Search results for: academic/practice partnerships

Authors: Lily Farris, Chantel E. Canessa, Rena Heathcote, Susan Shumay, Suzanna V. McRae, Alissa Collingridge, Minna K. Miller

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Objective: To describe how the Lean approach can be applied to improve access, quality and safety of care in an ambulatory pediatric primary care setting. Background: Lean was originally developed by Toyota manufacturing in Japan, and subsequently adapted for use in the healthcare sector. Lean is a systematic approach, focused on identifying and reducing waste within organizational processes, improving patient-centered care and efficiency. Limited literature is available on the implementation of the Lean methodologies in a pediatric ambulatory care setting. Methods: A strategic continuous improvement event or Rapid Process Improvement Workshop (RPIW) was launched with the aim evaluating and structurally supporting clinic workflow, capacity building, sustainability, and ultimately improving access to care and enhancing the patient experience. The Lean process consists of five specific activities: Current state/process assessment (value stream map); development of a future state map (value stream map after waste reduction); identification, quantification and prioritization of the process improvement opportunities; implementation and evaluation of process changes; and audits to sustain the gains. Staff engagement is a critical component of the Lean process. Results: Through the implementation of the RPIW and shifting workload among the administrative team, four hours of wasted time moving between desks and doing work was eliminated from the Administrative Clerks role. To streamline clinic flow, the Nursing Assistants completed patient measurements and vitals for Nurse Practitioners, reducing patient wait times and adding value to the patients visit with the Nurse Practitioners. Additionally, through the Nurse Practitioners engagement in the Lean processes a need was recognized to articulate clinic vision, mission and the alignment of NP role and scope of practice with the agency and Ministry of Health strategic plan. Conclusions: Continuous improvement work in the Pediatric Primary Care NP Clinic has provided a unique opportunity to improve the quality of care delivered and has facilitated further alignment of the daily continuous improvement work with the strategic priorities of the Ministry of Health.

Keywords: ambulatory care, lean, pediatric primary care, system efficiency

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Authors: Hayley Lawrence, Nabi Shah, Sarah Dyer

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Aims: Lumbar punctures are a common bedside procedure performed in acute medicine. Published guidance exists on the standardised documentation of invasive procedures in order to reduce the risk of complications. The audit aim was to assess current standards of documentation in accordance with both the GMC and the National Standards for Invasive Procedures guidelines. A second cycle was conducted after introducing a standardised sticker created using current guidelines. This would assess whether the sticker improved documentation, aiming for 100% standard in each step of the procedure. Methods: An initial prospective audit of current practice was conducted over a 3-month period. Patients were identified by their presenting complaints and by colleagues assessing acute medical patients. Initial findings were presented locally, and a further prospective audit was conducted following the implementation of a standardised sticker. Results: 19 lumbar punctures were included in the first cycle and 13 procedures in the second. Pre-procedure documentation was collected for each cycle, whereby documentation of ‘Indication’ improved from 5.3% to 84.6%, ‘Consent’ from 84.2% to 100%, ‘Coagulopathy’ from 0% to 61.5%, ‘Drug Chart checked’ from 0% to 100%, ‘Position of patient’ from 26.3% to 100% and use of ‘Aseptic Technique’ from 83.3% to 100% from the first to the second cycle respectively. ‘Level of Doctor’ and ‘Supervision’ decreased from 53% to 31% and 53% to 46%, respectively, in the second cycle. Documentation of the procedure itself also demonstrated improvements, with ‘Level of Insertion’ 15.8% to 100%, ‘Name of Antiseptic Used’ 11.1% to 69.2%, ‘Local Anaesthetic Used’ 26.3% to 53.8%, ‘Needle Gauge’ 42.1% to 76.9%, ‘Number of Attempts’ 78.9% to 100% and ‘Traumatic/Atraumatic’ procedure 26.3% to 92.3%, respectively. A similar number of opening pressures were documented in each cycle at 57.9% and 53.8%, respectively, but its documentation was deemed ‘Not Applicable’ in a higher number of patients in the second cycle. Post-procedure documentation improved, with ‘Number of Samples obtained’ increasing from 52.6% to 92.3% and documentation of ‘Immediate Complications’ increasing from 78.9% to 100%. ‘Dressing Applied’ was poorly documented in the first cycle at 16.7%. This was not included on the standardised sticker, resulting in 0% documentation in the second cycle. Documentation of Clinicians’ Name and Bleep reduced from 63.2% to 15.4%, but when the name only was analysed, this increased to 84.6%. Conclusions: Standardised stickers for lumbar punctures do improve documentation and hence should result in improved patient safety. There is still room for improvement to reach 100% standard in each area, especially with respect to the clinician’s name and contact details being documented. Final adjustments will be made to the sticker before being included in a lumbar puncture kit, which will be made readily available in the acute medical wards. Future audits could be extended to include other common bedside procedures performed in acute medicine to ensure documentation of all these procedures reaches 100% standard.

Keywords: invasive procedure, lumbar puncture, medical record keeping, procedure checklist, procedure documentation, standardised documentation

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Authors: M. Isabel Santos, Ana Breda, Ana Margarida Almeida

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Research on academic abilities of individuals with autism spectrum disorder (ASD) underlines the importance of mathematics interventions. Yet the proposal of digital applications for children and youth with ASD continues to attract little attention, namely, regarding the development of mathematical reasoning, being the use of the digital technologies an area of great interest for individuals with this disorder and its use is certainly a facilitative strategy in the development of their mathematical abilities. The use of digital technologies can be an effective way to create innovative learning opportunities to these students and to develop creative, personalized and constructive environments, where they can develop differentiated abilities. The children with ASD often respond well to learning activities involving information presented visually. In this context, we present the digital Learning Environment on Mathematics for Autistic children (LEMA) that was a research project conducive to a PhD in Multimedia in Education and was developed by the Thematic Line Geometrix, located in the Department of Mathematics, in a collaboration effort with DigiMedia Research Center, of the Department of Communication and Art (University of Aveiro, Portugal). LEMA is a digital mathematical learning environment which activities are dynamically adapted to the user’s profile, towards the development of mathematical abilities of children aged 6–12 years diagnosed with ASD. LEMA has already been evaluated with end-users (both students and teacher’s experts) and based on the analysis of the collected data readjustments were made, enabling the continuous improvement of the prototype, namely considering the integration of universal design for learning (UDL) approaches, which are of most importance in ASD, due to its heterogeneity. The learning strategies incorporated in LEMA are: (i) provide options to custom choice of math activities, according to user’s profile; (ii) integrates simple interfaces with few elements, presenting only the features and content needed for the ongoing task; (iii) uses a simple visual and textual language; (iv) uses of different types of feedbacks (auditory, visual, positive/negative reinforcement, hints with helpful instructions including math concept definitions, solved math activities using split and easier tasks and, finally, the use of videos/animations that show a solution to the proposed activity); (v) provides information in multiple representation, such as text, video, audio and image for better content and vocabulary understanding in order to stimulate, motivate and engage users to mathematical learning, also helping users to focus on content; (vi) avoids using elements that distract or interfere with focus and attention; (vii) provides clear instructions and orientation about tasks to ease the user understanding of the content and the content language, in order to stimulate, motivate and engage the user; and (viii) uses buttons, familiarly icons and contrast between font and background. Since these children may experience little sensory tolerance and may have an impaired motor skill, besides the user to have the possibility to interact with LEMA through the mouse (point and click with a single button), the user has the possibility to interact with LEMA through Kinect device (using simple gesture moves).

Keywords: autism spectrum disorder, digital technologies, inclusion, mathematical abilities, mathematical learning activities

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Authors: Teresa Wills, Geraldine Mccarthy, Nicola Cornally

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Background: Obesity is an emerging healthcare epidemic affecting virtually all age and socio-economic groups and is one of the most serious and prevalent diseases of the 21st century. It is a public health challenge because of its prevalence, associated costs and health effects. The increasing prevalence of obesity has created a social perception that overweight body sizes are healthy and normal. This normalization of obesity within our society and the acceptance of higher body weights have led to individuals being unaware of the reality of their weight status and gravity of this situation thus impeding recognition of obesity. Given the escalating global health problem of obesity and its co-morbidities, the need to re-appraise its management is more compelling than ever. It is widely accepted that the causes of obesity are complex and multi-factorial. Engagement of individuals in weight management programmes is difficult if they do not perceive they have a problem with their weight. Recognition of the problem is a key component of obesity management and identifying the main predictors of behaviour is key to designing health behaviour interventions. Aim: The aim of the research was to determine factors relating to motivation to change behaviours in individuals who perceive themselves to be overweight. Method: The research design was quantitative, correlational and cross-sectional. The design was guided by the Health Belief Model. Data were collected online using a multi-section and multi-item questionnaire, developed from a review of the theoretical and empirical research. A sample of 202 men and women who perceived themselves to be overweight participated in the research. Descriptive and inferential statistical analyses were employed to describe relationships between variables. Findings: Following multivariate regression analysis, perceived barriers to weight loss and perceived benefits of weight loss were significant predictors of motivation to change behaviour. The perceived barriers to weight loss which were significant were psychological barriers to weight loss (p = < 0.019) and environmental barriers to physical activity (p= < 0.032).The greatest predictor of motivation to change behaviour was the perceived benefits of weight loss (p < 0.001). Perceived susceptibility to obesity and perceived severity of obesity did not emerge as significant predictors in this model. Total variance explained by the model was 33.5%. Conclusion: Perceived barriers to weight loss and perceived benefits of weight loss are important determinants of motivation to change behaviour. These findings have important implications for health professionals to help inform their practice and for the development of intervention programmes to prevent and control obesity.

