Search results for: teaching practice

Authors: Chloe E. Edwards, Yasaman Shahtaheri

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Risk management plays a fundamental role in project planning and delivery. The purpose of incorporating risk management into project management practices is to identify and address uncertainties related to key project-related activities. The uncertainties, known as risk events, can relate to project deliverables that are quantifiable and are often measured by impact to project schedule, cost, or environmental impact. Risk management should be incorporated as an iterative practice throughout the planning, execution, and commissioning phases of a project. This paper specifically examines how risk management contributes to effective project planning and delivery through a case study of a transportation project. This case study focused solely on impacts to project schedule regarding three milestones: readiness for delivery, readiness for testing and commissioning, and completion of the facility. The case study followed the ISO 31000: Risk Management – Guidelines. The key factors that are outlined by these guidelines include understanding the scope and context of the project, conducting a risk assessment including identification, analysis, and evaluation, and lastly, risk treatment through mitigation measures. This process requires continuous consultation with subject matter experts and monitoring to iteratively update the risks accordingly. The risk identification process led to a total of fourteen risks related to design, permitting, construction, and commissioning. The analysis involved running 1,000 Monte Carlo simulations through @RISK 8.0 Industrial software to determine potential milestone completion dates based on the project baseline schedule. These dates include the best case, most likely case, and worst case to provide an estimated delay for each milestone. Evaluation of these results provided insight into which risks were the highest contributors to the projected milestone completion dates. Based on the analysis results, the risk management team was able to provide recommendations for mitigation measures to reduce the likelihood of risks occurring. The risk management team also provided recommendations for managing the identified risks and project activities moving forward to meet the most likely or best-case milestone completion dates.

Keywords: construction management, monte carlo simulation, project delivery, risk assessment, transportation engineering

Procedia PDF Downloads 103

Authors: A. Drelick, T. Sondergeld, M. Decarlo-Tecce, K. McGinley

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In 1975, a free, appropriate public education (FAPE) was granted for all students in the United States regardless of their disabilities. As a result, the special education landscape has been reshaped through new policies and legislation. Progress monitoring, a specific component of an Individual Education Program (IEP) calls, for the use of data collection to determine the appropriateness of services provided to students with disabilities. The recent US Supreme Court ruling in Endrew F. v. Douglas County warrants giving increased attention to student progress, specifically pertaining to improving functional, or non-academic, skills that are addressed outside the general education curriculum. While using technology to enhance data collection has become a common practice for measuring academic growth, its application for non-academic IEP goals is uncertain. A mixed-methods study examined current practices and rationales for implementing technology-based progress monitoring focused on non-academic IEP goals. Fifty-seven participants responded to an online survey regarding their progress monitoring programs for non-academic goals. After isolated analysis and interpretation of quantitative and qualitative results, data were synthesized to produce meta-inferences that drew broader conclusions on the topic. For the purpose of this paper, specific focus will be placed on the perceived barriers and benefits of implementing technology-based progress monitoring protocols for non-academic IEP goals. The findings of this study highlight facts impacting the use of technology-based progress monitoring. Perceived barriers to implementation include: (1) lack of training, (2) access to technology, (3) outdated or inoperable technology, (4) reluctance to change, (5) cost, (6) lack of individualization within technology-based programs, and (7) legal issues in special education; while perceived benefits include: (1) overall ease of use, (2) accessibility, (3) organization, (4) potential for improved presentation of data, (5) streamlining the progress-monitoring process, and (6) legal issues in special education. Based on these conclusions, recommendations are made to IEP teams, school districts, and software developers to improve the progress-monitoring process for functional skills.

Keywords: special education, progress monitoring, functional skills, technology

Procedia PDF Downloads 240

Authors: Chua Si Wen Alicia, Marcus Goh Tian Xi, Eunice Gan Ghee Wu, Helen Bound, Lee Liang Ying, Albert Lee

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In a world full of rapid changes, people often need a set of skills to help them navigate an ever-changing workscape. These skills, often known as “future-oriented skills,” include learning to learn, critical thinking, understanding multiple perspectives, and knowledge creation. Future-oriented skills are typically assumed to be domain-general, applicable to multiple domains, and can be cultivated through a learning approach called Dialogical Inquiry. Dialogical Inquiry is known for its benefits of making sense of multiple perspectives, encouraging critical thinking, and developing learner’s capability to learn. However, it currently exists as a quantitative tool, which makes it hard to track and compare learning processes over time. With these concerns, the present research aimed to develop and validate a quantitative tool for the Map of Dialogical Inquiry, focusing Imagining aspect of learning. The Imagining aspect four dimensions: 1) speculative/ look for alternatives, 2) risk taking/ break rules, 3) create/ design, and 4) vision/ imagine. To do so, an exploratory literature review was conducted to better understand the dimensions of Imagining. This included deep-diving into the history of the creation of the Map of Dialogical Inquiry and a review on how “Imagining” has been conceptually defined in the field of social psychology, education, and beyond. Then, we synthesised and validated scales. These scales measured the dimension of Imagination and related concepts like creativity, divergent thinking regulatory focus, and instrumental risk. Thereafter, items were adapted from the aforementioned procured scales to form items that would contribute to the preliminary version of the Imagining Scale. For scale validation, 250 participants were recruited. A Confirmatory Factor Analysis (CFA) sought to establish dimensionality of the Imagining Scale with an iterative procedure in item removal. Reliability and validity of the scale’s dimensions were sought through measurements of Cronbach’s alpha, convergent validity, and discriminant validity. While CFA found that the distinction of Imagining’s four dimensions could not be validated, the scale was able to establish high reliability with a Cronbach alpha of .96. In addition, the convergent validity of the Imagining scale was established. A lack of strong discriminant validity may point to overlaps with other components of the Dialogical Map as a measure of learning. Thus, a holistic approach to forming the tool – encompassing all eight different components may be preferable.

Keywords: learning, education, imagining, pedagogy, dialogical teaching

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Authors: Cesar Julio Recalde

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Background: The role of intangible assets in today´s society is undeniable and continuously growing. More than 80% of corporate market is related to intellectual capital(IC). However, corporate governance principles and practices seem strongly based and oriented towards tangible assets. The impact of intangible assets on corporate governance might require prevention and adaptative actions. Adherence to voluntary mechanisms of intellectual capital reporting (ICR) seems to be a gateway towards adapting corporate governance to intangible assets influence and a conceptual cornerstone. The impact of adherence to intellectual capital reporting on corporate governance and performance needs to be evaluated. Purposes: This work has a sequential two folded purpose: (1) exploring the influences exerted by IC on corporate governance theory and practice, and within that context (2) analyzing the impact of adherence to voluntary mechanisms of ICR on corporate governance. Design and summary: This work employs the theory of the firm and agency theory in order to conceptually explore the effects of each dimension of IC on key corporate governance issues, namely property rights and control by shareholders and residual claims by stakeholders, fiduciary duties of management and the board, opportunistic behavior and transparency. A comprehensive IC taxonomy and map is presented. Within the resulting context, internal and external impact of ICR on corporate governance and performance is conceptually analyzed. IRC constraint and barriers are identified. Intellectual liabilities are presented within the context of IRC. Finally, IRC regulatory framework is surveyed. Findings: Relevant conclusions were rendered on the influence of intellectual capital on corporate governance. Sufficient evidence of a positive impact of IRC on corporate governance and performance was found. Additionally, it was found that IRC exerts a leveraging effect on IC itself. Intellectual liabilities are insufficiently researched and seem to have a relevant importance on IC measuring. IRC regulatory framework was found to be insufficiently developed to capture the essence of intangible assets and to meet corporate governance challenges facing IC. Originality: This work develops a progressive approach to conceptually analyze the mutual influences between IC and corporate governance. An epistemic ideogram represents the intersection of analyzed theories. An IC map is presented. The relatively new topic of intellectual liabilities is conceptually analyzed in the context of IRC. Social liabilities and client liabilities are presented.

