). The study begins by examining the historical context of management theories, tracing the progression from classical to contemporary models, and identifying key drivers of change. Through a comprehensive review of existing literature and case studies, this paper provides valuable insights into the principles and practices of modern management, offering a roadmap for organizations aiming to navigate the complexities of the contemporary business world. The paper examines the growing role of digital technology in modern management, focusing on incorporating AI, machine learning, and data analytics to streamline operations and facilitate informed decision-making. Moreover, the research highlights the emergence of new principles, such as adaptability, flexibility, public participation, trust, transparency, and digital mindset, as crucial components of modern management. Also, the role of business leaders is investigated by studying contemporary leadership styles, such as transformational, situational, and servant leadership, emphasizing the significance of emotional intelligence, empathy, and collaboration in fostering a healthy organizational culture. Furthermore, the research delves into the crucial role of environmental sustainability, corporate social responsibility (CSR), and corporate digital responsibility (CDR). Organizations strive to balance economic growth with ethical considerations and long-term viability. The primary research question for this study is: "What are the key principles, practices, and innovations that define modern management, and how can organizations effectively implement these strategies to thrive in the rapidly changing business landscape?." The research contributes to a comprehensive understanding of modern management by examining its historical context, the impact of digital technologies, the importance of contemporary leadership styles, and the role of CSR and CDR in today's business landscape.

Keywords: modern management, digital technology, leadership styles, adaptability, innovation, corporate social responsibility, organizational success, corporate digital responsibility

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Authors: Hamid Abbasi, Neda Jourabchi, Ranasadat Abedi, Kiarash Tajernarenj, Mehdi Farhoudi, Sarvin Sanaie

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Background: Alpha lipoic acid (ALA), fat- and water-soluble, coenzyme with sulfuret content, has received considerable attention for its potential therapeutic role in diabetes, cardiovascular diseases, cancers, and central nervous disease. This investigation aims to evaluate the probable protective effects of ALA in stroke patients. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, This meta-analysis was performed. The PICO criteria for this meta-analysis were as follows: Population/Patients (P: stroke patients); Intervention (I: ALA); Comparison (C: control); Outcome (O: blood glucose, lipid profile, oxidative stress, inflammatory factors).In addition, Studies that were excluded from the analysis consisted of in vitro, in vivo, and ex vivo studies, case reports, quasi-experimental studies. Scopus, PubMed, Web of Science, EMBASE databases were searched until August 2023. Results: Of 496 records that were screened in the title/abstract stage, 9 studies were included in this meta-analysis. The sample sizes in the included studies vary between 28 and 90. The result of risk of bias was performed via risk of bias (RoB) in randomized-controlled trials (RCTs) based on the second version of the Cochrane RoB assessment tool. 8 studies had a definitely high risk of bias. Discussion: To the best of our knowledge, The present meta-analysis is the first study addressing the effectiveness of ALA supplementation in enhancing post-stroke metabolic markers, including lipid profile, oxidative stress, and inflammatory indices. It is imperative to acknowledge certain potential limitations inherent in this study. First of all, type of treatment (oral or intravenous infusion) could alter the bioavailability of ALA. Our study had restricted evidence regarding the impact of ALA supplementation on included outcomes. Therefore, further research is warranted to develop into the effects of ALA specifically on inflammation and oxidative stress. Funding: The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 72825). Registration: This study was registered in the International prospective register of systematic reviews (PROSPERO ID: CR42023461612).

Keywords: alpha-lipoic acid, lipid profile, blood glucose, inflammatory factors, oxidative stress, meta-analysis, post-stroke

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Authors: Nursyafiq Ali Shibramulisi, Nor Farah Fauzi, Nur Azniza Zawin Anuar, Nurul Atikah Azmi, Janice Hew Pei Fang

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Background: Work related musculoskeletal disorders (WRMD) among dental personnel have been underestimated and under-reported worldwide and specifically in Malaysia. The problem will arise and progress slowly over time, as it results from accumulated injury throughout the period of work. Several risk factors, such as repetitive movement, static posture, vibration, and adapting poor working postures, have been identified to be contributing to WRMSD in dental practices. Dental personnel is at higher risk of getting this problem as it is their working nature and core business. This would cause pain and dysfunction syndrome among them and result in absence from work and substandard services to their patients. Methodology: A cross-sectional study involving 19 government dental clinics in Perak was done over the period of 3 months. Those who met the criteria were selected to participate in this study. Malay version of the Self-Reported Nordic Musculoskeletal Discomfort Form was used to identify the prevalence of WRMSD, while the intensity of pain in the respective regions was evaluated using a 10-point scale according to ‘Pain as The 5ᵗʰ Vital Sign’ by MOH Malaysia and later on were analyzed using SPSS version 25. Descriptive statistics, including mean and SD and median and IQR, were used for numerical data. Categorical data were described by percentage. Pearson’s Chi-Square Test and Spearman’s Correlation were used to find the association between the prevalence of WRMSD and other socio-demographic data. Results: 159 dentists, 73 dental therapists, 26 dental lab technicians, 81 dental surgery assistants, and 23 dental attendants participated in this study. The mean age for the participants was 34.9±7.4 and their mean years of service was 9.97±7.5. Most of them were female (78.5%), Malay (71.3%), married (69.6%) and right-handed (90.1%). The highest prevalence of WRMSD was neck (58.0%), followed by shoulder (48.1%), upper back (42.0%), lower back (40.6%), hand/wrist (31.5%), feet (21.3%), knee (12.2%), thigh 7.7%) and lastly elbow (6.9%). Most of those who reported having neck pain scaled their pain experiences at 2 out of 10 (19.5%), while for those who suffered upper back discomfort, most of them scaled their pain experience at 6 out of 10 (17.8%). It was found that there was a significant relationship between age and pain at neck (p=0.007), elbow (p=0.027), lower back (p=0.032), thigh (p=0.039), knee (p=0.001) and feet (p=0.000) regions. Job position also had been found to be having a significant relationship with pain experienced at the lower back (p=0.018), thigh (p=0.011), knee, and feet (p=0.000). Conclusion: The prevalence of WRMSD among dental personnel in Perak was found to be high. Age and job position were found to be having a significant relationship with pain experienced in several regions. Intervention programs should be planned and conducted to prevent and reduce the occurrence of WRMSD, as all harmful or unergonomic practices should be avoided at all costs.

Keywords: WRMSD, ergonomic, dentistry, dental

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Authors: Revaz Gvelesiani

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The problem of compliance between the state economic policy and entrepreneurial policy of businesses is primarily manifested in the contradictions related to the congruence between entrepreneurship development and self-development strategies. Among various types (financial, monetary, social, etc.) of the state economic policy aiming at the development of entrepreneurship, economic order policy is of special importance. Its goal is to set the framework for both public and private economic activities and achieve coherence between the societal value system and the formation of the economic order framework. Economic order policy, in its turn, involves intrinsic contradiction between the social and the competitive order. Competitive order is oriented on the principle of success, while social order _ on the criteria of need satisfaction, which contradicts, at least partly, to the principles of success. Thus within the economic order policy, on the one hand, the state makes efforts to form social order and expand its frontiers, while, on the other hand, market is determined to establish functioning competitive order and ensure its realization. Locating the adequate spaces for and setting the rational border between the state (social order) and the private (competitive order) activities, represents the phenomenon of the decisive importance from the entrepreneurship development strategy standpoint. In the countries where the above mentioned spaces and borders are “set” correctly, entrepreneurship agents (small, medium-sized and large businesses) achieve great success by means of seizing the respective segments and maintaining the leading positions in the internal, the European and the world markets for a long time. As for the entrepreneurship self-development strategy, above all, it involves: •market identification; •interactions with consumers; •continuous innovations; •competition strategy; •relationships with partners; •new management philosophy, etc. The analysis of compliance between the entrepreneurship strategy and entrepreneurship culture should be the reference point for any kind of internationalization in order to avoid shocks of cultural nature and the economic backwardness. Stabilization can be achieved only when the employee actions reflect the existing culture and the new contents of culture (targeted culture) is turned into the implicit consciousness of the personnel. The future leaders should learn how to manage different cultures. Entrepreneurship can be managed successfully if its strategy and culture are coherent. However, not rarely enterprises (organizations) show various forms of violation of both personal and team actions. If personal and team non-observances appear as the form of influence upon the culture, it will lead to global destruction of the system and structure. This is the entrepreneurship culture pathology that complicates to achieve compliance between the entrepreneurship strategy and entrepreneurship culture. Thus, the intrinsic contradictions of entrepreneurship development and self-development strategies complicate the task of reaching compliance between the state economic policy and the company entrepreneurship policy: on the one hand, there is a contradiction between the social and the competitive order within economic order policy and on the other hand, the contradiction exists between entrepreneurship strategy and entrepreneurship culture within entrepreneurship policy.