Keywords: motivation to change behaviours, obesity, predictors of behavior, interventions, overweight

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Authors: Frances Turner

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Gloves are significant physical objects, being one of the oldest forms of dress. Glove culture is part of every facet of life; its extraordinary history encompasses practicality, and symbolism reflecting a wide range of social practices. The survival of not only the gloves but associated articles enables the possibility to analyse real lives, however so far this area has been largely neglected. Limited information is available to students, researchers, or those involved with the design and making of gloves. There are several museums and independent collectors in England that hold collections of gloves (some from as early as 16th century), machinery, tools, designs and patterns, marketing materials and significant archives which demonstrate the rich heritage of English glove design and manufacturing, being of national significance and worthy of international interest. Through a research glove network which now exists thanks to research grant funding, there is potential for the holders of glove collections to make connections and explore links between these resources to promote a stronger understanding of the significance, breadth and heritage of the English glove industry. The network takes an interdisciplinary approach to bring together interested parties from academia, museums and manufacturing, with expert knowledge of the production, collections, conservation and display of English leather gloves. Academics from diverse arts and humanities disciplines benefit from the opportunities to share research and discuss ideas with network members from non-academic contexts including museums and heritage organisations, industry, and contemporary designers. The fragmented collections when considered in entirety provide an overview of English glove making since earliest times and those who wore them. This paper makes connections and explores links between these resources to promote a stronger understanding of the significance, breadth and heritage of the English Glove industry. The following areas are explored: current content and status of the individual museum collections, potential links, sharing of information histories, social and cultural and relationship to history of fashion design, manufacturing and materials, approaches to maintenance and conservation, access to the collections and strategies for future understanding of their national significance. The facilitation of knowledge exchange and exploration of the collections through the network informs organisations’ future strategies for the maintenance, access and conservation of their collections. By involving industry in the network, it is possible to ensure a contemporary perspective on glove-making in addition to the input from heritage partners. The slow fashion movement and awareness of artisan craft and how these can be preserved and adopted for glove and accessory design is addressed. Artisan leather glove making was a skilled and significant industry in England that has now declined to the point where there is little production remaining utilising the specialist skills that have hardly changed since earliest times. This heritage will be identified and preserved for future generations of the rich cultural history of gloves may be lost.

Keywords: artisan glove-making skills, English leather gloves, glove culture, the glove network

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Authors: Gamze Safak, Umut Arslanoglu

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Cultural and tourism conservation and development zones and tourism centers are the boundaries declared for the purpose of protecting, using, and evaluating the sectoral development and planned development in areas where historical and cultural values are heavily involved and/or where tourism potential is high. The most rapidly changing regions in Turkey are tourism areas, especially the coastal areas. Planning these regions is not about only an economic gain but also a natural and physical environment and refers to a complex process. If the tourism sector is not well controlled, excessive use of natural resources and wrong location choices may cause damage to natural areas, historical values, and socio-cultural structure. Since the strategic decisions taken in the environmental order and zoning plans, which are the means of guiding the physical environment of the Ministry of Culture and Tourism, which have the authority to make plans in tourism centers, are transformed into plan decisions that find the spatial expression, comprehensive evaluation of all kinds of data, following the historical development and based on the correct and current data is required. In addition, the authority has a number of competences in tourism promotion as well as the authority to plan, leading to the necessity of taking part in the applications requiring complex analysis such as the management and integration of the country's economic, political, social and cultural resources. For this purpose, Tourism Inventory System (TES) project, which consists of a series of subsystems, has been developed in order to solve complex planning and method problems in the management of site-related information. The scope of the project is based on the integration of numerical and verbal data in the regions within the jurisdiction of the authority, and the monitoring of the historical development of urban planning studies, making the spatial data of the institution easily accessible, shared, questionable and traceable in international standards. A dynamic and continuous system design has been put into practice by utilizing the advantage of the use of Geographical Information Systems in the planning process to play a role in making the right decisions, revealing the tools of social, economic, cultural development, and preservation of natural and cultural values. This paper, which is prepared by the project team members in TES (Tourism Inventory System), will present a study regarding the applicability of GIS in cultural and natural heritage conservation.

Keywords: cultural conservation, GIS, geographic information system, tourism inventory system, urban planning

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Authors: Nabamita Nath, Sanghamitra Sarkar

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Urban development in traditional neighbourhoods of cities is undergoing a sea change due to imposition of irregular development patterns on a predominantly inclusive urban fabric. In recent times, traditional neighbourhoods of Kolkata have experienced irregular urban development which has resulted in transformation of its immediate urban character. The goal is to study and analyse impact of new urban developments within traditional neighbourhoods of Kolkata and establish development guidelines to balance the old with the new. Various cities predominantly in third world countries are also experiencing similar development patterns in their traditional neighbourhoods. Existing literature surveys of development patterns in such neighbourhoods have established 9 major parameters viz. edge, movement, node, landmark, size-density, pattern-grain-texture, open spaces, urban spaces, urban form and views-vistas of the neighbourhood. To evaluate impact of urban development in traditional neighbourhoods of Kolkata, 3 different areas have been chronologically selected based on their settlement patterns. Parameters established through literature surveys have been applied to the selected areas to study and analyse the existing patterns of development. The main sources of this study included extensive on-site surveys, academic archive, census data, organisational records and informational websites. Applying the established parameters, 5 major conclusions were derived. Firstly, it was found that pedestrian friendly neighbourhoods of the city were becoming more car-centric. This has resulted in loss of interactive and social spaces which defined the cultural heritage of Kolkata. Secondly, the urban pattern which was composed of dense and compact fabric is gradually losing its character due to incorporation of new building typologies. Thirdly, the new building typologies include gated communities with private open spaces which is a stark departure from the existing built typology. However, these open spaces have not contributed in creation of inclusive public places for the community which are a significant part of such heritage neighbourhood precincts. Fourthly, commercial zones that primarily developed along major access routes have now infiltrated within these neighbourhoods. Gated communities do not favour formation of on-street commercial activities generating haphazard development patterns. Lastly, individual residential buildings that reflected Indo-saracenic and Neo-gothic architectural styles are converting into multi-storeyed residential apartments. As a result, the axis that created a definite visual identity for a neighbourhood is progressively following an irregular pattern. Thus, uniformity of the old skyline is gradually becoming inconsistent. The major issue currently is threat caused by irregular urban development to heritage zones and buildings of traditional neighbourhoods. Streets, lanes, courtyards, open spaces and buildings of old neighbourhoods imparted a unique cultural identity to the city that is disappearing with emerging urban development patterns. It has been concluded that specific guidelines for urban development should be regulated primarily based on existing urban form of traditional neighbourhoods. Such neighbourhood development strategies should be formulated for various cities of third world countries to control irregular developments thereby balancing heritage and development.

