Search results for: patient communication

Authors: M. B. Ricardo De Oliveira, A. Borghi-Silva, L. Di Thommazo, D. Braatz

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Prototypes can be understood as representations of a product concept. Furthermore, prototyping consists in an important stage in product development and results in better team communication, decision making, testing and problem solving through feedback. Although there are several methods of prototyping suggested by recent studies for designers to choose from, some methods present different advantages, such as cost and time reduction, performance and fidelity, which should be taken in account during a product development project. In this multidisciplinary study, involving areas of physiotherapy, engineering and computer science (hardware and software), we compared four developed prototypes of an ergometric step: a virtual prototype, a 3D printed prototype, a bricolage prototype and a prototype manufactured by a third-party company. These prototypes were evaluated in a comparative-qualitative approach for their contribution to the concept’s maturation of the product, the different prototyping methods used and the advantages and disadvantages of each one based on the product’s design specifications (performance, safety, materials, cost, maintenance, usability, ergonomics and portability). Our results indicated that despite prototypes show overall advantages, all of them have limitations, thus being crucial to have different methods of testing and interacting with the product. Additionally, virtual and 3D printed prototypes were essential at early stages of the project due to their low-cost and high-fidelity representation of the product, while the prototype manufactured by a third-party company and bricolage prototype introduced functional tests in real scenarios, allowing more detailed evaluations. This study also resulted in a patent for an ergometric step.

Keywords: Product Design, Product Development, Prototypes, Step

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Authors: Daniela Magalhaes, Jorge Pedro, Pedro Souteiro, Joao S. Neves, Sofia Castro-Oliveira, Vanessa Guerreiro, Rita Bettencourt- Silva, Maria M. Costa, Ana Varela, Joana Queiros, Paula Freitas, Davide Carvalho

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Introduction: Obesity is an independent risk factor for renal dysfunction. Our aims were: (1) evaluate the impact of bariatric surgery (BS) on renal function; (2) clarify the factors determining the postoperative evolution of the glomerular filtration rate (GFR); (3) access the occurrence of oxalate-mediated renal complications. Methods: We investigated a cohort of 1448 obese patients who underwent bariatric surgery. Those with basal GFR (GFR0) < 30mL/min or without information about the GFR 2-year post-surgery (GFR2) were excluded. Results: We included 725 patients, of whom 647 (89.2%) women, with 41 (IQR 34-51) years, a median weight of 112.4 (IQR 103.0-125.0) kg and a median BMI of 43.4 (IQR 40.6-46.9) kg/m2. Of these, 459 (63.3%) performed gastric bypass (RYGB), 144 (19.9%) placed an adjustable gastric band (AGB) and 122 (16.8%) underwent vertical gastrectomy (VG). At 2-year post-surgery, excess weight loss (EWL) was 60.1 (IQR 43.7-72.4) %. There was a significant improve of metabolic and inflammatory status, as well as a significant decrease in the proportion of patients with diabetes, arterial hypertension and dyslipidemia (p < 0.0001). At baseline, 38 (5.2%) of subjects had hyperfiltration with a GFR0 ≥ 125mL/min/1.73m2, 492 (67.9%) had a GFR0 90-124 mL/min/1.73m2, 178 (24.6%) had a GFR0 60-89 mL/min/1.73m2, and 17 (2.3%) had a GFR0 < 60 mL/min/1.73m2. GFR decreased in 63.2% of patients with hyperfiltration (ΔGFR=-2.5±7.6), and increased in 96.6% (ΔGFR=22.2±12.0) and 82.4% (ΔGFR=24.3±30.0) of the subjects with GFR0 60-89 and < 60 mL/min/1.73m2, respectively ( p < 0.0001). This trend was maintained when adjustment was made for the type of surgery performed. Of 321 patients, 10 (3.3%) had a urinary albumin excretion (UAE) > 300 mg/dL (A3), 44 (14.6%) had a UAE 30-300 mg/dL (A2) and 247 (82.1%) has a UAE < 30 mg/dL (A1). Albuminuria decreased after surgery and at 2-year follow-up only 1 (0.3%) patient had A3, 17 (5.6%) had A2 and 283 (94%) had A1 (p < 0,0001). In multivariate analysis, the variables independently associated with ΔGFR were BMI (positively) and fasting plasma glucose (negatively). During the 2-year follow-up, only 57 of the 725 patients had transient urinary excretion of calcium oxalate crystals. None has records of oxalate-mediated renal complications at our center. Conclusions: The evolution of GFR after BS seems to depend on the initial renal function, as it decreases in subjects with hyperfiltration, but tends to increase in those with renal dysfunction. Our results suggest that BS is associated with improvement of renal outcomes, without significant increase of renal complications. So, apart the clear benefits in metabolic and inflammatory status, maybe obese adults with nondialysis-dependent CKD should be referred for bariatric surgery evaluation.

Keywords: albuminuria, bariatric surgery, glomerular filtration rate, renal function

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Authors: Lakmini Wijesooriya, Vicki Chalker, Jessica Day, Priyantha Perera, N. P. Sunil-Chandra

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M. pneumoniae has been identified as an etiology for exacerbation of asthma (EQA), although viruses play a major role in EOA. M. pneumoniae infection is treated empirically with macrolides, and its antibiotic sensitivity is not detected routinely. Characterization of the organism by genotyping and determination of macrolide resistance is important epidemiologically as it guides the empiric antibiotic treatment. To date, there is no such characterization of M. pneumoniae performed in Sri Lanka. The present study describes the characterization of M. pneumoniae detected from a child with EOA following a screening of 100 children with EOA. Of the hundred children with EOA, M. pneumoniae was identified only in one child by Real-Time polymerase chain reaction (PCR) test for identifying the community-acquired respiratory distress syndrome (CARDS) toxin nucleotide sequences. The M. pneumoniae identified from this patient underwent detection of macrolide resistance via conventional PCR, amplifying and sequencing the region of the 23S rDNA gene that contains single nucleotide polymorphisms that confer resistance. Genotyping of the isolate was performed via nested Multilocus Sequence Typing (MLST) in which eight (8) housekeeping genes (ppa, pgm, gyrB, gmk, glyA, atpA, arcC, and adk) were amplified via nested PCR followed by gene sequencing and analysis. As per MLST analysis, the M. pneumoniae was identified as sequence type 14 (ST14), and no mutations that confer resistance were detected. Resistance to macrolides in M. pneumoniae is an increasing problem globally. Establishing surveillance systems is the key to informing local prescriptions. In the absence of local surveillance data, antibiotics are started empirically. If the relevant microbiological samples are not obtained before antibiotic therapy, as in most occasions in children, the course of antibiotic is completed without a microbiological diagnosis. This happens more frequently in therapy for M. pneumoniae which is treated with a macrolide in most patients. Hence, it is important to understand the macrolide sensitivity of M. pneumoniae in the setting. The M. pneumoniae detected in the present study was macrolide sensitive. Further studies are needed to examine a larger dataset in Sri Lanka to determine macrolide resistance levels to inform the use of macrolides in children with EOA. The MLST type varies in different geographical settings, and it also provides a clue to the existence of macrolide resistance. The present study enhances the database of the global distribution of different genotypes of M. pneumoniae as this is the first such characterization performed with the increased number of samples to determine macrolide resistance level in Sri Lanka. M. pneumoniae detected from a child with exacerbation of asthma in Sri Lanka was characterized as ST14 by MLST and no mutations that confer resistance were detected.

