Search results for: pedestrian preference

Authors: Anna Bohers, Emília Hroncová, Juraj Ladomerský

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Oil sludge with its main characteristic of high acidity is a waste product generated from the operation of refinery and petrochemical plants. Former refinery and petrochemical plant - Petrochema Dubová is present in Slovakia as well. Its activities was to process the crude oil through sulfonation and adsorption technology for production of lubricating and special oils, synthetic detergents and special white oils for cosmetic and medical purposes. Seventy years ago – period, when this historical acid sludge burden has been created – comparing to the environmental awareness the production was in preference. That is the reason why, as in many countries, also in Slovakia a historical environmental burden is present until now – 229 211 m3 of oil sludge in the middle of the National Park of Nízke Tatry mountain chain. Neither one of tried treatment methods – bio or non-biologic one - was proved as suitable for processing or for recovery in the reason of different factors admission: i.e. strong aggressivity, difficulty with handling because of its sludgy and liquid state et sim. As a potential solution, also incineration was tested, but it was not proven as a suitable method, as the concentration of SO2 in combustion gases was too high, and it was not possible to decrease it under the acceptable value of 2000 mg.mn-3. That is the reason why the operation of incineration plant has been terminated, and the acid sludge landfills are present until nowadays. The objective of this paper is to present a new possibility of processing and valorization of acid sludgy-waste. The processing of oil sludge was performed through the effective separation - thermal desorption technology, through which it is possible to split the sludgy material into the matrix (soil, sediments) and organic contaminants. In order to boost the efficiency in the processing of acid sludge through thermal desorption, the work will present the possibility of application of an original technology – Method of Blowing Decomposition for recovering of organic matter into technological lubricating oil.

Keywords: hazardous waste, oil sludge, remediation, thermal desorption

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Authors: Puja Mahesh

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Purpose: A good slogan captures the essence of your brand's promised consumer benefit in one short phrase. A good slogan conjures up positive imagery about your business or your product. A good slogan has the element of immediacy. Immediacy does not necessarily mean that the slogan will inspire consumers to run right out and buy your product. It does mean, however, that your slogan has an immediate cognitive impact. It forces your audience to "stop-and-think" after exposure as a necessary first step toward remembering your slogan promise. A good slogan is memorable and durability. When your slogan promise is occupying prime real estate in the consumer's subconscious, it aids in recall and activates preference for your brand when you want it -when consumers are ready to buy. The objective of current study is to understand the consumer perception of slogans/taglines of higher education sector in India. Design/Methodology/Approach: Survey of 500 consumers (largely comprising of youth) will be done using questionnaire. Universities and institutes will be chosen on the basis of various streams and Credible Rankings. The perception will be taken from the respondents on the basis of scale. Findings: Catchy phrases, rhymes, music, jingles, avatars (visual representations) and unique imagery are just a few of the mnemonic clutter-busting tactics commonly used in slogans to stand apart from the competition and to aid in memory recall. The study will reveal whether it is true that catchy phrases, rhymes, music, jingles, avatars (visual representations) and unique imagery across disciplines and universities help in building stronger brands. It will also be found whether consumers pay more attention to reputation of University/ College or brand identity. Originality/Value: Researcher has not come across any study of Consumer Perception of Slogans/Taglines of Higher Education Brands in India. Also, it would be interesting to understand Consumer Perception of various colleges/streams particularly Management colleges who invest a lot of time in branding exercise.

Keywords: consumer perception, higher education, slogans, taglines

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Authors: George Cudjoe Agbemabiese, John Paul Kosiba, Michael Boadi Nyamekye, Vanessa Narkie Tetteh, Caleb Nunoo, Mohammed Muniru Husseini

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The smartphone industry continues to experience massive growth, evidenced by expanding markets and an increasing number of brands, models and manufacturers. As technology advances rapidly, manufacturers of smartphones are consistently introducing new innovations to keep up with the latest evolving industry trends and customer demand for more modern devices. This study aimed to assess the influence of artificial intelligence (AI) voice assistant (VA) on improving customer experience, resulting in the continuous use of mobile brands. Specifically, this article assesses the role of hedonic, utilitarian, and social benefits provided by AIVA on customer experience and the continuance intention to use mobile phone brands. Using a primary data collection instrument, the quantitative approach was adopted to examine the study's variables. Data from 348 valid responses were used for the analysis based on structural equation modeling (SEM) with AMOS version 23. Three main factors were identified to influence customer experience, which results in continuous usage of mobile phone brands. These factors are social benefits, hedonic benefits, and utilitarian benefits. In conclusion, a significant and positive relationship exists between the factors influencing customer experience for continuous usage of mobile phone brands. The study concludes that mobile brands that invest in delivering positive user experiences are in a better position to improve usage and increase preference for their brands. The study recommends that mobile brands consider and research their prospects' and customers' social, hedonic, and utilitarian needs to provide them with desired products and experiences.

Keywords: artificial intelligence, continuance usage, customer experience, smartphone industry

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Authors: Gordana Ćetković, Sanja Podunavac-Kuzmanović, Jasna Čanadanović-Brunet, Vesna Tumbas Šaponjac, Vanja Šeregelj, Jelena Vulić, Slađana Stajčić

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The color of food is one of the decisive factors for consumers. Potential toxicity of artificial food colorants has led to the consumers' preference for natural products over products with artificial colors. Natural pigments have many bioactive functions, such as antioxidant, provitamin and many other. Having this in mind, the acceptability of natural colorants by the consumers is much higher. Being present in all photosynthetic plant tissues carotenoids are probably most widespread pigments in nature. Carrot (Daucus carota) is a good source of functional food components. Carrot is especially rich in carotenoids, mainly α- and β-carotene and lutein. For this study, carrot was extracted using classical extraction with hexane and ethyl acetate, as well as supercritical CO₂ extraction. The extraction efficiency was evaluated by estimation of carotenoid yield determined spectrophotometrically. Classical extraction using hexane (18.27 mg β-carotene/100 g DM) was the most efficient method for isolation of carotenoids, compared to ethyl acetate classical extraction (15.73 mg β-carotene/100 g DM) and supercritical CO₂ extraction (0.19 mg β-carotene/100 g DM). Three carrot extracts were tested in terms of antioxidant activity using DPPH and reducing power assay as well. Surprisingly, ethyl acetate extract had the best antioxidant activity on DPPH radicals (AADPPH=120.07 μmol TE/100 g) while hexane extract showed the best reducing power (RP=1494.97 μmol TE/100 g). Hexane extract was chosen as the most potent source of carotenoids and was encapsulated in whey protein by freeze-drying. Carotenoid encapsulation efficiency was found to be high (89.33%). Based on our results it can be concluded that carotenoids from carrot can be efficiently extracted using hexane and classical extraction method. This extract has the potential to be applied in encapsulated form due to high encapsulation efficiency and coloring capacity. Therefore it can be used for dietary supplements development and food fortification.

