Search results for: flexible classroom management

Authors: Amin AminiKhafri, James M. Dawson-Edwards, Ryan M. Simpson, Simaan M. AbouRizk

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Earned value management (EVM) has been introduced as an integrated method to combine schedule, budget, and work breakdown structure (WBS). EVM provides various indices to demonstrate project performance including the cost performance index (CPI). CPI is also used to forecast final project cost at completion based on the cost performance during the project execution. Knowing the final project cost during execution can initiate corrective actions, which can enhance project outputs. CPI, however, is not constant during the project, and calculating the final project cost using a variable index is an inaccurate and challenging task for practitioners. Since CPI is based on the cumulative progress values and because of the learning curve effect, CPI variation dampens and stabilizes as project progress. Although various definitions for the CPI stability have been proposed in literature, many scholars have agreed upon the definition that considers a project as stable if the CPI at 20% completion varies less than 0.1 from the final CPI. While 20% completion point is recognized as the stability point for military development projects, construction projects stability have not been studied. In the current study, an empirical study was first conducted using construction project data to determine the stability point for construction projects. Early findings have demonstrated that a majority of construction projects stabilize towards completion (i.e., after 70% completion point). To investigate the effect of CPI stability on cost forecast accuracy, the correlation between CPI stability and project cost at completion forecast accuracy was also investigated. It was determined that as projects progress closer towards completion, variation of the CPI decreases and final project cost forecast accuracy increases. Most projects were found to have 90% accuracy in the final cost forecast at 70% completion point, which is inlined with findings from the CPI stability findings. It can be concluded that early stabilization of the project CPI results in more accurate cost at completion forecasts.

Keywords: cost performance index, earned value management, empirical study, final project cost

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Authors: Ana Paula Almeida Castaldelli Maciel, Gabriela Medeiros, Amanda de Souza Machado, Maria Clara Pilatti, Ralpho Rinaldo dos Reis, Silvio Cesar Sampaio

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Sustainable agricultural systems are crucial to ensuring global food security and the long-term production of nutritious food. Comprehensive soil and water management practices, including nutrient management, balanced fertilizer use, and appropriate waste management, are essential for sustainable agriculture. Swine wastewater (SWW) treatment has become a significant focus due to environmental concerns related to heavy metals, antibiotics, resistant pathogens, and nutrients. In South America, small farms use soil to dispose of animal waste, a practice that is expected to increase with global pork production. The potential of SWW as a nutrient source is promising, contributing to global food security, nutrient cycling, and mineral fertilizer reduction. Short- and long-term studies evaluated the effects of SWW on soil and plant parameters, such as nutrients, heavy metals, organic matter (OM), cation exchange capacity (CEC), and pH. Although promising results have been observed in short- and medium-term applications, long-term applications require more attention due to heavy metal concentrations. Organic soil amendment strategies, due to their economic and ecological benefits, are commonly used to reduce the bioavailability of heavy metals. However, the rate of degradation and initial levels of OM must be monitored to avoid changes in soil pH and release of metals. The study aimed to evaluate the long-term effects of SWW application on soil fertility parameters, focusing on calcium (Ca), magnesium (Mg), and potassium (K), in addition to CEC and OM. Experiments were conducted at the Universidade Estadual do Oeste do Paraná, Brazil, using 24 drainage lysimeters for nine years, with different application rates of SWW and mineral fertilization. Principal Component Analysis (PCA) was then conducted to summarize the composite variables, known as principal components (PC), and limit the dimensionality to be evaluated. The retained PCs were then correlated with the original variables to identify the level of association between each variable and each PC. Data were interpreted using Analysis of Variance - ANOVA for general linear models (GLM). As OM was not measured in the 2007 soybean experiment, it was assessed separately from PCA to avoid loss of information. PCA and ANOVA indicated that crop type, SWW, and mineral fertilization significantly influenced soil nutrient levels. Soybeans presented higher concentrations of Ca, Mg, and CEC. The application of SWW influenced K levels, with higher concentrations observed in SWW from biodigesters and higher doses of swine manure. Variability in nutrient concentrations in SWW due to factors such as animal age and feed composition makes standard recommendations challenging. OM levels increased in SWW-treated soils, improving soil fertility and structure. In conclusion, the application of SWW can increase soil fertility and crop productivity, reducing environmental risks. However, careful management and long-term monitoring are essential to optimize benefits and minimize adverse effects.

Keywords: contamination, water research, biodigester, nutrients

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Authors: Zenaida Chitu, Roxana Bojariu, Liliana Velea, Roxana Burcea

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A number of studies show that extreme air temperature affects mortality related to cardiovascular diseases, particularly among elderly people. In Romania, the summer thermal discomfort expressed by Universal Thermal Climate Index (UTCI) is highest in the Southern part of the country, where Bucharest, the largest Romanian urban agglomeration, is also located. The urban characteristics such as high building density and reduced green areas enhance the increase of the air temperature during summer. In Bucharest, as in many other large cities, the effect of heat urban island is present and determines an increase of air temperature compared to surrounding areas. This increase is particularly important during heat wave periods in summer. In this context, the researchers performed a temperature-mortality analysis based on daily deaths related to cardiovascular diseases, recorded between 2010 and 2019 in Bucharest. The temperature-mortality relationship was modeled by applying distributed lag non-linear model (DLNM) that includes a bi-dimensional cross-basis function and flexible natural cubic spline functions with three internal knots in the 10th, 75th and 90th percentiles of the temperature distribution, for modelling both exposure-response and lagged-response dimensions. Firstly, this study applied this analysis for the present climate. Extrapolation of the exposure-response associations beyond the observed data allowed us to estimate future effects on mortality due to temperature changes under climate change scenarios and specific assumptions. We used future projections of air temperature from five numerical experiments with regional climate models included in the EURO-CORDEX initiative under the relatively moderate (RCP 4.5) and pessimistic (RCP 8.5) concentration scenarios. The results of this analysis show for RCP 8.5 an ensemble-averaged increase with 6.1% of heat-attributable mortality fraction in future in comparison with present climate (2090-2100 vs. 2010-219), corresponding to an increase of 640 deaths/year, while mortality fraction due to the cold conditions will be reduced by 2.76%, corresponding to a decrease by 288 deaths/year. When mortality data is stratified according to the age, the ensemble-averaged increase of heat-attributable mortality fraction for elderly people (> 75 years) in the future is even higher (6.5 %). These findings reveal the necessity to carefully plan urban development in Bucharest to face the public health challenges raised by the climate change. Paper Details: This work is financed by the project URCLIM which is part of ERA4CS, an ERA-NET initiated by JPI Climate, and funded by Ministry of Environment, Romania with co-funding by the European Union (Grant 690462). A part of this work performed by one of the authors has received funding from the European Union’s Horizon 2020 research and innovation programme from the project EXHAUSTION under grant agreement No 820655.