Keywords: corporate governance, intellectual capital, intellectual capital reporting, intellectual assets, intellectual liabilities, voluntary mechanisms, regulatory framework

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Authors: Zeite Shumneiyang Koireng

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Liberation is the act of liberating or the state of being liberated. Indian philosophy, in general, understands liberation as moksa, which etymological is derived from the Sanskrit root muc+ktin meaning to loose, set free, to let go, discharge, release, liberate, deliver, etc. According to Indian schools of thought, moksa is the highest value on realizing which nothing remains to be realized. It is the cessation of birth and death, all kinds of pain and at the same time, it is the realization of one’s own self. Sankara’s Advaita philosophy is based on the following propositions: Brahman is the only Reality; the world has apparent reality, and the soul is not different from Brahman. According to Sankara, Brahman is the basis on which the world form appears; it is the sustaining ground of all various modification. It is the highest self and the self of all reveals himself by dividing himself [ as it was in the form of various objects] in multiple ways. The whole world is the manifestation of the Supreme Being. Brahman modifying itself into the Atman or internal self of all things is the world. Since Brahman is the Upadhana karana of the world, the sruti speaks of the world as the modification of Brahman into the Atman of the effect. Contemplation as the fulfillment of man finds a radical foundation in Aquinas teaching concerning the natural end or as he also referred to it, natural desire. The third book of the Summa Contra Gentiles begins the study of happiness with a consideration of natural desire. According to him, all creatures, even those devoid of understanding are ordered to God as an ultimate end. Intrinsically, a part of every nature is a tendency or inclination, originating in the natural form and tendency toward the end for which the possessor of nature exists. It is the study of the nature and finality of inclination that Aquinas establishes through an argument of induction man’s Contemplation of God as the fulfillment of his nature. The present paper is attempted to critically approach two important, seminal and originated thought, representing Indian and Western traditions which mark on the thinking of their respective times. Both these thoughts- Advaitic concept of Liberation in the Indian tradition and the concept of Contemplation in Thomas Aquinas’ Summa Contra Gentiles’- confront directly the question of the ultimate meaning of human existence. According to Sankara, it is knowledge and knowledge alone which is the means of moksa and the highest knowledge is moksa itself. Liberation in Sankara Vedanta is attained as a process of purification of self, which gradually and increasingly turns into purer and purer intentional construction. Man’s inner natural tendency for Aquinas is towards knowledge. The human subject is driven to know more and more about reality and in particular about the highest reality. Contemplation of this highest reality is fulfillment in the philosophy of Aquinas. Rather, Contemplation is the perfect activity in man’s present state of existence.

Keywords: liberation, Brahman, contemplation, fulfillment

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Authors: Umedov Mekhroz, Griaznova Svetlana

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In connection with the growth of oncological diseases, the design of centers for diagnostics and the production of radiopharmaceuticals is the most relevant area of healthcare facilities. The design of new nuclear medicine centers should be carried out from the standpoint of solving the following tasks: the availability of medical care, functionality, environmental friendliness, sustainable development, improving the safety of drugs, the use of which requires special care, reducing the rate of environmental pollution, ensuring comfortable conditions for the internal microclimate, adaptability. The purpose of this article is to substantiate architectural and planning solutions, formulate recommendations and principles for the design of nuclear medicine centers and determine the connections between the production and medical functions of a building. The advantages of combining the production of radiopharmaceuticals and the department of medical care: less radiation activity is accumulated, the cost of the final product is lower, and there is no need to hire a transport company with a special license for transportation. A medical imaging department is a structural unit of a medical institution in which diagnostic procedures are carried out in order to gain an idea of the internal structure of various organs of the body for clinical analysis. Depending on the needs of a particular institution, the department may include various rooms that provide medical imaging using radiography, ultrasound diagnostics, and the phenomenon of nuclear magnetic resonance. The production of radiopharmaceuticals is an object intended for the production of a pharmaceutical substance containing a radionuclide and intended for introduction into the human body or laboratory animal for the purpose of diagnosis, evaluation of the effectiveness of treatment, or for biomedical research. The research methodology includes the following subjects: study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research; An integrated approach to the study of existing international experience of PET / CT scan centers and the production of radiopharmaceuticals; Elaboration of graphical analysis and diagrams based on the system analysis of the processed information; Identification of methods and principles of functional zoning of nuclear medicine centers. The result of the research is the identification of the design principles of nuclear medicine centers with the functions of the production of radiopharmaceuticals and the department of medical imaging. This research will be applied to the design and construction of healthcare facilities in the field of nuclear medicine.

Keywords: architectural planning solutions, functional zoning, nuclear medicine, PET/CT scan, production of radiopharmaceuticals, radiotherapy

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Authors: Poonam Goswami

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Background: The diagnosis of a serious illness like cancer can have an impact on a patient’s emotional well-being and may result in psychological symptoms, anxiety, depression, and loss of control. Advance care planning discussions ensure patients’ values and goals of care, including patients’ freedom to choose their place of death, are respected. Unfortunately, these discussions are often delayed and are not initiated early in patients’ cancer trajectory. As a result, patients’ wishes often remains unknown until the last phase of their life. Evidence suggests that many patients inappropriately receive aggressive treatment near the end of life, which does lead to higher resource utilization, decreased quality of life, and increased cost. Additionally, the novel coronavirus disease 2019 (COVID-19) pandemic challenged the health care systems worldwide and raised important ethical issues, especially regarding the potential need for rationing health care in the context of scarce resources and crisis capacity. The importance of goal concordant care is now even substantially important and is heightened in the context of this pandemic. Problem: Although there is growing evidence on the effects of the ACP on the completion of advanced directives, improved patient and family concordance for preferences for medical care, and receipt of care, there is still a lack of standardized ACP conversation strategies for patients with cancer. Methods: The Key concepts of ACP include (1) assessing patient and family readiness, (2) identifying a surrogate decision maker ( medical power of attorney), (3) exploring patient and family understanding of the disease and treatment options,(4) discussing the values and goals of care, and options for end-of-life care, (5) documenting patient preferences in the medical record, and (6) revisiting the discussions at every change in the treatment plan and /or change in clinical status, including at every hospitalization. Conclusion/Implication for practice: Advance Care Planning (ACP) and end-of-life (EOL) discussions are important for patients, families, and health care providers. Adopting the verbal and nonverbal communication strategies can help overcome the barriers to effective communication on these difficult discussions. ACP with goals of care discussions should not be delayed until the patient is hospitalized.