Keywords: carotenoids, carrot, extraction, encapsulation

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Authors: Manish Pandey, Gurinderjit Kaur, Meenu Talwar, Sachin Chauhan, Jagbir Gill

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Health-care management systems are a unit of nice connection as a result of the supply a straightforward and fast management of all aspects relating to a patient, not essentially medical. What is more, there are unit additional and additional cases of pathologies during which diagnosing and treatment may be solely allotted by victimization medical imaging techniques. With associate ever-increasing prevalence, medical pictures area unit directly acquired in or regenerate into digital type, for his or her storage additionally as sequent retrieval and process. Data Mining is the process of extracting information from large data sets through using algorithms and Techniques drawn from the field of Statistics, Machine Learning and Data Base Management Systems. Forecasting may be a prediction of what's going to occur within the future, associated it's an unsure method. Owing to the uncertainty, the accuracy of a forecast is as vital because the outcome foretold by foretelling the freelance variables. A forecast management should be wont to establish if the accuracy of the forecast is within satisfactory limits. Fuzzy regression strategies have normally been wont to develop shopper preferences models that correlate the engineering characteristics with shopper preferences relating to a replacement product; the patron preference models offer a platform, wherever by product developers will decide the engineering characteristics so as to satisfy shopper preferences before developing the merchandise. Recent analysis shows that these fuzzy regression strategies area units normally will not to model client preferences. We tend to propose a Testing the strength of Exponential Regression Model over regression toward the mean Model.

Keywords: health-care management systems, fuzzy regression, data mining, forecasting, fuzzy membership function

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Authors: Neeti Nayak, Khalid Duri

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Despite the many advances made in transportation planning, the number of injuries and fatalities in the United States which involve motorized vehicles near intersections remain largely unchanged year over year. Data from the National Highway Traffic Safety Administration for 2018 indicates accidents involving motorized vehicles at traffic intersections accounted for 8,245 deaths and 914,811 injuries. Furthermore, collisions involving pedal cyclists killed 861 people (38% at intersections) and injured 46,295 (68% at intersections), while accidents involving pedestrians claimed 6,247 lives (25% at intersections) and injured 71,887 (56% at intersections)- the highest tallies registered in nearly 20 years. Some of the causes attributed to the rising number of accidents relate to increasing populations and the associated changes in land and traffic usage patterns, insufficient visibility conditions, and inadequate applications of traffic controls. Intersections that were initially designed with a particular land use pattern in mind may be rendered obsolete by subsequent developments. Many accidents involving pedestrians are accounted for by locations which should have been designed for safe crosswalks. Conventional solutions for evaluating intersection safety often require costly deployment of engineering surveys and analysis, which limit the capacity of resource-constrained administrations to satisfy their community’s needs for safe roadways adequately, effectively relegating mitigation efforts for high-risk areas to post-incident responses. This paper demonstrates how geospatial technology can identify high-risk locations and evaluate the viability of specific intersection management techniques. GIS is used to simulate relevant real-world conditions- the presence of traffic controls, zoning records, locations of interest for human activity, design speed of roadways, topographic details and immovable structures. The proposed methodology provides a low-cost mechanism for empowering urban planners to reduce the risks of accidents using 2-dimensional data representing multi-modal street networks, parcels, crosswalks and demographic information alongside 3-dimensional models of buildings, elevation, slope and aspect surfaces to evaluate visibility and lighting conditions and estimate probabilities for jaywalking and risks posed by blind or uncontrolled intersections. The proposed tools were developed using sample areas of Southern California, but the model will scale to other cities which conform to similar transportation standards given the availability of relevant GIS data.

Keywords: crosswalks, cyclist safety, geotechnology, GIS, intersection safety, pedestrian safety, roadway safety, transportation planning, urban design

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Authors: Jean Paul Hategekimana, Josiane Irakoze, Eugene Niyonzima, Annick Ndekezi

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Cassava (Manihot esculenta Crantz) is a root crop comprising an anti-nutritive factor known as cyanide. The compound can be removed by numerous processing methods such as boiling, fermentation, blanching, and sun drying to avoid the possibility of cyanide poisoning. Inappropriate processing mean can lead to disease and death. Cassava-based dishes are consumed in different ways, where cassava is cultivated according to their culture and preference. However, they have been shown to be unsafe based on high cyanide levels. The current study targeted to resolve the problem of high cyanide in cassava consumed in Rwanda. This study was conducted to determine the effect of slicing, blanching, and soaking time to reduce the fermentation duration of cassava for hydrogen cyanide (HCN) in mg/g removal. Cassava was sliced into three different portions (1cm, 2cm, and 5cm). The first portions were naturally fermented for seven days, where each portion was removed every 24 hours from soaking tanks and then oven dried at a temperature of 60°C and then milled to obtain naturally fermented cassava flours. Other portions of 1cm, 2cm, and 5cm were blanched for 2, 5, 10 min, respectively, and each similarly dried at 60°C and milled to produce blanched cassava flour. Other blanched portions were used to follow the previous fermentation steps. The last portions, which formed the control, were simply chopped. Cyanide content and starch content in mg/100g were investigated. According to the conducted analysis on different cassava treatments for detoxification, found that usual fermentation can be used, but for sliced portions aimed to size reduction for the easy hydrogen cyanide diffuse out and it takes four days to complete fermentation, which has reduced at 94.44% with significantly different (p<0.05)of total hydrogen cyanide contained in cassava to safe level of consumption, and what is recommended as more effective is to apply blanching combined with fermentation due to the fact that, it takes three days to complete hydrogen cyanide removal at 95.56% on significantly different (p<0.05) of reduction to the safe level of consumption.