Keywords: heritage, Kolkata, traditional neighbourhood, urban development

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Authors: Maximilian Elsen, Frank Tietze

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The development and diffusion of green technologies are crucial for achieving our ambitious climate targets. The Paris Agreement commits its members to develop strategies for achieving net zero greenhouse gas emissions by the second half of the century. Governments, executives, and academics are working on net-zero strategies and the business of rating organisations on their environmental, social and governance (ESG) performance has grown tremendously in its public interest. ESG data is now commonly integrated into traditional investment analysis and an important factor in investment decisions. Creating these metrics, however, is inherently challenging as environmental and social impacts are hard to measure and uniform requirements on ESG reporting are lacking. ESG metrics are often incomplete and inconsistent as they lack fully accepted reporting standards and are often of qualitative nature. This study explores the use of patent data for assessing the environmental performance of companies by focusing on their patented inventions in the space of climate change mitigation and adaptation technologies (CCMAT). The present study builds on the successful identification of CCMAT patents. In this context, the study adopts the Y02 patent classification, a fully cross-sectional tagging scheme that is fully incorporated in the Cooperative Patent Classification (CPC), to identify Climate Change Adaptation Technologies. The Y02 classification was jointly developed by the European Patent Office (EPO) and the United States Patent and Trademark Office (USPTO) and provides means to examine technologies in the field of mitigation and adaptation to climate change across relevant technologies. This paper develops sustainability-related metrics for firm-level patent portfolios. We do so by adopting a three-step approach. First, we identify relevant CCMAT patents based on their classification as Y02 CPC patents. Second, we examine the technological strength of the identified CCMAT patents by including more traditional metrics from the field of patent analytics while considering their relevance in the space of CCMAT. Such metrics include, among others, the number of forward citations a patent receives, as well as the backward citations and the size of the focal patent family. Third, we conduct our analysis on a firm level by sector for a sample of companies from different industries and compare the derived sustainability performance metrics with the firms’ environmental and financial performance based on carbon emissions and revenue data. The main outcome of this research is the development of sustainability-related metrics for firm-level environmental performance based on patent data. This research has the potential to complement existing ESG metrics from an innovation perspective by focusing on the environmental performance of companies and putting them into perspective to conventional financial performance metrics. We further provide insights into the environmental performance of companies on a sector level. This study has implications of both academic and practical nature. Academically, it contributes to the research on eco-innovation and the literature on innovation and intellectual property (IP). Practically, the study has implications for policymakers by deriving meaningful insights into the environmental performance from an innovation and IP perspective. Such metrics are further relevant for investors and potentially complement existing ESG data.

Keywords: climate change mitigation, innovation, patent portfolios, sustainability

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Authors: Mostafa Shahriari, Theophile Chaumont-Frelet, David Pardo

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Resistivity measurements are used to characterize the Earth’s subsurface. They are categorized into two different groups: (a) those acquired on the Earth’s surface, for instance, controlled source electromagnetic (CSEM) and Magnetotellurics (MT), and (b) those recorded with borehole logging instruments such as Logging-While-Drilling (LWD) devices. LWD instruments are mostly used for geo-steering purposes, i.e., to adjust dip and azimuthal angles of a well trajectory to drill along a particular geological target. Modern LWD tools measure all nine components of the magnetic field corresponding to three orthogonal transmitter and receiver orientations. In order to map the Earth’s subsurface and perform geo-steering, we invert measurements using a gradient-based method that utilizes the derivatives of the recorded measurements with respect to the inversion variables. For resistivity measurements, these inversion variables are usually the constant resistivity value of each layer and the bed boundary positions. It is well-known how to compute derivatives with respect to the constant resistivity value of each layer using semi-analytic or numerical methods. However, similar formulas for computing the derivatives with respect to bed boundary positions are unavailable. The main contribution of this work is to provide an adjoint-based formulation for computing derivatives with respect to the bed boundary positions. The key idea to obtain the aforementioned adjoint state formulations for the derivatives is to separate the tangential and normal components of the field and treat them differently. This formulation allows us to compute the derivatives faster and more accurately than with traditional finite differences approximations. In the presentation, we shall first derive a formula for computing the derivatives with respect to the bed boundary positions for the potential equation. Then, we shall extend our formulation to 3D Maxwell’s equations. Finally, by considering a 1D domain and reducing the dimensionality of the problem, which is a common practice in the inversion of resistivity measurements, we shall derive a formulation to compute the derivatives of the measurements with respect to the bed boundary positions using a 1.5D variational formulation. Then, we shall illustrate the accuracy and convergence properties of our formulations by comparing numerical results with the analytical derivatives for the potential equation. For the 1.5D Maxwell’s system, we shall compare our numerical results based on the proposed adjoint-based formulation vs those obtained with a traditional finite difference approach. Numerical results shall show that our proposed adjoint-based technique produces enhanced accuracy solutions while its cost is negligible, as opposed to the finite difference approach that requires the solution of one additional problem per derivative.

Keywords: inverse problem, bed boundary positions, electromagnetism, potential equation

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Authors: Rozanne Janet Smith

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This article examined the corporate governance disclosures of the large and medium-sized auditing firms in South Africa. It is important that auditing firms disclose their practice of good corporate governance to the public, as they serve the public interest. The auditing profession has been criticized due to many corporate scandals in recent years. This has undermined the reputation of the profession, with experts and the public questioning whether auditing firms have corporate governance structures in place, and whether they are taking public interest into consideration. In South Africa there is no corporate governance code specifically for audit firms. Auditing firms are encouraged by IRBA to issue a transparency report in which they disclose corporate governance structures and application, but this is not compulsory in South Africa. Moreover, the information issued in these transparency reports is limited and often only focuses on audit quality, and not governance. Through a literature review it was found that the UK is one of only a few countries who has a corporate governance code for audit firms. As South Africa initially used the UK Cadbury report to develop the King IV Code, it was fitting to use the UK Audit Firm Governance Code as a benchmark to determine if audit firms in South Africa are disclosing relevant corporate governance information in their transparency reports and/or integrated reports. This study contributes to the existing body of knowledge by pursuing the following objective: To determine the improvement in the corporate governance disclosures of large and medium-sized auditing firms in South Africa through comparative research. Available data from 2019 will be used and compared to the disclosures in the 2023/2024 transparency and or integrated reports of the large and medium-sized auditing firms in South Africa. To achieve this objective a constructivist research paradigm was applied. Qualitative secondary information was gathered for the analysis. A content analysis was selected to collect the qualitative data by analyzing the integrated reports and/or transparency reports of large and medium-sized auditing firms with 20 or more partners and to determine what is disclosed on their corporate governance practices. These transparency reports and integrated reports were then read and analyzed in depth and compared to the principles stated in the UK Code. Since there are only nine medium-sized and large auditing firms in South Africa, the researcher was able to conduct the content analysis by reading each report in depth. The following six principles which are found in the UK Code were assessed for disclosure. (1) Leadership, (2) Values, (3) INED, (4) Operations, (5) Reporting, and (6) Dialogue. The results reveal that the auditing firms are not disclosing the corporate governance principles and practices to the necessary extent. Although there has been some improvement, the disclosure is not to the extent which it should be. There is still a need for a South African audit firm governance code.

Keywords: auditing firms, corporate governance, South Africa, disclosure

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Authors: Anne Prip, Kirsten Alling Møller, Dorte Lisbet Nielsen, Mary Jarden, Marie-Helene Olsen, Anne Kjaergaard Danielsen

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Background: The development in cancer care has shifted towards shorter hospital stays and more outpatient treatment. Today, cancer care and treatment predominantly takes place in outpatient settings where encounters between patients and health care professionals are often brief. This development will probably continue internationally as the global cancer burden seems to be growing significantly. Furthermore, the number of patients who require ambulatory treatments such as chemotherapy is increasing. Focusing on the encounters between health care professionals and patients during oncology treatment has thus become increasingly important due to a growing trend in outpatient cancer management. Objective: The aim of the systematic review was to summarize the literature from the perspective of the patient, on experiences of and the need for communication and relationships with the health care professional during chemotherapy treatment in an outpatient setting. Method: The review was designed and carried out according to the PRISMA guidelines and PICO framework. The systematic search was conducted in Medline, CINAHL, The Cochrane Library and Joanna Briggs Institute Evidence Based Practice Database. Results: In all, 1174 studies were identified by literature search. After duplicates were removed, the remaining studies (n = 1053) were screened for inclusion. Nine studies were included; qualitative (n = 5) and quantitative (n = 4) as they met the inclusions criteria. The review identified that communication and relationships between health care professionals and patients were important for the patients’ ability to cope with cancer and also had an impact on patients’ satisfaction with care in the outpatient clinic. Furthermore, the review showed that hope and positivity was a need and strategy for patients with cancer and was facilitated by health care professionals. Finally, it revealed that outpatient clinic visits framed and influenced communication and relationships. Conclusions: This review identified the significance of communication and the relationships between patients and health care professionals in the outpatient setting as it supports patients’ ability to cope with cancer. The review showed the need for health care professionals to pay attention to the relational aspects of communication in an outpatient clinic as encounters are often brief. Furthermore, the review helps to specify which elements of the communication are central in the patient-health care professional interaction from the patients' perspective. Finally, it shows a need for more research to investigate which type of interaction and intervention would be the most effective in supporting patients’ coping during chemotherapy in an outpatient clinic.