Keywords: cardiovascular diseases, climate change, extreme air temperature, mortality

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Authors: Rafika Bayu Kusumandari, Istyarini, Ispen Safrel

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Character education will be more meaningful if carried out since early childhood. This is because early childhood education is the foundation of the formation of character. This study intends to find a model of character education in early childhood based on Javanese culture. In keeping with the focus of the study, long-term goals to be achieved through this research is to find once described the development of a model of character education in early childhood Javanese culture based in Semarang are then applied across early childhood education institutions in Semarang City. The specific objective of the study is: Describe the character models and management education in early childhood Java-based culture in Semarang City. The benefits of this research are; Provide an overview of the model and describe the management of character education in early childhood Java-based culture in Semarang City. Referring to the objectives of the research program was designed with a "Research and Development", meaning that a program of research followed by development programs for improvement or refinement. To produce a prototype model of character education in early childhood Java-based culture in the city, taken systematic measures in the form of the action, reflection, evaluation and innovation by applying qualitative research methods, descriptive, development, experimentation, and evaluation. This study aims to gain in-depth description of the model of character education in early childhood Java-based culture in the city of Semarang. The reason for the use of the use of qualitative methods researcher's knowledge, no study results and empirical research specifically about the model of character education in early childhood Java-based culture in the city of Semarang. On the implementation of character education early childhood adapted to the characteristics of each school and the emphasis of each agency arrangements for early childhood education, culture-based Java. Javanese culture should be introduced early in order not to erode the cultural lost outside the entrance as the era of globalization. In addition, Java is promoting a culture of courtesy and manners are very appropriate for the character formation of children of early age.

Keywords: education character, Javanese culture, childhood, character

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Authors: Syed Hammad Ali, Rijan Bhakta Kayastha, Ahuti Shrestha, Iram Bano

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The hydrology of Upper Indus basin is not recognized well due to the intricacies in the climate and geography, and the scarcity of data above 5000 meters above sea level where most of the precipitation falls in the form of snow. The main objective of this study is to measure the contributions of different components of runoff in Upper Indus basin. To achieve this goal, the Modified positive degree-day model (MPDDM) was used to simulate the runoff and investigate its components in two catchments of Upper Indus basin, Hunza and Gilgit River basins. These two catchments were selected because of their different glacier coverage, contrasting area distribution at high altitudes and significant impact on the Upper Indus River flow. The components of runoff like snow-ice melt and rainfall-base flow were identified by the model. The simulation results show that the MPDDM shows a good agreement between observed and modeled runoff of these two catchments and the effects of snow-ice are mainly reliant on the catchment characteristics and the glaciated area. For Gilgit River basin, the largest contributor to runoff is rain-base flow, whereas large contribution of snow-ice melt observed in Hunza River basin due to its large fraction of glaciated area. This research will not only contribute to the better understanding of the impacts of climate change on the hydrological response in the Upper Indus, but will also provide guidance for the development of hydropower potential, water resources management and offer a possible evaluation of future water quantity and availability in these catchments.

Keywords: future discharge projection, positive degree day, regional climate model, water resource management

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Authors: D. Norton

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This qualitative study focuses on the lived experience and displacement of young white-collar masculinities in Japan. In recent years, the salaryman lifestyle has undergone significant disruption - increased competition for regular employment, rise in non-regular structurings of labour across public/private sectors, and shifting role expectations within the home. Despite this, related scholarship hints at a continued reinforcement of the traditional male gender role - that the salaryman remains a key benchmark of Japanese masculine identity. For those in structural proximity to these more ‘normative’ performativities, interest lies their engagement with such narratives - how they make sense of their masculinity in response to stated changes. In light of the historical emphasis on labour and breadwinning logics, notions of respective security or precarity generated as a result remain unclear. Similarly, concern extends to developments within the private sphere - by what means young white-collar men construct ideas of singlehood and companionship according to traditional gender ideologies or more contemporary, flexible readings. The influence of these still-emergent status distinctions on the logics of the social group in question is yet to be explored in depth by gender scholars. This project, therefore, focuses on a salaryman archetype as hegemonic - its transformation amidst these changes and socialising mechanisms that continue to legitimate unequal gender hierarchies. For data collection, a series of ethnographic interviews were held over a period of 12 months with university-educated, white-collar male employees from both Osaka and the Greater Tokyo Area. Findings suggest a modern salaryman ideal reflecting both continuities and shifts within white-collar employment. Whilst receptive to more contemporary workplace practices, the narratives of those interviewed remain imbued with logics supporting patterns of internal hegemony. Regular/non-regular distinction emerged as the foremost variable for both material and discursive patterns of white-collar stratification, with variants of displacement for each social group. Despite the heightened valorisation of stable employment, regular workers articulated various concerns over a model of corporate masculinity seen to be incompatible with recent socioeconomic developments. Likewise, non-regular employees face detachment owing to a still-inflexible perception of their working masculinity as marginalized amidst economic precarity. In seeking to negotiate respective challenges, those interviewed demonstrated an engagement with various concurrent social changes that would often either accommodate, reinforce, or expand upon traditional role behaviours. Few of these narratives offered any notable transgression of said ideal, however, suggesting that within the spectre of white-collar employment in Japan for the near future, any substantive transformation of corporate masculinity remains dependant upon economic developments, less so the agency of those involved.

