Search results for: patient decision aid

Authors: Joanna Bajerska, Agata Chmurzyńska, Agata Muzsik, Patrycja Krzyżanowska, Klaudia Łochocka, Jarosław Walkowiak

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The Mediterranean diet (MED) is regarded as beneficial in the therapy of central obesity-associated metabolic abnormalities. However, in the traditional diet of the Central European countries, food items with positive nutritional profiles (rye bread, oats, buckwheat, herrings, linseed and rapeseed oil, berries, apples, plums, root vegetables etc.) are also used. We hypothesized that the Central European Diet (CED) may be comparatively effective in reducing symptoms of central obesity as MED. We tested the health effects of the CED, which is an environmentally friendly regional diet and the traditional MED diet in a group of postmenopausal centrally obese women. A total 58 with a mean age of 60 y (50-70y), body mass index (in kg/m(2)) of 33.4 (22.6-47.3), and waist circumference of 105 cm (87.5-137 cm) were randomly assigned to receive either the diet based on food items commonly used in Central Europe (the CED group; n = 29) or the Mediterranean diet (the MED group; n = 29) for 15 weeks. Body mass and body composition were measured with a Bod Pod (Cosmed, Italy). A non-elastic flexible measuring tape was used to measure waist circumference. Additionally, blood pressure, plasma lipid and glucose levels were assessed with the use of a biochemical analyzer. A total of 50 subjects [86% (CED 83%; MED 90%)] completed the intervention. A high dietary compliance for both described diets was achieved. The mean (±SEM) weight and waist circumference changes were -7.4 ± 0.7 kg; -8.3 ± 0.7 cm and -8.1 ± 0.5 kg; -7.1 ± 0.6 cm for the CED and MED groups, respectively. Moreover, there were no differences between the effectiveness of the diets used in terms of the influence on fat mass, blood pressure, and biochemical parameters. The preliminary data suggest that both described diets may be successfully used for improving central obesity-associated metabolic abnormalities. The project was financed by the National Science Centre awarded based on the number of decision DEC-013/09/B/NZ9/02365

Keywords: central european diet, central obesity, Mediterranean diet, metabolic abnormalities

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Authors: Solene Masloh, Anne Chevrel, Maxime Culot, Leonardo Scapozza, Magali Zeisser-Labouebe

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The limited stability of clinically proven therapeutic antibodies limits their administration by the parenteral route. However, oral administration remains the best alternative as it is the most convenient and less invasive one. Obtaining a targeted treatment based on biologics, which can be orally administered, would, therefore, be an ideal situation to improve patient adherence and compliance. Nevertheless, the delivery of macromolecules through the intestine remains challenging because of their sensitivity to the harsh conditions of the gastrointestinal tract and their low permeability across the intestinal mucosa. To address this challenge, this project aims to demonstrate that targeting receptor-mediated endocytosis followed by transcytosis could maximize the intestinal uptake and transport of large molecules, such as Nanofitins. These affinity proteins of 7 kDa with binding properties similar to antibodies have already demonstrated retained stability in the digestive tract and local efficiency. However, their size does not allow passive diffusion through the intestinal barrier. Nanofitins having a controlled affinity for membrane receptors involved in the transcytosis mechanism used naturally for the transport of large molecules in humans were generated. Proteins were expressed using ribosome display and selected based on affinity to the targeted receptor and other characteristics. Their uptake and transport ex vivo across viable porcine intestines were investigated using an Ussing chambers system. In this paper, we will report the results achieved while addressing the different challenges linked to this study. To validate the ex vivo model, first, we proved the presence of the receptors targeted in humans on the porcine intestine. Then, after the identification of an optimal way of detection of Nanofitins, transport experiments were performed on porcine intestines with viability followed during the time of the experiment. The results, showing that the physiological process of transcytosis is capable of being triggered by the binding of Nanofitins on their target, will be reported here. In conclusion, the results show that Nanofitins can be transported across the intestinal barrier by triggering the receptor-mediated transcytosis and that the ex vivo model is an interesting technique to assess biologics absorption through the intestine.

Keywords: ex-vivo, Nanofitins, oral administration, transcytosis

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Authors: Chitra Rajagopal, Indra Deo Kumar, Ruchi Joshi, Binoy Bhargavan

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Role of fighter planes in modern network centric military warfare scenarios has changed significantly in the recent past. New generation fighter planes have multirole capability of engaging both air and ground targets with high precision. Multirole aircraft undertakes missions such as Air to Air combat, Air defense, Air to Surface role (including Air interdiction, Close air support, Maritime attack, Suppression and Destruction of enemy air defense), Reconnaissance, Electronic warfare missions, etc. Designers have primarily focused on development of technologies to enhance the combat performance of the fighter planes and very little attention is given to human factor aspects of technologies. Unique physical and psychological challenges are imposed on the pilots to meet operational requirements during these missions. Newly evolved technologies have enhanced aircraft performance in terms of its speed, firepower, stealth, electronic warfare, situational awareness, and vulnerability reduction capabilities. This paper highlights the impact of emerging technologies on human factors for various military operations and missions. Technologies such as ‘cooperative knowledge-based systems’ to aid pilot’s decision making in military conflict scenarios as well as simulation technologies to enhance human performance is also studied as a part of research work. Current and emerging pilot protection technologies and systems which form part of the integrated life support systems in new generation fighter planes is discussed. System safety analysis application to quantify the human reliability in military operations is also studied.