Keywords: mycoplasma pneumoniae, Sri Lanka, characterization, macrolide resistance

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Authors: Arunima Verma, Padmabati Mondal

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Serotonin-receptor binding plays a key role in several neurological and biological processes, including mood, sleep, hunger, cognition, learning, and memory. In this article, we performed molecular dynamics simulation to examine the key residues that play an essential role in the binding of serotonin to the G-protein-coupled 5-HT₁ᴮ receptor (5-HT₁ᴮ R) via electrostatic interactions. An end-point free energy calculation method (MM-PBSA) determines the stability of the 5-HT1B R due to serotonin binding. The single-point mutation of the polar or charged amino acid residues (Asp129, Thr134) on the binding sites and the calculation of binding free energy validate the importance of these residues in the stability of the serotonin-receptor complex. Principal component analysis indicates the serotonin-bound 5-HT1BR is more stabilized than the apo-receptor in terms of dynamical changes. The difference dynamic cross-correlations map shows the correlation between the transmembrane and mini-Go, which indicates signal transduction happening between mini-Go and the receptor. Allosteric communication reveals the key nodes for signal transduction in 5-HT1BR. These results provide useful insights into the signal transduction pathways and mutagenesis study to regulate the functionality of the complex. The developed protocols can be applied to study local non-covalent interactions and long-range allosteric communications in any protein-ligand system for computer-aided drug design.

Keywords: allostery, CADD, MD simulations, MM-PBSA

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Authors: Nahed Al-Hajeri

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Time and cost is an integral part of every construction plan and can affect each party’s contractual obligations. The performance of both time and cost are usually important to the client and contractor during the project. Almost all construction projects are experiencing time overrun. These time overruns always contributed as expensive to both client and contractor. Construction of any project inside the gathering centers involves complex management skills related to work force, materials, plant, machineries, new technologies etc. It also involves many agencies interdependent on each other like the vendors, structural and functional designers including various types of specialized engineers and it includes support of contractors and specialized contractors. This paper mainly highlights the types of construction delays due to which project suffer time and cost overrun. This paper also speaks about the delay causes and factors that contribute to the construction sequence delay for the oil and gas projects. Construction delay is supposed to be one of the repeated problems in the construction projects and it has an opposing effect on project success in terms of time, cost and quality. Some effective methods are identified to minimize delays in construction projects such as: 1. Site management and supervision, 2. Effective strategic planning, 3. Clear information and communication channel. Our research paper studies the types of delay with some real examples with statistic results and suggests solutions to overcome this problem.

Keywords: non-compensable delay, delays caused by force majeure, compensable delay, delays caused by the owner or the owner’s representative, non-excusable delay, delay caused by the contractor or the contractor’s representative, concurrent delay, delays resulting from two separate causes at the same time

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Authors: Ophir Segal, Daniel Weltsch, Shay Tenenbaum, Ran Thein

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Purpose: Patients with lateral patellar dislocation (LPD) are not always referred to perform an MRI. This might be the case in first time LPD patients without surgical indications or in patients with recurrent LPD who had MRI in previous episodes. Unfortunately, in some cases, there are additional knee pathological findings, which include tearing of the collateral or cruciate ligaments and injury to the tendons or menisci. These findings might be overlooked during the physical examination or masked by nonspecific clinical findings like knee pain, effusion, or hemarthrosis. The prevalence of these findings, which can be revealed by MRI, is misreported in literature and is considered rare. In our practice, all patients with LPD are sent for MRI after LPD. Therefore, we have designed a retrospective comparative study to evaluate the prevalence of additional pathological findings in patients with acute traumatic LPD that had performed MRI, comparing different groups of patients according to age, sex, and Tibial Tuberosity-Trochlear Groove(TT-TG) distance. Methods: MRI of the knee in patients after traumatic LPD were evaluated for the presence of additional pathological findings such as injuries to ligaments: Anterior/Posterior cruciate ligament(ACL, PCL), Medial/Lateral collateral ligament(MCL, LCL), injuries to tendons(QUADICEPS, PATELLAR), menisci(Medial/Lateral meniscus(MM, LM)) and tibial plateau, by a fellowship-trained, senior musculoskeletal radiologist. A comparison between different groups of patients was performed according to age (age group < 25 years, age group > 25 years), sex (Male/Female group), and TT-TG distance (TT-TG<15 groups, TT-TG>15 groups). A descriptive and comparative statistical analysis was performed. Results: 150 patients were included in this study. All suffered from LPD between the years 2012-2017 (mean age 21.3( ± SD 8.9), 86 males). ACL, PCL, MCL, and LCL complete or partial tears were found in 17(11.3%), 3(2%), 22(14.6%), and 4(2.7%) of the patients, respectively. MM and LM tears were found in 10(6.7%) and 3(2%) of the patients, respectively. A higher prevalence of PCL injury, MM tear, and LM tear were found in the older age group compared to the younger group of patients (10.5% vs. 1.8%, 18.4% vs. 2.7%, and 7.9% vs. 0%, respectively, p<0.05). A higher prevalence of non-displaced MM tear and LCL injury was found in the male group compared to the female group (8.1% vs. 0% and 8.1% vs. 0% respectively, p<0.05). A higher prevalence of ACL injury was found in the normal TT-TG group compared to the pathologic TT-TG group (17.5% vs. 2.3%, p= 0.0184). Conclusions: Overall, 43 out of 150 (28.7%) of the patient's MRI’s were positive for additional pathological radiological findings. Interestingly, a higher prevalence of additional pathologies was found in the groups of patients with a lower risk for recurrent LPD, including males, patients older than 25, and patients with TT-TG lower than 15mm, and therefore might not be referred for an MRI scan. Thus, we recommend a strict physical examination, awareness to the high prevalence of additional pathological findings, and to consider performing an MRI in all patients after LPD.