Keywords: economic order policy, entrepreneurship, development contradictions, self-development contradictions

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Authors: F. Moghtaderi, M. Burke, J. Troelsen

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There has been a significant decline in active travel as well as the massive increase use of car-dependent travel mode in many countries during past two decades. Evidential risks for people’s physical and mental health problems are followed by this increased use of motorized travel mode. These problems range from overweight and obesity to increasing air pollution. In response to these rising concerns, local councils and other interested organizations around the world have introduced a variety of initiatives regarding reduce the dominance of cars for the daily journeys. However, the nature of these kinds of interventions, which related to the human behavior, make lots of complexities. People’s travel behavior and changing this behavior, has two different aspects. People’s attitudes and perceptions toward the sustainable and healthy modes of travel, and motorized travel modes (especially private car use) is one these two aspects. The other one related to people’s behavior change processes. There are no comprehensive model in order to guide policy interventions to increase the level of succeed of such interventions. A comprehensive theoretical framework is required in accordance to facilitate and guide the processes of data collection and analysis to achieve the best possible guidelines for policy makers. Regarding this gaps in the travel behavior change research, this paper attempted to identify and suggest a multidimensional framework in order to facilitate planning interventions. A structured mixed-method is suggested regarding the expand the scope and improve the analytic power of the result according to the complexity of human behavior. In order to recognize people’s attitudes, a theory with the focus on people’s attitudes towards a particular travel behavior was needed. The literature around the theory of planned behavior (TPB) was the most useful, and had been proven to be a good predictor of behavior change. Another aspect of the research, related to the people’s decision-making process regarding explore guidelines for the further interventions. Therefore, a theory was needed to facilitate and direct the interventions’ design. The concept of the transtheoretical model of behavior change (TTM) was used regarding reach a set of useful guidelines for the further interventions with the aim to increase active travel and sustainable modes of travel. Consequently, a combination of these two theories (TTM and TPB) had presented as an appropriate concept to identify and design implemented travel behavior change interventions.

Keywords: behavior change theories, theoretical framework, travel behavior change interventions, urban research

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Authors: Allyson Dale, Max Hlywa

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The Canadian public expects the highest moral standards from Canadian Armed Forces (CAF) members and Department of National Defence (DND) employees. The Chief, Professional Conduct and Culture (CPCC) stood up in April 2021 with the mission of ensuring that the defence culture and members’ conduct are aligned with the ethical principles and values that the organization aspires towards. The Defence Ethics Program (DEP), which stood up in 1997, is a values-based ethics program for individuals and organizations within the DND/CAF and now falls under CPCC. The DEP is divided into five key functional areas, including policy, communications, collaboration, training and education, and advice and guidance. The main focus of the DEP is to foster an ethical culture within defence so that members and organizations perform to the highest ethical standards. The measurement of organizational ethics is often complex and challenging. In order to monitor whether the DEP is achieving its intended outcomes, a performance measurement framework (PMF) was developed using the Director General Military Personnel Research and Analysis (DGMPRA) PMF development process. This evidence-based process is based on subject-matter expertise from the defence team. The goal of this presentation is to describe each stage of the DGMPRA PMF development process and to present and discuss the products of the DEP PMF (e.g., logic model). Specifically, first, a strategic framework was developed to provide a high-level overview of the strategic objectives, mission, and vision of the DEP. Next, Key Performance Questions were created based on the objectives in the strategic framework. A logic model detailing the activities, outputs (what is produced by the program activities), and intended outcomes of the program were developed to demonstrate how the program works. Finally, Key Performance Indicators were developed based on both the intended outcomes in the logic model and the Key Performance Questions in order to monitor program effectiveness. The Key Performance Indicators measure aspects of organizational ethics such as ethical conduct and decision-making, DEP collaborations, and knowledge and awareness of the Defence Ethics Code while leveraging ethics-related items from multiple DGMPRA surveys where appropriate.

Keywords: defence ethics, ethical culture, organizational performance, performance measurement framework

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Authors: Asif Arshid, Ying Huang, Denver Tolliver

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Finite Element (FE) method coupled with ever-increasing computational powers has substantially advanced the reliability of deterministic three dimensional structural analyses of a structure with uniform material properties. However, railways trackbed is made up of diverse group of materials including steel, wood, rock and soil, while each material has its own varying levels of heterogeneity and imperfections. It is observed that the application of probabilistic methods for trackbed structural analysis while incorporating the material and geometric variabilities is deeply underworked. The authors developed and validated a 3-dimensional FE based numerical trackbed model and in this study, they investigated the influence of variability in Young modulus and thicknesses of granular layers (Ballast and Subgrade) on the reliability index (-index) of the subgrade layer. The influence of these factors is accounted for by changing their Coefficients of Variance (COV) while keeping their means constant. These variations are formulated using Gaussian Normal distribution. Two failure mechanisms in subgrade namely Progressive Shear Failure and Excessive Plastic Deformation are examined. Preliminary results of risk-based probabilistic analysis for Progressive Shear Failure revealed that the variations in Ballast depth are the most influential factor for vertical stress at the top of subgrade surface. Whereas, in case of Excessive Plastic Deformations in subgrade layer, the variations in its own depth and Young modulus proved to be most important while ballast properties remained almost indifferent. For both these failure moods, it is also observed that the reliability index for subgrade failure increases with the increase in COV of ballast depth and subgrade Young modulus. The findings of this work is of particular significance in studying the combined effect of construction imperfections and variations in ground conditions on the structural performance of railroad trackbed and evaluating the associated risk involved. In addition, it also provides an additional tool to supplement the deterministic analysis procedures and decision making for railroad maintenance.

Keywords: finite element analysis, numerical modeling, probabilistic methods, risk and reliability analysis, subgrade

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Authors: Belaynesh Tefera, Ahmed Mohammed, Zelalem Bayisa

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This study focuses on the issue of underage internal migration from rural to urban areas in Ethiopia, specifically in the context of child labor. It addresses the significant disparities in living standards between rural and urban areas, which motivate individuals from rural areas to migrate to urban areas in search of better economic opportunities. The study was conducted in Addis Ababa, where there is a high prevalence of underage internal migrants engaged in child labor due to extreme poverty in rural parts of the country. The aim of this study is to explore the life experiences of shoe-makers who have migrated from rural areas of Ethiopia to Addis Ababa. The focus is on understanding the factors that push these underage individuals to migrate, the challenges they face, and the implications for child labor. This study adopts a qualitative approach, using semistructured face-to-face interviews with underage migrants. A total of 27 interviews were conducted in Addis Ababa, Ethiopia, until the point of data saturation. The criteria for selecting interviewees include working as shoemakers and migrating to Addis Ababa underage, below 16 years old. The interviews were audio-taped, transcribed into Amharic, and then translated into English for analysis. The study reveals that the major push factors for underage internal migration are socioeconomic and environmental factors. Despite improvements in living standards for underage migrants and their families, there is a high prevalence of child labor and lack of access to education among them. Most interviewees migrated without the accompaniment of their family members and faced various challenges, including sleeping on the streets. This study highlights the role of social marketing in addressing the issues of underage internal migration and child labor. It suggests that social marketing can be an effective strategy to protect children from abuse, loneliness, and harassment during their migration process. The data collection involved conducting in-depth interviews with the underage migrants. The interviews were transcribed and translated for analysis. The analysis focused on identifying common themes and patterns within the interview data. The study addresses the factors contributing to underage internal migration, the challenges faced by underage migrants, the prevalence of child labor, and the potential role of social marketing in addressing these issues. The study concludes that although Ethiopia has policies against child internal migration, it is difficult to protect underage laborers who migrate from rural to urban areas due to the voluntary nature of their migration. The study suggests that social marketing can serve as a solution to protect children from abuse and other challenges faced during migration.