Keywords: combat effectiveness, emerging technologies, human factors, systems safety analysis

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Authors: Dinka Fikadu, Mulugeta Shegaze

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Background: Currently in health facility, provider-initiated human immunodeficiency virus testing is the key entry point to prevention, care, treatment and support services, but most people remains unaware of their HIV status due to various reasons. In many high-prevalence countries, fewer than one in ten people with HIV are aware of their HIV status. HIV, the virus that causes AIDS, “acquired immunodeficiency syndrome, "has become one of the world’s most serious health and development challenges. Reaching individuals with HIV who do not know their serostatus is a global public health priority. Objective: To assess utilization of provider initiated HIV testing and counseling and associated factors among adult outpatient department patients. Methods: Health facility based cross sectional study was conducted among 392 adult outpatient department patients in Wonchi woreda from February 24 to March 24 /2013. The study participant was recruited patients from all adult outpatient department patients of all four public health facilities of wonchi woreda using systematic sampling. A structured interviewer administered questionnaire was used to elicit all important variables from the study participants and multiple logistic regression analysis was used. Result: A total of 371 adult outpatient department patients aged between 15 to 64 years were actively participated in the study and 291(78.4%) of them utilized provider initiated HIV testing and counseling and 80(21.6%) of them refused. Knowledge on HIV is low in the study population; majority of the participants didn’t have comprehensive knowledge (64.7%) and (35.3%) fail to reject misconception about means of HIV transmission and prevention. Utilization of provider-initiated HIV testing and counseling were associated with divorced/widowed marital status[AOR (95%CI) = 0.32(0.15, 0.69)], being male sex [AOR (95%CI) =1.81(1.01, 3.24)], having comprehensive knowledge on HIV [AOR (95%CI) =0.408(0.220,0.759)],having awareness about provider initiated HIV testing and counseling [AOR(95%CI) =2.89(1.48,5.66)] and receiving test on HIV before[AOR (95%CI)=4.15(2.30, 7.47)]. Conclusion: Utilization of provider initiated HIV testing and counseling among adult outpatient departments in wonchi woreda public health facility was [(78.4%)].Strengthening health information through mass media and peer education on HIV to address barrier to testing in the community such as low awareness on PITC, to increase up take of PITC among adult OPD patients.

Keywords: utilization, human immune deficiency, testing, provider, initiate

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Authors: Sara Tokhi Arab, Tariq Salari, Ryozo Noguchi, Tofael Ahamed

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Land suitability analysis is essential for table grape cultivation in order to increase its production and productivity under the dry condition of Afghanistan. In this context, the main aim of this paper was to determine the suitable locations for vineyards based on satellite remote sensing and GIS (geographical information system) in Kabul Province of Afghanistan. The Landsat8 OLI (operational land imager) and thermal infrared sensor (TIRS) and shuttle radar topography mission digital elevation model (SRTM DEM) images were processed to obtain the normalized difference vegetation index (NDVI), normalized difference moisture index (NDMI), land surface temperature (LST), and topographic criteria (elevation, aspect, and slope). Moreover, Jaxa rainfall (mm per hour), soil properties information are also used for the physical suitability of vineyards. Besides, socio-economic criteria were collected through field surveys from Kabul Province in order to develop the socio-economic suitability map. Finally, the suitable classes were determined using weighted overly based on a reclassification of each criterion based on AHP (Analytical Hierarchy Process) weights. The results indicated that only 11.1% of areas were highly suitable, 24.8% were moderately suitable, 35.7% were marginally suitable and 28.4% were not physically suitable for grapes production. However, 15.7% were highly suitable, 17.6% were moderately suitable, 28.4% were marginally suitable and 38.3% were not socio-economically suitable for table grapes production in Kabul Province. This research could help decision-makers, growers, and other stakeholders with conducting precise land assessments by identifying the main limiting factors for the production of table grapes management and able to increase land productivity more precisely.

Keywords: vineyards, land physical suitability, socio-economic suitability, AHP

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Authors: Karen Bell

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While there is broad agreement among governments and civil society globally about the need to develop more sustainable societies, the best way to achieve this is still contested. In particular, there are differences regarding whether to continue to implement market-based approaches or to move to alternative redistributive-based approaches. In this paper, ‘Green Economy’ and ‘Living Well’ strategies are compared as examples of these two different strategies for achieving social, ecological and economic sustainability. The paper is based on a 3-year ESRC funded project on transitions to sustainability which examines the implementation of the ‘Green Economy’ paradigm in South Korea and the 'Living Well' paradigm in Bolivia. As well as outlining and analysing secondary data, the paper also draws on over 100 interviews with a range of local stakeholders in these countries carried out by the author between and including 2016 and 2018. The work indicates that the Living Well paradigm seems to better integrate social, ecological and economic concerns and may better deliver sustainability in the time frame necessary than the dominant Green Economy paradigm. This seems to be primarily because Living Well emphasises redistribution to reduce inequality and ensure human needs are met; living in harmony with nature, taking into account natural limits and cycles; respecting traditional values and practices where these support sustainability and human well-being; sovereignty and local control of natural resources; and participative decision-making, based on grassroots community organising. It is, therefore, argued that to achieve inclusive, just and effective transitions to sustainability we should aim to foster equality, respect planetary limits, build on local traditions, bring resources into public ownership and enhance participatory democracy. This will require a radically different approach to that offered within the market-based agenda currently dominating global sustainability debates and activities.

Keywords: environmental transition, green economy, inclusive sustainability, living well, sustainable transition

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Authors: Jane Mullen

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Little research has been undertaken on adult dyslexia and the impact it has on those who have professional careers. There are many complexities behind the career decisions people make, but for teachers who are dyslexic, it can be even more complex. Dyslexia particularly impacts on written and verbal communication, as well as planning and organisation skills which are essential skills for a teacher. As the teachers are aware of their areas of weakness many, make the conscious decision not to disclose their disability at work. In England, the reduction to three attempts to pass the compulsory English and Maths tests prior to undertaking teacher training may mean that dyslexics are now excluded from trying to enter the profession. Together with the fact that dyslexic teachers often chose to remain ‘hidden’ the situation appears to be counter to the inclusive rhetoric that dominates the current educational discourse. This paper is based on in-depth narrative research that has been undertaken with a small group of teachers who are dyslexic in England and firstly explores the strategies and resources that the teachers have found useful. The narratives of the teachers are full of difficulties as well as diversity, consequently, the paper secondly examines how life experiences have impacted on the way the teachers see their dyslexia and how it affects them professionally. Using a narrative methodology enables the teachers to tell their ‘stories’ of how they feel their dyslexia impacts on their lives professionally. The first interview centred around a limited number of semi structured questions about family background, educational experiences, career development, management roles and professional disclosure. The second interview focused on the complexities of being a teacher who is dyslexic and to ‘unlock’ some of their work based narratives visual elicitation was used. Photographs of work-based strategies, issues or concerns were sent to the researcher and these were used as the basis for discussion in the second interview. The paper concludes by discussing possible reasonable adjustments and professional development that might benefit teachers who are dyslexic.

