Search results for: key audit matters

Authors: Alvaro Armenta-Ramade, Arturo Serrano-Santoyo, Veronica Rojas-Mendizabal, Roberto Conte-Galvan

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The availability and affordability of commercial off-the-shell products have brought a major impetus in the development of university projects related to the design, construction and launching of small satellites on a global scale. Universities in emerging economies as well as in least developed countries have been able to develop prototypes of small satellites (cubesats and cansats) with limited budgets. The experience gained in the development of small satellites gives rise to capacity building for designing more complex aerospace systems. This trend has significantly increased the pace and number of aerospace university projects around the world. In the case of Mexico, projects funded by different agencies have been very effective in accelerating the capacity building and technology transfer initiatives in the aerospace ecosystem. However, many of this initiatives have centered their efforts in technology development matters with minimum or no considerations of key regulatory issues related to frequency assignment, management and licensing, as well as launching requirements and measures of mitigation of space debris. These regulatory concerns are fundamental to accomplish successful missions that take into account the complete value chain of an aerospace project. The purpose of this paper is to develop a regulatory framework to support the efforts of educational institutions working on the development of small satellites in Mexico. We base our framework on recommendations from the International Telecommunications Union (ITU), the United Nations Office for Outer Space Affairs (UNOOSA) and other major actors of the Mexican regulatory ecosystem. In order to develop an integrated and cohesive framework, we draw on complexity science to identify the agents, their role and interactions. Our goal is to create a guiding instrument available both in print and online that can also be used in other regions of the world

Keywords: capacity building, complexity science, cubesats, space regulations, small satellites

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Authors: Uche Lucy Onyekwelu, Uche B. Ugwuanyi

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Suffice to say that socio-economic disruptions of any form is likely to affect the wellbeing of the citizenry. The upsurge of social disequilibrium caused by the incessant disruptive tendencies exhibited by youths and some others in Nigeria are not helping matters. In Nigeria the social unrest has caused different forms of draw backs in Socio Economic Development. This study has empirically evaluated the impact of insecurity and insurgency on the Economic Development of Nigeria. The paper noted that the different forms of insecurity in Nigeria are namely: Insurgency and Banditry as witnessed in Northern Nigeria; Militancy: Niger Delta area and self-determination groups pursuing various forms of agenda such as Sit –at- Home Syndrome in the South Eastern Nigeria and other secessionist movements. All these have in one way or the other hampered Economic development in Nigeria. Data for this study were collected through primary and secondary sources using questionnaire and some existing documentations. Cost of investment in different aspects of security outfits in Nigeria represents the independent variable while the differentials in the Gross Domestic Product(GDP) and Human Development Index(HDI) are the measures of the dependent variable. Descriptive statistics and Simple Linear Regression analytical tool were employed in the data analysis. The result revealed that Insurgency/Insecurity negatively affect the economic development of the different parts of Nigeria. Following the findings, a model to analyse the effect of insecurity and insurgency was developed, named INSECUREDEVNIG. It implies that the economic development of Nigeria will continue to deteriorate if insurgency and insecurity continue. The study therefore recommends that the government should do all it could to nurture its human capital, adequately fund the state security apparatus and employ individuals of high integrity to manage the various security outfits in Nigeria. The government should also as a matter of urgency train the security personnel in intelligence cum Information and Communications Technology to enable them ensure the effectiveness of implementation of security policies needed to sustain Gross Domestic Product and Human Capital Index of Nigeria.

Keywords: insecurity, insurgency, gross domestic product, human development index, Nigeria

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Authors: Brian Tung, Yam Wing Siu, Tsun Se Cheong

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Purpose: This research aims to explore how personal and environmental factors, especially the socio-economic changes and behavioral changes fostered by the COVID-19 outbreak pandemic, affect the financial vulnerability of a specific segment of people in financial distress. Innovative research methodology of machine learning will be applied to data collected from over 300 local individuals in Hong Kong seeking counseling or similar services in recent years. Results: First, machine learning has found that too much exposure to digital services and information on digitized services may lead to adverse effects on respondents’ financial vulnerability. Second, the improvement in financial literacy level provides benefits to the financially vulnerable group, especially those respondents who have started with a lower level. Third, serious addiction to digital technology can lead to worsened debt servicing ability. Machine learning also has found a strong correlation between debt servicing situations and income-seeking behavior as well as spending behavior. In addition, if the vulnerable groups are able to make appropriate investments, they can reduce the probability of incurring financial distress. Finally, being too active in borrowing and repayment can result in a higher likelihood of over-indebtedness. Conclusion: Findings can be employed in formulating a better counseling strategy for professionals. Debt counseling services can be more preventive in nature. For example, according to the findings, with a low level of financial literacy, the respondents are prone to overspending and unable to react properly to the e-marketing promotion messages pop-up from digital services or even falling into financial/investment scams. In addition, people with low levels of financial knowledge will benefit from financial education. Therefore, financial education programs could include tech-savvy matters as special features.

Keywords: personal finance, digitization of the economy, COVID-19 pandemic, addiction to digital technology, financial vulnerability

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Authors: Lisa Fox, Jill Aylott

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There is a global need to identify ways to engage doctors in non-clinical matters such as medical leadership, service improvement and health system transformation. Using the core principles of Realistic Evaluation (RE), this study examined what works, for doctors of different grades, specialities and experience in an acute NHS Hospital Trust in the UK. Realistic Evaluation is an alternative to more traditional cause and effect evaluation models and seeks to understand the interdependencies of Context, Mechanism and Outcome proposing that Context (C) + Mechanism (M) = Outcome (O). In this study, the context, mechanism and outcome were examined from within individual medical leaders to determine what enables levels of medical engagement in a specific improvement project to reduce hospital inpatient mortality. Five qualitative case studies were undertaken with consultants who had regularly completed mortality reviews over a six month period. The case studies involved semi-structured interviews to test the theory behind the drivers for medical engagement. The interviews were analysed using a theory-driven thematic analysis to identify CMO configurations to explain what works, for whom and in what circumstances. The findings showed that consultants with a longer length of service became more engaged if there were opportunities to be involved in the beginning of an improvement project, with more opportunities to affect the design. Those that are new to a consultant role were more engaged if they felt able to apply any learning directly into their own settings or if they could use it as an opportunity to understand more about the organisation they are working in. This study concludes that RE is a useful methodology for better understanding the complexities of motivation and consultant engagement in a trust wide service improvement project. The study showed that there should be differentiated and bespoke training programmes to maximise each individual doctor’s propensity for medical engagement. The RE identified that there are different ways to ensure that doctors have the right skills to feel confident in service improvement projects.