Keywords: additional findings, lateral patellar dislocation (LPD), MRI scan, traumatic patellar dislocation, cruciate ligaments injuries, menisci injuries, collateral ligaments injuries

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Authors: Nadhifah A. Nugraha, Dida D. Damayanti, Widia Juliani

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Airplanes manufacturing is growing along with the increasing demand from consumers. The helicopter's tail called Tailboom is a product of the helicopter division at XYZ Corp, where the Tailboom assembly line is a pull system. Based on observations of existing conditions that occur at XYZ Corp, production is still unable to meet the demands of consumers; lead time occurs greater than the plan agreed upon by the consumers. In the assembly process, each work station experiences a lack of parts and components needed to assemble components. This happens because of the delay in getting the required part information, and there is no warning about the availability of parts needed, it makes some parts unavailable in assembly warehouse. The lack of parts and components from the previous work station causes the assembly process to stop, and the assembly line also stops at the next station. In its completion, the production time was late and not on the schedule. In resolving these problems, the controlling process is needed, which is controlling the assembly line to get all components and subassembly in the right amount and at the right time. This study applies one of Just In Time tools, namely Kanban and automation, should be added as efficiently and effectively communication line becomes electronic Kanban. The problem can be solved by reducing non-value added time, such as waiting time and idle time. The proposed results of controlling the assembly line of Tailboom result in a smooth assembly line without waiting, reduced lead time, and achieving production time according to the schedule agreed with the consumers.

Keywords: kanban, e-Kanban, lead time, pull system

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Authors: Boon Yih Mah

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Web-based Cognitive Writing Instruction (WeCWI)’s contribution towards language development can be divided into linguistic and non-linguistic perspectives. In linguistic perspective, WeCWI focuses on the literacy and language discoveries, while the cognitive and psychological discoveries are the hubs in non-linguistic perspective. In linguistic perspective, WeCWI draws attention to free reading and enterprises, which are supported by the language acquisition theories. Besides, the adoption of process genre approach as a hybrid guided writing approach fosters literacy development. Literacy and language developments are interconnected in the communication process; hence, WeCWI encourages meaningful discussion based on the interactionist theory that involves input, negotiation, output, and interactional feedback. Rooted in the e-learning interaction-based model, WeCWI promotes online discussion via synchronous and asynchronous communications, which allows interactions happened among the learners, instructor, and digital content. In non-linguistic perspective, WeCWI highlights on the contribution of reading, discussion, and writing towards cognitive development. Based on the inquiry models, learners’ critical thinking is fostered during information exploration process through interaction and questioning. Lastly, to lower writing anxiety, WeCWI develops the instructional tool with supportive features to facilitate the writing process. To bring a positive user experience to the learner, WeCWI aims to create the instructional tool with different interface designs based on two different types of perceptual learning style.

Keywords: WeCWI, literacy discovery, language discovery, cognitive discovery, psychological discovery

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Authors: Jalal Khan, Daniyal Ali Sehrai, Shakeel Ahmad

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This paper presents the design and performance evaluation of multiband metamaterial based antenna operating in the 3.6 GHz (4G), 14.33 GHz, and 28.86 GHz (5G) frequency bands, for future mobile and handheld devices. The radiating element of the proposed design is made up of a conductive material supported by a 1.524 mm thicker Rogers-4003 substrate, having a relative dielectric constant and loss tangent of 3.55 and 0.0027, respectively. The substrate is backed by truncated ground plane. The future mobile communication system is based on higher frequencies, which are highly affected by the atmospheric conditions. Therefore, to overcome the path loss problem, essential enhancements and improvements must be made in the overall performance of the antenna. The traditional ground plane does not provide the in-phase reflection and surface wave suppression due to which side and back lobes are produced. This will affect the antenna performance in terms of gain and efficiency. To enhance the overall performance of the antenna, a metamaterial acting as a high impedance surface (HIS) is used as a reflector in the proposed design. The simulated gain of the metamaterial based antenna is enhanced from {2.76-6.47, 4.83-6.71 and 7.52-7.73} dB at 3.6, 14.33 and 28.89 GHz, respectively relative to the gain of the antenna backed by a traditional ground plane. The proposed antenna radiated efficiently with a radiated efficiency (>85 %) in all the three frequency bands with and without metamaterial surface. The total volume of the antenna is (L x W x h=45 x 40 x 1.524) mm³. The antenna can be potentially used for wireless handheld devices and mobile terminal. All the simulations have been performed using the Computer Simulation Technology (CST) software.

Keywords: CST MWS, fourth generation/fifth generation, 4G/5G, high gain, multiband, metamaterial

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Authors: Vishwanath Pethri Kamath, Jayantha Gowda Sarapanahalli, Vishal Mishra, Siddhesh Balwant Bandgar

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Recognition of emotional information is essential in any form of communication. Growing HCI (Human-Computer Interaction) in recent times indicates the importance of understanding of emotions expressed and becomes crucial for improving the system or the interaction itself. In this research work, textual data for emotion recognition is used. The text being the least expressive amongst the multimodal resources poses various challenges such as contextual information and also sequential nature of the language construction. In this research work, the proposal is made for a neural architecture to resolve not less than 8 emotions from textual data sources derived from multiple datasets using google pre-trained word2vec word embeddings and a Multi-head attention-based bidirectional LSTM model with a one-vs-all Multi-Level Classification. The emotions targeted in this research are Anger, Disgust, Fear, Guilt, Joy, Sadness, Shame, and Surprise. Textual data from multiple datasets were used for this research work such as ISEAR, Go Emotions, Affect datasets for creating the emotions’ dataset. Data samples overlap or conflicts were considered with careful preprocessing. Our results show a significant improvement with the modeling architecture and as good as 10 points improvement in recognizing some emotions.