Keywords: dyslexia, life history, narrative, professional, professional development, strategies, teachers

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Authors: Nafiseh Mirabdolhosseini, Jerry Zhou, Vincent Ho

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The dramatic global rise in acid reflux has also led to oesophageal adenocarcinoma (OAC) becoming the fastest-growing cancer in developed countries. While gastroscopy with biopsy is used to diagnose OAC patients, this labour-intensive and expensive process is not suitable for population screening. This study aims to design, develop, and implement a minimally invasive system to capture optical data of the distal oesophagus for rapid screening of potential abnormalities. To develop the system and understand user requirements, a user-centric approach was employed by utilising co-design strategies. Target users’ segments were identified, and 38 patients and 14 health providers were interviewed. Next, the technical requirements were developed based on consultations with the industry. A minimally invasive optical system was designed and developed considering patient comfort. This system consists of the sensing catheter, controller unit, and analysis program. Its procedure only takes 10 minutes to perform and does not require cleaning afterward since it has a single-use catheter. A prototype system was evaluated for safety and efficacy for both laboratory and clinical performance. This prototype performed successfully when submerged in simulated gastric fluid without showing evidence of erosion after 24 hours. The system effectively recorded a video of the mid-distal oesophagus of a healthy volunteer (34-year-old male). The recorded images were used to develop an automated program to identify abnormalities in the distal oesophagus. Further data from a larger clinical study will be used to train the automated program. This system allows for quick visual assessment of the lower oesophagus in primary care settings and can serve as a screening tool for oesophageal adenocarcinoma. In addition, this system is able to be coupled with 24hr ambulatory pH monitoring to better correlate oesophageal physiological changes with reflux symptoms. It also can provide additional information on lower oesophageal sphincter functions such as opening times and bolus retention.

Keywords: endoscopy, MedTech, oesophageal adenocarcinoma, optical system, screening tool

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Authors: Aliya Hisam, Zia Ul Haq, Sohail Aziz, Patrick Doherty, Jill Pell

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Objective: To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome(post-ACS) patients. Methodology: In a randomized controlled trial, post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counseling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three-time points (baseline, 12 weeks and 24 weeks). Result: At baseline, 160 patients (80 in each group; mean age 52.66+8.46 years; 126 males, 78.75%) were recruited, of which 121(75.62%) continued and were analyzed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs. control 43.87, p<.001) and 24 weeks (53.52 vs. 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs. control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group. Conclusion: MCard is feasible and effective at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.

Keywords: acute coronary syndrome, mobile health augmented cardiac rehabilitation (MCard), cardiovascular diseases, cardiac rehabilitation, health-related quality of life, short form 12, MacNew QLMI

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Authors: E. Maoz

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Background: As a teaching method, project-based learning is strongly linked to developing students’ critical thinking skills. It combines creative independent thinking, team work, and disciplinary subject-field integration. In the 'Introduction to Nursing Research Methods' course (year 3, Generic Track), project based learning is used to teach the topic of 'Evidence-Based Nursing'. This topic examines a clinical care issue encountered by students in the field. At the end of their project, students present proposals for managing the said issue. Proposals are the product of independent integrative thinking integrating a wide range of factors influencing the issue’s management. Method: Papers by 27 groups of students (165 students) were content analyzed to identify which themes emerged from the students' recommendations for managing the clinical issue. Findings: Five main themes emerged—current management approach; adapting procedures in line with current recent research recommendations; training for change (veteran nursing staff, beginner students, patients, significant others); analysis of 'economic benefit vs. patient benefit'; multidisciplinary team engagement in implementing change in practice. Two surprising themes also emerged: advertising and marketing using new technologies, which reflects how the new generation thinks. Summary and Recommendations: Among the main challenges in nursing education is training nursing graduates to think independently, integratively, and critically. Combining PBL with classical teaching methods stimulates students cognitively while opening new vistas with implications on all levels of the profession: management, research, education, and practice. Advanced students can successfully grasp and interpret the current state of clinical practice. They are competent and open to leading change and able to consider the diverse factors and interconnections that characterize the nurse's work.

Keywords: evidence based nursing, critical thinking skills, project based learning, students education

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Authors: Hani Malik

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Background: Clinician burnout is a growing phenomenon in current health systems worldwide. Increasing emotional exhaustion, depersonalisation, and reduced personal accomplishment threaten the effective delivery of healthcare. This can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in clinicians. Objectives: To conduct a scoping review and identify high-quality studies on mindfulness practice in clinician burnout, synthesize themes that emerge from these studies, and discuss the implications of the results to healthcare leadership and innovation. Methodology: A focused scoping review was carried out to investigate the effects of mindfulness practice on clinician burnout. High-ranking journals were targeted to analyse high-quality studies and synthesize common themes in the literature. Studies conducted on current, practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Grey literature and studies conducted only on allied health personnel were excluded from this review. Analysis:31 studies were included in this scoping review. Mindfulness practice was found to decrease emotional exhaustion and depersonalisation while improving mood, responses to stress, and vigour. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged which include: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to clinician mindfulness practice. Conclusion: Mindfulness had widely been reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate clinician leader will play a crucial role in addressing gaps in current practice, prioritise staff mental health, and provide a supportive platform for innovation.

Keywords: mindfulness practice, clinician burnout, healthcare leadership, COVID-19

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Authors: Ahmedou Moulaye Idriss, Tfeil Yahya, Tamas Ungi, Gabor Fichtinger

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Image-guided therapy (IGT) plays a crucial role in minimally invasive procedures for liver interventions. Accurate segmentation of the liver and precise needle placement is essential for successful interventions such as needle aspiration. In this study, we propose a deep learning-based liver 3D slicer designed to enhance segmentation accuracy and facilitate needle aspiration procedures. The developed 3D slicer leverages state-of-the-art convolutional neural networks (CNNs) for automatic liver segmentation in medical images. The CNN model is trained on a diverse dataset of liver images obtained from various imaging modalities, including computed tomography (CT) and magnetic resonance imaging (MRI). The trained model demonstrates robust performance in accurately delineating liver boundaries, even in cases with anatomical variations and pathological conditions. Furthermore, the 3D slicer integrates advanced image registration techniques to ensure accurate alignment of preoperative images with real-time interventional imaging. This alignment enhances the precision of needle placement during aspiration procedures, minimizing the risk of complications and improving overall intervention outcomes. To validate the efficacy of the proposed deep learning-based 3D slicer, a comprehensive evaluation is conducted using a dataset of clinical cases. Quantitative metrics, including the Dice similarity coefficient and Hausdorff distance, are employed to assess the accuracy of liver segmentation. Additionally, the performance of the 3D slicer in guiding needle aspiration procedures is evaluated through simulated and clinical interventions. Preliminary results demonstrate the effectiveness of the developed 3D slicer in achieving accurate liver segmentation and guiding needle aspiration procedures with high precision. The integration of deep learning techniques into the IGT workflow shows great promise for enhancing the efficiency and safety of liver interventions, ultimately contributing to improved patient outcomes.