Keywords: realistic evaluation, medical leadership, medical engagement, patient safety, service improvement

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Authors: Manvelidze irakli, Iashvili Genadi

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Research has shown that public institutions in Autonomous Republic of Ajara try their best to make their official electronic data (web-pages, social websites) more informative and improve them. Part of public institutions offer interesting electronic services and initiatives to the public although they are seldom used in communication process. The statistical analysis of the use of web-pages and social websites of public institutions for example their facebook page show lack of activity. The reason could be the fact that public institutions give people less possibility of interaction in official web-pages. Second reason could be the fact that these web-pages are less known to the public and the third reason could be the fact that heads of these institutions lack awareness about the necessity of strengthening citizens’ involvement. In order to increase people’s involvement in this process it is necessary to have at least 23 e-services in one web-page. The research has shown that 11 of the 16 public institutions have only 5 services which are contact, social networks and hotline. Besides introducing innovative services government institutions should evaluate them and make them popular and easily accessible for the public. It would be easy to solve this problem if public institutions had concrete strategic plan of public relations which involved matters connected with maximum usage of electronic services while interaction with citizens. For this moment only one governmental body has a functioning action plan of public relations. As a result of the research organizational, social, methodological and technical problems have been revealed. It should be considered that there are many feedback possibilities like forum, RSS, blogs, wiki, twitter, social networks, etc. usage of only one or three of such instruments indicate that there is no strategy of regional electronic governance. It is necessary to develop more mechanisms of feedback which will increase electronic interaction, discussions and it is necessary to introduce the service of online petitions. It is important to reduce the so-called “digital inequality” and increase internet access for the public. State actions should decrease such problems. In the end if such shortcomings will be improved the role of electronic interactions in democratic processes will increase.

Keywords: e-Government, electronic services, information technology, regional government, regional government

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Authors: Nikolett Deutsch, Éva Pintér, Péter Bagó, Miklós Hetényi

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Strategic technology management has emerged and evolved parallelly with strategic management paradigms. It focuses on the opportunity for organizations operating mainly in technology-intensive industries to explore and exploit technological capabilities upon which competitive advantage can be obtained. As strategic technology management involves multifunction within an organization, requires broad and diversified knowledge, and must be developed and implemented with business objectives to enable a firm’s profitability and growth, excellence in strategic technology management provides unique opportunities for organizations in terms of building a successful future. Accordingly, a framework supporting the evaluation of the technological readiness level of management can significantly contribute to developing organizational competitiveness through a better understanding of strategic-level capabilities and deficiencies in operations. In the last decade, several innovation maturity assessment models have appeared and become designated management tools that can serve as references for future practical approaches expected to be used by corporate leaders, strategists, and technology managers to understand and manage technological capabilities and capacities. The aim of this paper is to provide a comprehensive review of the state-of-the-art innovation maturity frameworks, to investigate the critical lessons learned from their application, to identify the similarities and differences among the models, and identify the main aspects and elements valid for the field and critical functions of technology management. To this end, a systematic literature review was carried out considering the relevant papers and articles published in highly ranked international journals around the 27 most widely known innovation maturity models from four relevant digital sources. Key findings suggest that despite the diversity of the given models, there is still room for improvement regarding the common understanding of innovation typologies, the full coverage of innovation capabilities, and the generalist approach to the validation and practical applicability of the structure and content of the models. Furthermore, the paper proposes an initial structure by considering the maturity assessment of the technological capacities and capabilities - i.e., technology identification, technology selection, technology acquisition, technology exploitation, and technology protection - covered by strategic technology management.

Keywords: innovation capabilities, innovation maturity models, technology audit, technology management, technology management maturity models

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Authors: Nur Syahidatul Idany Abdul Ghani, Rahizar Ramli, Jamilah Mohamad, Ahmad Saifizul, Mohamed Rehan Karim

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Increasing fatalities in road accidents in Malaysia over the last 10 years are quite alarming. Based on Malaysian Institute of Road Safety Research (Miros) latest research ‘Predicting Malaysian Road Fatalities for year 2020; it is predicted that road fatalities in Malaysia for 2015 is 8,780 and 10,716 for the year 2020 which 30 percent of fatalities were caused by accidents involving commercial vehicles. Government, related agencies and NGOs have continuously and persistently work to reduce the statistics through enforcement, educating the public, training to drivers, road safety campaigns, advertisements etc. However, the trend of casualties does not show encouraging pattern but instead, steadily growing. Thus, this comparative study reviews the literature pertaining on method of measurement used to evaluate commercial drivers competency. In several studies driving competency has been assessed with different assessment based on the license procedures and requirements according to the country regulation. The assessment criteria that has been establish for commercial drivers generally focus on driving tasks and assessment e.g. theory test, medical test and road assessment rather than driving competency test or physical test. Realizing the importance of specific assessment test for drivers competency this comparative study reviews the most discussed literature related to competency assessment method to identify competency of the drivers include (1. judgement and reaction, 2. skill of drivers, 3. experiences and fatigue). The concluding analysis of this paper is a comparative table for assessment methodology to access driver’s competency. A comparative study is a further discussion reviewing past literature to provide an overview on existing assessment test and potential subject matters that can be identified for further studies to increase awareness of the drivers, passengers as well as the authorities about the importance of competent drivers in order to improve safety in commercial vehicles.

Keywords: commercial vehicles, driver’s competency, specific assessment

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Authors: Mehrdad Ahmadi, Mohamad Babaie, Shiva Osouli, Bahareh Salehi, Nadia Kalantaraian

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The olive fruit fly, Bactrocera oleae Gmelin (Diptera: Tephritidae), is one of the most serious pests in olive orchards in growing province in Iran. The female lay eggs in green olive fruit and larvae hatch inside the fruit, where they feed upon the fruit matters. One of the main ecologically friendly and species-specific systems of pest control is the sterile insect technique (SIT) which is based on the release of large numbers of sterilized insects. The objective of our work was to develop a SIT against B. oleae by using of gamma radiation for the laboratory and field trial in Iran. Oviposition of female mated by irradiated males is one of the main parameters to determine achievement of SIT. To conclude the sterile dose, pupae were placed under 0 to 160 Gy of gamma radiation. The main factor in SIT is the productivity of females which are mated by irradiated males. The emerged adults from irradiated pupae were mated with untreated adults of the same age by confining them inside the transparent cages. The fecundity of the irradiated males mated with non-irradiated females was decreased with the increasing radiation dose level. It was observed that the number of eggs and also the percentage of the egg hatching was significantly (P < 0.05) affected in either IM x NF crosses compared with NM x NF crosses in F₁ generation at all doses. Also, the statistical analysis showed a significant difference (P < 0.05) in the mean number of eggs laid between irradiated and non-irradiated females crossed with irradiated males, which suggests that the males were susceptible to gamma radiation. The egg hatching percentage declined markedly with the increase of the radiation dose of the treated males in mating trials which demonstrated that egg hatch rate was dose dependent. Our results specified that gamma radiation affects the longevity of irradiated B. oleae larvae (established from irradiated pupae) and significantly increased their larval duration. Results show the gamma radiation, and SIT can be used successfully against olive fruit flies.