Keywords: cassava, cyanide, blanching, drying, fermentation

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Authors: Legkikh Victoria

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The purpose of keeping bi/multilingualism is usually a way to let the child speak two/three languages at the same level. The main problem which normally appears is a mixed language or a domination of one language. The same level of two or more languages would be ideal but practically not easily reachable. So it was made an experiment with a girl with a natural multilingualism as an attempt to avoid a dominant language in the preschool age. The girl lives in Germany and the main languages for her are Italian, Russian and German but she also hears every day English. ‘One parent – one language’ strategy was used since the beginning so Italian and Russian were spoken to her since her birth, English was spoken between the parents and when she was 1,5 it was added German as a language of a nursery. In order to avoid a dominant language, she was always put in international groups with activity in different languages. Even if it was not possible to avoid an interference of languages in this case we can talk not only about natural multilingualism but also about balanced bilingualism in preschool time. The languages have been developing in parallel with different accents in a different period. Now at the age of 6 we can see natural horizontal multilingualism Russian/Italian/German/English. At the moment, her Russian/Italian bilingualism is balanced. German vocabulary is less but the language is active and English is receptive. We can also see a reciprocal interference of all the three languages (English is receptive so the simple phrases are normally said correctly but they are not enough to judge the level of language interference and it is not noticed any ‘English’ mistakes in other languages). After analysis of the state of every language, we can see as a positive and negative result of the experiment. As a positive result we can see that in the age of 6 the girl does not refuse any language, three languages are active, she differentiate languages and even if she says a word from another language she notifies that it is not a correct word, and the most important are the fact, that she does not have a preferred language. As a prove of the last statement it is to be noticed not only her self-identification as ‘half Russian and half Italian’ but also an answer to the question about her ‘mother tongue’: ‘I do not know, probably, when I have my own children I will speak one day Russian and one day Italian and sometimes German’. As a negative result, we can notice that not only a development of all the three languages are a little bit slower than it is supposed for her age but since she does not have a dominating language she also does not have a ‘perfect’ language and the interference is reciprocal. In any case, the experiment shows that it is possible to keep at least two languages without a preference in a pre-school multilingual space.

Keywords: balanced bilingualism, language interference, natural multilingualism, preschool multilingual education

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Authors: Chiung-Hui Chen

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Traditional service channel is losing its edge due to emerging service technology. To establish interaction with the clients, the service industry is using effective mechanism to give clients direct access to services with emerging technologies. Thus, as service science receives attention, special and unique consumption pattern evolves; henceforth, leading to new market mechanism and influencing attitudes toward life and consumption patterns. The market demand for customized services is thus valued due to the emphasis of personal value, and is gradually changing the demand and supply relationship in the traditional industry. In respect of interior design service, in the process of traditional interior design, a designer converts to a concrete form the concept generated from the ideas and needs dictated by a user (client), by using his/her professional knowledge and drawing tool. The final product is generated through iterations of communication and modification, which is a very time-consuming process. Although this process has been accelerated with the help of computer graphics software today, repeated discussions and confirmations with users are still required to complete the task. In consideration of what is addressed above a space user’s life model is analyzed with visualization technique to create an interaction system modeled after interior design knowledge. The space user document intuitively personal life experience in a model requirement chart, allowing a researcher to analyze interrelation between analysis documents, identify the logic and the substance of data conversion. The repeated data which is documented are then transformed into design information for reuse and sharing. A professional interior designer may sort out the correlation among user’s preference, life pattern and design specification, thus deciding the critical design elements in the process of service design.

Keywords: information design, life model-based, aesthetic computing, communication

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Authors: Aziz Zulazmi Samsudin, Siti Norhedayah Abdul Latif

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The lack of normalization of mental health as a conversational topic is becoming increasingly evident in certain cultures. The fact that students underutilize mental health services in schools can be attributed to the presence of various barriers that impede their willingness to seek for help. Stigma surrounding mental health services continue to be the most prevalent barrier for help seeking behavior. Alternative barriers have emerged that are both personal and public in nature that can have a substantial impact on students’ preference to seek for help in schools. A sequential explanatory study was carried out among 256 Muslim students in a school with dual education system in exploring both their Self-Stigma of Seeking Help (SSOSH) and Mental Health Help-Seeking Attitude (MHSA). In addition, 12 students were interviewed in a focus group setting to explore further the phenomena of help seeking approach by students to understand the initial quantitative analysis. Preliminary findings indicated that the students’ level of self-stigma was only moderate, but they had a favorable attitude towards counselling help. There was no significant difference on gender for both variables; however, the lower the self-stigma, the higher the mental help-seeking attitude for this current study, which is a common trend of relationship between the two variables. The interview revealed that, apart from public stigma, the absence of a qualified counsellor, a lack of ethical principles of counselling, a confidentiality issue, and the emotional openness of the students were identified as other barriers to their help-seeking attitudes. This paper also discussed the recommendation made by students in addressing barriers to counselling and facilitating their counselling needs for the improvement of students' mental and academic well-being. Additionally, this research offers the most recent data about mental health in the context of schools with a dual education system in Brunei Darussalam. It is hoped to serve as a guide for policy makers to consider the provision of mental health services that is more appealing to the students’ mental and academic well-being.

Keywords: mental health help-seeking attitude (MHSA), public stigma, school counselling, self-stigma, self-stigma of seeking help (SSOSH), well-being.

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Authors: Dagnew Dessie Mengie

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The purpose of this study was to investigate German tourists' demand for Ethiopian tourism destinations. The author has made every effort to identify the differences in the preferences of German visitors’ demand in Ethiopia comparing with Egypt, Kenya, Tanzania, and South African tourism sectors if they are invited to visit at the same time. However, the demand for international tourism for Ethiopia currently lags behind these African countries. Therefore, to offer demand-driven tourism products, the Ethiopian government and tour and travel operators need to understand the important factors that affect international tourists’ decision to visit Ethiopian tourist destinations. The aim of this study was to analyze German Tourists’ Demand for Ethiopian destinations. The researcher aimed to identify the demand for German tourists’ preference for Ethiopian tourist destinations compared to the above-mentioned African countries. For collecting and analysing data for this study, both quantitative and qualitative methods of research are being used in this study. The most significant data are collected by using the primary data collection method i.e. survey and interviews which are the most and large number of potential responses and feedback from nine German active tourists,12 Ethiopian tourism officials, four African embassies, and four well functioning private tour companies and secondary data collected from books, journals, previous research and electronic websites. Based on the data analysis of the information gathered from interviews and questionnaires, the study disclosed that the majority of German tourists do have not that high demand for Ethiopian Tourist destinations due to the following reasons: (1) Many Germans are fascinated by adventures and safari and simply want to lie on the beach and relax. These interests have leaded them to look for other African countries which have these accesses. (2) Uncomfortable infrastructure and transport problems are attributed to the decreasing number of German tourists in the country. (3) Inadequate marketing operation of the Ethiopian Tourism Authority and its delegates in advertising and clarifying the above irregularities which are raised by the tourists.

Keywords: environmental benefits of tourism, social benefits of tourism, economic benefits of tourism, political factors on tourism

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Authors: Hasanzadeh Tahraband F., Kheirkhah M.