Keywords: deep learning, liver segmentation, 3D slicer, image guided therapy, needle aspiration

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Authors: Wei-Chieh Yeh, Yung-Tang Shen

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The concept of community building started in 1994 in Taiwan. After years of development, it fostered the notion of active local resident participation in community issues as co-operators, instead of minions. Participatory design gives participants more control in the decision-making process, helps to reduce the friction caused by arguments and assists in bringing different parties to consensus. This results in an increase in the efficiency of projects run in the community. Therefore, the participation of local residents is key to the success of community building. This study applied participatory design to develop plans for the reuse of deserted spaces in the community from the first stage of brainstorming for design ideas, making creative models to be employed later, through to the final stage of construction. After conducting a series of participatory designed activities, it aimed to integrate the different opinions of residents, develop a sense of belonging and reach a consensus. Besides this, it also aimed at building the residents’ awareness of their responsibilities for the environment and related issues of sustainable development. By reviewing relevant literature and understanding the history of related studies, the study formulated a theory. It took the “2012-2014 Changhua County Community Planner Counseling Program” as a case study to investigate the implementation process of participatory design. Research data are collected by document analysis, participants’ observation and in-depth interviews. After examining the three elements of “Design Participation”, “Construction Participation”, and” Follow–up Maintenance Participation” in the case, the study emerged with a promising conclusion: Maintenance works were carried out better compared to common public works. Besides this, maintenance costs were lower. Moreover, the works that residents were involved in were more creative. Most importantly, the community characteristics could be easy be recognized.

Keywords: participatory design, deserted space, community building, reuse

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Authors: Oluwaseun K. Oyebode, Josiah A. Adeyemo

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Hydrological modelling plays a crucial role in the planning and management of water resources, most especially in water stressed regions where the need to effectively manage the available water resources is of critical importance. However, due to the complex, nonlinear and dynamic behaviour of hydro-climatic interactions, achieving reliable modelling of water resource systems and accurate projection of hydrological parameters are extremely challenging. Although a significant number of modelling techniques (process-based and data-driven) have been developed and adopted in that regard, the field of hydrological modelling is still considered as one that has sluggishly progressed over the past decades. This is majorly as a result of the identification of some degree of uncertainty in the methodologies and results of techniques adopted. In recent times, evolutionary computation (EC) techniques have been developed and introduced in response to the search for efficient and reliable means of providing accurate solutions to hydrological related problems. This paper presents a comprehensive review of the underlying principles, methodological needs and applications of a promising evolutionary computation modelling technique – genetic programming (GP). It examines the specific characteristics of the technique which makes it suitable to solving hydrological modelling problems. It discusses the opportunities inherent in the application of GP in water related-studies such as rainfall estimation, rainfall-runoff modelling, streamflow forecasting, sediment transport modelling, water quality modelling and groundwater modelling among others. Furthermore, the means by which such opportunities could be harnessed in the near future are discussed. In all, a case for total embracement of GP and its variants in hydrological modelling studies is made so as to put in place strategies that would translate into achieving meaningful progress as it relates to modelling of water resource systems, and also positively influence decision-making by relevant stakeholders.

Keywords: computational modelling, evolutionary algorithms, genetic programming, hydrological modelling

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Authors: Carlos Alberto Ríos Reyes, Andrés Felipe Mejía Durán, Oscar Mauricio Castellanos Alarcón

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There is no doubt of great importance to make it known that planet Earth is an entity in constant change and transformation; processes such as construction and destruction are part of the evolution of the territory. Geoeducation workshops represent a significant contribution to the search for educational projects focused on teaching relevant geoscience topics to make natural threats known in schools through recreational and didactic activities. This initiative represents an educational alternative that must be developed with the participation of primary and secondary schools, universities, and local communities. The methodology is based on several phases, which include: diagnosis to know the best teaching method for basic concepts and establish a starting point for the topics to be taught, as well as to identify areas and concepts that need to be reinforced and/or deepened; design of activities that involve all students regardless of their ability or level; use of accessible materials and experimentation to support clear and concise explanations for all students; adaptation of the teaching-learning process to individual needs; sensitization about natural threats; and evaluation and feedback. It is expected to offer a series of activities and materials as a significant contribution to the search for educational projects focused on teaching relevant geoscientific topics such as natural threats associated with earthquakes, volcanic eruptions, floods, landslides, etc. The major findings of this study are the pedagogical strategies that primary and secondary school teachers can appropriate to face the challenge of transferring geological knowledge and to advise decision-makers and citizens on the importance of geosciences for daily life. We conclude that the knowledge of the natural threats to our planet is very important to contribute to mitigating their risk.

Keywords: workshops, geoeducation, curriculum, geosciences, natural threats

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Authors: Sonto Maputle

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Background: Support during labour increase women's chances of having positive childbirth experiences as well as childbirth outcomes. The purpose of this study was to determine the support provided by midwives to women during labour at the public hospital in Limpopo Province. The study was conducted at the Tertiary hospital in Limpopo Province. Methods: A qualitative, participant observation approach was used. Population consisted of all women that were admitted to deliver their babies and the midwives who provided midwifery care in the obstetric unit of one tertiary public hospital in Limpopo Province. Non-probability, purposive and convenience sampling were used to sample 24 women and 12 midwives. Data were collected through participant observations which included unstructured conversations with the use of observational guide, field notes of events and conversations that occurred when women interact with midwives were recorded verbatim and a Visual Analog Scale to complement the observations. Data was analysed qualitatively but were presented in the tables and bar graphs. Results: Five themes emerged as support provided by midwives during labour, namely; communication between women and midwives, informational support, emotional support activities, interpretation of the experienced labour pain and supportive care activities during labour. Conclusion: The communication was occurring when the midwife was rendering midwifery care and very limited for empowering. The information sharing focused on the assistive actions rather than on the activities that would promote mothers’ participation. The emotional support activities indicated lack of respect and disregard cultural preferences and this contributed to inability to exercise choices in decision-making. The study recommended the implementation of Batho Pele principles in order to provide woman-centred care during labour.