Keywords: fertility, olive fruit fly, radiation, sterile insect technique

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Authors: Dorsa Moayedi

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‘The Cities’ and Cinema have a history going as far back as silent films; however, the standards of picturing a city in a film are somewhat vague. ‘Genius Loci’ of a city can be easily described with parameters that architects have detected; nevertheless, the genius loci of an ‘urban movie’ is untouched. Cities have been among the provocative matters that pushed filmmakers to ponder upon them and to picture them along with their urban identity thoroughly in their artworks, though the impacts of the urban life on the plot and characters is neglected, and so a city in a movie is usually restricted to ‘the place where the story happens’. Cities and urban life are among those that are in constant change and ongoing expansion; therefore, they are always fresh and ready to challenge people with their existence. Thus, the relationship between the city and cinema is metamorphic, though it could be defined and explored. The dominant research on the idea of urbanism has been conducted by outstanding scholars of architecture, like Christian Norberg-Schulz, and the studies on Cinema have been done by theorists of cinema, like Christian Metz, who have mastered defining their own realm; still, the idea to mingle the domains to reach a unified theory which could be applied to ‘urban movies’ is barely worked on. In this research, we have sought mutual grounds to discuss ‘urbanism in cinema,’ the grounds that cinema could benefit from and get to a more accurate audio-visual representation of a city, in accordance with the ideas of Christopher Alexander and the term he coined ‘The Timeless Way of Building.’ We concentrate on movies that are dependent on urban life, mainly those that possess the names of cities, like ‘Nashville (1975), Manhattan (1979), Fargo (1996), Midnight in Paris (2011) or Roma (2018), according to the ideas of urban design and narratives of cinema. Contrary to what has often been assumed, cinema and architecture could be defined in line with similar parameters, and architectural terms could be applied to the research done on movies. Our findings indicate that the theories of Christopher Alexander can best fit the paradigm to study an ‘Urban Movie’, definitions of a timeless building, elaborate on the characteristics of a design that could be applied to definitions of an urban movie, and set a prototype for further filmmaking regarding the urban life.

Keywords: city, urbanism, urban movies, identity, representation

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Authors: Irena Lucy Ishimora, Eva Maria Putri Salsabila

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The constellation on Indonesian Legal System that varies shows a structural injustice – as a result of patriarchy – exists from the biggest range as a country to the smallest such as a family. Women in their lives, carry out excessive responsibilities in the community. However, the unequal positions between men and women in the society restrain women to fulfill their constructed role. Therefore, increasing the chance for women to become the victim of structural injustice. The lack of authority given to women and its effects can be seen through a case study of the Cirompang Indigenous Women’s involvement in natural resources management. The decision to make the Mount Halimun-Salak as a National Park and the expansion itself did not involve nor consider the existence of indigenous people (Kasepuhan Ciromopang) – especially the women’s experience regarding natural resources management – has been significantly impacting the fulfillment of the indigenous women’s rights. Moreover, the adat law that still reflects patriarchy, made matters worse because women are restricted from expressing their opinion. The writers explored the experience of Cirompang indigenous women through in-depth interviews with them and analyzed it with several theories such as ecofeminism, woman’s access to land and legal pluralism. This paper is important to show how the decision and expansion of the National Park reduced the rights of access to land, natural resources, expressing an opinion, and participating in development. Reflecting on the Cirompang Indigenous Women’s conditions on natural resources management, this paper aims to present the implications of the regulations that do not acknowledge Indigenous women’s experience and the proposed solutions. First, there should be an integration between the law regarding indigenous people and traditional rights in a regulation to align the understanding of indigenous people and their rights. Secondly, Indonesia as a country that’s rich with diversity should ratify the ILO Convention no 169 to reaffirm the protection of Indigenous people’s rights. Last, considering the position of indigenous women that still experienced unjustness in the community, the government and NGOs must collaborate to provide adequate assistance for them.

Keywords: Cirompang indigenous women, indigenous women’s rights, structural injustice, women access to land

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Authors: Abidemi C. Adegboye, Samuel Iweriebor

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The primary link between financial institutions and economic performance is the provision of resources by these institutions to businesses in order to drive enterprise expansion, sustainability, and development. In this study, the role of access to finance in driving innovations and productivity in Nigerian SMEs is investigated using the World Bank Enterprise Survey (ES) dataset. Innovation is defined based on the ES analysis using five compositions including product, method, organisational, use of foreign-licensed technology, and spending on R&D. The study considers finance in terms of source in meeting investment needs and in terms of access. Moreover, finance access is categorized as external and internal to a firm with each having different implications. The research methodology adopted a survey analysis based on the 2014 World Bank Enterprise Survey of 19 states in Nigeria. The survey comprised over 10,000 manufacturing and services firms, both at the small scale and medium scale levels. The logit estimation technique is used to estimate the relationships in the study. The results from the empirical analysis show that in general, access to finance drives SME innovation in Nigeria. In particular, ease of accessing bank loans and credit is shown to be the strongest positive force in driving all types of innovation among SMEs in Nigeria. In the same vein, the type of finance source for investment matters in terms of how it affects innovation: it is shown that both internal and external sources improve investment in product, process, and organisational innovation, but only external financing has effect on R&D spending and use of foreign licensed technology. Overall spending on R&D is only driven by access to external finance by the SMEs. For productivity, the results show that while structure of financing investment improves productivity, increased access to finance may actually lead to productivity decline among SMEs in Nigeria. There is a need for the financial system to evolve structures to increase fund availability to SMEs in Nigeria, especially for the purpose of innovation investment.

Keywords: access to finance, financing investment, innovation, productivity, SMEs

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Authors: Jiun-Horng Tsai, Shi-Jie, Nieh

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Fine particulate matter (PM₂.₅) has become an important issue all over the world over the last decade. Annual mean PM₂.₅ concentration has been over the ambient air quality standard of PM₂.₅ (annual average concentration as 15μg/m³) which adapted by Taiwan Environmental Protection Administration (TEPA). TEPA, therefore, has developed a number of air pollution control measures to improve the ambient concentration by reducing the emissions of primary fine particulate matter and the precursors of secondary PM₂.₅. This study investigated the potential improvement of ambient PM₂.₅ concentration by the TEPA program and the other scenario for further emission reduction on various sources. Four scenarios had been evaluated in this study, including a basic case and three reduction scenarios (A to C). The ambient PM₂.₅ concentration was evaluated by Community Multi-scale Air Quality modelling system (CMAQ) ver. 4.7.1 along with the Weather Research and Forecasting Model (WRF) ver. 3.4.1. The grid resolutions in the modelling work are 81 km × 81 km for domain 1 (covers East Asia), 27 km × 27 km for domain 2 (covers Southeast China and Taiwan), and 9 km × 9 km for domain 3 (covers Taiwan). The result of PM₂.₅ concentration simulation in different regions of Taiwan shows that the annual average concentration of basic case is 24.9 μg/m³, and are 22.6, 18.8, and 11.3 μg/m³, respectively, for scenarios A to C. The annual average concentration of PM₂.₅ would be reduced by 9-55 % for those control scenarios. The result of scenario C (the emissions of precursors reduce to allowance levels) could improve effectively the airborne PM₂.₅ concentration to attain the air quality standard. According to the results of unit precursor reduction contribution, the allowance emissions of PM₂.₅, SOₓ, and NOₓ are 16.8, 39, and 62 thousand tons per year, respectively. In the Kao-Ping air basin, the priority for reducing precursor emissions is PM₂.₅ > NOₓ > SOₓ, whereas the priority for reducing precursor emissions is PM₂.₅ > SOₓ > NOₓ in others area. The result indicates that the target pollutants that need to be reduced in different air basin are different, and the control measures need to be adapted to local conditions.