Keywords: underage, internal migration, social marketing, child labor, Ethiopia

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Authors: Fazıl Gökgöz, Fahrettin Filiz

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Load forecasting has become crucial in recent years and become popular in forecasting area. Many different power forecasting models have been tried out for this purpose. Electricity load forecasting is necessary for energy policies, healthy and reliable grid systems. Effective power forecasting of renewable energy load leads the decision makers to minimize the costs of electric utilities and power plants. Forecasting tools are required that can be used to predict how much renewable energy can be utilized. The purpose of this study is to explore the effectiveness of LSTM-based neural networks for estimating renewable energy loads. In this study, we present models for predicting renewable energy loads based on deep neural networks, especially the Long Term Memory (LSTM) algorithms. Deep learning allows multiple layers of models to learn representation of data. LSTM algorithms are able to store information for long periods of time. Deep learning models have recently been used to forecast the renewable energy sources such as predicting wind and solar energy power. Historical load and weather information represent the most important variables for the inputs within the power forecasting models. The dataset contained power consumption measurements are gathered between January 2016 and December 2017 with one-hour resolution. Models use publicly available data from the Turkish Renewable Energy Resources Support Mechanism. Forecasting studies have been carried out with these data via deep neural networks approach including LSTM technique for Turkish electricity markets. 432 different models are created by changing layers cell count and dropout. The adaptive moment estimation (ADAM) algorithm is used for training as a gradient-based optimizer instead of SGD (stochastic gradient). ADAM performed better than SGD in terms of faster convergence and lower error rates. Models performance is compared according to MAE (Mean Absolute Error) and MSE (Mean Squared Error). Best five MAE results out of 432 tested models are 0.66, 0.74, 0.85 and 1.09. The forecasting performance of the proposed LSTM models gives successful results compared to literature searches.

Keywords: deep learning, long short term memory, energy, renewable energy load forecasting

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Authors: Ana Breda, Catarina Cruz

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Daily, we face unpredictable events, often attributed to chance, as there is no justification for such an occurrence. Chance, understood as a source of uncertainty, is present in several aspects of human life, such as weather forecasts, dice rolling, and lottery. Surprisingly, humans and some animals can quickly adjust their behavior to handle efficiently doubly stochastic processes (random events with two layers of randomness, like unpredictable weather affecting dice rolling). This adjustment ability suggests that the human brain has built-in mechanisms for perceiving, understanding, and responding to simple probabilities. It also explains why current trends in mathematics education include probability concepts in official curriculum programs, starting from the third year of primary education onwards. In the first years of schooling, children learn to use a certain type of (specific) vocabulary, such as never, always, rarely, perhaps, likely, and unlikely, to help them to perceive and understand the probability of some events. These are keywords of crucial importance for their perception and understanding of probabilities. The development of the probabilistic concepts comes from facts and cause-effect sequences resulting from the subject's actions, as well as the notion of chance and intuitive estimates based on everyday experiences. As part of a junior summer school program, which took place at a Portuguese university, a non-formal learning experiment was carried out with 18 children in the 5th and 6th grades. This experience was designed to be implemented in a dynamic of a serious ice-breaking game, to assess their levels of probabilistic, critical, and creative thinking in understanding impossible, certain, equally probable, likely, and unlikely events, and also to gain insight into how the non-formal learning context influenced their achievements. The criteria used to evaluate probabilistic thinking included the creative ability to conceive events classified in the specified categories, the ability to properly justify the categorization, the ability to critically assess the events classified by other children, and the ability to make predictions based on a given probability. The data analysis employs a qualitative, descriptive, and interpretative-methods approach based on students' written productions, audio recordings, and researchers' field notes. This methodology allowed us to conclude that such an approach is an appropriate and helpful formative assessment tool. The promising results of this initial exploratory study require a future research study with children from these levels of education, from different regions, attending public or private schools, to validate and expand our findings.

Keywords: critical and creative thinking, non-formal mathematics learning, probabilistic thinking, serious game

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Authors: S. Chowdhury, A. Corlett

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Large tsunamis strike the British Columbia coast every few hundred years. The Cascadia Subduction Zone, which extends along the Pacific coast from Vancouver Island to Northern California is one of the most seismically active regions in Canada. Significant earthquakes have occurred in this region, including the 1700 Cascade Earthquake with an estimated magnitude of 9.2. Based on geological records, experts have predicted a 'great earthquake' of a similar magnitude within this region may happen any time. This earthquake is expected to generate a large tsunami that could impact the coastal communities on Vancouver Island. Since many of these communities are in remote locations, they are more likely to be vulnerable, as the post-earthquake relief efforts would be impacted by the damage to critical road infrastructures. To assess the coastal vulnerability within these communities, a hydrodynamic model has been developed using MIKE-21 software. We have considered a 500 year probabilistic earthquake design criteria including the subsidence in this model. The bathymetry information was collected from Canadian Hydrographic Services (CHS), and National Oceanic Atmospheric and Administration (NOAA). The arial survey was conducted using a Cessna-172 aircraft for the communities, and then the information was converted to generate a topographic digital elevation map. Both survey information was incorporated into the model, and the domain size of the model was about 1000km x 1300km. This model was calibrated with the tsunami occurred off the west coast of Moresby Island on October 28, 2012. The water levels from the model were compared with two tide gauge stations close to the Vancouver Island and the output from the model indicates the satisfactory result. For this study, the design water level was considered as High Water Level plus the Sea Level Rise for 2100 year. The hourly wind speeds from eight directions were collected from different wind stations and used a 200-year return period wind speed in the model for storm events. The regional model was set for 12 hrs simulation period, which takes more than 16 hrs to complete one simulation using double Xeon-E7 CPU computer plus a K-80 GPU. The boundary information for the local model was generated from the regional model. The local model was developed using a high resolution mesh to estimate the coastal flooding for the communities. It was observed from this study that many communities will be effected by the Cascadia tsunami and the inundation maps were developed for the communities. The infrastructures inside the coastal inundation area were identified. Coastal vulnerability planning and resilient design solutions will be implemented to significantly reduce the risk.

Keywords: tsunami, coastal flooding, coastal vulnerable, earthquake, Vancouver, wave propagation

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Authors: Fitih Ademe, Kibebew Kibret, Sheleme Beyene, Mezgebu Getnet, Gashaw Meteke

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Soil moisture and nutrient availability are the two key edaphic factors that affect crop yields and are directly or indirectly affected by climate variability and change. The study examined climate-induced yield level, yield variability and gap of maize during 1981-2010 main growing season in the Central Rift Valley (CRV) of Ethiopia. Pearson correlation test was employed to see the relationship between climate variables and yield. The coefficient of variation (CV) was used to analyze annual yield variability. Decision Support System for Agro-technology Transfer cropping system model (DSSAT-CSM) was used to simulate the growth and yield of maize for the study period. The result indicated that maize grain yield was strongly (P<0.01) and positively correlated with seasonal rainfall (r=0.67 at Melkassa and r = 0.69 at Ziway) in the CRV while day temperature affected grain yield negatively (r= -0.44) at Ziway (P<0.05) during the simulation period. Variations in total seasonal rainfall at Melkassa and Ziway explained 44.9 and 48.5% of the variation in yield, respectively, under optimum nutrition. Following variation in rainfall, high yield variability (CV=23.5%, Melkassa and CV=25.3%, Ziway) was observed for optimum nutrient simulation than the corresponding nutrient limited simulation (CV=16%, Melkassa and 24.1%, Ziway) in the study period. The observed farmers’ yield was 72, 52 and 43% of the researcher-managed, water-limited and potential yield of the crop, respectively, indicating a wide maize yield gap in the region. The study revealed rainfed crop production in the CRV is prone to yield variabilities due to its high dependence on seasonal rainfall and nutrient level. Moreover, the high coefficient of variation in the yield gap for the 30-year period also foretells the need for dependable water supply at both locations. Given the wide yield gap especially during lower rainfall years across the simulation periods, it signifies the requirement for a more dependable application of irrigation water and a potential shift to irrigated agriculture; hence, adopting options that can improve water availability and nutrient use efficiency would be crucial for crop production in the area.