Keywords: advance care planning, end of life, cancer, global, pandemic

Procedia PDF Downloads 122

Authors: Ronli Sifris

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The last Australian Parliamentary inquiry into surrogacy took place in 2016. Since then, a number of countries have reviewed their surrogacy laws, including countries such as New Zealand and the United Kingdom, which traditionally have invoked similar legal approaches to Australia on a broad range of issues. The time is ripe to reform Australia’s surrogacy laws with a view to putting in place a system that best protects the rights of all parties to a surrogacy arrangement, and especially the rights of the child. There are two specific, linked issues which tend to be particularly contentious in the surrogacy context. The first relates to legal parentage. There are questions around whether the surrogate or the intended parents should be deemed the legal parents of a child born through surrogacy and what should be the process for any transfer of parentage. The second key issue relates to compensation and whether a surrogate should be compensated for the reproductive labour inherent in conceiving, gestating, and birthing a child. This paper will invoke a comparative analysis with a view to considering how different countries are regulating surrogacy and which approach best protects the rights all parties involved in the surrogacy arrangement, especially the rights of the children born through surrogacy. The specific countries to be considered are Australia, Canada, and California (United States). I have selected these countries for the following reasons: Australia is the jurisdiction where the author is based, it is, therefore, the jurisdiction with which she has the most familiarity. It allows altruistic surrogacy only and post-birth parentage orders in favour of the intended parents of children born through altruistic surrogacy California, as a jurisdiction allowing for compensated surrogacy and pre-birth parentage orders in favour of the intended parents, sits at the other end of the spectrum to Australia thereby providing an interesting point of comparison. Canada sits somewhere in the middle; it ostensibly allows only altruistic surrogacy, but in practice, many aspects of the Canadian process resemble compensated surrogacy. In addition to conducting a comparative analysis with other countries, the paper will also consider international human rights law as its overarching framework for determining the approach that best protects the rights of a child born through surrogacy. Particular attention will be paid to the United Nations Convention on the Rights of the Child as the key children’s rights treaty. The European Court of Human Rights will also be extensively considered as it has decided a number of cases relating to the rights of children born through surrogacy.

Keywords: surrogacy, children’s rights, australia, compensation, parentage

Procedia PDF Downloads 120

Authors: Manuela S. Tolentino, John G. Nepomuceno

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The purpose of this investigation was to assess the implementation of inclusive education (IE) in 6 elementary and 5 secondary public schools in the City Schools Division of Dasmarinas. Participants in this study were 11 school heads, 73 teachers, 22 parents and 22 students (regular and with special needs) who were selected using purposive sampling. A 30-item questionnaire was used to gather data on the extent of the implementation of IE in the division while focus group discussion (FGD) was used to gather insights on what facilitate and hinder the implementation of the IE program. This study assessed the following variables: school culture and environment, inclusive education policy implementation, and curriculum design and practices. Data were analyzed using frequency count, mean and ranking. Results revealed that participants have similar assessment on the extent of the implementation of IE. School heads rated school culture and environment as highest in terms of implementation while teachers and pupils chose curriculum design and practices. On the other hand, parents felt that inclusive education policies are implemented best. School culture and environment are given high ratings. Participants perceived that the IE program in the division is making everyone feel welcome regardless of age, sex, social status, physical, mental and emotional state; students with or without disability are equally valued, and students help each. However, some aspects of the IE program implementation are given low ratings namely: partnership between staff, parents and caregivers, school’s effort to minimize discriminatory practice, and stakeholders sharing the philosophy of inclusion. As regards education policy implementation, indicators with the highest ranks were school’s effort to admit students from the locality especially students with special needs, and the implementation of the child protection policy and anti-bullying policy. The results of the FGD revealed that both school heads and teachers possessed the welcoming gesture to accommodate students with special needs. This can be linked to the increasing enrolment of SNE in the division. However, limitations of the teachers’ knowledge on handling learners, facilities and collaboration among stakeholders hinder the implementation of IE program. Based on the findings, inclusion program framework was developed for program enhancement. This will be the basis for the improvement of the program’s efficiency, the relationship between stakeholders, and formulation of solutions.

Keywords: inclusion, inclusive education, framework, special education

Procedia PDF Downloads 166

Authors: Kari Björn, Mikael Soini

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Higher Education system reforms, especially Finnish system of Universities of Applied Sciences in 2014 are discussed. The new steering model is based on major legislative changes, output-oriented funding and open information. The governmental steering reform, especially the financial model and the resulting institutional level responses, such as a curriculum reforms are discussed, focusing especially in engineering programs. The paper is motivated by management need to establish objective steering-related performance indicators and to apply them consistently across all educational programs. The close relationship to governmental steering and funding model imply that internally derived indicators can be directly applied. Metropolia University of Applied Sciences (MUAS) as a case institution is briefly introduced, focusing on engineering education in Information and Communications Technology (ICT), and its related programs. The reform forced consolidation of previously separate smaller programs into fewer units of student application. New curriculum ICT students have a common first year before they apply for a Major. A framework of parallel and longitudinal comparisons is introduced and used across Majors in two campuses. The new externally introduced performance criteria are applied internally on ICT Majors using data ex-ante and ex-post of program merger.  A comparative performance of the Majors after completion of joint first year is established, focusing on previously omitted Majors for completeness of analysis. Some new research questions resulting from transfer of Majors between campuses and quota setting are discussed. Practical orientation identifies best practices to share or targets needing most attention for improvement. This level of analysis is directly applicable at student group and teaching team level, where corrective actions are possible, when identified. The analysis is quantitative and the nature of the corrective actions are not discussed. Causal relationships and factor analysis are omitted, because campuses, their staff and various pedagogical implementation details contain still too many undetermined factors for our limited data. Such qualitative analysis is left for further research. Further study must, however, be guided by the relevance of the observations.

Keywords: engineering education, integrated curriculum, learning outcomes, performance measurement

Procedia PDF Downloads 232

Authors: Kamal Kaushik, Trisha, Dandapni, Sambit Nanda, A. Mukherjee, S. Pradhan

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INTRODUCTION: As complexity in radiotherapy practice and processes are increasing, there is a need to assure quality control to a greater extent. At present, no international literature available with regards to the optimal quality control indicators for radiotherapy; moreover, few clinical audits have been conducted in the field of radiotherapy. The primary aim is to improve the processes that directly impact clinical outcomes for patients in terms of patient safety and quality of care. PROCEDURE: A team of an Oncologist, a Medical Physicist and a Radiation Therapist was formed for weekly clinical audits of patient’s undergoing radiotherapy audits The stages for audits include Pre planning audits, Simulation, Planning, Daily QA, Implementation and Execution (with image guidance). Errors in all the parts of the chain were evaluated and recorded for the development of further departmental protocols for radiotherapy. EVALUATION: The errors at various stages of radiotherapy chain were evaluated and recorded for comparison before starting the clinical audits in the department of radiotherapy and after starting the audits. It was also evaluated to find the stage in which maximum errors were recorded. The clinical audits were used to structure standard protocols (in the form of checklist) in department of Radiotherapy, which may lead to further reduce the occurrences of clinical errors in the chain of radiotherapy. RESULTS: The aim of this study is to perform a comparison between number of errors in different part of RT chain in two groups (A- Before Audit and B-After Audit). Group A: 94 pts. (48 males,46 female), Total no. of errors in RT chain:19 (9 needed Resimulation) Group B: 94 pts. (61 males,33 females), Total no. of errors in RT chain: 8 (4 needed Resimulation) CONCLUSION: After systematic periodic clinical audits percentage of error in radiotherapy process reduced more than 50% within 2 months. There is a great need in improving quality control in radiotherapy, and the role of clinical audits can only grow. Although clinical audits are time-consuming and complex undertakings, the potential benefits in terms of identifying and rectifying errors in quality control procedures are potentially enormous. Radiotherapy being a chain of various process. There is always a probability of occurrence of error in any part of the chain which may further propagate in the chain till execution of treatment. Structuring departmental protocols and policies helps in reducing, if not completely eradicating occurrence of such incidents.