Keywords: communication between women and midwives, labour pains, informational and emotional support, physical comforting measures

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Authors: Fatima Saab

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This paper attempts to study colloquialism in audio-visual translation, with particular emphasis given to investigating the difficulties and challenges encountered by subtitlers in translating Lebanese colloquial into English. To achieve the main objectives of this study, ample and thorough cultural and translational analysis of examples drawn from the subtitled movie Capernaum are presented in order to identify the strategies used to overcome cultural barriers and differences and to show the process of decision-making by the translator. Also, special attention is given to explain the technicalities in translating subtitles and how they affect the translation process. The research is a descriptive analytical study whereby the writer sets out empirical observations, consisting of descriptive and analytical examination of the difficulties and problems associated with translating Arabic colloquialisms, specifically Lebanese, into English in the subtitled film, Capernaum. The research methodology utilizes a qualitative approach to group the selected data into the subtitling strategies presented by Gottlieb under the domesticating or foreignizing strategies according to Venuti's Model. It is shown that producing the same meanings to a foreign audience is not an easy task. The background of cultural elements and the stories that make up the history and mindset of the Lebanese and Arabic peoples leads to the use of the transfer and paraphrase methodologies most of the time (81% of the sample used for analysis). The research shows that translating and subtitling colloquialism needs special skills by the translators to overcome the challenges imposed by the limited presentation space as well as cultural differences. Translation of colloquial Arabic/Lebanese can be achieved to a certain extent and delivering the meaning and effect of the source language culture is accomplished in as much as the translator investigates and relates to the target culture.

Keywords: Lebanese colloquial, audio-visual translation, subtitling, Capernaum

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Authors: Aditi Taunk, George Iskander, Kitty Ka Kit Ho, Mark Willcox, Naresh Kumar

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Bacterial infections on biomaterial implants and medical devices accounts for 60-70% of all hospital acquired infections (HAIs). Treatment or removal of these infected devices results in high patient mortality and morbidity along with increased hospital expenses. In addition, with no effective strategies currently available and rapid development of antibacterial resistance has made device-related infections extremely difficult to treat. Therefore, in this project we have developed biomaterial surfaces using antibacterial compounds that inhibit biofilm formation by interfering with the bacterial communication mechanism known as quorum sensing (QS). This study focuses on covalent attachment of potent quorum sensing (QS) inhibiting compounds, halogenated furanones (FUs) and dihydropyrrol-2-ones (DHPs), onto glass surfaces. The FUs were attached by photoactivating the azide groups on the surface, and the acid functionalized DHPs were immobilized on amine surface via EDC/NHS coupling. The modified surfaces were tested in vitro against pathogenic organisms such as Staphylococcus aureus and Pseudomonas aeruginosa using confocal laser scanning microscopy (CLSM). Successful attachment of compounds on the substrates was confirmed by X-ray photoelectron spectroscopy (XPS) and contact angle measurements. The antibacterial efficacy was assessed, and significant reduction in bacterial adhesion and biofilm formation was observed on the FU and DHP coated surfaces. The activity of the coating was dependent upon the type of substituent present on the phenyl group of the DHP compound. For example, the ortho-fluorophenyl DHP (DHP-2) exhibited 79% reduction in bacterial adhesion against S. aureus and para-fluorophenyl DHP (DHP-3) exhibited 70% reduction against P. aeruginosa. The results were found to be comparable to DHP coated surfaces prepared in earlier study via Michael addition reaction. FUs and DHPs were able to retain their in vitro antibacterial efficacy after covalent attachment via azide chemistry. This approach is a promising strategy to develop efficient antibacterial biomaterials to reduce device related infections.

Keywords: antibacterial biomaterials, biomedical device-related infections, quorum sensing, surface functionalization

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Authors: Rihab Gamaoun, Cynthia El Hage, Laura Ruiz, Erin Prosk, Antonio Vigano

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Introduction: Santé Cannabis (SC), a Canadian medical cannabis-specialized group of clinics based in Montreal and in the province of Québec, has served more than 5000 patients seeking cannabis-based treatment prescription for medical indications over the past five years. Within a research frame, data on the use of medical cannabis products from all the above patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to gather information on the profiles of both patients and prescribed medical cannabis products at SC clinics and to assess the safety of medical cannabis among Canadian patients. Methods: Using a retrospective analysis of the database, records of 2585 patients who were prescribed medical cannabis products for therapeutic purposes between 01-November 2017 and 04-September 2019 were included. Patients’ demographics, primary diagnosis, route of administration, and chemovars recorded at the initial visits were investigated. Results: At baseline: 9% of SC patients were female, with a mean age of 57 (SD= 15.8, range= [18-96]); Cannabis products were prescribed mainly for patients with a diagnosis of chronic pain (65.9% of patients), cancer (9.4%), neurological disorders (6.5%), mood disorders (5.8 %) and inflammatory diseases (4.1%). Route of administration and chemovars of prescribed cannabis products were the following: 96% of patients received cannabis oil (51% CBD rich, 42.5% CBD:THC); 32.1% dried cannabis (21.3% CBD:THC, 7.4% THC rich, 3.4 CBD rich), and 2.1% oral spray cannabis (1.1% CBD:THC, 0.8% CBD rich, 0.2% THC rich). Most patients were prescribed simultaneously, a combination of products with different administration routes and chemovars. Safety analysis is undergoing. Conclusion: Our results provided initial information on the profile of medical cannabis products prescribed in a Canadian population and the experienced adverse events over the past three years. The Santé Cannabis database represents a unique opportunity for comparing clinical practices in prescribing and titrating cannabis-based medications across different centers. Ultimately real-world data, including information about safety and effectiveness, will help to create standardized and validated guidelines for choosing dose, route of administration, and chemovars types for the cannabis-based medication in different diseases and indications.