Keywords: climate variability, crop model, water availability, yield gap, yield variability

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Authors: Sharmin Shahid, Zaher Zain

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The purpose of this study is to explore and examines the theoretical frameworks of ethical leadership style and affective organizational commitment. Additionally, to investigate the extent to which employee orientation and ethical guidance either strengthen or weaken on the relationship between ethical leadership style and affective commitment. The study will also measure the mediating effects of leader’s integrity either influence to inspire and revival employee’s affective commitment or not. The methodology of the study comprised sample of 237 managers, departmental heads, top-level executives, and professors of several financial institutions, banks, and universities in Bangladesh who are directly related with decision making process of respective organization. A cross sectional research design will be used to examine the direct, moderating, and mediating analysis among the research key variables. Data were gathered based on personal administered questionnaire. The findings of the study will be significance because it will provide the real scenario of leadership style which leads to financial and strategic success of any organizations. In addition, the results will be interesting enough to find out either ethical leadership style have positive relationship with affective commitment or not. Employee-orientation and ethical guidance is a moderator to improve leadership style and affective commitment, whereas, leader’s integrity mediates the relationships between leadership style and affective organizational commitment to do the right thing in the right way for the betterment of entire organizational success. Research limitations of the study are the data collected by self administered questionnaire, a method with well-known shortcomings. Second, the study concentrated on financial institutions, banks top executives, and universities professors in Bangladesh. An important implication of the research is that the interesting findings will give some insight to the leadership style and helps management to focus on their management and leadership efficacy, as that could improve their affective organizational commitment. The findings will be original and unique value adding with the existing literature on leadership studies. The study is based on a comprehensive literature review. The results will be based on a sample of financial institutions, banks, and universities in Bangladesh. The research findings are useful to academics and corporate leaders of financial institutions, banks, and universities all over the world.

Keywords: affective organizational commitment, Bangladesh, ethical guidance, ethical leadership style

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Authors: Malab Sana Balouch, Meenakshi Nayar

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Hemispatial Neglect is a common disorder primarily associated with right hemispheric stroke, in the acute phase of which it can occur up to 82% of the time. Such individuals fail to acknowledge or respond to people and objects in their left field of vision due to deficits in attention and awareness. Persistent hemispatial neglect significantly impedes post-stroke recovery, leading to longer hospital stays post-stroke, increased functional dependency, longer-term disability in ADLs and increased risk of falls. Recently, evidence has emerged for the use of dopamine agonist Rotigotine in neglect. The aim of our Quality Improvement Project (QIP) is to evaluate and better the current protocols and practice in assessment, documentation and management of neglect and rotigotine use at the Neurorehabilitation unit at Charing Cross Hospital (CNRU). In addition, it brings light to rotigotine use in the management of hemispatial neglect and paves the way for future research in the field. Our QIP was based in the CNRU. All patients admitted to the CNRU suffering from a right-sided stroke from 2nd of February 2018 to the 2nd of February 2021 were included in the project. Each patient’s multidisciplinary team report and hospital notes were searched for information, including bio-data, fulfilment of the inclusion criteria (having hemispatial neglect) and data related to rotigotine use. This includes whether or not the drug was administered, any contraindications to drug in patients that did not receive it, and any therapeutic benefits(subjective or objective improvement in neglect) in those that did receive the rotigotine. Data was simultaneously entered into excel sheet and further statistical analysis was done on SPSS 20.0. Out of 80 patients suffering from right sided strokes, 72.5% were infarcts and 27.5% were hemorrhagic strokes, with vast majority of both types of strokes were in the middle cerebral artery territory (MCA). A total of 31 (38.8%) of our patients were noted to have hemispatial neglect, with the highest number of cases being associated with MCA strokes. Almost half of our patients with MCA strokes suffered from neglect. Neglect was more common in male patients. Out of the 31 patients suffering from visuospatial neglect, only 16% actually received rotigotine and 80% of them were noted to have an objective improvement in their neglect tests and 20% revealed subjective improvement. After thoroughly going through neglect-associated documentation, the following recommendations/plans were put in place for the future. We plan to liaise with the occupational therapy team at our rehab unit to set a battery of tests that would be done on all patients presenting with neglect and recommend clear documentation of outcomes of each neglect screen under it. Also to create two proformas; one for the therapy team to aid in systematic documentation of neglect screens done prior to and after rotigotine administration and a second proforma for the medical team with clear documentation of rotigotine use, its benefits and any contraindications if not administered.

Keywords: hemispatial Neglect, right hemispheric stroke, rotigotine, neglect, dopamine agonist

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Authors: Vanessa Bennemann, Gabriela Laste, Márcia Inês Goettert

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The gestational period is a phase in which the pregnant woman undergoes constant physiological and hormonal changes, which are part of the woman’s biological cycle, the development of the fetus, childbirth, and lactation. These are factors of response to the immunological adaptation of the human reproductive process that is directly related to the pregnancy’s well-being and development. Although most pregnancies occur without complications, about 15% of pregnant women will develop potentially fatal complications, implying maternal and fetal risk. Therefore, requiring specialized care for high-risk pregnant women (HRPW) with obstetric interventions for the survival of the mother and/or fetus. Among the risk factors that characterize HRPW are the women's age, gestational diabetes mellitus (GDM), autoimmune diseases, infectious diseases such as syphilis and HIV, hypertension (SAH), preeclampsia, eclampsia, HELLP syndrome, uterine contraction abnormalities, and premature placental detachment (PPD), thyroid disorders, among others. Thus, pregnancy has an impact on the thyroid gland causing changes in the functioning of the mother's thyroid gland, altering the thyroid hormone (TH) profiles and production as pregnancy progresses. Considering, throughout the gestational period, the interpretation of the results of the tests to evaluate the thyroid functioning depends on the stage in which the pregnancy is. Thyroid disorders are directly related to adverse obstetric outcomes and in child development. Therefore, the adequate release of TH is important for a pregnancy without complications and optimal fetal growth and development. Objective: Investigate the physiological effects caused by thyroid disorders in the gestational period. Methods: A search for articles indexed in PubMed, Scielo, and MDPI databases, was performed using the term “AND”, with the descriptors: Pregnancy, Thyroid. With several combinations that included: Melatonin, Thyroidopathy, Inflammatory processes, Cytokines, Anti-inflammatory, Antioxidant, High-risk pregnancy. Subsequently, the screening was performed through the analysis of titles and/or abstracts. The criteria were: including clinical studies in general, randomized or not, in the period of 10 years prior to the research, in the English literature; excluded: experimental studies, case reports, research in the development phase. Results: In the preliminary results, a total of studies (n=183) were found, (n=57) excluded, such as studies of cancer, diabetes, obesity, and skin diseases. Conclusion: To date, it has been identified that thyroid diseases can impair the fetus’s brain development. Further research is suggested on this matter to identify new substances that may have a potential therapeutic effect to aid the gestational period with thyroid diseases.