Keywords: ambulatory chemotherapy, communication, health care professional-patient relation, nurse-patient relation, outpatient care, systematic review

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Authors: Lori Lioce, Gary Maddux, Norven Goddard, Ishella Fogle, Bernard Schroer

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This paper presents the integration of technologies into nursing education. The collaborative effort includes the College of Nursing (CoN) at the University of Alabama in Huntsville (UAH) and the UAH Systems Management and Production Center (SMAP). The faculty at the CoN conducts needs assessments to identify education and training requirements. A team of CoN faculty and SMAP engineers then prioritize these requirements and establish improvement/development teams. The development teams consist of nurses to evaluate the models and to provide feedback and of undergraduate engineering students and their senior staff mentors from SMAP. The SMAP engineering staff develops and creates the physical models using 3D printing, silicone molds and specialized molding mixtures and techniques. The collaboration has focused on developing teaching and training, or clinical, simulators. In addition, the onset of the Covid-19 pandemic has intensified this relationship, as 3D modeling shifted to supplied personal protection equipment (PPE) to local health care providers. A secondary collaboration has been introducing students to clinical benchmarking through the UAH Center for Management and Economic Research. As a result of these successful collaborations the Model Exchange & Development of Nursing & Engineering Technology (MEDNET) has been established. MEDNET seeks to extend and expand the linkage between engineering and nursing to K-12 schools, technical schools and medical facilities in the region to the resources available from the CoN and SMAP. As an example, stereolithography (STL) files of the 3D printed models, along with the specifications to fabricate models, are available on the MEDNET website. Ten 3D printed models have been developed and are currently in use by the CoN. The following additional training simulators are currently under development:1) suture pads, 2) gelatin wound models and 3) printed wound tattoos. Specification sheets have been written for these simulations that describe the use, fabrication procedures and parts list. These specifications are available for viewing and download on MEDNET. Included in this paper are 1) descriptions of CoN, SMAP and MEDNET, 2) collaborative process used in product improvement/development, 3) 3D printed models of training and teaching simulators, 4) training simulators under development with specification sheets, 5) family care practice benchmarking, 6) integrating the simulators into the nursing curriculum, 7) utilizing MEDNET as a pandemic response, and 8) conclusions and lessons learned.

Keywords: 3D printing, nursing education, simulation, trainers

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Authors: John Zanetich

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Designing an educational activity that encourages inquiry and collaboration is key to engaging students in meaningful learning. Educational Information and Communications Technology (EICT) plays an important role in facilitating cooperative and collaborative learning in the classroom. The EICT also facilitates students’ learning and development of the critical thinking skills needed to solve real world problems. Projects and activities based on constructivism encourage students to embrace complexity as well as find relevance and joy in their learning. It also enhances the students’ capacity for creative and responsible real-world problem solving. Classroom activities based on constructivism offer students an opportunity to develop the higher–order-thinking skills of defining problems and identifying solutions. Participating in a classroom project is an activity for both acquiring experiential knowledge and applying new knowledge to practical situations. It also provides an opportunity for students to integrate new knowledge into a skill set using reflection. Classroom projects can be developed around a variety of learning objects including social media, knowledge management and learning communities. The construction of meaning through project-based learning is an approach that encourages interaction and problem-solving activities. Projects require active participation, collaboration and interaction to reach the agreed upon outcomes. Projects also serve to externalize the invisible cognitive and social processes taking place in the activity itself and in the student experience. This paper describes a classroom project designed to elicit interactions by helping students to unfreeze existing knowledge, to create new learning experiences, and then refreeze the new knowledge. Since constructivists believe that students construct their own meaning through active engagement and participation as well as interactions with others. knowledge management can be used to guide the exchange of both tacit and explicit knowledge in interpersonal interactions between students and guide the construction of meaning. This paper uses an action research approach to the development of a classroom project and describes the use of technology, social media and the active use of tacit knowledge in the college classroom. In this project, a closed group Facebook page becomes the virtual classroom where interaction is captured and measured using engagement analytics. In the virtual learning community, the principles of knowledge management are used to identify the process and components of the infrastructure of the learning process. The project identifies class member interests and measures student engagement in a learning community by analyzing regular posting on the Facebook page. These posts are used to foster and encourage interactions, reflect a student’s interest and serve as reaction points from which viewers of the post convert the explicit information in the post to implicit knowledge. The data was collected over an academic year and was provided, in part, by the Google analytic reports on Facebook and self-reports of posts by members. The results support the use of active tacit knowledge activities, knowledge management and social media to enhance the student learning experience and help create the knowledge that will be used by students to construct meaning.

Keywords: constructivism, knowledge management, tacit knowledge, social media

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Authors: Geng Cui, Naoto Imura, Katsuhiro Nishinari, Takahiro Ezaki

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The bullwhip effect, which refers to the amplification of demand variance as one moves up the supply chain, has been observed in various industries and extensively studied through analytic approaches. Existing methods to mitigate the bullwhip effect, such as decentralized demand information, vendor-managed inventory, and the Collaborative Planning, Forecasting, and Replenishment System, rely on the willingness and ability of supply chain participants to share their information. However, in practice, information sharing is often difficult to realize due to privacy concerns. The purpose of this study is to explore new ways to mitigate the bullwhip effect without the need for information sharing. This paper proposes a 'bullwhip absorption strategy' (BAS) to alleviate the bullwhip effect by absorbing it downstream in the supply chain. To achieve this, a two-stage supply chain system was employed, consisting of a single retailer and a single manufacturer. In each time period, the retailer receives an order generated according to an autoregressive process. Upon receiving the order, the retailer depletes the ordered amount, forecasts future demand based on past records, and places an order with the manufacturer using the order-up-to replenishment policy. The manufacturer follows a similar process. In essence, the mechanism of the model is similar to that of the beer game. The BAS is implemented at the retailer's level to counteract the bullwhip effect. This strategy requires the retailer to reduce the uncertainty in its orders, thereby absorbing the bullwhip effect downstream in the supply chain. The advantage of the BAS is that upstream participants can benefit from a reduced bullwhip effect. Although the retailer may incur additional costs, if the gain in the upstream segment can compensate for the retailer's loss, the entire supply chain will be better off. Two indicators, order variance and inventory variance, were used to quantify the bullwhip effect in relation to the strength of absorption. It was found that implementing the BAS at the retailer's level results in a reduction in both the retailer's and the manufacturer's order variances. However, when examining the impact on inventory variances, a trade-off relationship was observed. The manufacturer's inventory variance monotonically decreases with an increase in absorption strength, while the retailer's inventory variance does not always decrease as the absorption strength grows. This is especially true when the autoregression coefficient has a high value, causing the retailer's inventory variance to become a monotonically increasing function of the absorption strength. Finally, numerical simulations were conducted for verification, and the results were consistent with our theoretical analysis.

Keywords: bullwhip effect, supply chain management, inventory management, demand forecasting, order-to-up policy

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Authors: Luminiţa Duţică, Gheorghe Duţică

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One of the most powerful language innovation in the twentieth century music was the heterophony–hypostasis of the vertical syntax entered into the sphere of interest of many composers, such as George Enescu, Pierre Boulez, Mauricio Kagel, György Ligeti and others. The heterophonic syntax has a history of its growth, which means a succession of different concepts and writing techniques. The trajectory of settling this phenomenon does not necessarily take into account the chronology: there are highly complex primary stages and advanced stages of returning to the simple forms of writing. In folklore, the plurimelodic simultaneities are free or random and originate from the (unintentional) differences/‘deviations’ from the state of unison, through a variety of ornaments, melismas, imitations, elongations and abbreviations, all in a flexible rhythmic and non-periodic/immeasurable framework, proper to the parlando-rubato rhythmics. Within the general framework of the multivocal organization, the heterophonic syntax in elaborate (academic) version has imposed itself relatively late compared with polyphony and homophony. Of course, the explanation is simple, if we consider the causal relationship between the sound vocabulary elements – in this case, the modalism – and the typologies of vertical organization appropriate for it. Therefore, adding up the ‘classic’ pathway of the writing typologies (monody – polyphony – homophony), heterophony - applied equally to the structures of modal, serial or synthesis vocabulary – reclaims necessarily an own macrotemporal form, in the sense of the analogies enshrined by the evolution of the musical styles and languages: polyphony→fugue, homophony→sonata. Concerned about the prospect of edifying a new musical ontology, the composer Ştefan Niculescu experienced – along with the mathematical organization of heterophony according to his own original methods – the possibility of extrapolation of this phenomenon in macrostructural plan, reaching this way to the unique form of ‘synchrony’. Founded on coincidentia oppositorum principle (involving the ‘one-multiple’ binom), the sound architecture imagined by Ştefan Niculescu consists in one (temporal) model / algorithm of articulation of two sound states: 1. monovocality state (principle of identity) and 2. multivocality state (principle of difference). In this context, the heterophony becomes an (auto)generative mechanism, with macrotemporal amplitude, strategy that will be grown by the composer, practically throughout his creation (see the works: Ison I, Ison II, Unisonos I, Unisonos II, Duplum, Triplum, Psalmus, Héterophonies pour Montreux (Homages to Enescu and Bartók etc.). For the present demonstration, we selected one of the most edifying works of Ştefan Niculescu – Simphony II, Opus dacicum – where the form of (heterophony-)synchrony acquires monumental-symphonic features, representing an emblematic case for the complexity level achieved by this type of vertical syntax in the twentieth century music.