Keywords: text emotion recognition, bidirectional LSTM, multi-head attention, multi-level classification, google word2vec word embeddings

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Authors: Irene Kretchy, Frances Owusu-Daaku, Samuel Danquah

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Hypertension is the leading risk factor for cardiovascular diseases, and a major cause of death and disability worldwide. This study examined whether psychosocial variables influenced patients’ perception and experience of side effects of their medicines, how they coped with these experiences and the impact on mental health and medication adherence to conventional hypertension therapies. Methods: A hospital-based mixed methods study, using quantitative and qualitative approaches was conducted on hypertensive patients. Participants were asked about side effects, medication adherence, common psychological symptoms, and coping mechanisms with the aid of standard questionnaires. Information from the quantitative phase was analyzed with the Statistical Package for Social Sciences (SPSS) version 20. The interviews from the qualitative study were audio-taped with a digital audio recorder, manually transcribed and analyzed using thematic content analysis. The themes originated from participant interviews a posteriori. Results: The experiences of side effects – such as palpitations, frequent urination, recurrent bouts of hunger, erectile dysfunction, dizziness, cough, physical exhaustion - were categorized as no/low (39.75%), moderate (53.0%) and high (7.25%). Significant relationships between depression (x 2 = 24.21, P < 0.0001), anxiety (x 2 = 42.33, P < 0.0001), stress (x 2 = 39.73, P < 0.0001) and side effects were observed. A logistic regression model using the adjusted results for this association are reported – depression [OR = 1.9 (1.03 – 3.57), p = 0.04], anxiety [OR = 1.5 (1.22 – 1.77), p = < 0.001], and stress [OR = 1.3 (1.02 – 1.71), p = 0.04]. Side effects significantly increased the probability of individuals to be non-adherent [OR = 4.84 (95% CI 1.07 – 1.85), p = 0.04] with social factors, media influences and attitudes of primary caregivers further explaining this relationship. The personal adoption of medication modifying strategies, espousing the use of complementary and alternative treatments, and interventions made by clinicians were the main forms of coping with side effects. Conclusions: Results from this study show that contrary to a biomedical approach, the experience of side effects has biological, social and psychological interrelations. The result offers more support for the need for a multi-disciplinary approach to healthcare where all forms of expertise are incorporated into health provision and patient care. Additionally, medication side effects should be considered as a possible cause of non-adherence among hypertensive patients, thus addressing this problem from a Biopsychosocial perspective in any intervention may improve adherence and invariably control blood pressure.

Keywords: biopsychosocial, hypertension, medication adherence, psychological disorders

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Authors: Leo Latasch, Mario Di Gennaro

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Introduction: The goal of this project was to increase the resilience of the population as well as rescue organizations to make both quality and time-related improvements in handling crises. A helper network was created for this purpose. Methods: Social questions regarding the structure and purpose of helper networks were considered - specifically with regard to helper motivation, the level of commitment and collaboration between populations and agencies. The exchange of information, the coordinated use of volunteers, and the distribution of available resources will be ensured through defined communication and cooperation routines. Helper smartphones will also be used provide a picture of the situation on the ground. Results: The helper network was established and deployed based on the RESIBES information technology system. It consists of a service platform, a web portal and a smartphone app. The service platform is the central element for collaboration between the various rescue organizations, as well as for persons, associations, and companies from the population offering voluntary aid. The platform was used for: Registering helpers and resources and then requesting and assigning it in case of a disaster. These services allow the population's resources to be organized. The service platform also allows for a secure data exchange between services and external systems. Conclusions: The social and technical work priorities have allowed us to cover a full cycle of advance structural work, gaining an overview, damage management, evaluation, and feedback on experiences. This cycle allows experiences gained while handling the crisis to feed back into the cycle and improve preparations and management strategies.

Keywords: coordination, disaster, resilience, volunteers

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Authors: Rubina Shakya, Srijana Dangol, Dil Islam Mansur

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The exposure of constant stress stimuli in our daily lives is causing deterioration of neural connectivity in the brain. Interestingly, the improvement in larger-scale neural communication has been argued to rely on brain rhythms, which might be sensitive to binaural beats of particular frequency bands. The theoretical idea behind neural entrainment is that the rhythmic oscillatory activity within and between different brain regions can enhance cognitive function and mood state. So, we aimed to investigate whether the binaural beats of 40 Hz could enhance the cognition and the mood stability of the medical students at Kathmandu University of age 18-25 years old, which possibly, in the long run, might help to enhance their work productivity. The participants were asked to focus on the auditory stimuli of binaural beats with 200 Hz on the right side and 240 Hz on the left side of the headset for 15 minutes, every alternative day of three consecutive weeks. The Stroop’s test and the Brunel Mood Scale (BRUMS) were applied to assess the cognitive function and the mood state, respectively. The binaural beats significantly decreased the reaction time for the incoherent component of Stroop’s test in both male and female participants. For the mood state, scores of all positive emotions except ‘Calmness’ were significantly increased in the case of males. Whereas, scores of all positive emotions except ‘Vigor’ were significantly increased in the case of females. The results suggested that the meditation aided by binaural beats of 40 Hz helps in improving cognition and mood states to some extent.

Keywords: binaural beats, cognitive function, gamma neural oscillation, mood states

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Authors: Rizky Kertanegara

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Reception studies is one of the cultural studies lately evolved in the realm of communication science. This qualitative study was pioneered by Stuart Hall who initiated the dominant, negotiation, and opposition of audience reading to the text of the media. In its development, this reception studies is developed by Kim Christian Schroder become multidimensional reception studies. In this update, Schroder aware that there has been a bias between readings made by the informant with readings conducted by researchers over the informant. Therefore, he classifies the reception into two dimensions, namely the dimension of reading by informants and implications dimensions conducted by researcher. Using Schroder approach, these studies seek to describe the reception of adolescent girls, as research subjects, to the elements contained sexual openness in the music video Cinta Laura as the object of research. Researcher wanted to see how they interpret the values of Western culture based on the values of their culture as a teenager. Researchers used a descriptive qualitative research method by conducting in-depth interviews to the informants who comes from a religious school. The selection of informants was done by using purposeful sampling. Collaboration with the school, the researchers were able to select informants who could provide rich data related to the topic. The analysis showed that there is permissiveness informants in addressing sexual openness in the music video. In addition, informants from Catholic schools were more open than the informant derived from Islamic schools in accepting the values of sexual openness. This permisiveness is regarded as a form of self-actualization and gender equality.

Keywords: cultural studies, multidimensional reception model, sexual openness, youth audience

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Authors: Gupta Indu

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This paper aims to examine the relationship between foreign direct investment and globalization. Foreign direct investment plays an important role in globalization. It is dramatically increasing in the age of globalization. It has played an important role for economic growth in this global process. It can provide new markets and marketing channels, cheaper production facilities, access to new technology, products to a firm. FDI has come to play a major role in the internationalization of business. FDI has become even more important than trade. Growing liberalization of the national regulatory framework governing investment in enterprises and changes in capital markets profound changes have occurred in the size, scope and methods of FDI. New information technology systems, decline in global communication costs have made management of foreign investments far easier than in the past. FDI provide opportunities to host countries to enhance their economic development and opens new opportunities to home countries to optimize their earnings by employing their ideal resources. Smaller and weaker economies can drive out much local competition. For small and medium sized companies, FDI represents an opportunity to become more actively involved in international business activities. In the past decade, foreign direct investment has expanded its role by change in trade policy, investment policy, tariff liberalization, easing of restrictions on foreign investment and acquisition in many nations, and the deregulation and privatization of many industries. In present competitive scenario, FDI has become a prominent external source of finance for developing countries.