Keywords: pregnancy, thyroid, melatonin, high-risk pregnancy

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Authors: Ketan Tamirisa, Kathleen P. Tebb

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In the U.S., annually, there are over 1 million pregnancies in teenagers and most (85%) are unintended. The need for proactive prevention measures is imperative to support adolescents with their pregnancy prevention and family planning goals. To date, there is limited research examining the extent to which support from a sexual partner(s) influences contraceptive use. To address this gap, this study assessed the relationship between sexually active adolescents, sex-assigned birth as female, and their perceived support from their sexual partner(s) about their contraceptive use in the last three months. Baseline data from sexually active adolescent females, between 13-19 years who were not currently using a long-acting contraceptive device, were recruited from 32 school-based health centers (SBHCs) in seven states in the U.S. as part of a larger study to evaluate Health-E You/ Salud iTuTM, a web-based contraceptive decision support tool. Fisher’s exact test assessed the cross-sectional association between perceived sexual partner support of contraceptive use in the past three months (felt no support, felt little support, and felt a lot of support), and current use of non-barrier contraception. A total of 91 sexually active adolescent females were eligible and completed the baseline survey. The mean age was 16.7 and nearly half (49.3%) were Hispanic/Latina. Most (85.9%) indicated it was very important to avoid becoming pregnant. A total of 60 participants (65.9%) reported use of non-barrier contraception. Of these, most used birth control pills (n=26), followed by Depo-Provera injection (n=12), patch (n=1), and ring (n=1). Most of the participants (80.2%) indicated that they perceived a lot of support from their partners and 19.8% reported no or little support. Among those reporting a lot of support, 69.9% (51/73) reported current use of non-barrier contraception compared to 50% (9/18) who felt no/little support and reported contraceptive use. This difference approached but did not reach statistical significance (p=0.096). Results from this preliminary data indicate that many adolescents who are coming in for care at SBHCs are at risk of unintended pregnancy. Many participants also reported a lot of support from their sexual partner(s) to use contraception. While the associations only approached significance, this is likely due to the small sample size. This and future research can better understand this association to inform interventions aimed at sexual partners to strengthen education and social support, increase healthcare accessibility, and ultimately reduce rates of unintended pregnancy.

Keywords: adolescents, contraception, pregnancy, SBHCs, sexual partners

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Authors: Shofiayuningtyas Luftiani

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Some private schools in Indonesia started integrating the online program Gizmos in the teaching-learning process. Gizmos was developed to supplement the existing curriculum by integrating it into the instructional programs. The program has some features using an inquiry-based simulation, in which students conduct exploration by using a worksheet while teachers use the teacher guidelines to direct and assess students’ performance In this study, the discussion about Gizmos highlights its features as the assessment media of mathematics learning for secondary school students. The discussion is based on the case study and literature review from the Indonesian context. The purpose of applying Gizmos as an assessment media refers to the diagnostic assessment. As a part of the diagnostic assessment, the teachers review the student exploration sheet, analyze particularly in the students’ difficulties and consider findings in planning future learning process. This assessment becomes important since the teacher needs the data about students’ persistent weaknesses. Additionally, this program also helps to build student’ understanding by its interactive simulation. Currently, the assessment over-emphasizes the students’ answers in the worksheet based on the provided answer keys while students perform their skill in translating the question, doing the simulation and answering the question. Whereas, the assessment should involve the multiple perspectives and sources of students’ performance since teacher should adjust the instructional programs with the complexity of students’ learning needs and styles. Consequently, the approach to improving the assessment components is selected to challenge the current assessment. The purpose of this challenge is to involve not only the cognitive diagnosis but also the analysis of skills and error. Concerning the selected setting for this diagnostic assessment that develops the combination of cognitive diagnosis, skills analysis and error analysis, the teachers should create an assessment rubric. The rubric plays the important role as the guide to provide a set of criteria for the assessment. Without the precise rubric, the teacher potentially ineffectively documents and follows up the data about students at risk of failure. Furthermore, the teachers who employ the program of Gizmos as the diagnostic assessment might encounter some obstacles. Based on the condition of assessment in the selected setting, the obstacles involve the time constrain, the reluctance of higher teaching burden and the students’ behavior. Consequently, the teacher who chooses the Gizmos with those approaches has to plan, implement and evaluate the assessment. The main point of this assessment is not in the result of students’ worksheet. However, the diagnostic assessment has the two-stage process; the process to prompt and effectively follow-up both individual weaknesses and those of the learning process. Ultimately, the discussion of Gizmos as the media of the diagnostic assessment refers to the effort to improve the mathematical learning process.

Keywords: diagnostic assessment, error analysis, Gizmos online program, skills analysis

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Authors: Melanie Kerschner

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Language is our main means of social interaction. News journalism, especially opinion discourse, holds a powerful position in this context. Editorials can be regarded as encounters of different, partially contradictory relationships between discourse participants constructed through the editorial voice. Their primary goal is to shape public opinion by commenting on events already addressed by other journalistic genres in the given newspaper. In doing so, the author tries to establish a consensus over the negotiated matter (i.e. the news event) with the reader. At the same time, he/she claims authority over the “correct” description and evaluation of an event. Yet, how can the relationship and the interaction between the discourse participants, i.e. the journalist, the reader and the news actors represented in the editorial, be best visualized and studied from a cross-cultural perspective? The present research project attempts to give insights into the role of (media) culture in British, Italian and German editorials. For this purpose the presenter will propose a basic framework: the so called “pyramid of discourse participants”, comprising the author, the reader, two types of news actors and the semantic macro-structure (as meta-level of analysis). Based on this framework, the following questions will be addressed: • Which strategies does the author employ to persuade the reader and to prompt him to give his opinion (in the comment section)? • In which ways (and with which linguistic tools) is editorial opinion expressed? • Does the author use adjectives, adverbials and modal verbs to evaluate news actors, their actions and the current state of affairs or does he/she prefer nominal labels? • Which influence do language choice and the related media culture have on the representation of news events in editorials? • In how far does the social context of a given media culture influence the amount of criticism and the way it is mediated so that it is still culturally-acceptable? The following culture-contrastive study shall examine 45 editorials (i.e. 15 per media culture) from six national quality papers that are similar in distribution, importance and the kind of envisaged readership to make valuable conclusions about culturally-motivated similarities and differences in the coverage and assessment of news events. The thematic orientation of the editorials will be the NSA scandal and the reactions of various countries, as this topic was and still is relevant to each of the three media cultures. Starting out from the “pyramid of discourse participants” as underlying framework, eight different criteria will be assigned to the individual discourse participants in the micro-analysis of the editorials. For the purpose of illustration, a single criterion, referring to the salience of authorial opinion, will be selected to demonstrate how the pyramid of discourse participants can be applied as a basis for empirical analysis. Extracts from the corpus shall furthermore enhance the understanding.

Keywords: Micro-analysis of editorials, culture-contrastive research, media culture, interaction between discourse participants, evaluation

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Authors: Werner Roux Uys

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The Commissioner for the South African Revenue Service (SARS) holds a high position of trust in South African society and a lack of trust by taxpayers in the Commissioner’s actions or conduct could compromise SARS’ management of public finances. Tax morality – which is implicit in the social contract between taxpayers and the state – includes distinct phenomena that can cause a breakdown if there is a perceived lack of action on the part of the Commissioner to ensure public finances are kept safe. To promote tax morality, the Commissioner must support the judiciary in the exercise of its discretion to punish fraudulent tax activities and corrupt tax practices. For several years the political meddling in the Commissioner’s actions and conduct have caused perceived abuse of power at SARS, and taxpayers believed their hard-earned income paid over to SARS would be fruitless and wasteful expenditure. The purpose of this article is to identify and analyse previous decisions held by the South African judiciary regarding the Commissioner’s actions and conduct in tax matters, as well as consider important political statements and newspaper bulletins for the purpose of this research. The study applies a qualitative research approach and exploratory case study technique. Keywords were selected and inserted in the LexisNexis electronic database to systematically identify applicable case law where the ratio decidendi of the court referred to the actions and/or conduct of the Commissioner. Specific real-life statements, including political statements and newspaper bulletins, were selected to support the topic at hand. The purpose of the study is to educate the public about the perceptions that have transformed taxpayers’ behaviour towards the Commissioner for SARS since South Africa’s fledgling constitutional democracy was inaugurated in 1994. The study adds to the literature by identifying key characteristics or distinct phenomena regarding the actions and conduct of the Commissioner affecting taxpayers’ behaviour, including discretionary decision-making. From the findings, it emerged that SARS must abide by its (own) laws and that there is a need to educate not only South African taxpayers about tax morality, but also the public in general.