Keywords: airborne PM₂.₅, community multi-scale air quality modelling system, control measures, weather research and forecasting model

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Authors: Sehrish Qayyum

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Active military power contention is shifting to economic and cyberwar to retain hegemony. Attuned Pestle analysis confirms that structural stress of hegemon’s power loss drives a containment approach towards caging actions. Ongoing diplomatic, asymmetric, proxy and direct wars are increasing stress hegemon’s power retention due to tangled military and economic alliances. It creates the condition of catalepsy with defective reflexive control which affects the core warfare operations. When one’s own power is doubted it gives power to one’s own doubt to ruin all planning either done with superlative cost-benefit analysis. Strategically calculated estimation of Hegemon’s power game since the early WWI to WWII, WWII-to Cold War and then to the current era in three chronological periods exposits that Thucydides’s trap became the reason for war broke out. Thirst for power is the demise of imagination and cooperation for better sense to prevail instead it drives ashes to dust. Pestle analysis is a wide array of evaluation from political and economic to legal dimensions of the state matters. It helps to develop the Pacification and Security Policy Plan (PSPP) to avoid hegemon’s structural stress of power loss in fact, in turn, creates an alliance with maximum amicable outputs. PSPP may serve to regulate and pause the hurricane of power clashes. PSPP along with a strategic work plan is based on Pestle analysis to deal with any conceivable war condition and approach for saving international peace. Getting tangled into self-imposed epistemic dilemmas results in regret that becomes the only option of performance. It is a generic application of probability tests to find the best possible options and conditions to develop PSPP for any adversity possible so far. Innovation in expertise begets innovation in planning and action-plan to serve as a rheostat approach to deal with any plausible power clash.

Keywords: alliance, hegemon, pestle analysis, pacification and security policy plan, security

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Authors: Elisavet Arsenaki

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Paracetamol overdose is associated with significant and possibly permanent consequences including hepatotoxicity, acute and chronic liver failure, and death. This quality improvement project explores the prevalence of accidental iatrogenic paracetamol overdose in hospital patients with a low body weight, defined as <50kg and assesses the impact of educational posters in trying to reduce it. The study included all adult inpatients on the admissions ward, a short stay ward for patients requiring 12-72 hour treatment, and consisted of three cycles. Each cycle consisted of 3 days of data collection in a given month (data collection for cycle 1 occurred in January 2022, February 2022 for cycle 2 and March 2022 for cycle 3). All patients given paracetamol had their prescribed dose checked against their charted weight to identify the percentage of adult inpatients <50kg who were prescribed 1g of paracetamol instead of 500mg. In the first cycle of the audit, data were collected from 83 patients who were prescribed paracetamol on the admissions ward. Subsequently, four A4 educational posters were displayed across the ward, on two separate occasions and with a one-month interval in between each poster display. The aim of this was to remind prescribing doctors of their responsibility to check patient body weight prior to prescribing paracetamol. Data were collected again one week after each round of poster display, from 72 and 70 patients respectively. Over the 3 cycles with a cumulative 225 patients, 15 weighed <50kg (6.67%) and of those, 5 were incorrectly prescribed 1g of paracetamol, yielding a 33.3% prevalence of accidental iatrogenic paracetamol overdose in adult inpatients. In cycle 1 of the project, 3 out of 6 adult patients weighing <50kg were overdosed on paracetamol, meaning that 50% of low weight patients were prescribed the wrong dose of paracetamol for their weight. In the second data collection cycle, 1 out of 5 <50kg patients were overdosed (20%) and in the third cycle, 1 out of 4 (25%). The use of educational posters resulted in a lower prevalence of accidental iatrogenic paracetamol overdose in low body weight adult inpatients. However, the differences observed were statistically insignificant (p value 0.993 and 0.995 respectively). Educational posters did not induce a significant decrease in the prevalence of accidental iatrogenic paracetamol overdose. More robust strategies need to be employed to further decrease paracetamol overdose in patients weighing <50kg.

Keywords: iatrogenic, overdose, paracetamol, patient, safety

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Authors: Brid Dinnee, Jessica Taylor, Joseph Hartland, Michael Natarajan

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Background:The third stage of labour (TSL) can be complicated by Post-Partum Haemorrhage (PPH), which can have a significant impact on maternal mortality and morbidity. In Africa, 33.9% of maternal deaths are attributable to PPH1. In order to minimise this figure, current recommendations for the developing world are that all women have active management of the third stage of labour (AMTSL). The aim of this project was to examine TSL practice in a rural Ugandan Hospital, highlight any deviation from best practice and identify barriers to change in resource limited settings as part of a 4th year medical student External Student Selected Component field trip. Method: Five key elements from the current World Health Organisation (WHO) guidelines on AMTSL were used to develop an audit tool. All daytime vaginal deliveries over a two week period in July 2016 were audited. In addition to this, a retrospective comparison of PPH rates, between 2006 (when ubiquitous use of intramuscular oxytocin for management of TSL was introduced) and 2015 was performed. Results: Eight vaginal deliveries were observed; at all of which intramuscular oxytocin was administered and controlled cord traction used. Against WHO recommendation, all umbilical cords were clamped within one minute, and no infants received early skin-to-skin contact. In only one case was uterine massage performed after placental delivery. A retrospective comparison of data rates identified a 40% reduction in total number of PPHs from November 2006 to November 2015. Maternal deaths per delivery reduced from 2% to 0.5%. Discussion: Maternal mortality and PPH are still major issues in developing countries. Maternal mortality due to PPH can be reduced by good practices regarding TSL, but not all of these are used in low-resource settings. There is a notable difference in outcomes between the developed and developing world. At Kitovu Hospital, there has been a reduction in maternal mortality and number of PPHs following introduction of IM Oxytocin administration. In order to further improve these rates, staff education and further government funding is key.

Keywords: post-partum haemorrhage, PPH, third stage labour, Uganda

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Authors: Liz van Acker, Linda Colley

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Political processes are shaped by the gendered culture of parliaments. This paper examines how the institution of parliament has been affected by the changing number of women in politics. In order to understand how and why gender change occurs, the paper employs a feminist historical institutionalism approach. It argues that while it is difficult to change the gendered nature of political institutions, it is possible, from a gender perspective, to understand the processes of change both formally and informally. Increasing women’s representation has been a slow process which has not occurred without political struggles. A broadly defined ‘feminist historical institutionalism’ has critiqued existing approaches to institutions and combined historical institutional analysis with tools of gender to enhance our understanding of institutional processes and change. The paper examines the gendered rules, norms, and practices that influence institutional design choices and processes. Institutions such as Parliament often are able to adjust to women’s entry and absorb them without too much interruption. Exploring the hidden aspects to informal institutions involves identifying unspoken and accepted norms that may guide decision-making – exposing and questioning the gender status quo. This paper examines the representation of women in the Queensland Parliament, Australia. It places the Queensland experience in historical context, as well as in the national and international context. The study is interesting, given that its gender representation has rocketed from one of the worst performing states in 2012 to one of the best performing in 2015 with further improvements in 2017. The state currently has a re-elected female Premier, a female Deputy Premier and a female-dominated cabinet – in fact, Queensland was the first ministry in Australia to have a majority of women in its Cabinet. However, it is unnecessary to dig far below these headlines to see that this is uncharacteristic of its history: progress towards this current position has been slow and patchy. The paper finds that matters such as the glass ceiling and the use of quotas explain women’s recent success in Queensland politics.