Keywords: gender ideologies, hegemonic masculinity, Japan, white-collar employment

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Authors: Tugba Sevinc Gamsiz, Emine Koroglu, Ozcan Keskin

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Aim: Nonalcoholic fatty liver disease (NAFLD) is considered the most common chronic liver disease in the general population. The higher mortality and morbidity among NAFLD patients and lack of symptoms makes early detection and management important. In our study, we aimed to evaluate the relationship between noninvasive imaging and biochemical markers in diabetic and nondiabetic patients diagnosed with NAFLD. Materials and Methods: The study was conducted from (September 2017) to (December 2017) on adults admitted to Internal Medicine and Gastroenterology outpatient clinics with hepatic steatosis reported on ultrasound or transient elastography within the last six months that exclude patients with other liver diseases or alcohol abuse. The data were collected and analyzed retrospectively. Number cruncher statistical system (NCSS) 2007 program was used for statistical analysis. Results: 116 patients were included in this study. Diabetic patients compared to nondiabetics had significantly higher Controlled Attenuation Parameter (CAP), Liver Stiffness Measurement (LSM) and fibrosis values. Also, hypertension, hepatomegaly, high BMI, hypertriglyceridemia, hyperglycemia, high A1c, and hyperuricemia were found to be risk factors for NAFLD progression to fibrosis. Advanced fibrosis (F3, F4) was present in 18,6 % of all our patients; 35,8 % of diabetic and 5,7 % of nondiabetic patients diagnosed with hepatic steatosis. Conclusion: Transient elastography is now used in daily clinical practice as an accurate noninvasive tool during follow-up of patients with fatty liver. Early diagnosis of the stage of liver fibrosis improves the monitoring and management of patients, especially in those with metabolic syndrome criteria.

Keywords: diabetes, elastography, fatty liver, fibrosis, metabolic syndrome

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Authors: R. K. Yadav, S. Baral, H. R. Paudel, R. Basnet

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The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public healthcare providers in the fight against tuberculosis using international healthcare standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal. A total of 20 respondents participated in the study. Barriers to PPM were identified in the following three themes: 1) Obstacles related to TB case detection, 2) Obstacles related to patients, and 3) Obstacles related to the healthcare system. PPM implementation was challenged by following subthemes that included staff turnover, low private sector participation in workshops, a lack of training, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies. The study concludes that numerous barriers exist in the way of effective implementation of the PPM approach, including TB cases detection barriers such as knowledge of TB diagnosis and treatment, HW attitude, workload, patient-related barriers such as knowledge of TB, self-medication practice, stigma and discrimination, financial status, and health system-related barriers such as staff turnover and poor engagement of the private sector in workshops, training, recording, and re-evaluation. Government stakeholders must work together with private sector stakeholders to perform joint monitoring and supervision. Private practitioners should receive training and orientation, and presumptive TB patients should be given adequate time and counseling as well as motivation to visit a government health facility.

Keywords: barrier, tuberculosis, case finding, PPM, nepal

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Authors: F. O. Danquah, F. Frimpong, E. Owusu Danquah, T. Frimpong, J. Adu, S. K. Amposah, P. Amankwaa-Yeboah, N. E. Amengor

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In the face of global concerns such as population increase, climate change, and limited natural resources, sustainable agriculture practices are critical for ensuring food security and environmental stewardship. The study was conducted in the Forest zones of Ghana during the major and minor seasons of 2023 cropping seasons to evaluate maize yield productivity improvement and profitability of integrating Cajanus cajan (pigeonpea) into a maize production system described as a pigeonpea-maize cropping system. This is towards an integrated soil fertility management (ISFM) with a legume shrub pigeonpea for sustainable maize production while improving smallholder farmers' resilience to climate change. A split-plot design with maize-pigeonpea (Pigeonpea-Maize intercrop – MPP and No pigeonpea/ Sole maize – NPP) and inorganic fertilizer rate (250 kg/ha of 15-15-15 N-P2O5-K2O + 250 kg/ha Sulphate of Ammonia (SoA) – Full rate (FR), 125 kg/ha of 15-15-15 N-P2O5-K2O + 125 kg/ha Sulphate of Ammonia (SoA) – Half rate (HR) and no inorganic fertilizer (NF) as control) was used as the main plot and subplot treatments respectively. The results indicated a significant interaction of the pigeonpea-maize cropping system and inorganic fertilizer rate on the growth and yield of the maize with better and similar maize productivity when HR and FR were used with pigeonpea biomass. Thus, the integration of pigeonpea and its biomass would result in the reduction of recommended fertiliser rate to half. This would improve farmers’ income and profitability for sustainable maize production in the face of climate change.

Keywords: agroforestry tree, climate change, integrated soil fertility management, resource use efficiency

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Authors: Kamyar Maleki Bagherabadi, Torstein Aarseth Bø, Truls Flatberg, Olve Mo

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Hydrogen fuel cells and batteries are one of the promising solutions aligned with carbon emission reduction goals for the marine sector. However, the higher installation and operation costs of hydrogen-based systems compared to conventional diesel gensets raise questions about the appropriate hydrogen tank size, energy, and fuel consumption estimations. Ship designers need methodologies and tools to calculate energy and fuel consumption for different component sizes to facilitate decision-making regarding feasibility and performance for retrofits and design cases. The aim of this work is to compare three alternative modeling approaches for the estimation of energy and fuel consumption with various hydrogen tank sizes, battery capacities, and load-sharing strategies. A fishery vessel is selected as an example, using logged load demand data over a year of operations. The modeled power system consists of a PEM fuel cell, a diesel genset, and a battery. The methodologies used are: first, an energy-based model; second, considering load variations during the time domain with a rule-based Power Management System (PMS); and third, a load variations model and dynamic PMS strategy based on optimization with perfect foresight. The errors and potentials of the methods are discussed, and design sensitivity studies for this case are conducted. The results show that the energy-based method can estimate fuel and energy consumption with acceptable accuracy. However, models that consider time variation of the load provide more realistic estimations of energy and fuel consumption regarding hydrogen tank and battery size, still within low computational time.

Keywords: fuel cell, battery, hydrogen, hybrid power system, power management system

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Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba, Marek Jan Kuzniewski

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Introduction: Vitamin D3 has a proven pleiotropic effect, not only responsible for calcium and phosphate management, but also influencing normal functioning of the whole body. Aim: Evaluation of vitamin D3 resources and its effect on a nutritional status, obesity type and glomerular filtration in kidney transplant recipients. Methods: Group of 152 (81 women and 71 men, average age 47.8 ± 11.6 years) patients with a functioning renal transplant their body composition was assessed using the bioimpendance method (BIA) and anthropometric measurements more than 3 months after the transplant. The nutritional status and the obesity type were determined with the Waist to Height Ratio (WHtR) and the Waist to Hip Ratio (WHR). 25- Hydroxyvitamin D3 (25 (OH)D3) was determined, together with its correlation with the obesity type and the glomerular filtration rate (eGFR) calculated with the MDRD formula. Results: The mean 25 (OH)D3 level was 20.4 ng/ml. 30ng/ml was considered as a minimum correct level 22,7% of patients from the study group were classified to be a correct body weight, 56,7% of participants had an android type and 20,6% had a gynoid type. Significant correlation was observed between 25 (OH)D3 deficiency and abdominal obesity (p < 0.005) in patients. Furthermore, a statistically significant relationship was demonstrated between the 25 (OH)D3 levels and eGFR in patients after a kidney transplant. Patients with an android body type had lower eGFR versus those with the gynoid body type (p=0.004). Conclusions: Correct diet in patients after a kidney transplant determines minimum recommended serum levels of vitamin D3. Excessive fatty tissue, low levels of 25 (OH)D3), may be a predictor for android obesity and renal injury; therefore, correct diet and pharmacological management together with physical activities adapted to the physical fitness level of a patient are necessary.