Keywords: foreign direct investment, globalization, economic development, information technology systems new opportunities

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Authors: Silas Webb, Joseph Hartland

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Background: Long-term retention of patients on ART has become a major health challenge in Sub-Saharan Africa (SSA). In 2010 a systematic review of 39 papers found that 30% of patients were no longer taking their ARTs two years after starting treatment. In the same review, it was noted that there was a paucity of data as to why patients become lost to follow-up (LTFU) in SSA. This project was performed in Mulanje Mission Hospital in Malawi as part of Swindon Academy’s Global Health eSSC. The HIV prevalence for Malawi is 10.3%, one of the highest rates in the world, however prevalence soars to 18% in the Mulanje. Therefore it is essential that patients at risk of being LTFU are identified early and managed appropriately to help them continue to participate in the service. Methodology: All patients on adult antiretroviral formulations at MMH, who were classified as ‘defaulters’ (patients missing a scheduled follow up visit by more than two months) over the last 12 months were included in the study. Demographic varibales were collected from Mastercards for data analysis. A comparison group of patients currently not lost to follow up was created by using all of the patients who attended the HIV clinic between 18th-22nd July 2016 who had never defaulted from ART. Data was analysed using the chi squared (χ²) test, as data collected was categorical, with alpha levels set at 0.05. Results: Overall, 136 patients had defaulted from ART over the past 12 months at MMH. Of these, 43 patients had missing Mastercards, so 93 defaulter datasets were analysed. In the comparison group 93 datasets were also analysed and statistical analysis done using Chi-Squared testing. A higher proportion of men in the defaulting group was noted (χ²=0.034) and defaulters tended to be younger (χ²=0.052). 94.6% of patients who defaulted were taking Tenofovir, Lamivudine and Efavirenz, the standard first line ART therapy in Malawi. The mean length of time on ART was 39.0 months (RR: -22.4-100.4) in the defaulters group and 47.3 months (RR: -19.71-114.23) in the control group, with a mean difference of 8.3 less months in the defaulters group (χ ²=0.056). Discussion: The findings in this study echo the literature, however this review expands on that and shows the demographic for the patient at most risk of defaulting and being LTFU would be: a young male who has missed more than 4 doses of ART and is within his first year of treatment. For the hospital, this data is important at it identifies significant areas for public health focus. For instance, fear of disclosure and stigma may be disproportionately affecting younger men, so interventions can be aimed specifically at them to improve their health outcomes. The mean length of time on medication was 8.3 months less in the defaulters group, with a p-value of 0.056, emphasising the need for more intensive follow-up in the early stages of treatment, when patients are at the highest risk of defaulting.

Keywords: anti-retroviral therapy, ART, HIV, lost to follow up, Malawi

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Authors: Bonnie Clough, Tamara Ownsworth, Vladimir Estivill-Castro, Matt Stainer, Rene Hexel, Andrew Bulmer, Wendy Moyle, Allison Waters, David Neumann, Jayke Bennett

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The success of global vaccination programs is reliant on the uptake of vaccines to achieve herd immunity. Yet, many individuals do not obtain vaccines or venipuncture procedures when needed. Whilst health education may be effective for those individuals who are hesitant due to safety or efficacy concerns, for many of these individuals, the primary concern relates to blood or injection fear or phobia (BII). BII is highly prevalent and associated with a range of negative health impacts, both at individual and population levels. Exposure therapy is an efficacious treatment for specific phobias, including BII, but has high patient dropout and low implementation by therapists. Whilst virtual reality approaches exposure therapy may be more acceptable, they have similarly low rates of implementation by therapists and are often difficult to tailor to an individual client’s needs. It was proposed that a piloted robot may be able to adequately facilitate fear induction and be an acceptable approach to exposure therapy. The current study examined fear induction responses, acceptability, and feasibility of a piloted robot for BII exposure. A Nao humanoid robot was programmed to connect with a virtual reality head-mounted display, enabling live streaming and exploration of real environments from a distance. Thirty adult participants with BII fear were randomly assigned to robot-pilot or virtual reality exposure conditions in a laboratory-based fear exposure task. All participants also completed a computer-based two-dimensional exposure task, with an order of conditions counterbalanced across participants. Measures included fear (heart rate variability, galvanic skin response, stress indices, and subjective units of distress), engagement with a feared stimulus (eye gaze: time to first fixation and a total number of fixations), acceptability, and perceived treatment credibility. Preliminary results indicate that fear responses can be adequately induced via a robot-piloted platform. Further results will be discussed, as will implications for the treatment of BII phobia and other fears. It is anticipated that piloted robots may provide a useful platform for facilitating exposure therapy, being more acceptable than in-vivo exposure and more flexible than virtual reality exposure.

Keywords: anxiety, digital mental health, exposure therapy, phobia, robot, virtual reality

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Authors: Saeed Ullah Jan

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This study has examined the e-readiness in libraries of public sector universities in Khyber Pakhtunkhwa. Efforts were made to evaluate the availability of human resources, electronic infrastructure, and network services and programs in the public sector university libraries. The population of the study was the twenty-seven public sector university libraries of Khyber Pakhtunkhwa. A quantitative approach was adopted, and a questionnaire-based survey was conducted to collect data from the librarian/in charge of public sector university libraries. The collected data were analyzed using Statistical Package for Social Sciences version 22 (SPSS). The mean score of the knowledge component interpreted magnitudes below three which indicates that the respondents are poorly or moderately satisfied regards knowledge of libraries. The satisfaction level of the respondents about the other components, such as electronic infrastructure, network services and programs, and enhancers of the networked world, was rated as average or below. The study suggested that major aspects of existing public-sector university libraries require significant transformation. For this purpose, the government should provide all the required resources and facilities to meet the population's informational and recreational demands. The Information Communication Technology (ICT) infrastructure of public university libraries needs improvement in terms of the availability of computer equipment, databases, network servers, multimedia projectors, digital cameras, uninterruptible power supply, scanners, and backup devices such as hard discs and Digital Video Disc/Compact Disc.