Keywords: heterophony, modalism, serialism, synchrony, syntax

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Authors: Chidiebere Joy Nwankwo, Benjamin S. C. Uzochukwu, Florence T. Sibeudu

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Background: Family planning is one of the most cost-effective ways to prevent maternal, infant, and child mortality. It can decrease maternal mortality by reducing the number of unintended pregnancies, the number of abortions, and the proportion of births at high risk. It has been seen to improve the health and economic well-being of families and communities and ensures women’s planned childbearing in order to achieve education and career goals which could raise family income thereby reducing poverty. The choice and use of a particular family planning method and their sources vary globally. Rural Communities often face significant challenges in accessing and utilizing family planning services. Aim: This study set out to assess Access and Utilization of Family Planning Services among Women of Reproductive Age in a Rural Community of Enugu state, Nigeria. Rural communities were chosen for this study because past demographic surveys have shown that women in urban areas are more likely to accept and practice family planning compared to those in rural areas. Method: A Descriptive Cross-sectional Research design was employed to achieve the aim and objectives of the study. Data collected from 177 consenting participants using interviewer-administered questionnaires was analysed using Descriptive statistics to summarize the Socio-demographic characteristics of the participants and Access and Utilization of Family Planning Services among the participants including Reasons for using different Family Planning Methods and Barriers encountered in Access and Utilization of these services. A Cross-tabulation between Socio-demographic Characteristics of respondents and the use of Family Planning services was carried out. Result: The findings of this study revealed that majority of the participants (72.9%) have not utilized any family planning service. Out of those (27.1%) that have used any family planning service, majority of them are still currently using a form of family planning service and have access to them in health facilities, patent medicine vendors and others based on multiple responses. Male condoms were the most utilized modern family planning service. Based on multiple responses, inaccessibility, personal beliefs and partner’s objection were the most identified barriers encountered in accessing family planning services. Conclusion: Access and uptake of family planning services in rural communities is lower than the national average. Increasing access to family planning is an urgent priority for rural areas Interventions that will scale up Access and Utilization of family planning services in rural communities should be intensified.

Keywords: access, family planning, rural community, utilization

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Authors: Ajay Das, Sandip Basu

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Introduction: There is increasing recognition that diverse streams of knowledge can often be recombined in novel ways to generate new knowledge. However, knowledge recombination theory has not been applied to examine the effects of collaborator diversity on the quality of knowledge such collaborators produce. This is surprising because one would expect that a collaborative team with certain aspects of diversity should be able to recombine process elements related to knowledge development, which are relatively tacit, but also complementary because of the collaborator’s varying backgrounds. Theory and Hypotheses: We propose to examine two aspects of diversity in the environments of collaborative teams to try and capture such potential recombinations of relatively tacit, process knowledge. The first aspect of diversity in team members’ environments is geographical. Collaborators with more geographical distance between them (perhaps working in different countries) often have more autonomy in the processes they adopt for knowledge development. In the absence of overt monitoring, such collaborators are likely to adopt differing approaches to knowledge development. The sharing of such varying approaches among collaborators is likely to result in greater quality of the common collaborative pursuit. The second aspect is diversity in the work backgrounds of team members. Such diversity can also increase the potential for knowledge recombination. For example, if one or more members are from a manufacturing center (versus all of them being from a purely R&D center), such members will provide unique perspectives on the implementation of innovative ideas. Again, knowledge that has been evaluated from these diverse perspectives is likely to be of a higher quality. In addition to the above aspects of environmental diversity among team members, we also plan to examine the extent to which individual collaborators are in different environments from the primary innovation center of their employing firms. Proposed Methods: We will test our model on a sample of firms in the semiconductor industry. Our level of analysis will be individual patents generated by these firms and the teams involved in the generation of these. Information on manufacturing activities of our sample firms will be obtained from SEMI, a proprietary database of the semiconductor industry, as well as company 10-K reports. Conclusion: We believe that our results will represent a preliminary attempt to understand how various forms of diversity in collaborative teams impact the knowledge development process. Our dependent variable of knowledge quality is important to study since higher values of this variable can not only drive firm performance but the broader development of regions and societies through spillover impacts on future innovation. The results of this study will, therefore, inform future research and practice in innovation, geographical location, and vertical integration.

Keywords: innovation, manufacturing strategy, knowledge, diversity

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Authors: Alireza Barari, Saeed Shirali, Ahmad Abdi

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Introduction: Exercise has contradictory effects on the immune system. Glutamine supplementation may increase the resistance of the immune system in athletes. The Glutamine is one of the most recognized immune nutrients that as a fuel source, substrate in the synthesis of nucleotides and amino acids and is also known to be part of the antioxidant defense. Several studies have shown that improving glutamine levels in plasma and tissues can have beneficial effects on the function of immune cells such as lymphocytes and neutrophils. This study aimed to investigate the effects of resistance training and training combined with glutamine supplementation to improve the levels of cortisol and immunoglobulin in untrained young men. The research shows that physical training can increase the cytokines in the athlete’s body of course; glutamine can counteract the negative effects of resistance training on immune function and stability of the mast cell membrane. Materials and methods: This semi-experimental study was conducted on 30 male non-athletes. They were randomly divided into three groups: control (no exercise), resistance training, resistance training and glutamine supplementation, respectively. Resistance training for 4 weeks and glutamine supplementation in 0.3 gr/kg/day after practice was applied. The resistance-training program consisted of eight exercises (leg press, lat pull, chest press, squat, seatedrow, abdominal crunch, shoulder press, biceps curl and triceps press down) four times per week. Participants performed 3 sets of 10 repetitions at 60–75% 1-RM. Anthropometry indexes (weight, body mass index, and body fat percentage), oxygen uptake (VO2max) Maximal, cortisol levels of immunoglobulins (IgA, IgG, IgM) were evaluated Pre- and post-test. Results: Results showed four week resistance training with and without glutamine cause significant increase in body weight, BMI and significantly decreased (P < 0/001) in BF. Vo2max also increased in both groups of exercise (P < 0/05) and exercise with glutamine (P < 0/001), such as in both groups significant reduction in IgG (P < 0/05) was observed. But no significant difference observed in levels of cortisol, IgA, IgM in any of the groups. No significant change observed in either parameter in the control group. No significant difference observed between the groups. Discussion: The alterations in the hormonal and immunological parameters can be used in order to assess the effect overload on the body, whether acute or chronically. The plasmatic concentration of glutamine has been associated to the functionality of the immunological system in individuals sub-mitted to intense physical training. resistance training has destructive effects on the immune system and glutamine supplementation cannot neutralize the damaging effects of power exercise on the immune system.

Keywords: glutamine, resistance traning, immuglobulins, cortisol

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Authors: Vadim Kulikov

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The classical Stroop effect is the phenomenon that it takes more time to name the ink color of a printed word if the word denotes a conflicting color than if it denotes the same color. Over the last 80 years, there have been many variations of the experiment revealing various mechanisms behind semantic, attentional, behavioral and perceptual processing. The Stroop task is known to exhibit asymmetry. Reading the words out loud is hardly dependent on the ink color, but naming the ink color is significantly influenced by the incongruent words. This asymmetry is reversed, if instead of naming the color, one has to point at a corresponding color patch. Another debated aspects are the notions of automaticity and how much of the effect is due to semantic and how much due to response stage interference. Is automaticity a continuous or an all-or-none phenomenon? There are many models and theories in the literature tackling these questions which will be discussed in the presentation. None of them, however, seems to capture all the findings at once. A computational model is proposed which is based on the philosophical idea developed by the author that the mind operates as a collection of different information processing modalities such as different sensory and descriptive modalities, which produce emergent phenomena through mutual interaction and coherence. This is the framework theory where ‘framework’ attempts to generalize the concepts of modality, perspective and ‘point of view’. The architecture of this computational model consists of blocks of neurons, each block corresponding to one framework. In the simplest case there are four: visual color processing, text reading, speech production and attention selection modalities. In experiments where button pressing or pointing is required, a corresponding block is added. In the beginning, the weights of the neural connections are mostly set to zero. The network is trained using Hebbian learning to establish connections (corresponding to ‘coherence’ in framework theory) between these different modalities. The amount of data fed into the network is supposed to mimic the amount of practice a human encounters, in particular it is assumed that converting written text into spoken words is a more practiced skill than converting visually perceived colors to spoken color-names. After the training, the network performs the Stroop task. The RT’s are measured in a canonical way, as these are continuous time recurrent neural networks (CTRNN). The above-described aspects of the Stroop phenomenon along with many others are replicated. The model is similar to some existing connectionist models but as will be discussed in the presentation, has many advantages: it predicts more data, the architecture is simpler and biologically more plausible.