Keywords: kidney transplantation, glomerular filtration rate, obesity, vitamin D3

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Authors: H. Hakim, C. Kibert, C. Fabre, S. Monadizadeh

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Construction industry is an industry saddled with chronic problems of high waste generation. Waste management that is to ensure materials are utilized in an efficient manner would make a major contribution to mitigating the negative environmental impacts of construction waste including finite resources depletion and growing occupied landfill areas to name a few. Furthermore, ‘material resource efficiency’ has been found an economically smart approach specially when considered during the design phase. One effective strategy is to utilizing off-site construction process which includes a series of prefabricated systems such as mobile, modular, and HUD construction (Department of Housing and Urban Development manufactured buildings). These types of buildings are by nature material and resource-efficient. Despite conventional construction that is exposed to adverse weather conditions, manufactured construction production line is capable of creating repetitive units in a factory controlled environment. A factory can have several parallel projects underway with a high speed and in a timely manner which simplifies the storage of excess materials and re-allocating to the next projects. The literature reports that prefabricated construction significantly helps reduce errors, site theft, rework, and delayed problems and can ultimately lead to a considerable waste reduction. However, there is not sufficient data to quantify this reduction when it comes to a regular modular house in the U.S. Therefore, this manuscript aims to provide an analysis of waste originated from a manufactured factory trend. The analysis was made possible with several visits and data collection of Homes of Merits, a Florida Manufactured and Modular Homebuilder. The results quantify and verify a noticeable construction waste reduction.

Keywords: construction waste, modular construction, prefabricated buildings, waste management

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Authors: Osman Ali, Jeanne Kriek

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Introduction: The current instructional approach entrenched in memorizing does not assist conceptual understanding in science. Instructional approaches that encourage research, investigation, and experimentation, which depict how scientists work, should be encouraged. One such teaching strategy is problem-based learning (PBL). PBL has many advantages; enhanced self-directed learning and improved problem-solving and critical thinking skills. However, despite many advantages, PBL has challenges. Research confirmed is time-consuming and difficult to formulate ill-structured questions. Professional development interventions are needed for in-service educators to adopt the PBL strategy. The purposively selected educators had to implement PBL in their classrooms after the intervention to develop their practice and then reflect on the implementation. They had to indicate their achievements and challenges. This study differs from previous studies as the rural educators were subjected to implementing PBL in their classrooms and reflected on their experiences, beliefs, and attitudes regarding PBL. Theoretical Framework: The study reinforced Vygotskian sociocultural theory. According to Vygotsky, the development of a child's cognitive is sustained by the interaction between the child and more able peers in his immediate environment. The theory suggests that social interactions in small groups create an opportunity for learners to form concepts and skills on their own better than working individually. PBL emphasized learning in small groups. Research Methodology: An exploratory case study was employed. The reason is that the study was not necessarily for specific conclusive evidence. Non-probability purposive sampling was adopted to choose eight schools from 89 rural public schools. In each school, two educators were approached, teaching physical sciences in grades 10 and 11 (N = 16). The research instruments were questionnaires, interviews, and lesson observation protocol. Two open-ended questionnaires were developed before and after intervention and analyzed thematically. Three themes were identified. The semi-structured interviews and responses were coded and transcribed into three themes. Subsequently, the Reform Teaching Observation Protocol (RTOP) was adopted for lesson observation and was analyzed using five constructs. Results: Evidence from analyzing the questionnaires before and after the intervention shows that participants knew better what was required to develop an ill-structured problem during the implementation. Furthermore, indications from the interviews are that participants had positive views about the PBL strategy. They stated that they only act as facilitators, and learners’ problem-solving and critical thinking skills are enhanced. They suggested a change in curriculum to adopt the PBL strategy. However, most participants may not continue to apply the PBL strategy stating that it is time-consuming and difficult to complete the Annual Teaching Plan (ATP). They complained about materials and equipment and learners' readiness to work. Evidence from RTOP shows that after the intervention, participants learn to encourage exploration and use learners' questions and comments to determine the direction and focus of classroom discussions.

Keywords: problem-solving, self-directed, critical thinking, intervention

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Authors: Latif Duran, Erdem Aydin, Ahmet Baydin, Ali Kemal Erenler, Iskender Aksoy

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Aim: In this retrospective study, we aim to contribute to the literature by presenting the proposals for taking measures to reduce the mortality by examining the demographic characteristics of the pediatric age group patients presenting with trauma and the factors that may cause mortality Material and Method: This study has been performed by retrospectively investigating the data obtained from the patient files and the hospital automation registration system of the pediatric trauma patients who applied to the Adult Emergency Department of the Ondokuz Mayıs University Medical Faculty between January 1, 2016, and December 31, 2016. Results: 289 of 415 patients involved in our study, were males. The median age was 11.3 years. The most common trauma mechanism was falling from the high. A significant statistical difference was found on the association between trauma mechanisms and gender. An increase in the number of trauma cases was found especially in the summer months. The study showed that thoracic and abdominal trauma was relevant to the increased mortality. Computerized tomography was the most common diagnostic imaging modality. The presence of subarachnoid hemorrhage has increased the risk of mortality by 62.3 fold. Eight of the patients (1.9%) died. Scoring systems were statistically significant to predict mortality. Conclusion: Children are vulnerable to trauma because of their unique anatomical and physiological differences compared to adult patient groups. It will be more successful in the mortality rate and in the post-traumatic healing process by administering the patient triage fast and most appropriate trauma centers in the prehospital period, management of the critical patients with the scoring systems and management with standard treatment protocols