Keywords: audit, clinical, radiotherapy, improving functionality

Procedia PDF Downloads 83

Authors: Rosaline Govender, Shubnam Rambharos

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Universities are, to a certain extent, the source of under-preparedness ideologically, structurally, and pedagogically, particularly since organizational cultures often alienate students by failing to enable epistemological access. This is evident in the unsustainably low graduation rates that characterize South African higher education, which indicate that under 30% graduate in minimum time, under two-thirds graduate within 6 years, and one-third have not graduated after 10 years. Although the statistics for the Faculty of Accounting and Informatics at the Durban University of Technology (DUT) in South Africa have improved significantly from 2019 to 2021, the graduation (32%), throughput (50%), and dropout rates (16%) are still a matter for concern as the graduation rates, in particular, are quite similar to the national statistics. For our students to succeed, higher education should take a multi-pronged approach to ensure student success, and student engagement is one of the ways to support our students. Student engagement depends not only on students’ teaching and learning experiences but, more importantly, on their social and academic integration, their sense of belonging, and their emotional connections in the institution. Such experiences need to challenge students academically and engage their intellect, grow their communication skills, build self-discipline, and promote confidence. The aim of this mixed methods study is to explore the multi-pronged nature of student success within the Faculty of Accounting and Informatics at DUT and focuses on the enabling and constraining factors of student success. The sources of data were the Mid-year student experience survey (N=60), the Hambisa Student Survey (N=85), and semi structured focus group interviews with first, second, and third year students of the Faculty of Accounting and Informatics Hambisa program. The Hambisa (“Moving forward”) focus area is part of the Siyaphumelela 2.0 project at DUT and seeks to understand the multiple challenges that are impacting student success which create a large “middle” cohort of students that are stuck in transition within academic programs. Using the lens of the sociocultural influences on student engagement framework, we conducted a thematic analysis of the two surveys and focus group interviews. Preliminary findings indicate that living conditions, choice of program, access to resources, motivation, institutional support, infrastructure, and pedagogical practices impact student engagement and, thus, student success. It is envisaged that the findings from this project will assist the university in being better prepared to enable student success.

Keywords: social and academic integration, socio-cultural influences, student engagement, student success

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Authors: Hyun-Ju Oh, Soon-Rim Suh, Mihan Kim

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The steady and rapid increase of the older population is a global phenomenon. Chronic diseases and disabilities are increased due to aging. In general, exercise has been known to be most effective in preventing and managing chronic back pain. However, it is hard for the older women to initiate and maintain the exercise. Transtheoretical model (TTM) is one of the theories explain behavioral changes such as exercise. The application of the program considering the stage of behavior change is effective for the elderly woman to start and maintain the exercise. The purpose of this study was to develop TTM based exercise program and to examine its effect for elderly women with chronic back-pain. For the program evaluation, the non-equivalent control pre-posttest design was applied. The independent variable of this study is exercise intervention program. The contents of the program were constructed considering the characteristics of the elderly women with chronic low back pain, focusing on the process of change, the stage of change by the previous studies. The developed exercise program was applied to the elderly women with chronic low back pain in the planning stage and the preparation stage. The subjects were 50 older women over 65 years of age with chronic back-pain who did not practice regular exercise. The experimental group (n=25) received the 8weeks TTM based exercise program. The control group received the book which named low back pain management. Data were collected at three times: before the exercise intervention, right after the intervention, and 4weeks after the intervention. The dependent variables were the processes of change, decisional balance, exercise self-efficacy, back-pain, depression and muscle strength. The results of this study were as follows. Processes of change (<.001), pros of decisional balance (<.001), exercise self-efficacy (<.001), back pain (<.001), depression (<.001), muscle strength (<.001) were higher in the experimental group than in the control group right after the program and 4weeks after the programs. The results of this study show that applying the TTM based exercise program increases the use of the change process, increases the exercise self-efficacy, increases the stage of changing the exercise behavior and strengthens the muscular strength by lowering the degree of pain and depression Respectively. The significance of the study was to confirm the effect of continuous exercise by maintaining regular exercise habits by applying exercise program of the transtheoretical model to the chronic low back pain elderly with exercise intention.

Keywords: chronic back pain, elderly, exercise, women

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Authors: Farnia Nayar Parshi, Mohammad Shariful Islam

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Though earth construction is an ancient technology, researchers are working on increasing its strength by adding different types of stabilizers. Ordinary Portland cement for sandy soil and lime for clayey soil is very popular practice as well as recommended by various authorities for making stabilized blocks for satisfactory performance. The addition of these additives improves compressive strength but fails to improve ductility. The addition of both synthetic and natural fibers increases both compressive strength and ductility. Studies are conducted to make earth blocks more cost-effective, energy-efficient and sustainable. In this experiment, an agricultural waste banana fiber and biochar is used to study the compressive stress-strain behavior of earth blocks made with four types of soil low plastic clay, sandy low plastic clay, very fine sand and medium to fine sand. Biochar is a charcoal-like carbon usually produced from organic or agricultural waste in high temperatures through a controlled condition called pyrolysis. In this experimental study, biochar was collected from BBI (Bangladesh Biochar Initiative) produced from wood flakes around 400 deg. Celsius. Locally available PPC (Portland Pozzolana Cement) is used. 5 cm × 5 cm × 5 cm earth blocks were made with eight different combinations such as bare soil, soil with 6% cement, soil with 6% cement and 5% biochar, soil with 6% cement, 5% biochar and 1% fiber, soil with 1% fiber, soil with 5% biochar and 1% fiber and soil with 6% cement and 1% fiber. All samples were prepared with 10-12% water content. Uniaxial compressive strength tests were conducted on 21 days old earth blocks. Stress-strain diagram shows that the addition of banana fiber improved compressive strength drastically, but the combined effect of fiber and biochar is different based on different soil types. For clayey soil, 6% cement and 1% fiber give maximum compressive strength of 991 kPa, and for very fine sand, a combination of 5% biochar, 6% cement and 1% fiber gives maximum compressive strength of 522 kPa as well as ductility. For medium-to-find sand, 6% cement and 1% fiber give the best result, 1530 kPa, among other combinations. The addition of fiber increases not only ductility but also compressive strength as well. The effect of biochar with fiber varies with the soil type.