Keywords: medical cannabis, real-world data, safety, pharmacovigilance

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Authors: Abhay Asthana, Shally Toshkhani, Gyati Shilakari

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The objective of the present research work is to develop a topical biodegradable dermal patch based formulation to aid accelerated wound healing. It is always better for patient compliance to be able to reduce the frequency of dressings with improved drug delivery and overall therapeutic efficacy. In present study optimized formulation using biodegradable components was obtained evaluating polymers and excipients (HPMC K4M, Ethylcellulose, Povidone, Polyethylene glycol and Gelatin) to impart significant folding endurance, elasticity, and strength. Molten gelatin was used to get a mixture using ethylene glycol. Chitosan dissolved in acidic medium was mixed with stirring to Gelatin mixture. With continued stirring to the mixture Curcumin was added with the aid of DCM and Methanol in an optimized ratio of 60:40 to get homogenous dispersion. Polymers were dispersed with stirring in the final formulation. The mixture was sonicated casted to get the film form. All steps were carried out under strict aseptic conditions. The final formulation was a thin uniformly smooth textured film with dark brown-yellow color. The film was found to have folding endurance was around 20 to 21 times without a crack in an optimized formulation at RT (23°C). The drug content was in range 96 to 102% and it passed the content uniform test. The final moisture content of the optimized formulation film was NMT 9.0%. The films passed stability study conducted at refrigerated conditions (4±0.2°C) and at room temperature (23 ± 2°C) for 30 days. Further, the drug content and texture remained undisturbed with stability study conducted at RT 23±2°C for 45 and 90 days. Percentage cumulative drug release was found to be 80% in 12h and matched the biodegradation rate as tested in vivo with correlation factor R2>0.9. In in vivo study administration of one dose in equivalent quantity per 2 days was applied topically. The data demonstrated a significant improvement with percentage wound contraction in contrast to control and plain drug respectively in given period. The film based formulation developed shows promising results in terms of stability and in vivo performance.

Keywords: wound healing, biodegradable, polymers, patch

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Authors: Vijaya Madhuri Devraj, Swarnalatha Guditi, Kiran Kumar Bokara, Gangadhar Taduri

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Cell-based strategies may open therapeutic approaches that promote tolerance through manipulation of macrophages to increase long-term transplant survival rates and minimize side effects of the current immune suppressive regimens. The aim of the present study was, therefore, to test and compare the therapeutic potential of MSC and Tregs on macrophage polarization to develop an alternate cell-based treatment option in kidney transplantation. In the current protocol, macrophages from kidney transplant recipients with graft dysfunction were co-cultured with MSCs and Treg cells with and without cell-cell contact on transwell plates, further to quantitatively assess macrophage polarization in response to MSC and Treg treatment over time, M1 and M2 cell surface markers were used. Additionally, multiple soluble analytes were analyzed in cell supernatant by using bead-based immunoassays. Furthermore, to confirm our findings, gene expression analysis was done. MSCs induced the formation of M2 macrophages more than Tregs when macrophages M0 were cultured in transwell without cell contact. From this, we deduced the mechanism that soluble factors present in the MSCs condition media are involved in skewing of macrophages towards type 2 macrophages; similarly, in co-culture with cell-cell contact, MSCs resulted in more M2 type macrophages than Tregs. And an important finding of this study is the combination of both MSC-Treg showed significantly effective and consistent results in both with and without cell contact setups. Hence, it is suggestive to prefer MSCs over Tregs for secretome-based therapy and a combination of both for either therapy for effective transplantation outcomes. Our findings underline a key role of Tregs and MSCs in promoting macrophage polarization towards anti-inflammatory type. The study has great importance in prolongation of allograft and patient survival without any rejection by cell-based therapy, which induce self-tolerance and controlling infection.

Keywords: graft rejection, graft tolerance, macrophage polarization, mesenchymal stem cells, regulatory T cells, transplant immunology

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Authors: Dmitry K. Shaytan, Georgy D. Laptev

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In our research we aimed to test a managerial approach for the fuzzy front end (FFE) of innovation by creating controlled experiment/ business case in a breakthrough innovation development. The experiment was in the sport industry and covered all aspects of the customer discovery stage from ideation to prototyping followed by patent application. In the paper we describe and analyze mile stones, tasks, management challenges, decisions made to create the break through innovation, evaluate overall managerial efficiency that was at the considered FFE stage. We set managerial outcome of the FFE stage as a valid product concept in hand. In our paper we introduce hypothetical construct “Q-factor” that helps us in the experiment to distinguish quality of FFE outcomes. The experiment simulated for entrepreneur the FFE of innovation and put on his shoulders responsibility for the outcome of valid product concept. While developing managerial approach to reach the outcome there was a decision to look on product concept from the cognitive psychology and cognitive science point of view. This view helped us to develop the profile of a person whose projection (mental representation) of a new product could optimize for a manager or entrepreneur FFE activities. In the experiment this profile was tested to develop breakthrough innovation for swimmers. Following the managerial approach the product concept was created to help swimmers to feel/sense water. The working prototype was developed to estimate the product concept validity and value added effect for customers. Based on feedback from coachers and swimmers there were strong positive effect that gave high value for customers, and for the experiment – the valid product concept being developed by proposed managerial approach for the FFE. In conclusions there is a suggestion of managerial approach that was derived from experiment.

Keywords: concept development, concept testing, customer discovery, entrepreneurship, entrepreneurial management, idea generation, idea screening, startup management

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Authors: María-Dolores Olvera-Lobo, Bryan John Robinson, Juncal Gutierrez-Artacho

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Graduates are equipped with a wide range of generic competencies which complement solid curricular competencies and facilitate their access to the labour market in diverse fields and careers. However, some generic competencies such as instrumental, personal and systemic competencies related to teamwork and interpersonal communication skills, decision-making and organization skills are seldom taught explicitly and even less often assessed. In this context, translator training has embraced a broad range of competencies specified in the undergraduate program currently taught at universities and opens up the learning experience to cover areas often ignored due to the difficulties inherent in both teaching and assessment. In practice, translator training combines two well-established approaches to teaching/learning: project-based learning and genuinely cooperative – or merely collaborative – learning. Our professional approach to translator training is a model focused on and adapted to the teleworking context of professional translation and presented through the medium of blended e-learning. Teamwork-related competencies are extremely relevant, and they require explicit and implicit teaching so that graduates can be confident about their capacity to make their way in professional contexts. In order to highlight the importance of teamwork and intra-team relationships beyond the classroom, we aim to raise awareness of teamwork processes so as to empower translation students in managing their interaction and ensure that they gain valuable pre-professional experience. With these objectives, at the University of Granada (Spain) we have developed a range of classroom activities and assessment tools. The results of their application are summarized in this study.