Keywords: commissioner, SARS, action and conduct, judiciary, discretionry, decsion-making

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Authors: Johanida L. Etado

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The study determined the Administrative traits and capabilities of Mindanao State University Heads of office as perceived by their respondents. Specifically, this study attempted to find out: To get the primary data, a self- constructed survey questionnaire which was validated by a panel of experts, including the adviser. Most of the MSU head of office were aware of their duties and responsibilities as a manager. Considering their vast knowledge and expertise on the technical or task aspects of the job, it is not surprising that respondents perceived them to a high degree as work or task oriented. MSU head of office were knowledgeable and capable in performing field-specific, specialized tasks and enabling them to coordinate work, solve problems, communicate effectively, and also understand the big picture in light of the front-line work that must be performed. The significance of coaching or mentoring in this instance may be explained by the less number of Master’s or Doctorate degree holder among employees resulting to close supervision and mentorship of head of office towards the latter; Without comparison, interpersonal or human relation capabilities is a very effective way in dealing with people as it gives them the opportunity to influence their employees. In the case of MSU head of office, the best way of dealing with problematic employees is by establishing trust and allowing them to partake in the decision making even on setting organizational goals as it would make them feel part of the organization; Thus, it is recommended that the success of an organization depends largely with the effectiveness of the head of unit. In this case, being development oriented would mean encouraging both head officers & employees to know not only the technical know hoe of the organisation but also the visions, missions, goals & the latter’s aspirations to establish cooperation & harmonious working environment; hence, orientation & reorientation time to time would enable them to be more development oriented; With respect to human relations, effective interpersonal relationship between head of unit & employee is of paramount importance. In order to strengthen the relationship between the two, the management should establish an upward & downward communication where two parties will have to establish an open & transparent communication, either through verbal & non-verbal one.

Keywords: administrator, administrative traits, leadership traits, work orientation

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Authors: Mohd Nizam Osman

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This study explores issues and challenges of information and communication technology (ICT) adoption and application for business-related performance of Agro-based small and medium-scale enterprises (SMEs) in the state of Selangor, Malaysia. Globally, SMEs have championed the socio-economic development of nations across the globe, including Malaysia. Thus, the objectives of this study explore issues and challenges of agro-based SMEs' adoption and usage of ICT, the business-related performance of SMEs via the adoption of ICT, and the impact of incentives on SMEs' adoption and use of ICT. The study was conducted in Selangor, Malaysia. A qualitative research approach was deployed for the study. Data for the study emanated from semi-structured interviews and field note observation of 14 informants who are registered as small-scale business owners and operators. Based on thematic analysis, data were triangulated to ensure consistency and validation of findings for the study. Findings revealed that SMEs are faced with a lack of funding, low expertise, and lack of storage, leading to an unsustainable supply of goods and services. Although effective communication, ease of business activities/transactions, and information search by way of research were among the business performance experienced by SMEs' adoption of ICT. Further findings showed that loan conditions and personal and business interests hindered SMEs' reception and access to programs, schemes, and incentives geared at aiding the continuous growth and development of agro-based SMEs. The study suggests the need for policy change in terms of diversification of channels of funding and access to funds to enable credit guarantee schemes and peer or community-based financing. Consequently, the study recommends the engagement of SMEs in policy decision-making to ascertain the type of incentives relevant to their business operations. Likewise, from a technological standpoint, the study suggests the expansion of the framework of technology acceptance with focuses on affordability, type of users, and level of usage.

Keywords: ICT adoption, business related performance, agro-based SMEs, ICT application for SMEs

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Authors: Aziza Barnawi

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Background: Regular exercise reduces risk factors associated with cardiovascular diseases. Over the past decade, exercise interventions have been introduced to reduce the risk of and prevent coronary artery disease (CAD). Elevated low-density lipoproteins (LDL) contribute to the formation of atherosclerosis, its manifestations on the endothelial narrow the coronary artery and affect the endothelial function. Therefore, flow-mediated dilation (FMD) technique is used to assess the function. The results of previous studies have been inconsistent and difficult to interpret across different types of exercise programs. The relationship between exercise therapy and lipid levels has been extensively studied, and it is known to improve the lipid profile and endothelial function. However, the effectiveness of exercise in altering LDL levels and improving blood flow is controversial. Objective: This review aims to explore the evidence and quantify the impact of exercise training on LDL levels and vascular function by FMD. Methods: Electronic databases were searched PubMed, Google Scholar, Web of Science, the Cochrane Library, and EBSCO using the keywords: “low and/or moderate aerobic training”, “blood flow”, “atherosclerosis”, “LDL mediated blood flow”, “Cardiac Rehabilitation”, “low-density lipoproteins”, “flow-mediated dilation”, “endothelial function”, “brachial artery flow-mediated dilation”, “oxidized low-density lipoproteins” and “coronary artery disease”. The studies were conducted for 6 weeks or more and influenced LDL levels and/or FMD. Studies with different intensity training and endurance training in healthy or CAD individuals were included. Results: Twenty-one randomized controlled trials (RCTs) (14 FMD and 7 LDL studies) with 776 participants (605 exercise participants and 171 control participants) met eligibility criteria and were included in the systematic review. Endurance training resulted in a greater reduction in LDL levels and their subfractions and a better FMD response. Overall, the training groups showed improved physical fitness status compared with the control groups. Participants whose exercise duration was ≥150 minutes /week had significant improvement in FMD and LDL levels compared with those with <150 minutes/week.Conclusion: In conclusion, although the relationship between physical training, LDL levels, and blood flow in CAD is complex and multifaceted, there are promising results for controlling primary and secondary prevention of CAD by exercise. Exercise training, including resistance, aerobic, and interval training, is positively correlated with improved FMD. However, the small body of evidence for LDL studies (resistance and interval training) did not prove to be significantly associated with improved blood flow. Increasing evidence suggests that exercise training is a promising adjunctive therapy to improve cardiovascular health, potentially improving blood flow and contributing to the overall management of CAD.

Keywords: exercise training, low density lipoprotein, flow mediated dilation, coronary artery disease

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Authors: Abubakar Dikko

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The research investigates the causes of unemployment in Namibia, Nigeria and South Africa, and the role of Capital Accumulation in reducing the unemployment profile of these economies as proposed by the post-Keynesian economics. This is conducted through extensive review of literature on the NAIRU models and focused on the post-Keynesian view of unemployment within the NAIRU framework. The NAIRU (non-accelerating inflation rate of unemployment) model has become a dominant framework used in macroeconomic analysis of unemployment. The study views the post-Keynesian economics arguments that capital accumulation is a major determinant of unemployment. Unemployment remains the fundamental socio-economic challenge facing African economies. It has been a burden to citizens of those economies. Namibia, Nigeria and South Africa are great African nations battling with high unemployment rates. In 2013, the countries recorded high unemployment rates of 16.9%, 23.9% and 24.9% respectively. Most of the unemployed in these economies comprises of youth. Roughly about 40% working age South Africans has jobs, whereas in Nigeria and Namibia is less than that. Unemployment in Africa has wide implications on households which has led to extensive poverty and inequality, and created a rampant criminality. Recently in South Africa there has been a case of xenophobic attacks which were caused by the citizens of the country as a result of unemployment. The high unemployment rate in the country led the citizens to chase away foreigners in the country claiming that they have taken away their jobs. The study proposes that there is a strong relationship between capital accumulation and unemployment in Namibia, Nigeria and South Africa, and capital accumulation is responsible for high unemployment rates in these countries. For the economies to achieve steady state level of employment and satisfactory level of economic growth and development there is need for capital accumulation to take place. The countries in the study have been selected after a critical research and investigations. They are selected based on the following criteria; African economies with high unemployment rates above 15% and have about 40% of their workforce unemployed. This level of unemployment is the critical level of unemployment in Africa as expressed by International Labour Organization (ILO). The African countries with low level of capital accumulation. Adequate statistical measures have been employed using a time-series analysis in the study and the results revealed that capital accumulation is the main driver of unemployment performance in the chosen African countries. An increase in the accumulation of capital causes unemployment to reduce significantly. The results of the research work will be useful and relevant to federal governments and ministries, departments and agencies (MDAs) of Namibia, Nigeria and South Africa to resolve the issue of high and persistent unemployment rates in their economies which are great burden that slows growth and development of developing economies. Also, the result can be useful to World Bank, African Development Bank and International Labour Organization (ILO) in their further research and studies on how to tackle unemployment in developing and emerging economies.