Keywords: banana fiber, biochar, cement, compressed stabilized earth blocks, compressive strength

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Authors: O. Davies, K. Veravalli, P. Panwalkar, M. Tofighi, P. Butterick, B. Healy, A. Mofidi

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Vancomycin resistant enterococcus infection is a condition that usually impacts ICUs, transplant, dialysis, and cancer units, often as a nosocomial infection. After an outbreak in the acute trauma and orthopaedic unit in Morriston hospital, we aimed to access the conditions that predispose VRE infections in our unit. Thirteen cases of VRE infection and five cases of VRE colonisations were identified in patients who were treated for orthopaedic care between 1/1/2020 and 1/11/2021. Cases were reviewed to identify predisposing factors, specifically looking at age, presenting condition and treatment, presence of infection and antibiotic care, active haemo-oncological condition, long term renal dialysis, previous hospitalisation, VRE predisposition, and clearance (PREVENT) scores, and outcome of care. The presenting condition, treatment, presence of postoperative infection, VRE scores, age was compared between colonised and the infected cohort. VRE type in both colonised and infection group was Enterococcus Faecium in all but one patient. The colonised group had the same age (T=0.6 P>0.05) and sex (2=0.115, p=0.74), presenting condition and treatment which consisted of peri-femoral fixation or arthroplasty in all patients. The infected group had one case of myelodysplasia and four cases of chronic renal failure requiring dialysis. All of the infected patient had sustained an infected complication of their fracture fixation or arthroplasty requiring reoperation and antibiotics. The infected group had an average VRE predisposition score of 8.5 versus the score of 3 in the colonised group (F=36, p<0.001). PREVENT score was 7 in the infected group and 2 in the colonised group(F=153, p<0.001). Six patients(55%) succumbed to their infection, and one VRE infection resulted in limb loss. In the orthopaedic cohort, VRE infection is a nosocomial condition that has peri-femoral predilection and is seen in association with immunosuppression or renal failure. The VRE infection cohort has been treated for infective complication of original surgery weeks prior to VRE infection. Based on our findings, we advise avoidance of infective complications, change of practice in use of antibiotics and use radical surgery and surveillance for VRE infections beyond infective precautions. PREVENT score shows that the infected group are unlikely to clear their VRE in the future but not the colonised group.

Keywords: surgical site infection, enterococcus, orthopaedic surgery, vancomycin resistance

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Authors: Sahar Navabakhsh, Rokia Raslan, Yair Schwartz

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Decision-making on regeneration of housing estates, whether to refurbish or re-build, has been mostly triggered by economic factors. To enable sustainable growth, it is vital that environmental and social impacts of different scenarios are also taken into account. The methodology used to include all the three sustainable development pillars is called Life Cycle Sustainability Assessment (LCSA), which comprises of Life Cycle Assessment (LCA) for the assessment of environmental impacts of buildings. Current practice of LCA is regularly conducted post design stage and by sustainability experts. Not only is undertaking an LCA at this stage less effective, but issues such as the limited scope for the definition and assessment of environmental impacts, the implication of changes in the system boundary and the alteration of each of the variable metrics, employment of different Life Cycle Impact Assessment Methods and use of various inventory data for Life Cycle Inventory Analysis can result in considerably contrasting results. Given the niche nature and scarce specialist domain of LCA of buildings, the majority of the stakeholders do not contribute to the generation or interpretation of the impact assessment, and the results can be generated and interpreted subjectively due to the mentioned uncertainties. For an effective and democratic assessment of environmental impacts, different stakeholders, and in particular the community and design team should collaborate in the process of data collection, assessment and analysis. This paper examines and evaluates a participatory approach to LCSA through the analysis of a case study of a housing estate in South West London. The study has been conducted throughout tier-based collaborative methods to collect and share data through surveys and co-design workshops with the community members and the design team as the main stakeholders. The assessment of lifecycle impacts is conducted throughout the process and has influenced the decision-making on the design of the Community Plan. The evaluation concludes better assessment transparency and outcome, alongside other socio-economic benefits of identifying and engaging the most contributive stakeholders in the process of conducting LCSA.

Keywords: life cycle assessment, participatory LCA, life cycle sustainability assessment, participatory processes, decision-making, housing estate regeneration

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Authors: M. R. Babaei, S. M. Hosseini, S. Rahmani, L. Moradi

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Today, the quality of education and training systems and the effectiveness of the education systems of most concern to stakeholders and decision-makers of our country's development in each country. In Iran this is a double issue of concern to numerous reasons; So that governments, over the past decade have hardly even paid the running costs of education. ICT is claiming it has the power to change the structure of a program for training, reduce costs and increase quality, and do education systems and products consistent with the needs of the community and take steps to practice education. Own of the areas that the introduction of information technology has fundamentally changed is the field of education. The aim of this research is process reengineering management in schools simultaneously has been using field studies to collect data in the form of interviews and a questionnaire survey. The statistical community of this research has been the country of Iran and smart schools under the education. Sampling was targeted. The data collection tool was a questionnaire composed of two parts. The questionnaire consists of 36 questions that each question designates one of effective factors on the management of smart schools. Also each question consists of two parts. The first part designates the operating position in the management process, which represents the domain's belonging to the management agent (planning, organizing, leading, controlling). According to the classification of Dabryn and in second part the factors affect the process of managing the smart schools were examined, that Likert scale is used to classify. Questions the validity of the group of experts and prominent university professors in the fields of information technology, management and reengineering of approved and Cronbach's alpha reliability and also with the use of the formula is evaluated and approved. To analyse the data, descriptive and inferential statistics were used to analyse the factors contributing to the rating of (Linkert scale) descriptive statistics (frequency table data, mean, median, mode) was used. To analyse the data using analysis of variance and nonparametric tests and Friedman test, the assumption was evaluated. The research conclusions show that the factors influencing the management process re-engineering smart schools in school performance is affected.

Keywords: re-engineering, management process, smart school, Iran's school

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Authors: Barbara Peric

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The study of acquiring a third and additional language has garnered significant focus within second language acquisition (SLA) research. Initially, it was commonly viewed as merely an extension of second language acquisition (SLA). However, in the last two decades, numerous researchers have emphasized the need to recognize the unique characteristics of third language acquisition (TLA). This recognition is crucial for understanding the intricate cognitive processes that arise from the interaction of more than two linguistic systems in the learner's mind. This study investigates cross-linguistic influences in the acquisition of Spanish as a fourth language by students who have Croatian as a first language (L1). English as a second language (L2), and Italian as a third language (L3). Observational data suggests that influence or transfer of linguistic elements can arise not only from one's native language (L1) but also from non-native languages. This implies that, for individuals proficient in multiple languages, the native language doesn't consistently hold a superior position. Instead, it should be examined alongside other potential sources of linguistic transfer. Earlier studies have demonstrated that high proficiency in a second language can significantly impact cross-linguistic influences when acquiring a third and additional language. Among the extensively examined factors, the typological relationship stands out as one of the most scrutinized variables. The goal of the present study was to explore whether language typology and formal similarity or proficiency in the second language had a more significant impact on L4 acquisition. Participants in this study were third-year undergraduate students at Rochester Institute of Technology’s subsidiary in Croatia (RIT Croatia). All the participants had exclusively Croatian as L1, English as L2, Italian as L3 and were learning Spanish as L4 at the time of the study. All the participants had a high level of proficiency in English and low level of proficiency in Italian. Based on the error analysis the findings indicate that for some types of lexical errors such as coinage, language typology had a more significant impact and Italian language was the preferred source of transfer despite the law proficiency in that language. For some other types of lexical errors, such as calques, second language proficiency had a more significant impact, and English language was the preferred source of transfer. On the other hand, Croatian, Italian, and Spanish are more similar in the area of morphology due to higher degree of inflection compared to English and the strongest influence of the Croatian language was precisely in the area of morphology. The results emphasize the need to consider linguistic resemblances between the native language (L1) and the third and additional language as well as the learners' proficiency in the second language when developing successful teaching strategies for acquiring the third and additional language. These conclusions add to the expanding knowledge in the realm of Second Language Acquisition (SLA) and offer practical insights for language educators aiming to enhance the effectiveness of learning experiences in acquiring a third and additional language.