Keywords: ICT-libraries, e-readiness-libraries, e-readiness-university libraries, e-readiness-Pakistan

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Authors: B. K. Manjunatha Goud, Aruna Chanu Oinam

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The undergraduate medical curriculum is oriented towards training the students to undertake the responsibilities of a physician. During the training period, adequate emphasis is placed on inculcating logical and scientific habits of thought; clarity of expression and independence of judgment; and ability to collect and analyze information and to correlate them. At Ras Al Khaimah Medical and Health Sciences University (RAKMHSU), Biochemistry a basic medical science subject is taught in the 1st year of 5 years medical course with vertical interdisciplinary interaction with all subjects, which needs to be taught and learned adequately by the students to be related to clinical case or clinical problem in medicine and future diagnostics so that they can practice confidently and skillfully in the community. Based on these facts study was done to know the extent of usage of library resources by the students and the impact of study materials on their preparation for examination. It was a comparative cross sectional study included 100 and 80 1st and 2nd-year students who had successfully completed Biochemistry course. The purpose of the study was explained to all students [participants]. Information was collected on a pre-designed, pre-tested and self-administered questionnaire. The questionnaire was validated by the senior faculties and pre tested on students who were not involved in the study. The study results showed that 80.30% and 93.15% of 1st and 2nd year students have the clear idea of course outline given in course handout or study guide. We also found a statistically significant number of students agreed that they were benefited from the practical session and writing notes in the class hour. A high percentage of students [50% and 62.02%] disagreed that that reading only the handouts is enough for their examination as compared to other students. The study also showed that only 35% and 41% of students visited the library on daily basis for the learning process, around 65% of students were using lecture notes and text books as a tool for learning and to understand the subject and 45% and 53% of students used the library resources (recommended text books) compared to online sources before the examinations. The results presented here show that students perceived that e-learning resources like power point presentations along with text book reading using SQ4R technique had made a positive impact on various aspects of their learning in Biochemistry. The use of library by students has overall positive impact on learning process especially in medical field enhances the outcome, and medical students are better equipped to treat the patient. But it’s also true that use of library use has been in decline which will impact the knowledge aspects and outcome. In conclusion, a student has to be taught how to use the library as learning tool apart from lecture handouts.

Keywords: medical education, learning resources, study guide, biochemistry

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Authors: Munira Al-Azraqi

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Modern South Arabian Languages (MSAL) belong to the Semitic language family and are believed to be either a southern member of the west Semitic branch (Rubin 2010; Moscati et al 1969) or an eastern member of the south Semitic branch (Faber 1997), (Watson 2012). They are six languages which are still spoken in southern Arabia. They are used in Oman, Yemen, Saudi Arabia and in some of the Gulf states. Mehri is one of them however it has the highest number of speakers comparing to the other members of MSAL. It is used in Yemen, Oman, in parts of southern and eastern Saudi Arabia and in some of the Gulf states. The number of Mehri speakers is estimated at between 100,000 and 180,000. The problem that this language might face is that its speakers live in different places which are belonging to different countries. This might cause the language to change rapidly due to education and communication. There are some studies on Omani and Yemeni Mehri but not in Saudi Mehri. In the nineteenth century, travelers, western scholars and explorers played their parts in the discovery of these peoples and their languages. The historical turning point for the knowledge of the MSAL is 1898, when the Südarabische Expedition of the Imperial Academy of Vienna started. The three scholars, Müller, Jahn and Hein began their systematic collection of texts, which were later studied grammatically and lexically by Bittner (1908-1917), Jahn (1915), Leslau (1938) and Wagner (1953). Saudi Mehri has not been studied. This might be caused by the lack of information or the difficulty in collecting the data which this paper aims to shed light on.

Keywords: Modern South Arabian, Mehri, Saudi Arabia, endangered languages

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Authors: Lucia Perez, Maria Gaton y Santa Palella

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Starting from the etymology of the word culture, the Latin term ‘colere’, whose meaning is to cultivate, we understand that the society that cultivates its knowledge is laying the foundations for new possibilities. In this sense, art and fashion contain the same attributes: concept, aesthetic principles, and refined techniques. Both play a crucial role, communication, and this implies a sense of community, relationship with tradition, and innovation. This is the mirror in which to contemplate, but also the space that helps to grow. This is the framework where our object of study opens up: the anthropological management or the mission management model applied to fashion exhibitions in museums and cultural institutions. For this purpose, a bibliographic review has been carried out with its subsequent analysis, a case study of three successful exhibitions: ‘Christian Dior: designer of dreams’, ‘Balenciaga and the Spanish painting’, and ‘China: Through the Looking Glass’. The methodology has been completed with interviews focused on the curators. Amongst the results obtained, it is worth highlighting the fundamental role of transcendent leadership, which, in addition to being results-oriented, must align the motivations of the collaborators with the mission. The anthropological management model conceives management as a service, and it is oriented to the interests of the staff and the public, in short, of the person; this is what enables the objectives of effectiveness, efficiency, and social value to be achieved; dimensions, all necessary for the proper development of the mission of the exhibitions. Fashion, understood as art, is at the service of culture, and therefore of the human being, which defines a transcendent mission. We conclude that the profile of an anthropological management model applied to fashion exhibitions in museums is the ideal one to achieve the purpose of these institutions.

Keywords: art, culture, fashion, anthropological model, fashion exhibitions

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Authors: Susan Cardillo

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This research will consider ways to bridge the gap between Computer Science and Media Communications and while doing so create Social Entrepreneurship for student success. New Media, as it has been referred to, is considered content available on-demand through Internet, a digital device, usually containing some kind of interactivity and creative participation. It is the interplay between technology, images, media and communications. The next generation of the newspaper, radio, television, and film students need to have a working knowledge of the technologies that are available for the creation of their work and taught to use this knowledge to create a voice. The work is interdisciplinary; in communications, we understand the necessity of reporting and disseminating information. In documentary film we understand the instructional and historic aspects of media and technology and in the non-profit sector, we see the need for expanding outlets for good. So, the true necessity is to utilize ‘new media’ technologies to advance social causes while reporting information, teaching and creating art. Goals: The goal of this research is to give communications students a better understanding of the technology that is both, currently at their disposal, and on the horizon, so that they can use it in their media, communications and art endeavors to be a voice for their generation. There is no longer a need to be a computer scientist to have a working knowledge of communication technologies and how they will benefit our work. There are many free and easy to use applications available for the creation of interactive communications. Methodology: This is Qualitative-Case Study that puts these ideas into action. There is a survey at the end of the experiment that is qualitative in nature and allows for the participants to share ideas and feelings about the technology and approach.