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The trauma resulting from abortion causes fear, frustration, inability, lack of self-confidence, and psychological distress in women. The present study was conducted to determine the effect of midwifery counseling based on the Gamble approach on coping strategies of women with abortion. This randomized controlled clinical trial was conducted on women with abortions in April–October 2021, Karaj, Iran. Ninety-six eligible women were randomly assigned to two 48-member groups with 4, 6, and 8 blocks. The women in the intervention group participated in two 45-75-minute Gamble counseling programs. They were asked to fill out the demographic and fertility information questionnaire before the intervention and the cope operations preference inquiry questionnaire before, immediately (in the 4-6th week of the study), and three months after the intervention. The analysis of the data was done through Chi-square, independent sample t-test. The significance level was considered P<0.05. The results showed that the differences between the two groups before the intervention were not statistically significant in terms of demographic and fertility variables (P>0.05). However, the total mean score of the problem-focused dimension in 3-month post-abortion (97/34±8/69) and the emotion-focused dimension in 4-6 weeks and 3-month post-abortion (34/14±3/48 and 32/41±3/41) in the intervention group was significantly different from the control group (P<0.001). According to the results of the repeated measures ANOVA, the level of coping and its dimensions significantly changed in the intervention group over time (P<0.001). The results of the present study showed that Gamble counseling promoted the problem-focused dimension score and reduced the emotion-focused dimension score in women with abortion. It is recommended that Gamble counseling should be used as midwife-led counseling to increase coping strategies and reduce the psychological distress of women who have experienced abortion.

Keywords: midwife-led counseling, coping strategies, post-abortion, psychological distress, Iran

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Authors: Rahul Ranjan

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Using gender as a category to cull out historical analysis, feminist scholars have produced plethora of literature on the sexual symbolics and carnal practices of modern European empires. At a symbolic level, the penetration and conquest of faraway lands was charged with sexual significance and intrigue. The white male’s domination and possession of dark and fertile lands in Africa, Asia and the Americas offered, in Anne McClintock’s words, ‘a fantastic magic lantern of the mind onto which Europe projected its forbidden sexual desires and fears’. The politics of rape were also symbolically a question significant to the politics of empire. To the colonized subject, rape was a fearsome factor, a language that spoke of violent and voracious nature of imperial exploitation. The colonized often looked at rape as an act which colonizers used as tool of oppression. The rape as act of violence got encoded into the legal structure under the helm of Lord Macaulay in the so called ‘Age of Reform’ in 1860 under IPC (Indian penal code). Initially Lord Macaulay formed Indian Law Commission in 1837 in which he drafted a bill and defined the ‘crime of rape as sexual intercourse by a man to a woman against her will and without her consent , except in cases involving girls under nine years of age where consent was immaterial’. The modern English law of rape formulated under the colonial era introduced twofold issues to the forefront. On the one hand it deployed ‘technical experts’ who wrote textbooks of medical jurisprudence that were used as credential citation to make case more ‘objective’, while on the other hand the presumptions about barbaric subjects, the colonized women’s body that was docile which is prone to adultery reflected in cases. The untrustworthiness of native witness also remained an imperative for British jurists to put extra emphasis making ‘objective’ and ‘presumptuous’. This sort of formulation put women down on the pedestrian of justice because it disadvantaged her doubly through British legality and their thinking about the rape. The Imperial morality that acted as vanguards of women’s chastity coincided language of science propagated in the post-enlightenment which not only annulled non-conformist ideas but also made itself a hegemonic language, was often used as a tool and language in encoding of law. The medico-legal understanding of rape in the colonial India has its clear imprints in the post-colonial legality. The onus on the part of rape’s victim was dictated for the longest time and still continues does by widely referred idea that ‘there should signs, marks of resistance on the body of the victim’ otherwise it is likely to be considered consensual. Having said so, this paper looks at the textual continuity that had prolonged the colonial construct of women’s body and the self.

Keywords: body, politics, textual construct, phallocentric

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Authors: Ravi Patel, Krishna K. Krishnan

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In global supply chains, appropriate and sustainable suppliers play a vital role in supply chain development and feasibility. In a larger organization with huge number of suppliers, it is necessary to divide suppliers based on their past history of quality and delivery of each product category. Since performance of any organization widely depends on their suppliers, well evaluated selection criteria and decision-making models lead to improved supplier assessment and development. In this paper, SCOR® performance evaluation approach and ISO standards are used to determine selection criteria for better utilization of supplier assessment by using hybrid model of Analytic Hierchchy Problem (AHP) and Fuzzy Techniques for Order Preference by Similarity to Ideal Solution (FTOPSIS). AHP is used to determine the global weightage of criteria which helps TOPSIS to get supplier score by using triangular fuzzy set theory. Both qualitative and quantitative criteria are taken into consideration for the proposed model. In addition, a multi-product and multi-time period model is selected for order allocation. The optimization model integrates multi-objective integer linear programming (MOILP) for order allocation and a hybrid approach for supplier selection. The proposed MOILP model optimizes order allocation based on manufacturing process and product tolerances as per manufacturer’s requirement for quality product. The integrated model and solution approach are tested to find optimized solutions for different scenario. The detailed analysis shows the superiority of proposed model over other solutions which considered individual decision making models.

Keywords: AHP, fuzzy set theory, multi-criteria decision making, multi-objective integer linear programming, TOPSIS

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Authors: Ayman A. Al Hayek, Asirvatham A. Robert, Mohamed A. Al Dawish, Rim B. Braham, Hanouf S. Goudeh, Fahad S. Al Sabaan

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Introduction: The aim of this study was to explore the impact of insulin pump therapy on diabetes treatment satisfaction and glycemic control among patients with type 1 diabetes mellitus (T1DM) in Saudi Arabia. Methods: A 6-month, prospective study was conducted among 47 patients (aged17–24 years) with T1DM who attended the Insulin Pump Clinic at Prince Sultan Military Medical City, Riyadh, Saudi Arabia, between April 2014 and November 2014. The respondents were purposively and conveniently selected and were interviewed using the Arabic version of the Diabetes Treatment Satisfaction Questionnaire at baseline, 3, and 6 months. Demographics and clinical variables including hemoglobin A1c (HbA1c) were also collected. Results: The mean (±standard deviation) age of the study cohort was 19.1 ± 1.93 years. Seventeen patients were male (36.2%) and 30 were female (63.8%). Compared to baseline, significant positive differences were found in treatment satisfaction among female patients and patients with long-standing T1DM at 6 months. Frequency of hyperglycemia and hypoglycemia declined significantly in female patient’s at 6 months and in patients who had a shorter duration of T1DM. Furthermore, significant positive differences were found in HbA1c levels among female patients and among those who had a shorter duration of T1DM compared to baseline. Both female and male patients and those with a shorter duration of T1DM showed significant decline in insulin necessity at6months when compared to baseline. Conclusion: Although multiple daily injections is a feasible preference for insulin supply, insulin pumps should also be considered for patients with T1DM as it appears to increase patients’ treatment satisfaction, decrease the frequency of hypoglycemia, hyperglycemia, and reduce HbA1c levels.