Keywords: emergency service, pediatric patients, scoring systems, trauma, age groups

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Authors: Yusuf Garba Baba

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The construction industry and housing subsector are fraught with risks that have the potential of negatively impacting on the achievement of project objectives. The success or otherwise of most construction projects depends to large extent on how well these risks have been managed. The recent paradigm shift by the subsector to use of formal risk management approach in contrast to hitherto developed rules of thumb means that risks must not only be identified but also properly assessed and responded to in a systematic manner. The study focused on identifying risks associated with housing development projects and prioritisation assessment of the identified risks in order to provide basis for informed decision. The study used a three-step identification framework: review of literature for similar projects, expert consultation and questionnaire based survey to identify potential risk factors. Delphi survey method was employed in carrying out the relative prioritization assessment of the risks factors using computer-based Analytical Hierarchical Process (AHP) software. The results show that 19 out of the 50 risks significantly impact on housing development projects. The study concludes that although significant numbers of risk factors have been identified as having relevance and impacting to housing construction projects, economic risk group and, in particular, ‘changes in demand for houses’ is prioritised by most developers as posing a threat to the achievement of their housing development objectives. Unless these risks are carefully managed, their effects will continue to impede success in these projects. The study recommends the adoption and use of the combination of multi-technique identification framework and AHP prioritization assessment methodology as a suitable model for the assessment of risks in housing development projects.

Keywords: risk management, risk identification, risk analysis, analytic hierarchical process

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Authors: Chethika Gunasiri Wadumestrige Dona, Geetha Mohan, Kensuke Fukushi

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Solid waste in urban areas, especially from organic materials like garden waste, food, and degradable sources, can create health and environmental problems if not managed properly. Urban agriculture has emerged as a potential solution in developing countries to mitigate these issues. It offers the possibility of low-carbon economies and knowledge and innovation dissemination. Domestic composting is a significant aspect of urban agriculture, and its success relies on the attitudes of those who practice it. This study examines the perspectives of 402 urban farmers in the Colombo District, Sri Lanka, regarding domestic compost production. It aims to identify the factors that influence these perspectives. The research found that urban farmers are willing to participate in domestic composting because they believe that it facilitates effective recycling of organic waste within their households. The study used an ordinal regression model to determine the factors that shape farmers' perspectives. Age, family size, and crop preferences are significant determinants of the adoption of domestic composting practices among urban farmers in the Colombo District. These findings highlight the importance of understanding and addressing farmers' attitudes in designing effective waste management strategies. In addition, the study also emphasizes the need for tailored interventions that align with farmers' beliefs and preferences to enhance the adoption and implementation of domestic composting practices in urban areas. The insights gained from this study contribute to the academic discourse and offer practical guidance for policymakers and urban planners seeking to promote sustainable waste management practices and support the adoption of urban agriculture in the broader context of urban development.

Keywords: urban agriculture, domestic composting, farmers` perspectives, sustainable urban development

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Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann

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Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.

Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma

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Authors: Nadeem Munawar, David Galbraith, Tariq Mahmood

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Rodenticides are often included as part of an integrated pest management approach for managing rodent species since they are relatively quick and inexpensive to apply. The current field study was conducted to evaluate the effectiveness of formulated baits of zinc phosphide (2%) and the second generation anticoagulant brodifacoum (0.005%) against field rats inhabiting a wheat-groundnut cropping system. Burrow baiting was initiated at the early flowering stages of the respective crops, and continued through three growth stages (tillering / peg formation, flowering, and maturity). Three treatments were done at equal time intervals, with the final baiting being about 2 weeks before harvest. Treatment efficacy of the trials was assessed through counts of active rodent burrows before and after treatments at the three growth stages of these crops. The results indicated variable degrees of reduction in burrow activities following the three bait applications. The reductions in rodent activity in wheat were: 88.8% (at tillering), 92%, (at flowering/grain formation), and 95.5% (at maturity). In groundnut, the rodent activities were reduced by 91.8%, 93.5% and 95.8% at sowing, peg formation, and maturity stages, respectively. The estimated mortality at all three growth stages of both wheat and groundnut ranged between 60-85%. We recommend that a field efficacy study should be conducted with zinc phosphide and brodifacoum bait formulations to determine their field performance in the reduction of agricultural damage by rodent pest species. It is a promising alternative approach for use of the most potent second-generation anticoagulant (brodifacoum) in resistance management, particularly with respect to reducing environmental risks and secondary poisoning.

Keywords: brodifacoum, burrow baiting, second-generation anticoagulant, synergistic effect

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Authors: Merav Meiron-Goren, Orna Braun-Lewensohn, Tal Litvak-Hirsh

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In recent years, there has been an increasing tendency towards separation and divorce in relationships. Nevertheless, many couples in a first marriage do not anticipate this as a probable possibility and do not make any preparation for it. Same sex couples establishing a family encounter a much more complicated situation than do heterosexual couples. Although there is a trend towards legal recognition of same sex marriage, many countries, including Israel, do not recognize it. The absence of legal recognition or the existence of partial recognition creates complexity for these couples. They have to fight for their right to establish a family, like the recognition of the biological child of a woman, as a child of her woman spouse too, or the option of surrogacy for a male couple who want children, and more. The lack of legal recognition is burden on the lives of these couples. In the absence of clear norms regarding the conduct of the family unit, the couples must define for themselves the family structure, and deal with everyday dilemmas that lack institutional solutions. This may increase the friction between the two couple members, and it is one of the factors that make it difficult for them to maintain the relationship. This complexity exists, perhaps even more so, in separation. The end of relationship is often accompanied by a deep crisis, causing pain and stress. In most cases, there are also other conflicts that must be settled. These are more complicated when rights are in doubt or do not exist at all. Complex issues for separating same sex couples may include matters of property, recognition of parenthood, and care and support for the children. The significance of the study is based on the fact that same sex relationships are becoming more and more widespread, and are an integral part of the society. Even so, there is still an absence of research focusing on such relationships and their ending. The objective of the study is to research the perceptions of same sex couples regarding the possibility of separation, preparing for it, conflict management and resolving disputes through the separation process. It is also important to understand the point of view of couples that have gone through separation, how they coped with the emotional and practical difficulties involved in the separation process. The doctoral research will use a qualitative research method in a phenomenological approach, based on semi-structured in-depth interviews. The interviewees will be divided into three groups- at the beginning of a relationship, during the separation crisis and after separation, with a time perspective, with about 10 couples from each group. The main theoretical model serving as the basis of the study will be the Lazarus and Folkman theory of coping with stress. This model deals with the coping process, including cognitive appraisal of an experience as stressful, appraisal of the coping resources, and using strategies of coping. The strategies are divided into two main groups, emotion-focused forms of coping and problem-focused forms of coping.