Keywords: interactive storytelling, web documentary, mass communications, teaching

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Authors: Lito M. Amit, Venecio U. Ultra, Young Woong Song

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The purpose of this study was to document the prevalence and types of work-related health and safety problems among Filipino migrant workers and the link between their migration status and occupational health and safety (OHS) problems. We conducted a survey among 116 Filipino migrant workers who were both legal and undocumented. To assess the various forms of occupational health problems, we utilized the Korean occupational stress scale (KOSS), Nordic musculoskeletal questionnaire (NMQ) and a validated health and safety questionnaire. A focus group discussion (FGD) was also conducted to record relevant information that was limited by the questionnaires. Descriptive data were presented in frequency with percentages, mean, and standard deviation. Chi-square tests and logistic regression analyses were performed to estimate the degree of association between variables (p < 0.05). Among the eight subscales of KOSS, inadequate social support (2.48), organizational injustice (2.57), and lack of reward (2.52) were experienced by workers. There was a 44.83% prevalence of musculoskeletal disorders with arm/elbow having the highest rate, followed by shoulder and low back regions. Inadequate social support and discomfort in organizational climate and overall MSDs prevalence showed significant relationships with migration status (p < 0.05). There was a positive association between migration status and seven items under language and communication. A positive association was seen between migration status and some of the OHS problems of Filipino migrant workers in Korea. Undocumented workers in this study were seen to be more vulnerable to those stressors compared to those employed legally.

Keywords: Filipino workers, migration status, occupational health and safety, undocumented workers

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Authors: Saleh Maina

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There is an on-going debate among intellectuals and scholars of international relations and world politics over the direction which the world is heading particularly in the current era of globalization. On the one hand are adherents to the convergence thesis which is premised on the assumption that global social order is tending toward universalism which could translate into the possible end of the classical state system and the unification of world societies under a single and common ideological dispensation. The convergence thesis is hinged on the globalization process which is gradually reducing world societies into a 'global village'. On the other hand are intellectuals who hold the view that despite advances made in communication technology which appear to threaten the survival of the classical state system. Invariance, as expressed in the survival of the existing state system and the diverse social traditions in world societies, remain a realistic possibility contrary to the conclusions of the convergence thesis. The invariance thesis has been advanced by scholars like Samuel P. Huntington whose work on clash of civilizations suggests that world peace can only be sustained through the co-habitation of diverse civilizations across the world. The purpose of this paper is to examine both sides of the debate with the aim of making a realistic assessment on where world societies are headed, between convergence and invariance. Using the realist theory of international relations as our theoretical premise the paper argues that while there is sufficient ground to predict the future direction of world societies as headed towards some form of convergence, invariance as expressed in the co-existence of diverse civilizations will for a long time remain a major feature of the international system.

Keywords: convergence, invariance, clash of civilization, classical state system, universalism

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Authors: Cetin Arslan, Senol Tayan

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Social media is one of the most important and effective means of social interaction among people in which they create, share and exchange their ideas via photos, videos or voice messages. Although there are lots of communication tools, social media sites are the most prominent ones that allows the users articulate themselves in a matter of seconds all around the world with almost any expenses and thus, they became very popular and widespread after its emergence. As the usage of social media increases, it becomes an effective instrument in social matters. While it is possible to use social media to emphasize basic human rights and protest some failures of any government as in “Arab Spring”, it is also possible to spread propaganda and misinformation just to cause long lasting insurgency, upheaval, turmoil or disorder as an instrument of intervention to internal affairs and state sovereignty by some hostile groups or countries. It is certain that “social media” has positive effects on democracies letting people have chance to express themselves and to organize, but it is also obvious that the misuse of it, is very common that even a five-minute-long video can cause to wage a campaign against a country. Although it looks anti-democratic, when you consider the catastrophic effects of misuse of social media, it is a kind of area that serious precautions are to be taken without limiting democratic rights while allowing constant and perpetual share but preventing the criminal events. This article begins with the current developments in social media and gives some examples on misuse of it. Second part tries to put emphasize on the legal basis that can prevent criminal activities and the upheavals and insurgencies against state security. Last part makes comparison between democratic countries and international organizations’’ actions against such activities and proposes some further actions that are compatible with democratic norms.

Keywords: democracy, disorder, security, Social Media

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Authors: Ali A. Ukasha, Majdi F. Elbireki, Mohammad F. Abdullah

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Data security needed in data transmission, storage, and communication to ensure the security. This paper is divided into two parts. This work interests with the color image which is decomposed into red, green and blue channels. The blue and green channels are compressed using 3-levels discrete wavelet transform. The Arnold transform uses to changes the locations of red image channel pixels as image scrambling process. Then all these channels are encrypted separately using the key image that has same original size and are generating using private keys and modulo operations. Performing the X-OR and modulo operations between the encrypted channels images for image pixel values change purpose. The extracted contours from color images recovery can be obtained with accepted level of distortion using single step parallel contour extraction (SSPCE) method. Experiments have demonstrated that proposed algorithm can fully encrypt 2D Color images and completely reconstructed without any distortion. Also shown that the analyzed algorithm has extremely large security against some attacks like salt and pepper and Jpeg compression. Its proof that the color images can be protected with a higher security level. The presented method has easy hardware implementation and suitable for multimedia protection in real time applications such as wireless networks and mobile phone services.

Keywords: SSPCE method, image compression and salt and peppers attacks, bitplanes decomposition, Arnold transform, color image, wavelet transform, lossless image encryption

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Authors: Jesus Salmeron, Carmen De Vega, Maria Soledad Vicente, Mireia Olabarria, Olaia Martinez

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Dysphagia or difficulty in swallowing affects mostly elder people: 56-78% of the institutionalized and 44% of the hospitalized. Liquid food thickening is a necessary measure in this situation because it reduces the risk of penetration-aspiration. Until now, and as proposed by the American Dietetic Association in 2002, possible consistencies have been categorized in three groups attending to their viscosity: nectar (50-350 mPa•s), honey (350-1750 mPa•s) and pudding (>1750 mPa•s). The adequate viscosity level should be identified for every patient, according to her/his impairment. Nevertheless, a systematic review on dysphagia diet performed recently indicated that there is no evidence to suggest that there is any transition of clinical relevance between the three levels proposed. It was also stated that other physical properties of the bolus (slipperiness, density or cohesiveness, among others) could influence swallowing in affected patients and could contribute to the amount of remaining residue. Texture parameters need to be evaluated as possible alternative to viscosity. The aim of this study was to evaluate the instrumental extrusion-compression test as a possible tool to characterize changes along time in water thickened with various products and in the three theoretical consistencies. Six commercial thickeners were used: NM® (NM), Multi-thick® (M), Nutilis Powder® (Nut), Resource® (R), Thick&Easy® (TE) and Vegenat® (V). All of them with a modified starch base. Only one of them, Nut, also had a 6,4% of gum (guar, tara and xanthan). They were prepared as indicated in the instructions of each product and dispensing the correspondent amount for nectar, honey and pudding consistencies in 300 mL of tap water at 18ºC-20ºC. The mixture was stirred for about 30 s. Once it was homogeneously spread, it was dispensed in 30 mL plastic glasses; always to the same height. Each of these glasses was used as a measuring point. Viscosity was measured using a rotational viscometer (ST-2001, Selecta, Barcelona). Extrusion-compression test was performed using a TA.XT2i texture analyzer (Stable Micro Systems, UK) with a 25 mm diameter cylindrical probe (SMSP/25). Penetration distance was set at 10 mm and a speed of 3 mm/s. Measurements were made at 1, 5, 10, 20, 30, 40, 50 and 60 minutes from the moment samples were mixed. From the force (g)–time (s) curves obtained in the instrumental assays, maximum force peak (F) was chosen a reference parameter. Viscosity (mPa•s) and F (g) showed to be highly correlated and had similar development along time, following time-dependent quadratic models. It was possible to predict viscosity using F as an independent variable, as they were linearly correlated. In conclusion, compression-extrusion test could be an alternative and a useful tool to assess physical characteristics of thickened liquids.