Keywords: type 1 diabetes, insulin pump, Saudi Arabia, T1DM

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Authors: Ralene Sim, Stefan Mueller, N. Gopalakrishna Iyer, Ngian Chye Tan, Khee Chee Soo, R. Shetty Mahalakshmi, Hiang Khoon Tan

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Background: Regional failure in nasopharyngeal carcinoma (NPC) is managed by salvage treatment in the form of neck dissection. Radical neck dissection (RND) is preferred over modified radical neck dissection (MRND) since it is traditionally believed to offer better long-term disease control. However, with the advent of more advanced imaging modalities like high-resolution Magnetic Resonance Imaging, Computed Tomography, and Positron Emission Tomography-CT scans, earlier detection is achieved. Additionally, concurrent chemotherapy also contributes to reduced tumour burden. Hence, there may be a lesser need for an RND and a greater role for MRND. With this retrospective study, the primary aim is to ascertain whether MRND, as opposed to RND, has similar outcomes and hence, whether there would be more grounds to offer a less aggressive procedure to achieve lower patient morbidity. Methods: This is a retrospective study of 66 NPC patients treated at Singapore General Hospital between 1994 to 2016 for histologically proven regional recurrence, of which 41 patients underwent RND and 25 who underwent MRND, based on surgeon preference. The type of ND performed, primary treatment mode, adjuvant treatment, and pattern of recurrence were reviewed. Overall survival (OS) was calculated using Kaplan-Meier estimate and compared. Results: Overall, the disease parameters such as nodal involvement and extranodal extension were comparable between the two groups. Comparing MRND and RND, the median (IQR) OS is 1.76 (0.58 to 3.49) and 2.41 (0.78 to 4.11) respectively. However, the p-value found is 0.5301 and hence not statistically significant. Conclusion: RND is more aggressive and has been associated with greater morbidity. Hence, with similar outcomes, MRND could be an alternative salvage procedure for regional failure in selected NPC patients, allowing similar salvage rates with lesser mortality and morbidity.

Keywords: nasopharyngeal carcinoma, neck dissection, modified neck dissection, radical neck dissection

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Authors: Reihane Mehrparvar

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Human age could exceed further by altering gene expression through food intaking, although as a consequence of recent century eating patterns, human life-span getting shorter by emerging irregulating in autophagy mechanism, insulin, leptin, gut microbiota which are important etiological factors of type-2 diabetes, obesity, infertility, cancer, metabolic and autoimmune diseases. However, restricted calorie intake and vigorous exercise might be beneficial for losing weight and metabolic regulation in a short period but could not be implementable in the long term as a way of life. Therefore, the lack of a dietary program that is compatible with the genes of the body is essential. Sweet and high-glycemic-index (HGI) foods were associated with type-2 diabetes and cancer morbidity. The neuropsychological perspective characterizes the inclination of sweet and HGI-food consumption as addictive behavior; hence this process engages preference of gut microbiota, neural node, and dopaminergic functions. Moreover, meal composition is not the only factor that affects body hemostasis. In this narrative review, it is believed to attempt to investigate how the body responded to different food intakes and represent an accurate model based on current evidence. Eating frequently and ingesting unassimilable protein and carbohydrates may not be compatible with human genes and could cause impairments in the self-renovation mechanism. This trajectory indicates our body is more adapted to starvation and eating animal meat and marrow. Here has been recommended a model that takes into account three important factors: frequent eating, meal composition, and circadian rhythm, which may offer a promising intervention for obesity, inflammation, cardiovascular, autoimmune disorder, type-2 diabetes, insulin resistance, infertility, and cancer through intensifying autophagy-mechanism and eliminate medical costs.

Keywords: metabolic disease, anti-aging, type-2 diabetes, autophagy

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Authors: Ebuwa Osagie, Chet Biliyok, Yeung Hoi

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Regeneration energy requirement and ways to reduce it is the main aim of most CO2 capture researches currently being performed and thus, post-combustion carbon capture (PCC) option is identified to be the most suitable for the natural gas-fired power plants. From current research and development (R&D) activities worldwide, two main areas are being examined in order to reduce the regeneration energy requirement of amine-based PCC, namely: (a) development of new solvents with better overall performance than 30wt% monoethanolamine (MEA) aqueous solution, which is considered as the base-line solvent for solvent-based PCC, (b) Integration of the PCC Plant to the power plant. In scaling-up a PCC pilot plant to the size required for a commercial-scale natural gas-fired power plant, process modelling and simulation is very essential. In this work, an integrated process made up of a 482MWe natural gas-fired power plant, an MEA-based PCC plant which is developed and validated has been modelled and simulated. The PCC plant has four absorber columns and a single stripper column, the modelling and simulation was performed with Aspen Plus® V8.4. The gas turbine, the heat recovery steam generator and the steam cycle were modelled based on a 2010 US DOE report, while the MEA-based PCC plant was modelled as a rate-based process. The scaling of the amine plant was performed using a rate based calculation in preference to the equilibrium based approach for 90% CO2 capture. The power plant was integrated to the PCC plant in three ways: (i) flue gas stream from the power plant which is divided equally into four stream and each stream is fed into one of the four absorbers in the PCC plant. (ii) Steam draw-off from the IP/LP cross-over pipe in the steam cycle of the power plant used to regenerate solvent in the reboiler. (iii) Condensate returns from the reboiler to the power plant. The integration of a PCC plant to the NGCC plant resulted in a reduction of the power plant output by 73.56 MWe and the net efficiency of the integrated system is reduced by 7.3 % point efficiency. A secondary aim of this study is the parametric studies which have been performed to assess the impacts of natural gas on the overall performance of the integrated process and this is achieved through investigation of the capture efficiencies.

Keywords: natural gas-fired, power plant, MEA, CO2 capture, modelling, simulation

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Authors: Mehrdad Abkenari, Orod Zarrinkafsh, Mohsen Ramezan Shirazi

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Construction projects initiate in complicated dynamic environments and, due to the close relationships between project parameters and the unknown outer environment, they are faced with several uncertainties and risks. Success in time, cost and quality in large scale construction projects is uncertain in consequence of technological constraints, large number of stakeholders, too much time required, great capital requirements and poor definition of the extent and scope of the project. Projects that are faced with such environments and uncertainties can be well managed through utilization of the concept of risk management in project’s life cycle. Although the concept of risk is dependent on the opinion and idea of management, it suggests the risks of not achieving the project objectives as well. Furthermore, project’s risk analysis discusses the risks of development of inappropriate reactions. Since evaluation and prioritization of construction projects has been a difficult task, the network structure is considered to be an appropriate approach to analyze complex systems; therefore, we have used this structure for analyzing and modeling the issue. On the other hand, we face inadequacy of data in deterministic circumstances, and additionally the expert’s opinions are usually mathematically vague and are introduced in the form of linguistic variables instead of numerical expression. Owing to the fact that fuzzy logic is used for expressing the vagueness and uncertainty, formulation of expert’s opinion in the form of fuzzy numbers can be an appropriate approach. In other words, the evaluation and prioritization of construction projects on the basis of risk factors in real world is a complicated issue with lots of ambiguous qualitative characteristics. In this study, evaluated and prioritization the risk parameters and factors with fuzzy logy method by combination of three method DEMATEL (Decision Making Trial and Evaluation), ANP (Analytic Network Process) and TOPSIS (Technique for Order-Preference by Similarity Ideal Solution) on Construction Management.