Keywords: conflict management, coping, legal recognition, same-sex relationship, separation

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Authors: Raya Kathreen T. Fuentes, Christian Owen P. Domingo, Kaisha V. Durana, Kristine Chelsea Shynne M. Evangelista, Nicole A. Feliciano, Kathleen Patricia Q. Ferido, Christianna Joy J. Ferrer

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Diabetes Mellitus (DM) is a global public health concern. The foot ulcer is one of the most serious and costly complications of DM. Among the components of diabetes self-management (DSM), foot self-care was found to be one of the best preventive measures for foot ulcers yet is seldom performed. Thus, the purpose of this study is to determine how adequate foot self-care practices (FSP) are among Filipino adults with DM with the following objectives: 1) determine their DSM, 2) describe their FSP, 3) determine the relationship between FSP and DSM, and 4) determine the relationship of FSP to sociodemographic characteristics, disease-related characteristics, social support, and knowledge. A descriptive correlational design was utilized. 114 respondents aged 19-65 were selected through purposive sampling from diabetes clinics. A self-administered questionnaire regarding FSP, DSM, sociodemographic and disease-related characteristics, social support, and knowledge on diabetes were used. Pearson's correlation was utilized to determine the relationship between FSP and DSM while simple linear regression was used to determine the relationship of FSP to the factors aforementioned. Results showed that majority of the respondents have desirable DSM but inadequate FSP. FSP and DSM were shown to be positively correlated but not statistically significant (p = 0.8). Disparity among the two suggests that there is less emphasis on foot self-care compared to other components of DSM. Findings further revealed that patients diagnosed with DM for < 5 years demonstrated more adequate FSP compared to patients diagnosed for > 5 years which may suggest that newly diagnosed patients are more receptive to new information about DSM. Health education on DSM should place more emphasis on FSP. Reiteration of health education and continuous motivation should be done to all DM patients, not just to newly diagnosed patients, to improve compliance to FSP and enhance patient empowerment regarding self-care.

Keywords: diabetes mellitus, diabetes self-management, foot self-care practices, foot ulcer

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Authors: Elena Carbone, Chiara Meneghetti, Ivan Innocenti, Monica Musicanti, Paola Volpe, Francesca Pazzaglia

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Promoting environmental sustainability is becoming a priority for organizations. Little is known, however, on the extent to which green workplace behaviors are linked, alongside organizational determinants, and also to various employees’ individual characteristics. The BE-GREEN research project, in collaboration with Eni S.p.A., aimed at investigating the relationship between the adoption of green workplace behaviors and various employees’ job-related and broader individual characteristics as well as organizational determinants. A sample of 513 Eni employees was administered a survey assessing the adoption of green workplace behaviors and the management of events (e.g., near-miss, unsafe conditions, weak signals) that could anticipate the occurrence of incidents with a harmful environmental impact. The survey also assessed employees’ job-related (e.g., proneness toward behaving pro-environmentally at work) and general (e.g., soft skills, connectedness to nature and environmental awareness) characteristics and perceived organizational support (e.g., environmental culture, leadership). Results showed that the adoption of green workplace behaviors was associated with employees’ proneness toward behaving pro-environmentally at work, and these factors were, in turn, influenced by broader individual characteristics related to soft skills as well as a connectedness to nature and environmental awareness, along with perceived organizational support. The management of events potentially anticipating the occurrence of incidents with a harmful environmental impact was mainly associated with perceived organizational support. These findings highlight how, alongside organizational determinants, different employees’ individual characteristics influence their adoption of green workplace behaviors, with important implications for the development of interventions tailored to promote environmental sustainability in organizations.

Keywords: green workplace behaviors, soft skills, connectedness to nature, environmental awareness.

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Authors: Amanda Kavner, Richard Lamb

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Faster growth in science and technology of other nations may make staying globally competitive more difficult without shifting focus on how science is taught in US classes. An integral part of learning science involves visual and spatial thinking since complex, and real-world phenomena are often expressed in visual, symbolic, and concrete modes. The primary barrier to spatial thinking and visual literacy in Science, Technology, Engineering, and Math (STEM) fields is representational competence, which includes the ability to generate, transform, analyze and explain representations, as opposed to generic spatial ability. Although the relationship is known between the foundational visual literacy and the domain-specific science literacy, science literacy as a function of science learning is still not well understood. Moreover, the need for a more reliable measure is necessary to design resources which enhance the fundamental visuospatial cognitive processes behind scientific literacy. To support the improvement of students’ representational competence, first visualization skills necessary to process these science representations needed to be identified, which necessitates the development of an instrument to quantitatively measure visual literacy. With such a measure, schools, teachers, and curriculum designers can target the individual skills necessary to improve students’ visual literacy, thereby increasing science achievement. This project details the development of an artificial neural network capable of measuring science literacy using functional Near-Infrared Spectroscopy (fNIR) data. This data was previously collected by Project LENS standing for Leveraging Expertise in Neurotechnologies, a Science of Learning Collaborative Network (SL-CN) of scholars of STEM Education from three US universities (NSF award 1540888), utilizing mental rotation tasks, to assess student visual literacy. Hemodynamic response data from fNIRsoft was exported as an Excel file, with 80 of both 2D Wedge and Dash models (dash) and 3D Stick and Ball models (BL). Complexity data were in an Excel workbook separated by the participant (ID), containing information for both types of tasks. After changing strings to numbers for analysis, spreadsheets with measurement data and complexity data were uploaded to RapidMiner’s TurboPrep and merged. Using RapidMiner Studio, a Gradient Boosted Trees artificial neural network (ANN) consisting of 140 trees with a maximum depth of 7 branches was developed, and 99.7% of the ANN predictions are accurate. The ANN determined the biggest predictors to a successful mental rotation are the individual problem number, the response time and fNIR optode #16, located along the right prefrontal cortex important in processing visuospatial working memory and episodic memory retrieval; both vital for science literacy. With an unbiased measurement of science literacy provided by psychophysiological measurements with an ANN for analysis, educators and curriculum designers will be able to create targeted classroom resources to help improve student visuospatial literacy, therefore improving science literacy.