Keywords: connectionism, Hebbian learning, artificial neural networks, philosophy of mind, Stroop

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Authors: Cetin Balanuye

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The present study aims to accomplish two tasks: First, it critically reinterprets the actual relationship between democracy and the modern state in order to show that it is responsible for most of our current political problems and dilemmas. Second, it is argued that this relationship can be reimagined for better, and Spinozistic notions such as ‘conatus’, ‘power’ and ‘virtue’ are crucial in this pursuit. The significance of the present study lies in several interrelated observations: The world has never been a more heterogeneous place than today. People from different religious, cultural and historical backgrounds do equally have 'good reasons' to hold that their world views are the best ones. We have almost no authority to be respected equally by all these different world views. We no longer have gods at once we had in our ancient times. We have three big monotheistic religions, yet the God of which is significantly different from each other. The worse is that the believers of these religions do not seem eager to perform a duet, but rather tend to fight a duel with each other. Thanks to post-modernism, neither reason nor science is any longer seen as universally value-neutral guide to be employed in our search for a common ground. In sum, the question 'how should I live?' has never generated this much diversity before in terms of answers and the answers have never been this much away from a fairly objective evaluation. Our so-called liberal democracies are supposed to perform against this heterogenous, antagonistic and self-sustained web of discursive background. It is argued that our conception of 'State' with a weak emphasis on democracy is not a solution, if not itself the source of this topsy-turvy. Weak emphasis on democracy should be understood here as a kind of liberal democracy which operates in a partisan State, one which takes sides among rivals either for this or against that world view. This conception of State rests on a misleading understanding of the concept of power, and it is argued that it can only be corrected by means of a Spinoza-informed ontology of politics. The role of State in such an ontology is no longer a partisanship of any kind, nor is it representative of all-encompassing authority to favor any world view. State in this Spinozistic ontology equally encourages world views and their discursive practices to let them increase the power of acting and have more power to affect rules and regulations. World views can enhance every medium -in the sense of nonviolence ethology- to increase their power of acting. The more active a world view is, the more powerful and the more virtuous it is in terms of its effective power on the State. Though Spinoza has provided us with a limited guideline to understand what kind of democracy, he actually had in his mind, his ontology developed in Ethics is rich enough to imagine and inspire a better democratic practice to help us sustain the modern State in our extremely pluralistic contemporary societies.

Keywords: democracy, Islam, power, Spinoza

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Authors: Veronica Onyemauwa

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This research work examines the socio-ethical issues embedded in resource management and wealth creation in Nigeria, using Akwa Ibom State as a case study. The work is poised to proffer answers to the problematic questions raised, “why is the wealth of Akwa Ibom State not prudently managed, and wastages curbed in order to cater for the satisfaction of the indigent citizens, as Jesus Christ did in the feeding of five thousand people (John 6:12) ? Could ethical and responsible resource management not solve the paradox of poverty stricken people of Akwa Ibom in a rich economy? What ought to be done to better the lot of Akwa Ibomites? The research adopts phenomenological and sociological research methodology with primary and secondary sources of information to explore the socio-ethical issues embedded in resource management and wealth creation in Akwa Ibom State. Findings revealed that, reckless exploitation and mismanagement of the rich natural and human resources of Akwa Ibom State have spelt doom to the economic progress and survival of Akwa Ibomites in particular and Nigerians in general. Hence, hunger and poverty remain adversaries to majority of the people. Again, the culture of diversion of funds and squandermania institutionalized within the confine of Akwa Ibom State government, deter investment in economic enterprises, job and wealth creation that would have yielded economic dividends for Akwa Ibomites. These and many other unwholesome practices are responsible for the present deplorable condition of Akwa Ibom State in particular and Nigerian society in general. As a way out of this economic quagmire, it is imperative that, every unwholesome practice within the State be tackled more proactively and innovatively in the interest of the masses through responsible resource management and wealth creation. It is believed that, an effective leadership, a statesman with vision and commitment would transform the abundant resources to achieve meaningful development, create wealth and reduce poverty. Ethical leadership is required in all the tiers of government and public organizations to transform resources into more wealth. Thus, this paper advocates for ethics of virtue: a paradigm shift from exploitative leadership style to productive leadership style; change from atomistic human relation to corporative human relation; change from being subsistence to abundant in other to maximize the available resources in the State. To do otherwise is unethical and lack moral justification.

Keywords: corrective, mismanagement, resources, virtue ethics

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Authors: Gertrude I Hewapathirana, Mohamed M. Moustafa, Michel G. Zaitouni

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The purposes of this research are: (a) to provide an epistemological and ontological understanding of the WLB theory, practice, and research to illuminate how the WLB evolved between 2000 to 2020 and (b) to analyze peer-reviewed research to identify the gaps, hotspots, underlying dynamics, theoretical and thematic trends, influential authors, research collaborations, geographic networks, and the multidisciplinary nature of the WLB theory to guide future researchers. The research used four-step bibliometric network analysis to explore five research questions. Using keywords such as WLB and associated variants, 1190 peer-reviewed articles were extracted from the Scopus database and transformed to a plain text format for filtering. The analysis was conducted using the R version 4.1 software (R Development Core Team, 2021) and several libraries such as bibliometrics, word cloud, and ggplot2. We used the VOSviewer software (van Eck & Waltman, 2019) for network visualization. The WLB theory has grown into a multifaceted, multidisciplinary field of research. There is a paucity of research between 2000 to 2005 and an exponential growth from 2006 to 2015. The rapid increase of WLB research in the USA, UK, and Australia reflects the increasing workplace stresses due to hyper competitive workplaces, inflexible work systems, and increasing diversity and the emergence of WLB support mechanisms, legal and constitutional mandates to enhance employee and family wellbeing at multilevel social systems. A severe knowledge gap exists due to inadequate publications disseminating the "core" WLB research. "Locally-centralized-globally-discrete" collaboration among researchers indicates a "North-South" divide between developed and developing nations. A shortage in WLB research in developing nations and a lack of research collaboration hinder a global understanding of the WLB as a universal phenomenon. Policymakers and practitioners can use the findings to initiate supporting policies, and innovative work systems. The boundary expansion of the WLB concepts, categories, relations, and properties would facilitate researchers/theoreticians to test a variety of new dimensions. This is the most comprehensive WLB landscape analysis that reveals emerging trends, concepts, networks, underlying dynamics, gaps, and growing theoretical and disciplinary boundaries. It portrays the WLB as a universal theory.