Keywords: fuzzy logy, risk, prioritization, assessment

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Authors: Ibrahim Khan, Waqas Khalid

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The Healthcare sector is known to consume a higher proportion of total energy consumption in the HVAC market owing to an excessive cooling and heating requirement in maintaining human thermal comfort in indoor conditions, catering to patients undergoing treatment in hospital wards, rooms, and intensive care units. The indoor thermal comfort conditions in selected hospitals of Islamabad, Pakistan, were measured on a real-time basis with the collection of first-hand experimental data using calibrated sensors measuring Ambient Temperature, Wet Bulb Globe Temperature, Relative Humidity, Air Velocity, Light Intensity and CO2 levels. The Experimental data recorded was analyzed in conjunction with the Thermal Comfort Questionnaire Surveys, where the participants, including patients, doctors, nurses, and hospital staff, were assessed based on their thermal sensation, acceptability, preference, and comfort responses. The Recorded Dataset, including experimental and survey-based responses, was further analyzed in the development of a correlation between operative temperature, operative relative humidity, and other measured operative parameters with the predicted mean vote and adaptive predicted mean vote, with the adaptive temperature and adaptive relative humidity estimated using the seasonal data set gathered for both summer – hot and dry, and hot and humid as well as winter – cold and dry, and cold and humid climate conditions. The Machine Learning Logistic Regression Algorithm was incorporated to train the operative experimental data parameters and develop a correlation between patient sensations and the thermal environmental parameters for which a new ML-based adaptive thermal comfort model was proposed and developed in our study. Finally, the accuracy of our model was determined using the K-fold cross-validation.

Keywords: predicted mean vote, thermal comfort, energy management, logistic regression, machine learning

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Authors: Dagnew Dessie Mengie

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The purpose of this study was to investigate German tourists' demand for Ethiopian tourism destinations. The author has made every effort to identify the differences in the preferences of German visitors’ demand in Ethiopia comparing with Egypt, Kenya, Tanzania, and South African tourism sectors if they are invited to visit at the same time. However, the demand of international tourism for Ethiopia currently lags behind these African countries. Therefore, to offer demand-driven tourism products, the Ethiopian government, Tour & Travel operators need to understand the important factors that affect international tourists’ decision to visit Ethiopian tourist destinations. The aim of this study was intended to analyze German Tourists’ Demand towards Ethiopian destination. The researcher aimed to identify the demand for German tourists’ preference to Ethiopian tourist destinations comparing to the above-mentioned African countries. For collecting and analysing data for this study, both quantitative and qualitative methods of research are being used in this study. The most significant data are collected by using the primary data collection method i.e. survey and interviews which are the most and large number of potential responses and feedback from nine German active tourists,12 Ethiopian tourism officials, four African embassies, and four well functioning private tour companies and secondary data collected from books, journals, previous research and electronic websites. based on the data analysis of the information gathered from interviews and questionnaires, the study disclosed that majority of German tourists have not that much high demand on Ethiopian Tourist destinations due to the following reasons; Many Germans are fascinated by adventures, safari and simply want to lie on the beach and relax. These interests have leaded them to look for other African countries which have these accesses. Uncomfortable infrastructure and transport problems attributed for the decreasing the number of German tourists in the country. Inadequate marketing operation of Ethiopian Tourism Authority and its delegates in advertising and clarifying the above irregularities which are raised by the tourists.

Keywords: environmental benefits of tourism, social benefits of tourism, economical benefits of tourism, political factors in tourism

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Authors: Faheem Shahzad Baloch, Muhammad Azhar Nadeem, Muhammad Amjad Nawaz, Ephrem Habyarimana, Gonul Comertpay, Tolga Karakoy, Rustu Hatipoglu, Mehmet Zahit Yeken, Vahdettin Ciftci

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Turkey is considered a bridge between Europe, Asia, and Africa and possibly played an important role in the distribution of many crops including common bean. Hundreds of common bean landraces can be found in Turkey, particularly in farmers’ fields, and they consistently contribute to the overall production. To investigate the existing genetic diversity and hybridization events between the Andean and Mesoamerican gene pools in the Turkish common bean, 188 common bean accessions (182 landraces and 6 modern cultivars as controls) were collected from 19 different Turkish geographic regions. These accessions were characterized using phenotypic data (growth habit and seed weight), geographic provenance, 12557 high-quality whole-genome DArTseq markers, and 3767 novel DArTseq loci were also identified. The clustering algorithms resolved the Turkish common bean landrace germplasm into the two recognized gene pools, the Mesoamerican and Andean gene pools. Hybridization events were observed in both gene pools (14.36% of the accessions) but mostly in the Mesoamerican (7.97% of the accessions), and was low relative to previous European studies. The lower level of hybridization witnessed the existence of Turkish common bean germplasm in its original form as compared to Europe. Mesoamerican gene pool reflected a higher level of diversity, while the Andean gene pool was predominant (56.91% of the accessions), but genetically less diverse and phenotypically more pure, reflecting farmers greater preference for the Andean gene pool. We also found some genetically distinct landraces and overall, a meaningful level of genetic variability which can be used by the scientific community in breeding efforts to develop superior common bean strains.

Keywords: bean germplasm, DArTseq markers, genotyping by sequencing, Turkey, whole genome diversity

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Authors: Xuan Li

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The English language occupies a crucial position in the Chinese educational system and is officially introduced in the school curriculum from the third year of primary school onward. However, it is worth noting that along with the movement to remove primary-oriented education from preschools, the teaching of English is banned in preschools. Considering the worldwide trend of learning English at a young age, whether this ban can be implemented successfully is doubtful. With an initial focus on the interaction of language-in-education planning and policy (LEPP) at the macro level and actual practice at the micro level, this research selected three private preschools and two public preschools to explore what is taking place in terms of English education. All data collected is qualitative and is gained from documentary analysis, school observation, interviews, and focus groups. The findings show that: (1) although the English ban in preschool education aims to regulate all types of preschools and all adult Chinese participants are aware of this ban, there are very different scenarios according to type of preschool, such that no English classes are found in public schools while private preschools commonly provide some kind of English education; (2) even public schools do not have an English-free environment and parents’ demand for English education is high; (3) there is an obvious top-down hierarchy in both public and private schools, in which administrators make the decisions while others have little power to influence the school curriculum; (4) there is a clear gap in the perception of English teaching between children and adults, in which adults prefer foreign English teachers and think English teaching is just playing, while children do not have a clear preference regarding teachers and do not think English class is just for fun; (5) without macro support, there are many challenges involved in preschool English education, including the shortage of qualified teachers and teaching resources, ineffective personnel management and few opportunities for speaking English in daily life. Hopefully, this research will not only highlight the interaction of LEPP at different levels and the importance of individual agency but also raise the awareness of how to provide qualified and equal education for all children.