Keywords: artificial intelligence, artificial neural network, machine learning, science literacy, neuroscience

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Authors: Muhammad Hakim Bin Mat Tasir, Erwan Shahfizad Hasidan, Hamidah Makmor Bakry, M. Hafiz B. Izhar

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Every key performance indicator used to monitor a project’s construction progress emphasizes trade productivity or specific commodity run-down curves. Examples include the productivity of welding by the number of joints completed per day, quantity of NDT (Non-Destructive Tests) inspection per day, etc. This perspective is based on progress and productivity; however, it does not enable a system perspective of how we produce. This paper uses a project production system perspective by which projects are a collection of production systems comprising the interconnected network of processes and operations that represent all the work activities to execute a project from start to finish. Furthermore, it also uses the 5 Levels of production system optimization as a frame. The goal of the paper is to describe the application of Project Production Control (PPC) to control and improve the performance of several production processes associated with the fabrication and assembly of a Central Processing Platform (CPP) Jacket, part of an offshore mega project. More specifically, the fabrication and assembly of buoyancy tanks as they were identified as part of the critical path and required the highest demand for capacity. In total, seven buoyancy tanks were built, with a total estimated weight of 2,200 metric tons. These huge buoyancy tanks were designed to be reversed launching and self-upending of the jacket, easily retractable, and reusable for the next project, ensuring sustainability. Results showed that an effective application of PPC not only positively impacted construction progress and productivity but also exposed sources of detrimental variability as the focus of continuous improvement practices. This approach augmented conventional project management practices, and the results had a high impact on construction scheduling, planning, and control.

Keywords: offshore, construction, project management, sustainability

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Authors: S. Bellagamba, S. Malinconico, P. De Simone, F. Paglietti

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Until the 1990s, Italy was among the world’s leading producers of raw asbestos fibres and Asbestos Containing Materials (ACM) and one of the most contaminated Countries in Europe. To reduce asbestos-related health effects, Italy has adopted many laws and regulations regarding exposure thresholds, limits, and remediation tools. The Italian Environmental Ministry (MASE) has identified 42 Italian Superfund sites, 11 of which are mainly contaminated by Asbestos. The highest levels of exposure occur during remediation activities in the 42 superfund-sites and during the management of asbestos containing waste in landfills, which requires specific procedures. INAIL-DIT play a role as MASE scientific consultant on issues concerning pollution, remediation, and Asbestos Containing Waste (ACW) management. The aim is to identify the best Emergency Safety Measures, to suggest specific best pratics for remediation through occupational on site monitorings and laboratory analysis. Moreover, the aim of INAIL research is testing the available technologies for working activities and analytical methodologies. This paper describes the remediation of Bagnoli industrial facility (Naples), an Eternit factory which produced asbestos cement products. The remediation has been analyzed, considering a first phase focused on the demolition of structures and plants and a second phase regarding the characterization, screening, removal, and disposal of polluted soils. The project planned the complete removal of all the asbestos dispersed in the soil and subsoil and the recovery of the clean fraction. This work highlights the remediation techniques used and the prevention measures provide for workers and daily life areas protection. This study, considering the high number of asbestos cement factories in the world, can to serve as an important reference for similar situation at European or international scale.

Keywords: safety, asbestos, workers, contaminated sites, hazardous waste

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Authors: Ani Kojoyan

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Linguistic studies have been investigating a connection between gender and linguistic development since 1970s. Scholars claim that gender differences in first and second language learning are socially constructed. Recent studies to language learning and gender reveal that second language acquisition is also a social phenomenon directly influencing one’s gender identity. Those responsible for designing language learning-teaching materials should be encouraged to understand the importance of and address the gender sensitivity accurately in textbooks. Writing or compiling a textbook is not an easy task; it requires strong academic abilities, patience, and experience. For a long period of time Armenia has been involved in the compilation process of a number of foreign language textbooks. However, there have been very few discussions or evaluations of those textbooks which will allow specialists to theorize that practice. The present paper focuses on the analysis of gender sensitivity issues and policy aspects involved in an EFL textbook. For the research the following material has been considered – “A Basic English Grammar: Morphology”, first printed in 2011. The selection of the material is not accidental. First, the mentioned textbook has been widely used in university teaching over years. Secondly, in Armenia “A Basic English Grammar: Morphology” has considered one of the most successful English grammar textbooks in a university teaching environment and served a source-book for other authors to compile and design their textbooks. The present paper aims to find out whether an EFL textbook is gendered in the Armenian teaching environment, and whether the textbook compilers are aware of gendered messages while compiling educational materials. It also aims at investigating students’ attitude toward the gendered messages in those materials. And finally, it also aims at increasing the gender sensitivity among book compilers and educators in various educational settings. For this study qualitative and quantitative research methods of analyses have been applied, the quantitative – in terms of carrying out surveys among students (45 university students, 18-25 age group), and the qualitative one – by discourse analysis of the material and conducting in-depth and semi-structured interviews with the Armenian compilers of the textbook (interviews with 3 authors). The study is based on passive and active observations and teaching experience done in a university classroom environment in 2014-2015, 2015-2016. The findings suggest that the discussed and analyzed teaching materials (145 extracts and examples) include traditional examples of intensive use of language and role-modelling, particularly, men are mostly portrayed as active, progressive, aggressive, whereas women are often depicted as passive and weak. These modeled often serve as a ‘reliable basis’ for reinforcing the traditional roles that have been projected on female and male students. The survey results also show that such materials contribute directly to shaping learners’ social attitudes and expectations around issues of gender. The applied techniques and discussed issues can be generalized and applied to other foreign language textbook compilation processes, since those principles, regardless of a language, are mostly the same.