Keywords: third and additional language acquisition, cross-linguistic influences, language proficiency, language typology

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Authors: Recep Keşli, Hayriye Tokay, Cengiz Demir, İsmail Ceyhan

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Objective: In many countries, tuberculosis (TB) is still one of the most important diseases. Tuberculosis is among top 10 causes of death worldwide. The early diagnosis of active tuberculosis still depends on the presence of acid resistant bacilli (ARB) in stained smears. In this study, we aimed to investigate the diagnostic performances of Erlich Ziehl Neelsen (EZN), Kinyoun and two different fluorescent stains. Methods: The specimens were obtained from the patients who applied to Chest Diseases Departments of Ankara Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, and Afyon Kocatepe University, ANS Research and Practice Hospital. The study was carried out in the Medical Microbiology Laboratory, School of Medicine, Afyon Kocatepe University. All the non-sterile specimens were homogenized and decontaminated according to the EUCAST instructions. Samples were inoculated onto the Löwenstein-Jensen agars (bio-Merieux Marcy l'Etoile, France) and then incubated at 37˚C, for 40 days. Four smears were prepared from each specimen. Slides were stained with commercial EZN (BD, Sparks, USA), Kinyoun (SALUBRIS Istanbul, Turkey), Auramine (SALUBRIS Istanbul, Turkey) and Rhodamine (SALUBRIS Istanbul, Turkey) kit. While EZN and Kinyoun stainings were examined by light microscope, Auramine and Rhodamine slides were examined by fluorescence microscopy. Results: A total of 158 respiratory system samples (sputum, broncho alveolar lavage fluid…etc) were enrolled into the study. A hundred and two of the samples that processed were found as culture positive. The sensitivity, specificity, positive predictive, and negative predictive values were detected as 100%, 67.5%, 73.5%, and 100% for EZN, 100%, 70.9%, 77.4%, and 100% for Kinyoun, 100%,77.8%, 84.3%, 100% for Auramine, and 100%, 80% , 86.3%, and 100% for Rhodamine respectively. Conclusions: According to our study auramine and rhodamine staining methods showed the best diagnostic performance among the four investigated staining methods. In conclusion, the fluorochrome staining method may be accepted as the most reliable, rapid and useful method for diagnosis of the mycobacterial infections truly.

Keywords: acid resistant bacilli (ARB), auramine, Ehrlich-Ziehl-Neelsen (EZN), Kinyoun, Rhodamine

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Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

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Authors: Yosep Chong, Yejin Kim, Jingyun Choi, Hwanjo Yu, Eun Jung Lee, Chang Suk Kang

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For the past decades, immunohistochemistry (IHC) has been playing an important role in the diagnosis of human neoplasms, by helping pathologists to make a clearer decision on differential diagnosis, subtyping, personalized treatment plan, and finally prognosis prediction. However, the IHC performed in various tumors of daily practice often shows conflicting and very challenging results to interpret. Even comprehensive diagnosis synthesizing clinical, histologic and immunohistochemical findings can be helpless in some twisted cases. Another important issue is that the IHC data is increasing exponentially and more and more information have to be taken into account. For this reason, we reached an idea to develop an expert supporting system to help pathologists to make a better decision in diagnosing human neoplasms with IHC results. We gave probabilistic decision tree algorithm and tested the algorithm with real case data of lymphoid neoplasms, in which the IHC profile is more important to make a proper diagnosis than other human neoplasms. We designed probabilistic decision tree based on Bayesian theorem, program computational process using MATLAB (The MathWorks, Inc., USA) and prepared IHC profile database (about 104 disease category and 88 IHC antibodies) based on WHO classification by reviewing the literature. The initial probability of each neoplasm was set with the epidemiologic data of lymphoid neoplasm in Korea. With the IHC results of 131 patients sequentially selected, top three presumptive diagnoses for each case were made and compared with the original diagnoses. After the review of the data, 124 out of 131 were used for final analysis. As a result, the presumptive diagnoses were concordant with the original diagnoses in 118 cases (93.7%). The major reason of discordant cases was that the similarity of the IHC profile between two or three different neoplasms. The expert supporting system algorithm presented in this study is in its elementary stage and need more optimization using more advanced technology such as deep-learning with data of real cases, especially in differentiating T-cell lymphomas. Although it needs more refinement, it may be used to aid pathological decision making in future. A further application to determine IHC antibodies for a certain subset of differential diagnoses might be possible in near future.

Keywords: database, expert supporting system, immunohistochemistry, probabilistic decision tree

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Authors: Nezha Badi

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It has been shown in the literature that Algerian university students suffer from low levels of reading comprehension proficiency, which hinder their overall proficiency in English. This low level is mainly related to the methodology of teaching reading which is employed by the teacher in the classroom (a teacher-centered environment), as well as students’ poor sense of self-efficacy to undertake reading comprehension activities. Arguably, what is needed is an approach necessary for enhancing students’ self-beliefs about their abilities to deal with different reading comprehension activities. This can be done by providing them with opportunities to take responsibility for their own learning (learners’ autonomy). As a result of learning autonomy, learners’ beliefs about their abilities to deal with certain language tasks may increase, and hence, their language learning ability. Therefore, this experimental research study attempts to assess the extent to which an integrated approach combining one particular reading approach known as ‘collaborative strategic reading’ (CSR), and teacher’s attributional feedback (on students’ reading performance and strategy use) can improve the reading comprehension skill and the sense of self-efficacy of EFL Algerian university students. It also seeks to examine students’ main reasons for their successful or unsuccessful achievements in reading comprehension activities, and whether students’ attributions for their reading comprehension outcomes can be modified after exposure to the instruction. To obtain the data, different tools including a reading comprehension test, questionnaires, an observation, an interview, and learning logs were used with 105 second year Algerian EFL university students. The sample of the study was divided into three groups; one control group (with no treatment), one experimental group (CSR group) who received a CSR instruction, and a second intervention group (CSR Plus group) who received teacher’s attribution feedback in addition to the CSR intervention. Students in the CSR Plus group received the same experiment as the CSR group using the same tools, except that they were asked to keep learning logs, for which teacher’s feedback on reading performance and strategy use was provided. The results of this study indicate that the CSR and the attributional feedback intervention was effective in improving students’ reading comprehension proficiency and sense of self-efficacy. However, there was not a significant change in students’ adaptive and maladaptive attributions for their success and failure d from the pre-test to the post-test phase. Analysis of the perception questionnaire, the interview, and the learning logs shows that students have positive perceptions about the CSR and the attributional feedback instruction. Based on the findings, this study, therefore, seeks to provide EFL teachers in general and Algerian EFL university teachers in particular with pedagogical implications on how to teach reading comprehension to their students to help them achieve well and feel more self-efficacious in reading comprehension activities, and in English language learning more generally.