Keywords: individual agency, language-in-education planning and policy, micro context, preschool English education

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Authors: Mohammad Mahdi Hajiali

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Many of construction projects estimated in Iran have been influenced by the limitations of financial resources. As for Iran, a country that is developing, and to follow this development-oriented approach which many numbers of projects each year run in, if we can reduce the cost of projects by applying a method we will help greatly to minimize the cost of major construction projects and therefore projects will finish faster and more efficiently. One of the components of transportation infrastructure are roads that are considered to have a considerable share of the country budget. In addition, major budget of the related ministry is spending to repair, improve and maintain roads. Value Engineering is a simple and powerful methodology over the past six decades that has been successful in reducing the cost of many projects. Specific solution for using value engineering in the stage of project implementation is called value engineering change proposal (VECP). It was tried in this research to apply VECP in one of the road-building projects in Iran in order to enhance the value of this kind of projects and reduce their cost. In this case study after applying VECP, an idea was raised. It was about use of concrete pavement instead of hot mixed asphalt (HMA) and also using fiber in order to improve concrete pavement performance. VE group team made a decision that for choosing the best alternatives, get expert’s opinions in pavement systems and use Fuzzy TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) for ranking opinions of the experts. Finally, Jointed Plain Concrete Pavement (JPCP) was selected. Group also experimented concrete samples with available fibers in Iran and the results of experiments showed a significant increment in concrete specifications such as flexural strength. In the end, it was shown that by using of fiber-reinforced concrete pavement instead of asphalt pavement, we can achieve a significant saving in cost, time and also increment in quality, durability, and longevity.

Keywords: road-building projects, value engineering change proposal (VECP), Jointed Plain Concrete Pavement (JPCP), Fuzzy TOPSIS, fiber-reinforced concrete

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Authors: Gali Pesin, Yuliya Lipshits-Braziler, Sima Amram-Vaknin, Moshe Tatar

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The present study introduces four different patterns of seeking and providing help online among adolescents: (I) ‘Transceivers’ - adolescents who both seek as well as provide help online; (II) ‘Receivers’ - adolescents who seek help online, yet don’t provide it; (III) ‘Transmitters’ - adolescents who provide help online, yet don’t seek it; and (IV) ‘Idles’ - adolescents who refrain from seeking and providing help online. The study examined differences in seeking and providing help online between possible combinations of the four patterns, as well as gender differences within each pattern. Data was collected from 528 adolescents in Israel (59% were girls). Findings revealed that Transceivers are the largest group (45%) in this study, with higher representation of girls (65%). These adolescents seek help mainly around social difficulties, and they turn to peers who are both known and unknown to them. In addition, their preferred way to seek and provide help is through social network sites. Moreover, they often accept and give others emotional support. Receivers are the smallest group (5%) in this study. They turn to both known and unknown professionals more often than to friends and family. In addition, they seek help mostly around health and nutrition issues, and they usually receive instrumental support. For Receivers, the most important factor for seeking help online is anonymity, and the least important factor is familiarity with the help giver. Transmitters represent 16% of the adolescents in this study, with a greater representation of boys (52%). Their main reason to refrain from seeking help online is self-reliance. Nevertheless, these adolescents provide help to others online, mainly to those known to them through posting or responding to posts on social network sites. Idles represent 34% of the adolescents in this study. They refrain from seeking help online mainly due to their preference to seek help face to face, and due to their lack of trust in the internet or those using it. Idles and Transmitters are willing to seek help online mostly from friends and family. In addition, they are willing seek help online mainly regarding questions concerning military or civil service. They consider the most important facilitators for seeking help online as confidentiality and reliability. The present study’s main contribution is exploring the role of providing online help in understanding the adolescent behavior of seeking help online. In addition, the results of the present study have practical implications for the work of mental health providers, such as counseling psychologists and online mental health support.

Keywords: adolescents, counseling, online help-seeking, online help-providing

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Authors: Yu Liang

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The study of heritage in different contexts has been discussed during the past decades, which the relationship with other fields such as tourism, museum, and urban regeneration has also been interested in scholars. Governmental and policy attention were also fascinated by the use of heritage, which it is a ‘heritagisation’ process, to achieve certain goals because the advantage will appear in both economic development and social inclusion with suitable planning. In the case of Belfast, this city has been through tough ages due to its complicated ideology issues in the past; however, it is obvious to see the transformation through representing their Belfast heritages in tourism. Planners are willing to use this method to attract cultural tourists, investors and also residents to reborn and retrieve their confidence. One of the target topics is the establishment of Titanic Belfast that explores the culture of Titanic and the history of the shipbuilding industry in Belfast. Even though the cultural flagship brought economic and social benefit, not all of the people agreed on the vision of relaunching a sunken ship and felt proud of it. The aim of this research is to clarify the concept of a ‘heritagisation’ that it could achieve certain goals in consolidating areas, increasing local self-identity pride, and promoting tourism activities if well-planned. Moreover, to discuss the preference and the pros and cons of its practice with the Titanic culture in Belfast’s regeneration process, especially the Titanic Belfast flagship project. From the methodological point of view, a mixed incorporating qualitative point of interviews, observation, and secondary sources with different perspectives and approaches are adopted in this case study. The expected result would show that a great majority of outsiders and the planners were pleasured about the concept of Titanic Belfast’s establishment and agreed its attraction traveling to Belfast. Nevertheless, there were still an amount of locals disagree that the Titanic culture and the flagship would be representative of this city and would bring other advantages to them. In other words, some residents doubt or less likely to support the issue since they have been ignored out of the planning process. Hence, opinions are divided among 38 residents, various outsiders, and stakeholders, and their perspectives have drawn an interesting task for sustainable research in the future.