Keywords: feminist historical institutional approach, glass ceiling, quotas, women’s participation in politics

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Authors: Muhammad Hikmah

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Based on the population census in 2015, Indonesia consists of 254.9 millions of people, and 80% of them are Muslims (Data of Central Bureau of Statistic). Indonesia becomes the highest number of Muslims civilization in the world. The question would be, is the number of population proportional to the growth of Syariah transaction in Indonesia? It is going to be discussed in this research. The problem limitation of this research is in Syariah Banking. Therefore, Syariah transaction in this study is described as transaction only in Syariah Banking. The researcher focused on the study in Yogyakarta, a city in Indonesia. The development of Syariah Bank assets until January 2016, based on statistic data launched by Financial Services Authority (FSA), has increased Rp 287.44 trillion, however, a total amount of bank achieves Rp 6.198,15 trillions. It means that the assets of Syariah Bank are only 4.64% from the total amount of banking assets in Indonesia, though, Syariah Banking was first established in 1991, known as Bank Muamalat. As we can see that in these 25 years, Syariah Banking could only reach that number. Based on the press conference of FSA and Syariah Banking Exhibition iB Vaganza in 2015, the number of Syariah Bank’s customers are under 10 millions. With 80% of Muslims, Syariah Bank is not able to be a market leader in Indonesia. This will be answered in this research, how much the interest if Muslims in Yogyakarta towards Syariah Bank compared to conventional bank. This study will be conducted in Yogyakarta. The sampling will represent to the muslims having good knowledge of Islam, such as dawn prayer worshipers in some mosques in Yogyakarta. There are some reasons why Indonesian muslims are not interested in Syariah Bank, such as the people do not put trust in Syariah Bank; there are some obligation where they work to have conventional bank; business matters services which is not covered by Syariah Bank where most of them are limited to the laws authorities; and there is no sufficient knowledge about the importance of syariah transaction from religion point of view. Each of them is going to be discussed in this research. The suggestions of this study are we should share our knowledge about Islamic transaction anywhere and we need to support Syariah Bank to have Syariah principles. For those who have the authority should be active as well to announce the rules of the constitution supporting the development of syariah transaction in order to be apply perfectly. We hope that trust from the people will increase, and we should provide Syariah Banking products which fulfill business needs. Finally, syariah transaction will be the solution for all people in the world in bussiness transaction.

Keywords: shariah, Islamic, banking, Indonesia

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Authors: Anna Pudlo

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The EU law encompasses many supranational legal systems (EU law, ECHR, international public law and constitutional traditions common to the Member States) which guarantee the protection of fundamental rights, with partly overlapping scopes of applicability, various principles of interpretation of legal norms and a different hierarchy. In EU law, the prohibition of discrimination on grounds of sexual orientation originates from both the primary and secondary EU legislation. At present, the prohibition is considered to be a fundamental right in pursuance of Article 21 of the Charter, but the Court has not yet determined whether it is a right or a principle within the meaning of the Charter. Similarly, the Court has not deemed this criterion to be a general principle of EU law. The personal and materials scope of the prohibition of discrimination on grounds of sexual orientation based on Article 21 of the Charter requires each time to be specified in another legal act of the EU in accordance with Article 51 of the Charter. The effect of the prohibition of discrimination on grounds of sexual orientation understood as above will be two-fold, for the States and for the Union. On the one hand, one may refer to the legal instruments of review of EU law enforcement by a Member State laid down in the Treaties. On the other hand, EU law does not provide for the right to individual petition. Therefore, it is the duty of the domestic courts to protect the right of a person not to be discriminated on grounds of sexual orientation in line with the national procedural rules, within the limits and in accordance with the principles set out in EU law, in particular in Directive 2000/78. The development of the principle of non-discrimination in the Court’s case-law gives rise to certain doubts as to its applicability, namely whether the principle as the general principle of EU law may be granted an autonomous character, with respect to the applicability to matters not included in the personal or material scope of the Directives, although within the EU’s competence. Moreover, both the doctrine and the opinions of the Advocates-General have called for the general competence of CJEU with regard to fundamental rights which, however, might lead to a violation of the principle of separation of competence. The aim of this paper is to answer the question what is the nature of the prohibition of discrimination on grounds of sexual orientation in EU law (a general principle in EU law, or a principle or right under the Charter’s terminology). Therefore, the paper focuses on the nature of Article 21 of the Charter (a right or a principle) and the scope (personal and material) of the prohibition of discrimination based on sexual orientation in EU law as well as its effect (vertical or horizontal). The study has included the provisions of EU law together with the relevant CJEU case-law.

Keywords: EU law, EU principles, non-discrimination in EU law, Charter of the Fundamental Rights

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Authors: S. Kershaw, P. J. Barry, K. Webb

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Background: Cystic Fibrosis (CF) is a chronic lung disease where patients have chronic lung infection punctuated by acute exacerbations that require intermittent intravenous (IV) antibiotics during their lives. With time, peripheral venous access can become difficult and limited. Accessing these veins can become arduous, traumatic, painful and unworkable. A permanent intravascular access device or Port is a small device that is inserted into the central venous system that allows the delivery of medicine eliminating the need for peripheral venous access. Ports represent a convenient and efficient method when venous access is required on a permanent basis however they are also associated with significant vascular complications. Superior Vena Cava Obstruction (SVCO) is a rare but significant vascular complication of ports in this setting. Objective: We aimed to look at a single CF centre’s experience of port-related SVCO over a thirty year period. Methods: Retrospective data was extracted using patient’s notes, electronic radiological reports and local databases over a period in excess of 30 years from 1982 to 2014. Results: 13 patients were identified with SVCO as a result of their port. 11 patients had CF (9 female, 2 male), one male patient had Primary Ciliary Dyskinesia and one female patient had severe Asthma. The mean port function was 1532 days (range 110 – 4049) and the mean age at SVCO was 24 years (range 11.1 to 36.5 years). The most common symptoms were facial oedema (n=8, 61.5%) and dilated veins (n=6, 46.2%). 7 patients had their Ports removed after SVCO. 6 patients underwent attempted stenting (46.2%) and 6 did not. 4 out of the 6 who underwent stenting required/had re-intervention. 3 of the 6 patients who underwent stenting had symptom resolution, however, 4 of the 6 patients who were not stented had symptom resolution also. Symptom resolution was not guaranteed with stenting and required re-intervention in two-thirds. Conclusion: This case series represents the experience of one of the longest established CF units in the UK and represents the largest cohort ever reported in the literature.