Keywords: compression-extrusion test, dysphagia, texture analyzer, thickener

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Authors: Qasim HamaKhurshid HamaMurad, Normal Mat Jusoh, Uznir Ujang

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The concept of the city with an infrastructure of (information and communication) Technology embraces several definitions depending on the meanings of the word "smart" are (intelligent city, smart city, knowledge city, ubiquitous city, sustainable city, digital city). Many definitions of the city exist, but this chapter explores which one has been universally acknowledged. From literature analysis, it emerges that Smart City is the most used terminologies in literature through the digital database to indicate the smartness of a city. This paper share exploration the research from main seven website digital databases and journal about Smart City from "January 2015 to the February of 2020" to (a) Time research, to examine the causes of the Smart City phenomenon and other concept literature in the last five years (b) Review of words, to see how and where the smart city specification and relation different definition And(c) Geographical research to consider where Smart Cities' greatest concentrations are in the world and are Malaysia has interacting with the smart city, and (d) how many papers published from all Malaysia from 2015 to 2020 about smart citie. Three steps are followed to accomplish the goal. (1)The analysis covered publications Build a systematic literature review search strategy to gather a representative sub-set of papers on Smart City and other definitions utilizing (GoogleScholar, Elsevier, Scopus, ScienceDirect, IEEEXplore, WebofScience, Springer) January2015-February2020. (2)A bibliometric map was formed based on the bibliometric evaluation using the mapping technique VOSviewer to visualize differences. (3)VOSviewer application program was used to build initial clusters. The Map of Bibliometric Visualizes the analytical findings which targeted the word harmony.

Keywords: bibliometric research, smart city, ICT, VOSviewer, urban modernization

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Authors: Marlin Mubarak

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Background: Endometriosis is a complex disabling disease affecting young females in the reproductive period mainly. The aim of this project is to generate a diagnostic model to predict severity and stage of endometriosis prior to Laparoscopic surgery. This will help to improve the pre-operative diagnostic accuracy of stage 3 & 4 endometriosis and as a result, refer relevant women to a specialist centre for complex Laparoscopic surgery. The model is based on the British Society of Gynaecological Endoscopy (BSGE) pain questionnaire, clinical examination and ultrasound scan. Design: This is a prospective, observational, study, in which women completed the BSGE pain questionnaire, a BSGE requirement. Also, as part of the routine preoperative assessment patient had a routine ultrasound scan and when recto-vaginal and deep infiltrating endometriosis was suspected an MRI was performed. Setting: Luton & Dunstable University Hospital. Patients: Symptomatic women (n = 56) scheduled for laparoscopy due to pelvic pain. The age ranged between 17 – 52 years of age (mean 33.8 years, SD 8.7 years). Interventions: None outside the recognised and established endometriosis centre protocol set up by BSGE. Main Outcome Measure(s): Sensitivity and specificity of endometriosis diagnosis predicted by symptoms based on BSGE pain questionnaire, clinical examinations and imaging. Findings: The prevalence of diagnosed endometriosis was calculated to be 76.8% and the prevalence of advanced stage was 55.4%. Deep infiltrating endometriosis in various locations was diagnosed in 32/56 women (57.1%) and some had DIE involving several locations. Logistic regression analysis was performed on 36 clinical variables to create a simple clinical prediction model. After creating the scoring system using variables with P < 0.05, the model was applied to the whole dataset. The sensitivity was 83.87% and specificity 96%. The positive likelihood ratio was 20.97 and the negative likelihood ratio was 0.17, indicating that the model has a good predictive value and could be useful in predicting advanced stage endometriosis. Conclusions: This is a hypothesis-generating project with one operator, but future proposed research would provide validation of the model and establish its usefulness in the general setting. Predictive tools based on such model could help organise the appropriate investigation in clinical practice, reduce risks associated with surgery and improve outcome. It could be of value for future research to standardise the assessment of women presenting with pelvic pain. The model needs further testing in a general setting to assess if the initial results are reproducible.

Keywords: deep endometriosis, endometriosis, minimally invasive, MRI, ultrasound.

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Authors: Do Thi Ha, Khanitta Nuntaboot

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Background: Competency of nurses is vital to safe nursing practice as well as essential component to drive quality of nursing services. There exists little up to date information concerning actual competency among Vietnamese nurses. Purposes: The purpose of this study is to identify the actual nursing competency among nurses in clinical settings in Vietnam. Methods: A qualitative study, ethnographic method, comprised of the participant-observation, in-depth interview, and focus group discussion with multidisciplinary groups of nurses employing in Cho Ray hospital, Vietnam, managers/administrators, nurse teachers, medical doctors, other health care providers, patients and family members which derived from purposeful sampling technique. Content analysis was used for data analysis. Results: Five essential themes of nursing competencies among nurses were identified include (1) knowledge, (2) skills, (3) attitude and value-based nursing practice, (4) legal and ethical competencies, and (5) transcultural competencies. Basic and advanced knowledge were identified as further two dimensions of knowledge. There were five sub themes identified as further dimensions of skills include technical skills, communication skills, organizing and management skills, teamwork and interrelationship, and critical thinking skills. Conclusions: The findings from this study provide valuable information and understanding of the actual competency among nurses in clinical settings in Vietnam. It is expected that this understanding would assist in developing a guide to nursing education and training, nursing practice and relevant policy regulation used for promoting nursing competency among nurses.

Keywords: ethnographic method, nursing competency, qualitative design, Vietnam

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