Keywords: attributions, attributional feedback, collaborative strategic reading, self-efficacy

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Authors: Mateus L. O. Freitas, Flávia H. de M. Libório, Letycia L. Ricardo, Patrícia da C. Zonetti, Graciene de S. Bido

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Weeds compete with agricultural crops for resources such as light, water, and nutrients. This competition can cause significant damage to agricultural producers, and, currently, the use of agrochemicals is the most effective method for controlling these undesirable plants. Morning glory (Ipomoea grandifolia [Dammer] O'Donell) is an aggressive weed and significantly reduces agricultural productivity making harvesting difficult, especially mechanical harvesting. The biggest challenge in modern agriculture is to preserve high productivity reducing environmental damage and maintaining soil characteristics. No-till is a sustainable practice that can reduce the use of agrochemicals and environmental impacts due to the presence of plant residues in the soil, which release allelopathic compounds and reduce the incidence or alter the growth and development of crops and weeds. Sorghum (Sorghum bicolor [L.] Moench) is a forage with proven allelopathic activity, mainly for producing sorgholeone. In this context, this research aimed to evaluate the allelopathic action of sorghum fractions using hexane, dichloromethane, butanol, and ethyl acetate on the germination and initial growth of morning glory. The parameters analyzed were the percentage of germination, speed of germination, seedling length, and biomass weight (fresh and dry). The bioassays were performed in Petri dishes, kept in an incubation chamber for 7 days, at 25 °C, with a 12h photoperiod. The experimental design was completely randomized, with five replicates of each treatment. The data were evaluated by analysis of variance, and the averages between each treatment were compared using the Scott Knott test at a 5% significance level. The results indicated that the dichloromethane and ethyl acetate fractions showed bioherbicidal effects, promoting effective reductions on germination and initial growth of the morning glory. It was concluded that allelochemicals were probably extracted in these fractions. These secondary metabolites can reduce the use of agrochemicals and environmental impact, making agricultural production systems more sustainable.

Keywords: allelochemicals, secondary metabolism, sorgoleone, weeds

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Authors: Ridwaan N. Milase, Leonardo J. Van Zyl, Marla Trindade

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American foulbrood (AFB) is the world’s most devastating honeybee disease that has drastically reduced the population of Apis mellifera capensis since 2009. The outbreak has jeopardized the South African bee keeping industry as well as the agricultural sector dependent on honeybees for honey production and pollination, leading to significant economic losses. AFB is caused by Paenibacillus larvae, a spore-forming, Gram positive facultative anaerobic and flagellated bacterium. The use of antibiotics within beehives has selected for resistant strains of P. larvae, while the current practice of burning spore contaminated beehives and equipment contributes to the economic losses in the honeybee-keeping industry. Therefore, phage therapy is proposed as a promising alternative to combat P. larvae strains affecting A. mellifera capensis. The genomes of two P. larvae strains isolated from infected combs in the Western Cape have been sequenced and annotated using bioinformatics tools. Genome analyses has revealed that these P. larvae strains are lysogens to more than 6 different prophages and possess different type of clustered regularly interspaced short palindromic repeat (CRISPRs) regions per strain. Active prophages from one of the two P. larvae strains were detected and identified using PCR. Electron microscopy was used to determine the family of the identified active prophages. Lytic bacteriophages that specifically target the two P. larvae strains were purified from sewage wastewater, beehive materials, and soil samples to investigate their potential development as anti-P. larvae agents. Another alternative treatment being investigated is the development of a prophage endolysin cocktail. Endolysin genes of the prophages have been targeted, cloned and expressed in Escherichia coli. The heterologously expressed endolysins have been purified and are currently being assessed for their lytic activity against P. larvae strains and other commensal microorganisms that compose the honeybee larvae microbiota. The study has shown that phage therapy and endolysins have a great potential as alternative control methods for AFB disease affecting A. mellifera capensis.

Keywords: American foulbrood, bacteriophage, honeybee, Paenibacillus larvae

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Authors: Abigail Kusi Amponsah, Evans Frimpong Kyei, John Bright Agyemang, Hanson Boakye, Joana Kyei-Dompim, Collins Kwadwo Ahoto, Evans Oduro

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Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n =24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management

Keywords: Nursing-Related Barriers, Children, Pain Management, Ghana

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Authors: Lakmali Anthony, Madeline Gillies

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Background Breast cancer (BC) is usually managed with surgical resection. Many outcomes traditionally used to define successful operative management, such as resection margin, do not adequately reflect patients’ experience. Patient-reported outcomes (PRO) such as Health-Related Quality of life (HRQoL) provide a means by which the impact of surgery for cancer can be reported in a patient-centered way. This exploratory cross-sectional study aims to; (1) describe postoperative HRQoL in patients who underwent primary resection in a regional Australian hospital; (2) describe the prevalence of anxiety, depression and clinically significant fear of cancer recurrence (FCR) in this population; and (3) identify demographic, psychosocial, disease and treatment factors associated with poorer self-reported HRQoL. Methods Patients who had resection of BC in a regional Australian hospital between 2015 and 2022 were eligible. Participants were asked to complete a survey designed to assess HRQoL, as well as validated instruments that assess several other psychosocial PROs hypothesized to be associated with HRQoL; emotional distress, fear of cancer recurrence, social support, dispositional optimism, body image and spirituality. Results Forty-six patients completed the survey. Clinically significant levels of FCR and emotional distress were present in this group. Many domains of HRQoL were significantly worse than an Australian reference population for BC. Demographic and disease factors associated with poor HRQoL included smoking and ongoing adjuvant systemic therapy. The primary operation was not associated with HRQoL for breast cancer. All psychosocial factors measured were associated with HRQoL. Conclusion HRQoL is an important outcome in surgery for both research and clinical practice. This study provides an overview of the quality of life in a regional Australian population of postoperative breast cancer patients and the factors that affect it. Understanding HRQoL and awareness of patients particularly vulnerable to poor outcomes should be used to aid the informed consent and shared decision-making process between surgeon and patient.

Keywords: breast cancer, surgery, quality of life, regional population

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Authors: Ahmed Al Ansari, Khalid Al Khalifa