Keywords: ports, Superior Vena Cava Obstruction, cystic fibrosis, access devices

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Authors: Amina Akhtar, Rory O'Connor

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Introduction: There remains significant morbidity and mortality in young pedestrians hit by motor vehicles, even in the era of pedestrian crossings and speed limits. The aim of this study was to compare incidence and injury severity of motor vehicle-related pedestrian trauma according to time of day and season in a young population, based on the supposition that injuries would be more prevalent during dusk and dawn and during autumn and winter. Methods: Data was retrieved for patients between 10-25 years old from the National Trauma Audit and Research Network (TARN) database who had been involved as pedestrians in motor vehicle accidents between 2015-2020. The incidence of injuries, their severity (using the Injury Severity Score [ISS]), hospital transfer time, and mortality were analysed according to the hours of daylight, darkness, and season. Results: The study identified a seasonal pattern, showing that autumn was the predominant season and led to 34.9% of injuries, with a further 25.4% in winter in comparison to spring and summer, with 21.4% and 18.3% of injuries, respectively. However, visibility alone was not a sufficient factor as 49.5% of injuries occurred during the time of darkness, while 50.5% occurred during daylight. Importantly, the greatest injury rate (number of injuries/hour) occurred between 1500-1630, correlating to school pick-up times. A further significant relationship between injury severity score (ISS) and daylight was demonstrated (p-value= 0.0124), with moderate injuries (ISS 9-14) occurring most commonly during the day (72.7%) and more severe injuries (ISS>15) occurred during the night (55.8%). Conclusion: We have identified a relationship between time of day and the frequency and severity of pedestrian trauma in young people. In addition, particular time groupings correspond to the greatest injury rate, suggesting that reduced visibility coupled with school pick-up times may play a significant role. This could be addressed through a targeted public health approach to implementing change. We recommend targeted public health measures to improve road safety that focus on these times and that increase the visibility of children combined with education for drivers.

Keywords: major trauma, paediatric trauma, road traffic accidents, diurnal pattern

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Authors: Ana Luiza Aranha

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This paper contributes to the discussions that consider corruption as a challenge to the establishment of more democratically inclusive societies in Latin America. The paper advocates an intrinsic connection between democratic principles and corruption control – it is only possible to achieve just forms of democratic life if accountability institutions are able to control corruption, and therefore control the political exclusions that it brings. Departing from a non-trivial approach to corruption, and recognizing a gap in democratic theory when thinking about this phenomenon, corruption is understood as the breakdown of the democratic inclusive rule, whereby political decisions are made (and actions were taken) in spite of those potentially affected by them. Based on this idea, this paper proposes a new way of measuring corruption, moving away from usual aggregate measures – such as the Corruption Perception Index – and case studies of corruption scandals. The main argument sustains that corruption is intrinsically connected with the ability to be accountable and to provide public justification for the political conduct. The point advocated is that corruption involves a dimension of political exclusion. It generates a private benefit which is, from a democratic point of view, illegitimate, since it benefits some at the expense of the decisions made by the political community. Corruption is then a form of exclusion based on deception and opacity - for corruption, there is no plausible justification. Empirically, the paper uses the audit reports produced by the Brazilian anti-corruption agency (the CGU - Office of the Comptroller General) in its Inspections From Public Lotteries Program to exemplify how we can use this definition to separate corruption cases from mismanagement irregularities. On one side, there is poor management and inefficiencies, and, on the other, corruption, defined by the implausibility of public justifications – because the public officials would have to publicize illegitimate privileges and undue advantages. CGU reports provide the justifications given by the public officials for the irregularities found and also the acceptance or not by the control agency of these justifications. The analysis of this dialogue – between public officials and control agents – makes it possible to divide the irregularities on those that can be publicly justified versus those that cannot. In order to hold public officials accountable for their actions, making them responsible for the exclusions that they may cause (such as corruption), the accountability institutions fulfil an important role in reinforcing and empowering democracy and its basic inclusive condition.

Keywords: accountability, brazil, corruption, democracy

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Authors: Ibrahim Arslan

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Since 1984, Turkey has experienced a significant transformation in legal and economic matters. The most consequential examples of this transformation in recent years are the renewal of the Commercial Code and the Check Act. Nowadays, the commercial activity is not limited within the boundaries of the country; on the contrary, as required by the global economy, it has an international dimension. For this reason, unlike some other legal principles, the rules regulating the commercial life should be compatible with the international standards as much as possible. Otherwise the development possibility in the global markets will be limited. The Check Act has been adopted in 2009 and the Commercial Code has been adopted in 2011. The Commercial Code has been entered into force on 1 July 2012. The international dimension of check is in-disputable for it is based on the Geneva Convention. However, the Turkish business life has created a unique application of this legal tool. This application is called “post-date” checks. Indeed the majority of the checks being used in the market are post-dated checks. The holders of these checks have waited the date written on the check for presentation and collection. Thus, the actual situation has occurred. This actual situation has been legitimized via Check Act No. 5941 and post dated checks have gained a legal status. In the preparation of the new the Turkish Commercial Code one of the goals is "to ensure that the Turkish commercial law becomes a part of the international market". To achieve this goal, significant changes have been made especially concerning the independent external audition of the corporations, the board structure and public disclosure regulations. These changes aim to facilitate the internationalization of Turkish corporations as well as intensification of foreign direct investments through foreign capital. Although the target has been determined this way, after the adoption but five days before the entry into force of the Turkish Commercial Code No. 6102, a law made backward going alterations concerning independent external audition and public disclosure regulations. Turkish Commercial Code has been currently in force with its altered status. Both the regulations in the Check Act as well as the changes in the Commercial Code are not compatible with the goals introduced by rationale “to ensure Turkish commercial law to be a part of the international market” as such.

Keywords: Turkish Commercial Code No. 6102, Turkish Check Act, “post-date” checks, legal changes

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Authors: Emma Roberts

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The Rome II Regulation has established a uniform regime of conflict of law rules across the European Union (except for Denmark) which determines the law applicable in non-contractual obligations disputes. It marks a significant development towards the Europeanization of private international law and aims to provide the most appropriate connecting factors to achieve both legal certainty and justice in individual cases. Many non-contractual obligations are recognised to present such distinct factors that, to achieve these aims, a special rule is provided for determining the applicable law in cases in respect of product liability and environmental torts, for example. Throughout the legislative process, the European Parliament sought to establish a separate rule for road traffic accidents, recognising that these cases too present such novel situations that a blanket application of a lex loci damni approach would not provide an appropriate answer. Such attempts were rejected and, as a result, cases arising out of road traffic accidents are subject to the Regulation’s general lex loci damni rule along with its escape clause and limited exception. This paper offers a critique of the Regulation’s response to cross-border road traffic accident cases. In England and Wales, there have been few cases that have applied the Regulation’s provisions to date, but significantly the majority of such cases are in respect of road traffic accidents. This paper examines the decisions in those cases and challenges the legislators’ decision not to provide a special rule for such incidences. Owing to the diversity in compensation systems globally, applying the Regulation’s general rule to cases of road traffic accidents – given the breadth of matters that are to be subject to the lex cause – cannot ensure an outcome that provides ‘justice in individual cases’ as is assured by the Regulation's recitals. Not only does this paper suggest that the absence of a special rule for road traffic accidents means that the Regulation fails to achieve one of its principal aims, but it further makes out a compelling case for the legislative body of the European Union to implement a corrective instrument.