Keywords: work-life balance, co-citation networks; keyword co-occurrence network, bibliometric analysis

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Authors: R. Kaleeswari

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An investigation was carried out to assess the soil biological quality parameters in rice soils under rainfed and to compare soil quality indexing methods viz., Principal component analysis, Minimum data set and Indicator scoring method and to develop soil quality indices for formulating soil and crop management strategies.Soil samples were collected and analyzed for soil biological properties by adopting standard procedure. Biological indicators were determined for soil quality assessment, viz., microbial biomass carbon and nitrogen (MBC and MBN), potentially mineralizable nitrogen (PMN) and soil respiration and dehydrogenease activity. Among the methods of rice cultivation, Organic nutrition, Integrated Nutrient Management (INM) and System of Rice Intensification (SRI ), rice cultivation registered higher values of MBC, MBN and PMN. Mechanical and conventional rice cultivation registered lower values of biological quality indicators. Organic nutrient management and INM enhanced the soil respiration rate. SRI and aerobic rice cultivation methods increased the rate of soil respiration, while conventional and mechanical rice farming lowered the soil respiration rate. Dehydrogenase activity (DHA) was registered to be higher in soils under organic nutrition and Integrated Nutrient Management INM. System of Rice Intensification SRI and aerobic rice cultivation enhanced the DHA; while conventional and mechanical rice cultivation methods reduced DHA. The microbial biomass carbon (MBC) of the rice soils varied from 65 to 244 mg kg-1. Among the nutrient management practices, INM registered the highest available microbial biomass carbon of 285 mg kg-1.Potentially mineralizable N content of the rice soils varied from 20.3 to 56.8 mg kg-1. Aerobic rice farming registered the highest potentially mineralizable N of 78.9 mg kg-1..The soil respiration rate of the rice soils varied from 60 to 125 µgCO2 g-1. Nutrient management practices ofINM practice registered the highest. soil respiration rate of 129 µgCO2 g-1.The dehydrogenase activity of the rice soils varied from 38.3 to 135.3µgTPFg-1 day-1. SRI method of rice cultivation registered the highest dehydrogenase activity of 160.2 µgTPFg-1 day-1. Soil variables from each PC were considered for minimum soil data set (MDS). Principal component analysis (PCA) was used to select the representative soil quality indicators. In intensive rice cultivating regions, soil quality indicators were selected based on factor loading value and contribution percentage value using principal component analysis (PCA).Variables having significant difference within production systems were used for the preparation of minimum data set (MDS).

Keywords: soil quality, rice, biological properties, PCA analysis

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Authors: Pauline Cuenin, Marcelo Leles Romarco Oliveira

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Based on their localities and following their ecological rationality, family-based farmers have experimented, adapted and innovated to improve their production systems continuously for millennia. With the technological package transfer processes of the so-called Green Revolution for agricultural holdings, farmers have become increasingly dependent on ready-made "recipes" built from so-called "universal" and global knowledge to face the problems that emerge in the management of local agroecosystems, thus reducing their creative and experiential capacities. However, the production of novelties within farms is fundamental to the transition to more sustainable agro food systems. In fact, as the fruits of local knowledge and / or the contextualization of exogenous knowledge, novelties are seen as seeds of transition. By presenting new techniques, new organizational forms and epistemological approaches, agroecology was pointed out as a way to encourage and promote the creative capacity of farmers. From this perspective, this theoretical work aims to analyze how agroecology encourages the innovative capacity of farmers, and in general, the production of novelties. For this, an analysis was made of the theoretical and methodological bases of agroecology through a literature review, specifically looking for the way in which it articulates the local with the global, complemented by an analysis of agro ecological Brazilian experiences. It was emphasized that, based on the peasant way of doing agriculture, that is, on ecological / social co-evolution or still called co-production (interaction between human beings and living nature), agroecology recognizes and revalues peasant involves the deep interactions of the farmer with his site (bio-physical and social). As a "place science," practice and movement, it specifically takes into consideration the local and empirical knowledge of farmers, which allows questioning and modifying the paradigms that underpin the current agriculture that have disintegrated farmers' creative processes. In addition to upgrade the local, agroecology allows the dialogue of local knowledge with global knowledge, essential in the process of changes to get out of the dominant logic of thought and give shape to new experiences. In order to reach this articulation, agroecology involves new methodological focuses seeking participatory methods of study and intervention that express themselves in the form of horizontal spaces of socialization and collective learning that involve several actors with different knowledge. These processes promoted by agroecology favor the production of novelties at local levels for expansion at other levels, such as the global, through trans local agro ecological networks.

Keywords: agroecology, creativity, global, local, novelty

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Authors: Aleksandr Kavetskiy, Galina Yakubova, Nikolay Sargsyan, Stephen A. Prior, H. Allen Torbert

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Determining soil elemental content and distribution (mapping) within a field are key features of modern agricultural practice. While traditional chemical analysis is a time consuming and labor-intensive multi-step process (e.g., sample collections, transport to laboratory, physical preparations, and chemical analysis), neutron-gamma soil analysis can be performed in-situ. This analysis is based on the registration of gamma rays issued from nuclei upon interaction with neutrons. Soil elements such as Si, C, Fe, O, Al, K, and H (moisture) can be assessed with this method. Data received from analysis can be directly used for creating soil elemental distribution maps (based on ArcGIS software) suitable for agricultural purposes. The neutron-gamma analysis system developed for field application consisted of an MP320 Neutron Generator (Thermo Fisher Scientific, Inc.), 3 sodium iodide gamma detectors (SCIONIX, Inc.) with a total volume of 7 liters, 'split electronics' (XIA, LLC), a power system, and an operational computer. Paired with GPS, this system can be used in the scanning mode to acquire gamma spectra while traversing a field. Using acquired spectra, soil elemental content can be calculated. These data can be combined with geographical coordinates in a geographical information system (i.e., ArcGIS) to produce elemental distribution maps suitable for agricultural purposes. Special software has been developed that will acquire gamma spectra, process and sort data, calculate soil elemental content, and combine these data with measured geographic coordinates to create soil elemental distribution maps. For example, 5.5 hours was needed to acquire necessary data for creating a carbon distribution map of an 8.5 ha field. This paper will briefly describe the physics behind the neutron gamma analysis method, physical construction the measurement system, and main characteristics and modes of work when conducting field surveys. Soil elemental distribution maps resulting from field surveys will be presented. and discussed. Comparison of these maps with maps created on the bases of chemical analysis and soil moisture measurements determined by soil electrical conductivity was similar. The maps created by neutron-gamma analysis were reproducible, as well. Based on these facts, it can be asserted that neutron stimulated soil gamma spectroscopy paired with GPS system is fully applicable for soil elemental agricultural field mapping.

Keywords: ArcGIS mapping, neutron gamma analysis, soil elemental content, soil gamma spectroscopy

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Authors: Charléa M. Smith, Raiden L. Schodowski, Arletty Pinel

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Due to the COVID-19 pandemic, the Faculty of Medical Sciences of The University of the West Indies (UWI) Mona in Kingston, Jamaica, had to rapidly migrate to digital and blended learning. Students in the preclinical stage of the program transitioned to full-time online learning, while students in the clinical stage experienced decreased daily patient contact and the implementation of a blend of online lectures and virtual clinical practice. Such sudden changes were coupled with the institutional pressure of the need to introduce a novel approach to education without much time for preparation, as well as additional strain endured by the faculty, who were overwhelmed by serving as frontline workers. During the period July 20 to August 23, 2021, this study surveyed preclinical and clinical students to capture their experiences with these changes and their recommendations for future use of digital modalities of learning to enhance medical education. It was conducted with a fellow student of the 2021 cohort of the MultiPod mentoring program. A questionnaire was developed and distributed digitally via WhatsApp to all medical students of the UWI Mona campus to assess students’ experiences and perceptions of the advantages, challenges, and impact on individual knowledge proficiencies brought about by the transition to predominantly digital learning environments. 108 students replied, 53.7% preclinical and 46.3% clinical. 67.6% of the total were female and 30.6 % were male; 1.8% did not identify themselves by gender. 67.2% of preclinical students preferred blended learning and 60.3% considered that the content presented did not prepare them for clinical work. Only 31% considered that the online classes were interactive and encouraged student participation. 84.5% missed socialization with classmates and friends and 79.3% missed a focused environment for learning. 80% of the clinical students felt that they had not learned all that they expected and only 34% had virtual interaction with patients, mostly by telephone and video calls. Observing direct consultations was considered the most useful, yet this was the least-used modality. 96% of the preclinical students and 100% of the clinical ones supplemented their learning with additional online tools. The main recommendations from the survey are the use of interactive teaching strategies, more discussion time with lecturers, and increased virtual interactions with patients. Universities are returning to face-to-face learning, yet it is unlikely that blended education will disappear. This study demonstrates that students’ perceptions of their experience during mobility restrictions must be taken into consideration in creating more effective, inclusive, and efficient blended learning opportunities.