Keywords: capital accumulation, unemployment, NAIRU, Post-Keynesian economics

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Authors: Poonam Goswami

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Background: The diagnosis of a serious illness like cancer can have an impact on a patient’s emotional well-being and may result in psychological symptoms, anxiety, depression, and loss of control. Advance care planning discussions ensure patients’ values and goals of care, including patients’ freedom to choose their place of death, are respected. Unfortunately, these discussions are often delayed and are not initiated early in patients’ cancer trajectory. As a result, patients’ wishes often remains unknown until the last phase of their life. Evidence suggests that many patients inappropriately receive aggressive treatment near the end of life, which does lead to higher resource utilization, decreased quality of life, and increased cost. Additionally, the novel coronavirus disease 2019 (COVID-19) pandemic challenged the health care systems worldwide and raised important ethical issues, especially regarding the potential need for rationing health care in the context of scarce resources and crisis capacity. The importance of goal concordant care is now even substantially important and is heightened in the context of this pandemic. Problem: Although there is growing evidence on the effects of the ACP on the completion of advanced directives, improved patient and family concordance for preferences for medical care, and receipt of care, there is still a lack of standardized ACP conversation strategies for patients with cancer. Methods: The Key concepts of ACP include (1) assessing patient and family readiness, (2) identifying a surrogate decision maker ( medical power of attorney), (3) exploring patient and family understanding of the disease and treatment options,(4) discussing the values and goals of care, and options for end-of-life care, (5) documenting patient preferences in the medical record, and (6) revisiting the discussions at every change in the treatment plan and /or change in clinical status, including at every hospitalization. Conclusion/Implication for practice: Advance Care Planning (ACP) and end-of-life (EOL) discussions are important for patients, families, and health care providers. Adopting the verbal and nonverbal communication strategies can help overcome the barriers to effective communication on these difficult discussions. ACP with goals of care discussions should not be delayed until the patient is hospitalized.

Keywords: advance care planning, end of life, cancer, global, pandemic

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Authors: Gainiya Tazhina

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Higher education systems of many countries have increased diversity and ensured equal rights and opportunities for inclusive students in the last decades. Issues of diversity-equity-inclusion (DEI) in Kazakhstani higher education began to be considered in legislation in 2021-2023. The adoption of the Road Map of the Ministry of Education and Science for universities’ inclusivity indicated strategies for change. The paper traces how this government initiative is being implemented in universities across the country. Content analysis of legislative documents, media publications, surveys of students, staff and interviews with leaders have demonstrated the inconsistency of these strategic decisions. Thus, the Road Map required that by 2023 conditions for promoting and ensuring inclusive education and barrier-free environments should be created in 60% -100% of Kazakhstani universities, including spaces inside academic buildings and dormitories in a short period of time. (March 2023-August 2025). Educational programs and curricula have not been adapted to the needs of students with special education needs (SEN); teachers do not have the skills and methods to work with students with SEN, students from minority groups, and international students. 60% of universities have not created a barrier-free environment on campuses due to the high cost of elevators, tactile tiles and assistive devices. Only 1% of school-disabled graduates enter universities due to the unwillingness of universities to educate people with disabilities. At the same time, universities do not adapt their educational programs and services to the needs of inclusive students; their needs are not identified; they study under the same conditions as regular students. Accordingly, teaching staff does not have the knowledge and skills to teach inclusive students; university lecturers misunderstand or oversimplify the social phenomena of ‘inclusion’ and ‘diversity’. The situation is more acute with the creation of a barrier-free architectural environment on university campuses. Recent reports indicate that these reforms have not been implemented to date, proven controversial in practice due to the inconsistency of national research on inclusion in higher education. Widely announced reforms have not produced the expected results leading to distortions at the local level. Inconsistent policies, contradictory legislative acts without expertise of needs and developing specific implementation criteria, without training specialists and indicators for achieving reforms are doomed to failure and mistrust of society. Based on the results of this research, recommendations have been developed: (1) to overcome inconsistencies in legislation regarding DEI in higher education; (2) to encourage initiatives in universities' inclusive environments; (3) to develop projects that will promote public awareness of DEI.

Keywords: diversity-equity-inclusion, Kazakhstani universities, reforms, legislation, accessibility

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Authors: Abhishek Oswal

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Background: Inconsistencies between the guidelines for childhood asthma can pose a diagnostic challenge to clinicians. NICE guidelines are the most commonly followed guidelines in primary care in the UK; they state that to be diagnosed with asthma, a child must be more than 5 years old and must have objective evidence of the disease. When diagnoses are coded in general practice (GP), these guidelines may be superseded by communications from secondary care. Hence it is imperative that diagnoses are correct, as per up to date guidelines and evidence, as this affects follow up and management both in primary and secondary care. Methods: A snapshot audit at a general practice surgery was undertaken of children (less than 16 years old) with a coded diagnosis of 'asthma', to review the age at diagnosis and whether any objective evidence of asthma was documented at diagnosis. 50 cases of asthma in children presenting to the emergency department (ED) were then audited to review the age at presentation, whether there was evidence of previous asthma diagnosis and whether the patient was discharged from ED. A repeat audit is planned in ED this winter. Results: In a GP surgery, there were 83 coded cases of asthma in children. 51 children (61%) were diagnosed under 5, with 9 children (11%) who had objective evidence of asthma documented at diagnosis. In ED, 50 cases were collected, of which 4 were excluded as they were referred to the other services, or for incorrect coding. Of the 46 remaining, 27 diagnoses confirmed to NICE guidelines (59%). 33 children (72%) were discharged from ED. Discussion: The most likely reason for the apparent low rate of a correct diagnosis is the significant challenge of obtaining objective evidence of asthma in children. There were a number of patients who were diagnosed from secondary care services and then coded as 'asthma' in GP, without having objective documented evidence. The electronic patient record (EPR) system used in our emergency department (ED) did not allow coding of 'suspected diagnosis' or of 'viral induced wheeze'. This may have led to incorrect diagnoses coded in primary care, of children who had no confirmed diagnosis of asthma. We look forward to the re-audit, as the EPR system has been updated to allow suspected diagnoses. In contrast to the NICE guidelines used here, British Thoracic Society (BTS) guidelines allow for a trial of treatment and subsequent confirmation of diagnosis without objective evidence. It is possible that some of the cases which have been classified as incorrect in this audit may still meet other guidelines. Conclusion: The diagnosis of asthma in children is challenging. Incorrect diagnoses may be related to clinical pressures and the provision of services to allow compliance with NICE guidelines. Consensus statements between the various groups would also aid the decision-making process and diagnostic dilemmas that clinicians face, to allow more consistent care of the patient.