Keywords: accidents abroad, applicable law, cross-border torts, non-contractual obligations, road traffic accidents

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Authors: Zeliha Ustun, Mustafa Ersoz

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In the study, a traditional herbal supplement black cumin seed (Nigella sativa) oil properties has been studied to protect the main quality parameters by a new supplement application. Black cumin seed and its oil is used as a dietary supplement and preferred traditional remedy in Africa, Asia and Middle East for centuries. Now it has been consuming by millions of people in America and Europe as natural supplements and/or phytotherapeutic agents to support immune system, asthma, allergic rinnitis etc. by the scientists’ advices. With the study, it is aimed to prove that soft gelatin capsules are a new and more practical way of usage for Nigella sativa oil that has a longer stability. With the study soft gelatin capsules formulation has been developed to protect cold pressed black cumin seed oil physicochemical properties for a longer period. The product design has been developed in laboratory and implemented in pilot scale soft gelatin capsule manufacturing. Physicochemical properties (peroxide value, free fatty acids, fatty acid composition, refractive index, iodine value, saponification value, unsaponifiable matters) of Nigella sativa oil soft gelatin capsules and Nigella sativa oil in liquid form in amber glass bottles have been compared and followed for 8 months. The main parameters for capsules and liquid form found that for free fatty acids 2.29±0.03, 3.92±0.11 % oleic acid, peroxide 23.11±1.18, 27.85±2.50 meqO2/kg, refractive index at 20 0C 1.4738±0.00, 1.4737±0.00, soap 0 ppm, moisture and volatility 0.32±0.01, 0.36±0.01 %, iodine value 123.00±0.00, 122.00±0.00 wijs, saponification value 196.25±0.46, 194.13±0.35 mg KOH/g and unsaponifiable matter 7.72±0.13, 6.88±0.36 g/kg respectively. The main fatty acids are found that linoleic acid 56.17%, oleic acid 24.64%, palmitic acid 11,94 %. As a result, it is found that cold pressed Nigella sativa oil soft gelatin capsules physicochemical properties are more stable than the Nigella sativa oil stored in glass bottles.

Keywords: black cumin seed (Nigella sativa) oil, cold press, nutritional supplements, soft gelatin capsule

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Authors: Maria Medeiros, Suren Surenthiran, Abitha Muralithar, Soushma Seeburuth, Mohammed Mohammed

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Introduction: Appendicitis is the most common surgical emergency globally and can have devastating consequences. Diagnostic imaging in acute appendicitis has become increasingly common in aiding the diagnosis of acute appendicitis. Computerized tomography (CT) and ultrasound (US) are the most commonly used imaging modalities for diagnosing acute appendicitis. Pre-operative imaging has contributed to a reduction of negative appendicectomy rates from between 10-29% to 5%. Literature report CT scan has a diagnostic sensitivity of 94% in acute appendicitis. This clinical audit was conducted to establish if the CT scan's diagnostic yield for acute appendicitis matches the literature. CT scan has a high sensitivity and specificity for diagnosing acute appendicitis and its use can result in a lower negative appendicectomy rate. The aim of this study is to compare the pre-operative imaging findings from CT scans to the histopathology results post-operatively and establish the accuracy of CT scans in aiding the diagnosis of acute appendicitis. Methods: This was a retrospective study focusing on adult presentations to the general surgery department in a district general hospital in central London with an impression of acute appendicitis. We analyzed all patients from July 2022 to December 2022 who underwent a CT scan preceding appendicectomy. Pre-operative CT findings and post-operative histopathology findings were compared to establish the efficacy of CT scans in diagnosing acute appendicitis. Our results were also cross-referenced with pre-existing literature. Data was collected and anonymized using CERNER and analyzed in Microsoft Excel. Exclusion criteria: Children, age <16. Results: 65 patients had CT scans in which the report stated acute appendicitis. Of those 65 patients, 62 patients underwent diagnostic laparoscopies. 100% of patients who underwent an appendicectomy with a pre-operative CT scan showing acute appendicitis had acute appendicitis in histopathology analysis. 3 of the 65 patients who had a CT scan showing appendicitis received conservative treatment. Conclusion: CT scans positive for acute appendicitis had 100% sensitivity and a positive predictive value, which matches published research studies (sensitivity of 94%). The use of CT scans in the diagnostic work-up for acute appendicitis can be extremely helpful in a) confirming the diagnosis and b) reducing the rates of negative appendicectomies and consequently reducing unnecessary operative-associated risks for patients, reducing costs and reducing pressure on emergency theatre lists.

Keywords: acute apendicitis, CT scan, general surgery, imaging

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Authors: John Ibanga

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Since May 1999, when Nigeria returned to uninterrupted democratic rule, there have been various attempts by successive governments at committing themselves to democratic ideals. Such efforts include a revision of communication policies after repeated calls by civil society organisations, development partners, researchers, and academics to allow not only the commencement of campus radio broadcasting but also the takeoff of community radio broadcasting. Thus, in 2015, operating licenses were granted to several communities spread across the six geopolitical zones in the country for the establishment of community radio stations culminating in the establishment of the first community radio in Nigeria on July 17, 2015. And, since citizens’ involvement in policy matters and governance is one of the tenets of participatory democracy, it becomes imperative to investigate how the emerging community radio sector in Nigeria is facilitating participatory democracy among Nigerians, even in the face of attempts by the present government to silence all dissenting voices. This study, therefore, examines how residents in Ondo State, Southwest Nigeria, are utilising programmes on Ejule Nen and Kakaaki community radio stations in Ondo State, Nigeria, to deepen participatory democracy. Much of the existing studies on the role of community radio in participatory democracy and citizens' engagement efforts miss out on Nigeria because of the delayed implementation of community radio policy in Nigeria being Africa’s most populous nation as well as a major player in the affairs of the African continent. While the participatory communication and communication infrastructure theories were used as framework, data were collected from in-depth interviews with staff of the community radio station and community leaders, focus group discussions with the community residents, and qualitative content analysis of programmes on the station. The residents used the community radio stations as platforms for demanding accountability from government, mobilising resources for the execution of a number of community projects, promoting credible electoral practices, and influencing the implementation of free education policy in their communities. Hence the community radio stations became the reliable and authoritative voices of residents for participating in the public sphere and, generally, the democratic process.