Keywords: blended learning, collaborative teamwork, cross-curricular competencies, higher education, intra-team relationships, students’ perceptions, translator training

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Authors: Saeideh Soltanmohammadlou, Pilar M Guerrieri, Amir Kianfar, Sara Sadeghian, Yasaman Nafezi, Emily Irvin

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Architecture is rooted in the experiences of the residents in a place. Its foundations are based on needs and circumstances of each territory in terms of climate, available materials, economics and governmental policies, and cultural ideals and ideas of the people that live there. The architectural history of Iran echoes these architectural origins and has revealed certain trends reflecting this territory and culture. However, in recent years, new architectural patterns are developing that diverge from what has previously been considered classic forms of Iranian architecture. This article investigates architectural elements that make up the architecture created by religious minorities after the Safavid dynasty (one of the most significant ruling dynasties of Iran (from 1501 to 1736) in Iranian cities: Isfahan, Tabriz, Kerman, and Uremia. Similarities and differences are revealed between the architecture that composes neighborhoods of religious minorities in Iran and common national architectural trends in each era after this dynasty. This dynasty is specific as a point of reference in this article because Islam was identified as the state religion of Iran during this era. This decision changed the course of architecture in the country to incorporate religious motifs and meanings. The study associated with this article was conducted as a survey that sought to find links between architecture of religious minorities with Iranian national architecture. Interestingly, a merging of architectural forms and trends occur as immigrants interact with Iranian Islamic meanings. These observations are significant within the context of modern architecture around the world and within Western discourse because what are considered religious minorities in Iran are the dominant religions in Western nations. This makes Iran’s architecture particularly unique as it creates a kind of inverse relationship, than that of Western nations, to the ways in which religion influences architectural history.

Keywords: architecture, ethnic architecture, national architecture, religion architecture

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Authors: Jakub Młoźniak, Adam Szymański, Gabriela Stondzik, Dagny Krankowska, Tomasz Mikuła

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Nontuberculous mycobacteria (NTM) are bacterial species that cause diversely manifesting diseases mainly in immunocompromised patients. In people with HIV, NTM infection is an AIDS-defining disease and usually appears when the lymphocyte T CD4 count is below 50 cells/μl. The usage of antiretroviral therapy has decreased the prevalence of NTM among people with HIV, but the disease can still be observed especially among patients with late HIV diagnosis. Common presence in environment, human colonization, clinical similarity with tuberculosis and slow growth on culture makes NTM especially hard to diagnose. The study aimed to analyze the epidemiology and clinical course of NTM among patients with HIV. This study included patients with NTM and HIV admitted to our department between 2017 and 2023. Medical records of patients were analyzed and data on age, sex, median time from HIV diagnosis to identification of NTM infection, median CD4 count at NTM diagnosis, methods of determining NTM infection, type of species of mycobacteria identified, clinical symptoms and treatment course were gathered. Twenty-four patients (20 men, 4 women) with identified NTM were included in this study. Among them, 20 were HIV late presenters. The patients' median age was 40. The main symptoms which patients presented were fever, weight loss and cough. Pulmonary disease confirmed with positive cultures from sputum/bronchoalveolar lavage was present in 18 patients. M. avium was the most common species identified. M. marinum caused disseminated skin lesions in 1 patient. Out of all, 5 people were not treated for NTM caused by lack of symptoms and suspicion of colonization with mycobacterium. Concomitant tuberculosis was present in 6 patients. The median diagnostic time from HIV to NTM infections was 3.5 months. The median CD4 count at NTM identification was 69.5 cells/μl. Median NTM treatment time was 16 months but 7 patients haven’t finished their treatment yet. The most commonly used medications were ethambutol and clarithromycin. Among analyzed patients, 4 of them have died. NTM infections are still an important disease among patients who are HIV late presenters. This disease should be taken into consideration during the differential diagnosis of fever, weight loss and cough in people with HIV with lymphocyte T CD4 count <100 cells/μl. Presence of tuberculosis does not exclude nontuberculous mycobacterium coinfection.

Keywords: mycobacteriosis, HIV, late presenter, epidemiology

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Authors: Philippa Hunter

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How might history education support teachers and students to see the past as a provocation, be open to possible futures, and act differently? As teacher educators in an age of diversity and uncertainty, we need to question history’s curriculum nature, pedagogy, and policy intent. The cultural politics of history’s identity in the senior secondary curriculum influences educational socialization (disciplinary, professional, research) and engagement with curriculum decision-making. This paper reflects on curriculum disturbance that shaped a critical pedagogy stance to problematize school history’s certainties. The context is situated in an Aotearoa New Zealand university-based initial teacher education programme. A pedagogic innovation was activated whereby problematized history pedagogy [PHP] was conceptualized as the phenomenon and method of inquiry and storied in doctoral work. The PHP was a reciprocal research process involving history class’ participants and the teacher as researcher, in fashioning teaching identities, identifying with, and thinking critically about history pedagogy. PHP findings revealed evocative discourses of embodiment, nostalgia, and connectedness about living ‘inside the past’. Participants expressed certainty about their abilities as teachers living ‘outside the past’ to interpret historical perspectives. However, discomfort was evident in relation to ‘difficult knowledge’ or unfamiliar contexts of the past that exposed exclusion, powerlessness, or silenced voices. Participants identified history programmes as strongly masculine and conflict-focused. A normalized inquiry-transmission approach to history pedagogy was identified and critiqued. Individuals’ reflexive accounts of PHP implemented whilst on practicum indicate possibilities of history pedagogy as; inclusive and democratic, social and ethical reconstruction, and as a critical project. The PHP sought to reimagine history curriculum and identify spaces of possibility in secondary postgraduate teacher education.