Keywords: EFL textbooks, gender policy, gender sensitivity, qualitative and quantitative research methods

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Authors: Mathuravech Thanaphon, Thephasit Nat

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The Electricity Generating Authority of Thailand (EGAT) is focusing on expanding its pumped storage hydropower (PSH) capacity to increase the reliability of the system during peak demand and allow for greater integration of renewables. To achieve this requirement, Thailand will have to double its current renewable electricity production. To address the challenges of balancing supply and demand in the grid with increasing levels of RE penetration, as well as rising peak demand, EGAT has already been studying the potential for additional PSH capacity for several years to enable an increased share of RE and replace existing fossil fuel-fired generation. In addition, the role that pumped-storage hydropower would play in fulfilling multiple grid functions and renewable integration. The proposed sites for new PSH would help increase the reliability of power generation in Thailand. However, most of the electricity generation will come from RE, chiefly wind and photovoltaic, and significant additional Energy Storage capacity will be needed. In this paper, the impact of integrating the PSH system on the adequacy of renewable rich power generating systems to reduce the thermal power generating units is investigated. The variations of system adequacy indices are analyzed for different PSH-renewables capacities and storage levels. Power Development Plan 2018 rev.1 (PDP2018 rev.1), which is modified by integrating a six-new PSH system and RE planning and development aftermath in 2030, is the very challenge. The system adequacy indices through power generation are obtained using Multi-Objective Genetic Algorithm (MOGA) Optimization. MOGA is a probabilistic heuristic and stochastic algorithm that is able to find the global minima, which have the advantage that the fitness function does not necessarily require the gradient. In this sense, the method is more flexible in solving reliability optimization problems for a composite power system. The optimization with hourly time step takes years of planning horizon much larger than the weekly horizon that usually sets the scheduling studies. The objective function is to be optimized to maximize RE energy generation, minimize energy imbalances, and minimize thermal power generation using MATLAB. The PDP2018 rev.1 was set to be simulated based on its planned capacity stepping into 2030 and 2050. Therefore, the four main scenario analyses are conducted as the target of renewables share: 1) Business-As-Usual (BAU), 2) National Targets (30% RE in 2030), 3) Carbon Neutrality Targets (50% RE in 2050), and 5) 100% RE or full-decarbonization. According to the results, the generating system adequacy is significantly affected by both PSH-RE and Thermal units. When a PSH is integrated, it can provide hourly capacity to the power system as well as better allocate renewable energy generation to reduce thermal generations and improve system reliability. These results show that a significant level of reliability improvement can be obtained by PSH, especially in renewable-rich power systems.

Keywords: pumped storage hydropower, renewable energy integration, system adequacy, power development planning, RE100, multi-objective genetic algorithm

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Authors: Saniye Çeşmecioğlu

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The importance of project sustainability and success has become increasingly significant due to the proliferation of external environmental factors that have decreased project resistance in contemporary times. The primary approach to forestall the failure of projects is to ensure their long-term viability through the strategic selection of projects as creating judicious project selection framework within the organization. Decision-makers require precise decision contexts (models) that conform to the company's business objectives and sustainability expectations during the project selection process. The establishment of a rational model for project selection enables organizations to create a distinctive and objective framework for the selection process. Additionally, for the optimal implementation of this decision-making model, it is crucial to establish a Project Management Office (PMO) team and Project Steering Committee within the organizational structure to oversee the framework. These teams enable updating project selection criteria and weights in response to changing conditions, ensuring alignment with the company's business goals, and facilitating the selection of potentially viable projects. This paper presents a multi-criteria decision model for selecting project sustainability and project success criteria that ensures timely project completion and retention. The model was developed using MACBETH (Measuring Attractiveness by a Categorical Based Evaluation Technique) and was based on broadcaster companies’ expectations. The ultimate results of this study provide a model that endorses the process of selecting the appropriate project objectively by utilizing project selection and sustainability criteria along with their respective weights for organizations. Additionally, the study offers suggestions that may ascertain helpful in future endeavors.

Keywords: project portfolio management, project selection, multi-criteria decision making, project sustainability and success criteria, MACBETH

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Authors: Fuad Alzahrani, Yiannis Kyratsis

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Although emergency nurses, being the frontline workers in mass-gatherings, are essential for providing an effective public health response, little is known about the skills that emergency nurses have, or require, in order to respond effectively to a disaster event. This paper is designed to address this gap in the literature by conducting an empirical study on emergency nurses’ preparedness at the mass-gathering event of Hajj in Mecca city. To achieve this aim, this study conducted a cross-sectional survey among 106 emergency department nurses in all the public hospitals in Mecca in 2014. The results revealed that although emergency nurses’ role understanding is high; they have limited knowledge and awareness of how to respond appropriately to mass-gathering disaster events. To address this knowledge gap, the top three most beneficial types of education and training courses suggested are: hospital education sessions, the Emergency Management Saudi Course and workshop; and short courses in disaster management. Finally, recommendations and constructive strategies are developed to provide the best practice in enhancing disaster preparedness. This paper adds to the body of knowledge regarding emergency nurses and mass gathering disasters. This paper measures the level of disaster knowledge, previous disaster response experience and disaster education and training amongst emergency nurses in Mecca, Saudi Arabia. It is anticipated that this study will provide a foundation for future studies aimed at better preparing emergency nurses for disaster response. This paper employs new strategies to improve the emergency nurses’ response during mass gatherings for the Hajj. Increasing the emergency nurses’ knowledge will develop their effective responses in mass-gathering disasters.

Keywords: emergency nurses, mass-gatherings, hajj, disaster preparedness, disaster knowledge, perceived role, disaster training, previous disaster response experience

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Authors: Elzbieta Sikorska-Simmons

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Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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Authors: Kalpeshkumar L. Gupta, Shivali Rathore

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India is home to over 30 crore rural poor, aware of the criticality of the situation that has made to come with an innovative business idea. Entrepreneurship in India is on the verge of explosive growth and which is actually need of an hour for employment generation, poverty elevation at grass root through developmental intervention. India economic progress has started from the development of its small and medium scale enterprises to ensure that the sectors continues to stay competitive and achieve sustained growth in the era of global economy many incubators centers has been established with the mission to give the encouragement to many innovative ideas. If we define an Incubator, it is simply an enclosed apparatus in which premature small babies are placed and which provides a controlled and protective environment for their care this gives them a chance to adjust to outside environment, and grow stronger before they face the outside world. In a similar way the startup entrepreneur’s business idea is incubated in the incubation centers. Entrepreneurship has been conventionally rated as risky career, to break the myth and to augment the supply of new entrepreneurs through education; research training the incubation centers has been established, their goal is to help create and grow young businesses by providing them with necessary support and financial and technical services. The startup companies spend on an average two years in a business incubator during which numerous benefits like funding, office space, equipment’s etc. is provided by the incubators to the startup business. Present paper will study the background, role, objectives of different incubators set up in Indian Institute of Management (IIMs) and Indian Institute of Technology (IITs) for our study.

Keywords: incubation centres, entrepreneurship, Indian Institute of Management, Indian Institute of Technology

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