Keywords: community, community radio, democracy, participatory democracy

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Authors: Mehri Sadat Alavinasab Ashgezari, Gholam Reza Nabi Bidhendi, Fatemeh Sadat Alavinasab Ashkezari

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Atmospheric aerosol loading (AAL) from anthropogenic sources is an evidence in industrial development. The accelerated trends in material consumption at the global scale in recent years demonstrate consumption paradigms sensible to the planetary boundaries (PB). This paper is a statistical approach on recognizing the path of climate-relevant bulk materials production (CBMP) of steel, cement and plastics to AAL via an updated and validated spatiotemporal distribution. The methodology of statistical analysis used the most updated regional or global databases or instrumental technologies. This corresponded to a selection of processes and areas capable for tracking AAL within the last decade, analyzing the most validated data while leading to explore the behavior functions or models. The results also represented a correlation within socio economic metabolism idea between the materials specified as macronutrients of society and AAL as a PB with an unknown threshold. The selected country contributors of China, India, US and the sample country of Iran show comparable cumulative AAL values vs to the bulk materials domestic extraction and production rate in the study period of 2012 to 2022. Generally, there is a tendency towards gradual descend in the worldwide and regional aerosol concentration after 2015. As of our evaluation, a considerable share of human role, equivalent 20% from CBMP, is for the main anthropogenic species of aerosols, including sulfate, black carbon and organic particulate matters too. This study, in an innovative approach, also explores the potential role of AAL control mechanisms from the economy sectors where ordered and smoothing loading trends are accredited through the disordered phenomena of CBMP and aerosol precursor emissions. The equilibrium states envisioned is an approval to the well-established theory of Spin Glasses applicable in physical system like the Earth and here to AAL.

Keywords: atmospheric aeroso loading, material flows, climate bulk materials, industrial ecology

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Authors: Carl Ashworth, Matthys Campher

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Spinal anaesthesia has been identified as the “gold standard” for primary elective total hip and knee arthroplasty, which is most commonly performed using longer-acting local anaesthetics, such as hyperbaric bupivacaine, to prolong the duration of anaesthesia and analgesia suitable for these procedures. Ketamine is known to have local anaesthetic effects with potent analgesic properties and has been evaluated as a sole anaesthetic agent via intrathecal administration; however, the use of intrathecal ketamine as an adjunct to intrathecal hyperbaric bupivacaine, morphine, and fentanyl has not been extensively studied. The objective of this study was to identify the potential analgesic effects of the addition of intrathecal ketamine to spinal anaesthesia and to compare the efficacy and safety of adding intrathecal ketamine to spinal anaesthesia for hip- or knee arthroplasty with spinal anaesthesia for hip- or knee arthroplasty without intrathecal ketamine. The medical records of patients who underwent elective hip- or knee arthroplasty under spinal anaesthesia performed by an individual anaesthetist with either intrathecal hyperbaric bupivacaine, morphine and fentanyl or intrathecal hyperbaric bupivacaine, morphine, fentanyl and ketamine between June 4, 2020, and June 4, 2022, were retrospectively reviewed. These encounters were reviewed and analyzed from a perioperative pain perspective, with the primary outcome measure as the oral morphine equivalent (OME) usage in the 48 hours post-spinal anaesthesia, and secondary outcome measures including time to breakthrough analgesia, self-reported pain scores at rest and during movement at 24 and 48 hours after surgery, adverse effects of analgesia, complications, and length of stay. There were 26 patients identified who underwent TKR between June 4, 2020, and June 4, 2022, and 25 patients who underwent THR with the same conditions. It was identified that patients who underwent traditional spinal anaesthesia with the addition of ketamine for elective hip- or knee arthroplasty had a lower mean total OME in the 48 hours immediately post-spinal anaesthesia yet had a shorter time to breakthrough analgesia administration. The proposed mechanism of action for intrathecal ketamine as an additive to traditional spinal anaesthesia for elective hip- or knee arthroplasty is that it may prolong and attenuate the analgesic effect of traditional spinal anaesthesia. There were no significant differences identified in comparing the efficacy and safety of adding intrathecal ketamine to spinal anaesthesia for hip- or knee arthroplasty with spinal anaesthesia for hip- or knee arthroplasty without intrathecal ketamine.

Keywords: anaesthesia, spinal, intra-thecal, ketamine, spinal-morphine, bupivacaine

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Authors: David Crighton, Kelly Smith

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The ability to adopt creative pedagogical approaches is increasingly vital in today’s educational landscape. This study examines the institutional barriers that hinder educators, in the UK, from embracing such innovation, focusing specifically on the experiences and perspectives of educational leaders. Current literature primarily focuses on the challenges that academics and teachers encounter, particularly highlighting how management culture and audit processes negatively affect their ability to be creative in classrooms and lecture theatres. However, this focus leaves a gap in understanding management perspectives, which is crucial for providing a more holistic insight into the challenges encountered in educational settings. To explore this gap, we are conducting semi-structured interviews with senior leaders across various educational contexts, including universities, schools, and further education colleges. This qualitative methodology, combined with thematic analysis, aims to uncover the managerial, financial, and administrative pressures these leaders face in fostering creativity in teaching and supporting professional learning opportunities. Preliminary insights indicate that educational leaders face significant barriers, such as institutional policies, resource limitations, and external performance indicators. These challenges create a restrictive environment that stifles educators' creativity and innovation. Addressing these barriers is essential for empowering staff to adopt more creative pedagogical approaches, ultimately enhancing student engagement and learning outcomes. By alleviating these constraints, educational leaders can cultivate a culture that fosters creativity and flexibility in the classroom. These insights will inform practical recommendations to support institutional change and enhance professional learning opportunities, contributing to a more dynamic educational environment. In conclusion, this study offers a timely exploration of how leadership can influence the pedagogical landscape in a rapidly evolving educational context. The research seeks to highlight the crucial role that educational leaders play in shaping a culture of creativity and adaptability, ensuring that institutions are better equipped to respond to the challenges of contemporary education.

Keywords: educational leadership, professional learning, creative pedagogy, marketisation

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Authors: Rogaleva Liudmila, Malkin Valery

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Physical culture lessons are considered not only to be a means of physical development of students, but a matter of their personal development. Physical culture lessons can enable to develop such qualities of students as activity and initiation, readiness to cooperate, self-confidence, ability to define and reach targets, readiness to overcome difficulties and assess their abilities (and disadvantages) properly in any precise situation as well to be responsible for their own decision. The solution of this problem is possible under the circumstance if the students aware themselves as the subject of the activity that are able to develop their possibilities. The research was aimed to learn the matters that enable female teenagers of senior forms to become strong personalities attending physical culture lessons. There were two stages of the research. At the first stage we define the interests and demands of the girls. According the results of research we changed the programme of physical culture lessons. We took into consideration values of youth subculture: youth music, preferences to sport-dancing physical activities, demand of self-determination, revealing their individualities, needs of cooperative work. At the second stage we worked out motivating technology of course. This technology was aimed to create sush conditions under which students could show themselves as the subjects of activity and self-development. The active participation sport-dance festivals during 2-3 years creates the conditions for their self-realization. 78% students of the experimental groups considered their main motives to were: the interest, developing of their abilities, the satisfaction of the achievements of targets. Control groups 67% of the students claimed the success school good marks. The girls said that due to festivals they became self-confident (94%), responsible (86%), ability to cooperate (73%), aspiration for reaching the target (68%), self-exactingness (57 %). The main factors that provide successful performance were called: efforts to reach the target (87%), mutual support and mutual understanding (77%). The research on values showed that in the experimental groups we can find increase of importance of such values as: social initiative (active life) 83%, friends (75%), self-control (73%), effectiveness in deeds (58%).

Keywords: physical culture, subject, personal development, self-determination

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