Keywords: curriculum, pedagogy, problematise, reciprocal

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Authors: S. B. D. Samarasinghe, Malini Herath

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Participatory planning is a very important process for decision making and choosing the best alternative options for community welfare, development of the society and its interactions among community and professionals. People’s involvement is considered as the key guidance in participatory planning. Presently, Participatory planning is being used in many fields. It's not only limited to planning but also to disaster management, poverty, housing, etc. In the past, Disaster management practice was a top-down approach, but it raised many issues as it was converted to a bottom-up approach. There are several approaches that can aid disaster management. Community-Based Disaster Risk Management (CBDRM) is a very successful participatory approach to risk management that is often successfully applied by other disaster-prone countries. In the local context, CBDRM has been applied to prevent Diseases as well as to prevent disasters such as landslides, tsunamis and floods. From three years before, Sri Lanka has initiated the CBDRM approach to minimize landslide vulnerability. Hence, this study mainly focuses on the impact of CBDRM approaches on landslide hazards. Also to identify their successes and failures from both implementing parties and community. This research is carried out based on a qualitative method combined with a descriptive research approach. A successful framework was prepared via a literature review. Case studies were selected considering landslide CBDRM programs which were implemented by Disaster Management Center and National Building Research Organization in Badulla. Their processes were evaluated. Data collection is done through interviews and informal discussions. Then their ideas were quantified by using the Relative Effectiveness index. The resulting numerical value was used to rank the program effectiveness and their success, failures and impacting factors. Results show that there are several failures among implementing parties and the community. Overcoming those factors can make way for better conduction of future CBDRM programs.

Keywords: community-based disaster risk management, disaster management, preparedness, landslide

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Authors: Dagmawit Tewahido

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Purpose: This qualitative study was conducted to explore social norms around adolescent girls’ marriage practices in West Hararghe, Ethiopia, where early marriage is prohibited by law. Methods: Twenty Focus Group Discussions were conducted with Married and Unmarried adolescent girls, adolescent boys and parents of girls using locally developed vignettes. A total of 32 in-depth interviews were conducted with married and unmarried adolescent girls, husbands of adolescent girls and mothers-in-law. Key informant interviews were conducted with 36 district officials. Data analysis was assisted by Open Code computer software. The Social Norms Analysis Plot (SNAP) framework developed by CARE guided the development and analysis of vignettes. A thematic data analysis approach was utilized to summarize the data. Results: Early marriage is seen as a positive phenomenon in our study context, and girls who are not married by the perceived ideal age of 15 are socially sanctioned. They are particularly influenced by their peers to marry. Marrying early is considered a chance given by God and a symbol of good luck. The two common types of marriage are decided: 1) by adolescent girl and boy themselves without seeking parental permission (’Jalaa-deemaa’- meaning ‘to go along’), and 2) by just informing girl’s parents (‘Cabsaa’- meaning ‘to break the culture’). Relatives and marriage brokers also arrange early marriages. Girls usually accept the first marriage proposal regardless of their age. Parents generally tend not to oppose marriage arrangements chosen by their daughters. Conclusions: In the study context social norms encourage early marriage despite the existence of a law prohibiting marriage before the age of eighteen years. Early marriage commonly happens through consensual arrangements between adolescent girls and boys. Interventions to reduce early marriage need to consider the influence of Reference Groups on the decision makers for marriages, especially girls’ own peers.

Keywords: adolescent girls, social norms, early marriage, Ethiopia

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Authors: D. Naranchimeg, G. Ulziisaikhan

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Student dropout problem has not been recently investigated within the Mongolian higher education. A student dropping out is a personal decision, but it may cause unemployment and other social problems including low quality of life because students who are not completed a degree cannot find better-paid jobs. The research aims to determine percentage of at-risk students, and understand reasons for dropouts and to find a way to predict. The study based on the students of the Mongolian National University of Education including its Arkhangai branch school, National University of Mongolia, Mongolian University of Life Sciences, Mongolian University of Science and Technology, Mongolian National University of Medical Science, Ikh Zasag International University, and Dornod University. We conducted the paper survey by method of random sampling and have surveyed about 100 students per university. The margin of error - 4 %, confidence level -90%, and sample size was 846, but we excluded 56 students from this study. Causes for exclusion were missing data on the questionnaire. The survey has totally 17 questions, 4 of which was demographic questions. The survey shows that 1.4% of the students always thought to dropout whereas 61.8% of them thought sometimes. Also, results of the research suggest that students’ dropouts from university do not have relationships with their sex, marital and social status, and peer and faculty climate, whereas it slightly depends on their chosen specialization. Finally, the paper presents the reasons for dropping out provided by the students. The main two reasons for dropouts are personal reasons related with choosing wrong study program, not liking the course they had chosen (50.38%), and financial difficulties (42.66%). These findings reveal the importance of early prevention of dropout where possible, combined with increased attention to high school students in choosing right for them study program, and targeted financial support for those who are at risk.

Keywords: at risk students, dropout, faculty climate, Mongolian universities, peer climate

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Authors: Aynura Valiyeva, Basil John Thomas

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Intra-firm communication is critical for building synergy amongst internal business units of a firm, where employees from various functional departments and ranks incorporate their decision-making, understanding of organizational objectives, as well as common norms and culture for better organizational effectiveness. This study builds on and assesses a framework of the causes and consequences of effective communication in business interactions between customer and supplier firms, and the path for efficient communication within a firm. The proposed study’s structural equation modeling (SEM) analysis based on 352 sample responses collected from firm representatives at different job positions ranging from marketing to logistics operations, reveals that, in the frame of reference of intra-organizational communication, organization characteristics and shared values, top management support and style of leadership, as well as information technology, are all significantly related to communication effectiveness. Furthermore, the frequency and variety of interactions enhance the outcome of communication, that improves a company’s performance. The results reveal that cultural factors are significantly related to communication effectiveness, as well as the shared beliefs and goals. In terms of organizational factors, leadership style, top management support and information technology are significant determinants of effective communication. Among the contextual factors, interaction frequency and diversity are found to be priority factors. This study also tests the relationship between supplier and supplier firm performance in the context of communication effectiveness, and finds that they are closely related, when trust and commitment is built between business partners. When firms do business in other multicultural contexts, language and shared values with destination country must be considered significant elements of communication process.

Keywords: business performance, intra-firm communication, inter-firm communication, structural equation modeling

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