Keywords: Belfast, heritagisation, Titanic, Titanic Belfast, urban regeneration

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Authors: Sanjeev Prasher, T. Sai Vijay, Chandan Parsad, Abhishek Banerjee, Sahakari Nikhil Krishna, Subham Chatterjee

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With rapid rise in internet retailing, the industry is set for a major implosion. Due to the little difference among competitors, companies find it difficult to segment and target the right shoppers. The objective of the study is to segment Indian online shoppers on the basis of the factors – website characteristics and shopping values. Together, these cover extrinsic and intrinsic factors that affect shoppers as they visit web retailers. Data were collected using questionnaire from 319 Indian online shoppers, and factor analysis was used to confirm the factors influencing the shoppers in their selection of web portals. Thereafter, cluster analysis was applied, and different segments of shoppers were identified. The relationship between income groups and online shoppers’ segments was tracked using correspondence analysis. Significant findings from the study include that web entertainment and informativeness together contribute more than fifty percent of the total influence on the web shoppers. Contrary to general perception that shoppers seek utilitarian leverages, the present study highlights the preference for fun, excitement, and entertainment during browsing of the website. Four segments namely Information Seekers, Utility Seekers, Value Seekers and Core Shoppers were identified and profiled. Value seekers emerged to be the most dominant segment with two-fifth of the respondents falling for hedonic as well as utilitarian shopping values. With overlap among the segments, utilitarian shopping value garnered prominence with more than fifty-eight percent of the total respondents. Moreover, a strong relation has been established between the income levels and the segments of Indian online shoppers. Web shoppers show different motives from being utility seekers to information seekers, core shoppers and finally value seekers as income levels increase. Companies can strategically use this information for target marketing and align their web portals accordingly. This study can further be used to develop models revolving around satisfaction, trust and customer loyalty.

Keywords: online shopping, shopping values, effectiveness of information content, web informativeness, web entertainment, information seekers, utility seekers, value seekers, core shoppers

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Authors: Aita Bishowkarma

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Ensuring quality education in primary level in multi-ethnic, multi- religious, multi-cultural and multilingual country Nepal which accommodates 123 ethnic languages (CBS 2011) has come across a big challenge. The discourse on the policies and practices to take advantage of the rich heritage of cultural and linguistic diversity in the pursuit of quality primary education to ethnic/linguistic minority children in Nepal gives in a critical observation of Nepalese perspective in the global academia. Situating the linguistic diversity of Nepal, primary education to children is better through mother tongue. Nepali as official or national language is another important language to be taught to the children. Similarly, craze for English has been inevitable for international communication and job opportunity in the global markets. This paper critically examines the current use of trilingual policy in mother tongue based multilingual education (MT-MLE) in Nepal from the perspective of exploiting linguistic diversity in classroom pedagogy. The researcher adopted mixed method research design applying descriptive measure and explanatory research methods. 24 teachers and 48 students from 6 multilingual schools were selected purposively to dig out their language use, language attitude and language preferences to reveal their preference and attitude towards mother tongue, Nepali and English through questionnaire, interview and focus group discussion. The study shows, in a true multilingual system, all languages (mother tongue, languages of region, nation and wider communication) can have their legitimate place; bridging from the mother tongue to the regional language and national to international language; further leading to meaningful participation in the wider democratic global context. Trilingual policy of mother tongue, national language and international language seemed pertinent however, not sufficient. The finding of the study shows that for quality education in primary education mother tongue based critical multilingual pedagogy through language coexistence approach with contextual variation seems enviable.

Keywords: critical pedagogy, language co-existence, linguistic diversity, quality education

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Authors: Azizul Baten, Kamrul Hossain, Abdullah-Al-Zabir

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The objective of this study is to develop an appropriate stochastic frontier secondary schools efficiency model by ICT Intervention and to examine the impact of ICT challenges on secondary schools efficiency in the Sylhet division in Bangladesh using stochastic frontier analysis. The Translog stochastic frontier model was found an appropriate than the Cobb-Douglas model in secondary schools efficiency by ICT Intervention. Based on the results of the Cobb-Douglas model, it is found that the coefficient of the number of teachers, the number of students, and teaching ability had a positive effect on increasing the level of efficiency. It indicated that these are related to technical efficiency. In the case of inefficiency effects for both Cobb-Douglas and Translog models, the coefficient of the ICT lab decreased secondary school inefficiency, but the online class in school was found to increase the level of inefficiency. The coefficients of teacher’s preference for ICT tools like multimedia projectors played a contributor role in decreasing the secondary school inefficiency in the Sylhet division of Bangladesh. The interaction effects of the number of teachers and the classrooms, and the number of students and the number of classrooms, the number of students and teaching ability, and the classrooms and teaching ability of the teachers were recorded with the positive values and these have a positive impact on increasing the secondary school efficiency. The overall mean efficiency of urban secondary schools was found at 84.66% for the Translog model, while it was 83.63% for the Cobb-Douglas model. The overall mean efficiency of rural secondary schools was found at 80.98% for the Translog model, while it was 81.24% for the Cobb-Douglas model. So, the urban secondary schools performed better than the rural secondary schools in the Sylhet division. It is observed from the results of the Tobit model that the teacher-student ratio had a positive influence on secondary school efficiency. The teaching experiences of those who have 1 to 5 years and 10 years above, MPO type school, conventional teaching method have had a negative and significant influence on secondary school efficiency. The estimated value of σ-square (0.0625) was different from Zero, indicating a good fit. The value of γ (0.9872) was recorded as positive and it can be interpreted as follows: 98.72 percent of random variation around in secondary school outcomes due to inefficiency.

Keywords: efficiency, secondary schools, ICT, stochastic frontier analysis

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Authors: Madeleine Cox

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Objective; analyse patient choices in management of first trimester miscarriage, rates of complications including repeat procedure. Design: all first trimester miscarriages from a tertiary institution on the Gold Coast in a 6 month time frame (July to December 2021) were reviewed, including choice of management, histopathology, any representations or admissions, and potential complications. Results: a total of 224 first trimester miscarriages were identified. Of these, 183 (81%) opted to have surgical management in the first instance. Of the remaining patients, 18 (8%) opted to have medical management, and 28 (12.5%) opted to have expectant management. In total, 33(15%) patients required a repeat treatment for retained products. 1 had medical management for a small volume PROC post suction curette. A significant number of these patients initially opted for medical management but then elected to have shorter follow up than usual and went on to have retained products noted. 5 women who had small volumes of RPOC post medical or surgical management had repeat suction curette, however, had very small volumes of products on scan and on curette and may have had a good result with repeated misoprostol administration. It is important to note that whilst a common procedure, suction curettes are not without risk. 2 women had significant blood loss of 1L and 1.5L. A third women had a uterine perforation, a rare but recognised complication, she went on to require a laparoscopy which identified a small serosal bowel injury which was closed by the colorectal team. Conclusion: Management of first trimester miscarriage should be guided by patient preference. It is important to be able to provide patients with their choice of management, however, it is also important to have a good understanding of the risks of each management choice, chances of repeated procedure, appropriate time frame for follow up. Women who choose to undertake medical or expectant management should be supported through this time, with appropriate time frame between taking misoprostol and repeat scan so that the true effects can be evaluated. Patients returning for scans within 2-3 days are more likely to be booked for further surgery, however, may reflect patients who did not have adequate counselling or simply changed their mind on their preferred management options.

Keywords: miscarriage, gynaecology, obstetrics, first trimester

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