Keywords: blended learning, digital learning, medical education, student perceptions

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Authors: Ann P. Daunic, Nancy Corbett

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Background and Significance: Researchers emphasize the role that motivation, self-esteem, and self-regulation play in children’s early adjustment to the school culture, including skills such as identifying their own feelings and understanding the feelings of others. As social-emotional growth, academic learning, and successful integration within culture and society are inextricably connected, the Social-Emotional Learning Foundations (SELF) curriculum was designed to integrate social-emotional learning (SEL) instruction within early literacy instruction (specifically, reading) for Kindergarten and first-grade students at risk for emotional and behavioral difficulties. Storybook reading is a typically occurring activity in the primary grades; thus SELF provides an intervention that is both theoretically and practically sound. Methodology: The researchers will report on findings from the first two years of a three-year study funded by the US Department of Education’s Institute of Education Sciences to evaluate the effects of the SELF curriculum versus “business as usual” (BAU). SELF promotes the development of self-regulation by incorporating instructional strategies that support children’s use of SEL related vocabulary, self-talk, and critical thinking. The curriculum consists of a carefully coordinated set of materials and pedagogy designed specifically for primary grade children at early risk for emotional and behavioral difficulties. SELF lessons (approximately 50 at each grade level) are organized around 17 SEL topics within five critical competencies. SELF combines whole-group (the first in each topic) and small-group lessons (the 2nd and 3rd in each topic) to maximize opportunities for teacher modeling and language interactions. The researchers hypothesize that SELF offers a feasible and substantial opportunity within the classroom setting to provide a small-group social-emotional learning intervention integrated with K-1 literacy-related instruction. Participating target students (N = 876) were identified by their teachers as potentially at risk for emotional or behavioral issues. These students were selected from 122 Kindergarten and 100 first grade classrooms across diverse school districts in a southern state in the US. To measure the effectiveness of the SELF intervention, the researchers asked teachers to complete assessments related to social-emotional learning and adjustment to the school culture. A social-emotional learning related vocabulary assessment was administered directly to target students receiving small-group instruction. Data were analyzed using a 3-level MANOVA model with full information maximum likelihood to estimate coefficients and test hypotheses. Major Findings: SELF had significant positive effects on vocabulary, knowledge, and skills associated with social-emotional competencies, as evidenced by results from the measures administered. Effect sizes ranged from 0.41 for group (SELF vs. BAU) differences in vocabulary development to 0.68 for group differences in SEL related knowledge. Conclusion: Findings from two years of data collection indicate that SELF improved outcomes related to social-emotional learning and adjustment to the school culture. This study thus supports the integration of SEL with literacy instruction as a feasible and effective strategy to improve outcomes for K-1 students at risk for emotional and behavioral difficulties.

Keywords: Socio-cultural context for learning, social-emotional learning, social skills, vocabulary development

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Authors: Francesco Pisano

Abstract:

Islam has been an important topic in Turkey’s institutional identity. Since the dawn of the Turkish Republic, at the end of the First World War, the new Turkish leadership was urged to deal with the religious heritage of the Sultanate. Mustafa Kemal Ataturk, Turkey’s first President, led the country in a process of internal change, substantially modifying not merely the democratic stance of it, but also the way politics was addressing the Muslim faith. Islam was banned from the public sector of the society and was drastically marginalized to the mere private sphere of citizens’ lives. Headscarves were banned from institutional buildings together with any other religious practice, while the country was proceeding down a path of secularism and Westernization. This issue is demonstrated by the fact that even a new elected Prime Minister, Recep Tayyip Erdoğan, was initially barred from taking the institutional position, because of allegations that he had read a religious text while campaigning. Over the years, thanks to this initial internal shift, Turkey has often been seen by Western partners as one of the few countries that had managed to find a perfect balance between a democratic stance and an Islamic inherent nature. In the early 2000s, this led many academics to believe that Ankara could eventually have become the next European capital. Since then, the internal and external landscape of Turkey has drastically changed. Today, religion has returned to be an important point of reference for Turkish politics, considering also the failure of the European negotiations and the always more unstable external environment of the country. This paper wants to address this issue, looking at the important role religion has covered in the Turkish society and the way it has been politicized since the early years of the Republic. It will evolve from a more theoretical debate on secularism and the path of political westernization of Turkey under Ataturk’s rule to a more practical analysis of today’s situation, passing through the failure of Ankara’s accession into the EU and the current tense political relation with its traditional NATO allies. The final objective of this research, therefore, is not to offer a meticulous opinion on Turkey’s current international stance. This issue will be left entirely to the personal consideration of the reader. Rather, it will supplement the existing literature with a comprehensive and more structured analysis on the role Islam has played on Turkish politics since the early 1920s up until the political domestic revolution of the early 2000s, after the first electoral win of the Justice and Development Party (AKP).

Keywords: democracy, Islam, Mustafa Kemal Atatürk, Recep Tayyip Erdoğan, Turkey

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Authors: Ibrahim Abouelkhir

Abstract:

Background: Prior to this project, the number of CT aorta requests from our Emergency Department (ED) was reported by the radiology department to be high with a low positive event rate: only 1- 2% of CT aortas performed were positive for acute aortic syndrome. This trend raised concerns about the time required to process and report these scans, potentially impacting the timely reporting of other high-priority imaging, such as trauma-related scans. Other harms identified were unnecessary radiation, patients spending longer in ED contributing to overcrowding, and, most importantly, the patient not getting the right care the first time. The radiology department also raised the problem of reporting bias because they expected our CT aortas to be normal. Aim: The main aim of this project was to reduce the number of unnecessary CT aortas requested, which would be shown by 1. Number of CT aortas requested and 2. Positive event rate. Methodology: This was a quality improvement project carried out in the ED at Frimley Park Hospital, UK. Starting from 1 st January 2024, we recorded the number of days required to reach 35 CT aorta requests. We looked at all patients presenting to the ED over the age of 16 for whom a CT aorta was requested by the ED team. We looked at how many of these scans were positive for acute aortic syndrome. The intervention was a change in practice: all CT aortas should be approved by an ED consultant or ST4+ registrar (5th April 2024). We then reviewed the number of days it took to reach a total of 35 CT aorta requests following the intervention and again reviewed how many were positive. Results: Prior to the intervention, 35 CT Aorta scans were performed over a 20-day period. Following the implementation of the ED senior doctor vetting process, the same number of CT Aorta scan requests was observed over 50 days - more than twice the pre-intervention period. This indicates a significant reduction in the rate of CT Aorta scans being requested. During the pre-intervention phase, there were two positive cases of acute aortic syndrome. In the post-intervention period, there were zero. Conclusion: The mandatory review of CT Aorta scan requested by the ED consultant effectively reduced the number of scans requested. However, this intervention did not lead to an increase in positive scan results. We noted that post-intervention, approximately 50% of scans had been approved by registrar-grade doctors and, only 50% had been approved by ED consultants, and the majority were not in-person reviews. We wonder if restricting the approval to consultant grade only might improve the results, and furthermore, in person reviews should be the gold standard.

Keywords: quality improvement project, CT aorta scans, emergency department, radiology department, aortic dissection, scan request vetting, clinical outcomes, imaging efficiency

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Authors: Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee

Abstract:

Objective: To compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor. The three positions were: semi-recumbent, squatting, and squatting with the aid of ergonomically designed ankle supports. Methods: A randomized controlled trial was conducted at a regional teaching hospital in northern Taiwan. Data were collected from 168 primiparous women in their 38th to 42nd gestational week. None of the participants received epidural analgesia during labor and all were free of pregnancy and labor-related complications. Intervention: During labor, after full cervical dilation and when the fetal head had descended to at least the +1 station and had turned to the occiput anterior position, the experimental group was asked to push in the squatting position while wearing the ergonomically designed ankle supports; comparison group A was asked to push in the squatting position without the use of these supports; and comparison group B was asked to push in a standard semi-recumbent position. Measures: The participants completed a demographic and obstetrics datasheet, the Short Form McGill Pain Questionnaire (MPQ-SF), and the Labor Pushing Experience scale within 4-hours postpartum. Conclusion: In terms of delivery time, the duration between the start of pushing to crowning for the experimental group (squatting with ankle supports) averaged 25.52 minutes less (F =6.02, p< .05) than the time for comparison group B (semi-recumbent). Furthermore, the duration between the start of pushing to infant birth averaged 25.21 minutes less for the experimental group than for comparison group B (F =6.14, p< .05). Moreover, the experimental group had a lower average VAS pain score (5.05±3.22) than comparison group B and the average McGill pain score for the experimental group was lower than both comparison groups (F=18.12, p< .001). In summary, the participants in the group that delivered from a squatting position with ankle supports had better labor pushing experiences than their peers in the comparison groups. Results: In comparison to both unsupported squatting and semi-recumbent pushing, squatting with the aid of ergonomically designed ankle supports reduced pushing times, ameliorated labor pain, and improved the pushing experience. Clinical application and suggestion: The squatting with ankle-support intervention introduced in the present study may significantly reduce tiredness and difficulties in maintaining balance as well as increase pushing efficiency. Thus, this intervention may reduce the caring needs of women during the second stage of labor. This intervention may be introduced in midwifery education programs and in clinical practice as a method to improve the care of women during the second stage of labor.

Keywords: second stage of labor, pushing, squatting with ankle supports, squatting

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