Keywords: asthma, diagnosis, primary care, emergency department, guidelines, audit

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Authors: C. S. Chen, F. Y. Hui, B. S. Farhana, J. De Leon

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Introduction: Stroke can lead to long-term disability, affecting one’s quality of life. Providing stroke education to patient and family members is essential to optimize stroke recovery and prevent recurrent stroke. Currently, nurses conduct stroke education by handing out pamphlets and explaining their contents to patients. However, this is not always effective as nurses have varying levels of knowledge and depth of content discussed with the patient may not be consistent. With the advancement of information technology, health education is increasingly being disseminated via electronic software and studies have shown this to have benefitted patients. Hence, a multi-disciplinary team consisting of doctors, nurses and allied health professionals was formed to create the stroke journey map software to deliver consistent and concise stroke education. Research Objectives: To evaluate the effectiveness of using a stroke journey map software in improving patients’ perceived knowledge in the acute stroke unit during hospitalization. Methods: Patients admitted to the acute stroke unit were given stroke journey map software during patient education. The software consists of 31 interactive slides that are brightly coloured and 4 videos, based on input provided by the multi-disciplinary team. Participants were then assessed with pre-and-post survey questionnaires before and after viewing the software. The questionnaire consists of 10 questions with a 5-point Likert scale which sums up to a total score of 50. The inclusion criteria are patients diagnosed with ischemic stroke and are cognitively alert and oriented. This study was conducted between May 2017 to October 2017. Participation was voluntary. Results: A total of 33 participants participated in the study. The results demonstrated that the use of a stroke journey map as a stroke education medium was effective in improving patients’ perceived knowledge. A comparison of pre- and post-implementation data of stroke journey map revealed an overall mean increase in patients’ perceived knowledge from 24.06 to 40.06. The data is further broken down to evaluate patients’ perceived knowledge in 3 domains: (1) Understanding of disease process; (2) Management and treatment plans; (3) Post-discharge care. Each domain saw an increase in mean score from 10.7 to 16.2, 6.9 to 11.9 and 6.6 to 11.7 respectively. Project Impact: The implementation of stroke journey map has a positive impact in terms of (1) Increasing patient’s perceived knowledge which could contribute to greater empowerment of health; (2) Reducing need for stroke education material printouts making it environmentally friendly; (3) Decreasing time nurses spent on giving education resulting in more time to attend to patients’ needs. Conclusion: This study has demonstrated the benefit of using stroke journey map as a platform for stroke education. Overall, it has increased patients’ perceived knowledge in understanding their disease process, the management and treatment plans as well as the discharge process.

Keywords: acute stroke, education, ischemic stroke, knowledge, stroke

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Authors: Dorsa Pourmojib, Marc J. Boutin

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Urban space is used everyday by a diverse range of urban dwellers, each with different expectations. In this space, opportunities and resources are not distributed equitably among urban dwellers, despite the importance of inclusivity. In addition, some marginalized groups may not be considered. These include people with low incomes, immigrants from diverse cultures, various age groups, and those with special needs. To this end, this research aims to enhance social equity in urban space by bridging the gap between social equity and spatial equity in the urban context. This gap in the knowledge base related to urban design may be present for several reasons; lack of studies on relationship between social equity and spatial equity in urban open space, lack of practical design strategies for promoting social equity in urban open space, lack of proper site analysis in terms of context and users of the site both for designing new urban open spaces and developing the existing ones, and lack of researchers that are designers and finally it could be related to priorities of the city’s policies in addressing such issues, since it is time, money and energy consuming. The main objective of this project is addressing the aforementioned gap in the knowledge by exploring the relationship between social equity and spatial equity in urban open space. Answering the main question of this research is a promising step to this end; 'What are the considerations towards providing social equity through the design of urban elements that offer spatial equity?' To answer the main question of this research there are several secondary questions which should be addressed. Such as; how can the characteristics of social equity be translated to spatial equity? What are the diverse user’s needs and which of their needs are not considered in that site? What are the specific elements in the site which should be designed in order to promote social equity? What is the current situation of social and spatial equity in the proposed site? To answer the research questions and achieve the proposed objectives, a three-step methodology has been implemented. Firstly, a comprehensive research framework based on the available literature has been presented. Afterwards, three different urban spaces have been analyzed in terms of specific key research questions as the precedent studies; Naqsh-e Jahan Square (Iran), Superkilen Park (Denmark) and Campo Dei Fiori (Italy). In this regard, a proper gap analysis of the current situation and the proposed situation of these sites has been conducted. Finally, by combining the extracted design considerations from the precedent studies and the literature review, practical design strategies have been introduced as a result of this research. The presented guidelines enable the designers to create socially equitable urban spaces. To conclude, this research proposes a spatial approach to social inclusion and equity in urban space by presenting a practical framework and criteria for translating social equity to spatial equity in urban areas.

Keywords: inclusive urban design, social equity, social inclusion, spatial equity

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Authors: Shan Zhang, Peter Suechting

Abstract:

Predicting trade patterns is critical to decision-making in public and private domains, especially in the current context of trade disputes among major economies. In the past, U.S. recycling has relied heavily on strong demand for recyclable materials overseas. However, starting in 2017, a series of new recycling policies (bans and higher inspection standards) was enacted by multiple countries that were the primary importers of recyclables from the U.S. prior to that point. As the global trade flow of recycling shifts, some new importers, mostly developing countries in South and Southeast Asia, have been overwhelmed by the sheer quantities of scrap materials they have received. As the leading exporter of recyclable materials, the U.S. now has a pressing need to build its recycling industry domestically. With respect to the global trade in scrap materials used for recycling, the interest in this paper is (1) predicting how the export of recyclable materials from the U.S. might vary over time, and (2) predicting how international trade flows for recyclables might change in the future. Focusing on three major recyclable materials with a history of trade, this study uses data-driven and machine learning (ML) algorithms---supervised (shrinkage and tree methods) and unsupervised (neural network method)---to decipher the international trade pattern of recycling. Forecasting the potential trade values of recyclables in the future could help importing countries, to which those materials will shift next, to prepare related trade policies. Such policies can assist policymakers in minimizing negative environmental externalities and in finding the optimal amount of recyclables needed by each country. Such forecasts can also help exporting countries, like the U.S understand the importance of healthy domestic recycling industry. The preliminary result suggests that gravity models---in addition to particular selection macroeconomic predictor variables--are appropriate predictors of the total export value of recyclables. With the inclusion of variables measuring aspects of the political conditions (trade tariffs and bans), predictions show that recyclable materials are shifting from more policy-restricted countries to less policy-restricted countries in international recycling trade. Those countries also tend to have high manufacturing activities as a percentage of their GDP.

Keywords: environmental economics, machine learning, recycling, international trade

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Authors: Mohd Javaid, Shahbaz Khan, Abid Haleem

Abstract:

Purpose: Large numbers of 3D printing technologies are now available for sophisticated applications in different fields. Additive manufacturing has established its dominance in design, development, and customisation of the product. In the era of developing technologies, there is a need to identify the appropriate technology for different application. In order to fulfil this need, two widely used printing technologies such as Fused Deposition Modeling (FDM), and Binding-Jet 3D Printing are compared for effective utilisation in the current scenario for different applications. Methodology: Systematic literature review conducted for both technologies with applications and associated factors enabling for the same. Appropriate MCDM tool is used to compare critical factors for both the technologies. Findings: Both technologies have their potential and capabilities to provide better direction to the industry. Additionally, this paper is helpful to develop a decision support system for the proper selection of technologies according to their continuum of applications and associated research and development capability. The vital issue is raw materials, and research-based material development is key to the sustainability of the developed technologies. FDM is a low-cost technology which provides high strength product as compared to binding jet technology. Researcher and companies can take benefits of this study to achieve the required applications in lesser resources. Limitations: Study has undertaken the comparison with the opinion of experts, which may not always be free from bias, and some own limitations of each technology. Originality: Comparison between these technologies will help to identify best-suited technology as per the customer requirements. It also provides development in this different field as per their extensive capability where these technologies can be successfully adopted. Conclusion: FDM and binding jet technology play an active role in industrial development. These help to assist the customisation and production of personalised parts cost-effectively. So, there is a need to understand how these technologies can provide these developments rapidly. These technologies help in easy changes or in making revised versions of the product, which is not easily possible in the conventional manufacturing system. High machine cost, the requirement of skilled human resources, low surface finish, and mechanical strength of product and material changing option is the main limitation of this technology. However, these limitations vary from technology to technology. In the future, these technologies are to be commercially viable for efficient usage in direct manufacturing of varied parts.

Keywords: 3D printing, comparison, fused deposition modeling, FDM, binding jet technology

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