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Objective: Multisource feedback (MSF), also called the 360-Degree evaluation is an evaluation process by which questionnaires are distributed amongst medical peers and colleagues to assess physician performance from different sources other than the attending or the supervising physicians. The aim of this study was to design, implement, and evaluate a 360-Degree process in assessing emergency physicians trainee in the Kingdom of Bahrain. Method: The study was undertaken in Bahrain Defense Force Hospital which is a military teaching hospital in the Kingdom of Bahrain. Thirty emergency physicians (who represent the total population of the emergency physicians in our hospital) were assessed in this study. We developed an instrument modified from the Physician achievement review instrument PAR which was used to assess Physician in Alberta. We focused in our instrument to assess professionalism, communication skills and collaboration only. To achieve face and content validity, table of specification was constructed and a working group was involved in constructing the instrument. Expert opinion was considered as well. The instrument consisted of 39 items; were 15 items to assess professionalism, 13 items to assess communication skills, and 11 items to assess collaboration. Each emergency physicians was evaluated with 3 groups of raters, 4 Medical colleague emergency physicians, 4 medical colleague who are considered referral physicians from different departments, and 4 Coworkers from the emergency department. Independent administrative team was formed to carry on the responsibility of distributing the instruments and collecting them in closed envelopes. Each envelope was consisted of that instrument and a guide for the implementation of the MSF and the purpose of the study. Results: A total of 30 emergency physicians 16 males and 14 females who represent the total number of the emergency physicians in our hospital were assessed. The total collected forms is 269, were 105 surveys from coworkers working in emergency department, 93 surveys from medical colleague emergency physicians, and 116 surveys from referral physicians from different departments. The total mean response rates were 71.2%. The whole instrument was found to be suitable for factor analysis (KMO = 0.967; Bartlett test significant, p<0.00). Factor analysis showed that the data on the questionnaire decomposed into three factors which counted for 72.6% of the total variance: professionalism, collaboration, and communication. Reliability analysis indicated that the instrument full scale had high internal consistency (Cronbach’s α 0.98). The generalizability coefficients (Ep2) were 0.71 for the surveys. Conclusions: Based on the present results, the current instruments and procedures have high reliability, validity, and feasibility in assessing emergency physicians trainee in the emergency room.

Keywords: MSF system, emergency, validity, generalizability

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Authors: Yan Yan, Erhong Sun, Lin Peng, Xuchun Ye

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Aims: The present study aimed to explore Intensive Care Unit(ICU) nurses’ mental workload (MWL) and associated factors with it in performing human-machine tasks. Background: A wide range of emerging technologies have penetrated widely in the field of health care, and ICU nurses are facing a dramatic increase in nursing human-machine tasks. However, there is still a paucity of literature reporting on the general MWL of ICU nurses performing human-machine tasks and the associated influencing factors. Methods: A cross-sectional survey was employed. The data was collected from January to February 2021 from 9 tertiary hospitals in 6 provinces (Shanghai, Gansu, Guangdong, Liaoning, Shandong, and Hubei). Two-stage sampling was used to recruit eligible ICU nurses (n=427). The data were collected with an electronic questionnaire comprising sociodemographic characteristics and the measures of MWL, self-efficacy, system usability, and task difficulty. The univariate analysis, two-way analysis of variance(ANOVA), and a linear mixed model were used for data analysis. Results: Overall, the mental workload of ICU nurses in performing human-machine tasks was medium (score 52.04 on a 0-100 scale). Among the typical nursing human-machine tasks selected, the MWL of ICU nurses in completing first aid and life support tasks (‘Using a defibrillator to defibrillate’ and ‘Use of ventilator’) was significantly higher than others (p < .001). And ICU nurses’ MWL in performing human-machine tasks was also associated with age (p = .001), professional title (p = .002), years of working in ICU (p < .001), willingness to study emerging technology actively (p = .006), task difficulty (p < .001), and system usability (p < .001). Conclusion: The MWL of ICU nurses is at a moderate level in the context of a rapid increase in nursing human-machine tasks. However, there are significant differences in MWL when performing different types of human-machine tasks, and MWL can be influenced by a combination of factors. Nursing managers need to develop intervention strategies in multiple ways. Implications for practice: Multidimensional approaches are required to perform human-machine tasks better, including enhancing nurses' willingness to learn emerging technologies actively, developing training strategies that vary with tasks, and identifying obstacles in the process of human-machine system interaction.

Keywords: mental workload(MWL), nurse, ICU, human-machine, tasks, cross-sectional study, linear mixed model, China

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Authors: Inês Boticas, Diana P. Ferreira, Ana Eusébio, Carlos Silva, Pedro Magalhães, Ricardo Silva, Raul Fangueiro

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Since the beginning of the 20^th century, sportswear has a major contribution to the impact of fashion on our lives. Nowadays, the embracing of sportswear fashion/looks is undoubtedly noticeable, as the modern consumer searches for high comfort and linear aesthetics for its clothes. This compromise lead to the arise of the athleisure trend. Athleisure surges as a new style area that combines both wearability and fashion sense, differentiated from the archetypal sportswear, usually associated to “gym clothes”. Additionally, the possibility to functionalize and implement new technologies have shifted and progressively empowers the connection between the concepts of physical activities practice and well-being, allowing clothing to be more interactive and responsive with its surroundings. In this study, a design inspired in retro and urban lifestyle was envisioned, engineering textile structures that can respond to external stimuli. These structures are enhanced to be responsive to heat, water vapor and humidity, integrating shape memory polymers (SMP) to improve the breathability and heat-responsive behavior of the textiles and zinc oxide nanoparticles (ZnO NPs) to heighten the surface hydrophobic properties. The best results for hydrophobic exhibited superhydrophobic behavior with water contact angle (WAC) of more than 150 degrees. For the breathability and heat-response properties, SMP-coated samples showed an increase in water vapour permeability values of about 50% when compared with non SMP-coated samples. These innovative technological approaches were endorsed to design innovative clothing, in line with circular economy and eco-design principles, by assigning a substantial degree of mutability and versatility to the clothing. The development of a coat and shirt, in which different parts can be purchased separately to create multiple products, aims to combine the technicality of both the fabrics used and the making of the garments. This concept translates itself into a real constructive mechanism through the symbiosis of high-tech functionalities and the timeless design that follows the athleisure aesthetics.

Keywords: breathability, sportswear and casual clothing, sustainable design, superhydrophobicity

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Authors: Jill Steel

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The interlinked issues of emotional wellbeing and attainment continue to dominate international educational discourse. Reading skills are particularly important to attainment in all areas of the curriculum, and illiteracy is associated with reduced wellbeing and life prospects, with serious ramifications for the wider economy and society. Research shows that reading attainment is influenced by reading motivation and frequency. Reading to Dogs (RTD) is increasingly applied to promote reading motivation and frequency in schools despite a paucity of empirical evidence, specifically examining the influence of RTD on emotional wellbeing and engagement with reading. This research aims to examine whether RTD is effective in promoting these positive outcomes among children aged eight to nine years. This study also aims to inform much needed regulation of the field and standards of practice, including both child and dog welfare. Therefore, ethical matters such as children’s inclusion and safety, as well as the rights and wellbeing of dogs infuse the study throughout. The methodological design is a mixed method longitudinal study. A UK wide questionnaire will be distributed to teachers between January and June 2020 to understand their perceptions of RTD. Following this, a randomised controlled trial (N = 100) will begin in August 2020 in two schools of a comparable demographic, with N= 50 in the intervention school, and N= 50 in a waiting list control school. Reading and wellbeing assessments will be conducted prior to and immediately post RTD, and four weeks after RTD to measure sustained changes. The reading assessments include New Group Reading Test, Motivation to Read Profile (Gambrell et al., 1995), as well as reading frequency and reading anxiety assessments specifically designed for the study. Wellbeing assessments include Goodman’s SDQ, (1997) and pupil self-reporting questionnaires specifically designed for the study. Child, class teacher, and parent questionnaires and interviews prior to, during and post RTD will be conducted to measure perceptions of the impact of RTD on mood and motivation towards reading. This study will make a substantial contribution to our understanding of the effectiveness of RTD and thus have consequences for the fields of education and anthrozoology.

Keywords: animal assisted intervention, reading to dogs, welfare, wellbeing

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