Search results for: neurodevelopmental outcome

Authors: A. Lambert-Mogiliansky

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In this paper, we investigate the properties of simple rules for reappointment aimed at holding a public official accountable and monitor his activity. The public official allocates budget resources to various activities which results in the delivery of public services to citizens. He has discretion over the use of resource so he can divert some of them for private ends. Because of a liability constraint, zero diversion can never be secured in all states. The optimal reappointment mechanism under complete information is shown to exhibit some leniency thus departing from the zero tolerance principle. Under asymmetric information (about the state), a rule with random verification in a pre-announced subset is shown to be optimal in a class of common rules. Surprisingly, those common rules make little use of hard information about service delivery when available. Similarly, PO's claim about his record is of no value to improve the performance of the examined rules. In contrast requesting that the PO defends his records publicly can be very useful if the service users are given the chance to refute false claims with cheap talk complaints: the first best complete information outcome can be approached in the absence of any observation by the manager of the accountability mechanism.

Keywords: accountability, corruption, persuasion, debate

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Authors: F. U. Rahman, R. Q. Zhang

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This work aims to develop a systematic numerical technique which can be easily extended to many-body problem. The Lippmann Schwinger equation (integral form of the Schrodinger wave equation) is solved for the nonrelativistic radial wave of hydrogen atom using iterative integration scheme. As the unknown wave function appears on both sides of the Lippmann Schwinger equation, therefore an approximate wave function is used in order to solve the equation. The Green’s function is obtained by the method of Laplace transform for the radial wave equation with excluded potential term. Using the Lippmann Schwinger equation, the product of approximate wave function, the Green’s function and the potential term is integrated iteratively. Finally, the wave function is normalized and plotted against the standard radial wave for comparison. The outcome wave function converges to the standard wave function with the increasing number of iteration. Results are verified for the first fifteen states of hydrogen atom. The method is efficient and consistent and can be applied to complex systems in future.

Keywords: Green’s function, hydrogen atom, Lippmann Schwinger equation, radial wave

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Authors: Ernests Jansons, Karlis Agris Gross

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Winter brings snow and ice in the Northern Europe and with it the need to move safely over ice. It has been customary to select an appropriate material surface for movement over ice, but another way to influence the interaction with ice is to modify the ice surface. The objective of this work was to investigate the influence of ice topography on initiating movement over ice and on sliding velocity over ice in the laboratory and real-life conditions. The ice was prepared smooth, scratched or with solidified ice-droplets to represent the surface of ice after ice rain. In the laboratory, the coefficient of friction and the sliding velocity were measured, but the sliding velocity measured at the skeleton push-start facility. The scratched ice surface increased the resistance to movement and also showed the slowest sliding speed. Sliding was easier on the smooth ice and ice covered with frozen droplets. The contact surface was measured to determine the effect of contact area with sliding. Results from laboratory tests will be compared to loading under heavier loads to show the influence of load on sliding over different ice surfaces. This outcome provides a useful indicator for pedestrians and road traffic on the safety of movement over different ice surfaces as well as a reference for those involved with winter sports.

Keywords: contact area, friction, ice topography, sliding velocity

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Authors: Yahya N. Alfraidi, Abdel Halim Boussabaine

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Climate change risk impacts are one of the most challenging aspects that faces the built environment now and the near future. The impacts of climate change on buildings are considered in four different dimensions: physical, economic, social, and management. For each of these, the risks are discussed as they arise from various effects linked to climate change, including windstorms, precipitation, temperature change, flooding, and sea-level rise. For example, building assets in cities will be exposed to extreme hot summer days and nights due to the urban heat island effect and pollution. Buildings also could be vulnerable to water, electricity, gas, etc., scarcity. Building materials, fabric and systems could also be stressed by the emerging climate risks. More impotently the building users might experience extreme internal and extern comfort conditions leading to lower productivity, wellbeing and health problems. Thus, the main aim of this paper to document the emerging risks from climate change on building assets. An in-depth discussion on the consequences of these climate change risk is provided. It is expected that the outcome of this research will be a set of risk design indicators for developing and procuring resilient building assets.

Keywords: climate change, risks of climate change, risks on building from climate change, buildings

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Authors: Hediye Saglam

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This research has been carried out to bring in the 6 acquisitions in the 2014 Preschool Teaching Programme of the Turkish Ministry of Education through the method of analogy. This research is practiced based on the experimental pattern with pre-test and final test controlling groups. The working group of the study covers the group between 5-6 ages. The study takes 5 weeks including the 2 weeks spent for pre-test and the final test. It is conducted with the preschool teacher who gives the lesson along with the researcher in the in-class and out-of-class rainbow experiments of the students for 5 weeks. 'One Sample T Test' is used for the evaluation of the pre-test and final test. SPSS 17 programme is applied for the analysis of the data. Results: As an outcome of the study it is observed that analogy method affects children’s learning of the rainbow. For this very reason teachers should receive inservice training for different methods and techniques like analogy. This method should be included in preschool education programme and should be applied by teachers more often.

Keywords: acquisitions of preschool education programme, analogy method, pre-test/final test, rainbow experiments

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Authors: Malmi Amadoru, Chandana Gamage

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Sri Lanka is emerging as a global IT-BPO hub topping up among the 20 global outsourcing destinations. When setting up a new venture in Sri Lanka, talent sourcing plays one of the key functions due to the rapid growth of workforce. Getting competent people with right skills for right positions leads organizations achieving its vision, mission and objectives. It also drives in earning competitive advantage over industry competitors. Thus it is crucial to scan and recruit the best employees to an organization. However there is no published information available on recruitment methods utilized in Sri Lankan software industry, as a study of this nature had not being conducted previously in Sri Lanka. The main objective of this study was to explore various talent sourcing practices exploited in Sri Lankan software industry. Also this study analyses the extent which Sri Lanka has adopted different recruitment strategies utilized in worldwide and its deviations. The research outcome is beneficial for HR professionals to identify the current trends in recruitment practices. Moreover investors who are interested in IT-BPO engagements can gain a thorough knowledge about talent sourcing techniques in Sri Lankan software industry. Finally, this research clues trending areas which can be further investigated in future.

Keywords: IT-BPO, recruitment, Sri Lanka, software industry, talent

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Authors: Moez ul Hassan, Bushra Noman, Sarmad Hameed, Shahab Mehmood, Asma Bashir

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The importance of Noble prize winning “Patch Clamp Technique” is well documented. However, Patch Clamp Technique is very expensive and hence hinders research in developing countries. In this paper, detection, processing and recording of ultra low current from induced cells by using transimpedence amplifier is described. The sensitivity of the proposed amplifier is in the range of femto amperes (fA). Capacitive-feedback is used with active load to obtain a 20MΩ transimpedance gain. The challenging task in designing includes achieving adequate performance in gain, noise immunity and stability. The circuit designed by the authors was able to measure current in the rangeof 300fA to 100pA. Adequate performance shown by the amplifier with different input current and outcome result was found to be within the acceptable error range. Results were recorded using LabVIEW 8.5®for further research.

Keywords: drug discovery, ionic current, operational amplifier, patch clamp

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Authors: Anna Guitart Atienza, Ana Fernández del Río, Madhav Nekkar, Jelena Ljubicic, África Periáñez, Eura Shin, Lauren Bellhouse

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The use of digital devices in healthcare or mobile health (mHealth) has increased in recent years due to the advances in digital technology, making it possible to nudge healthy behaviors through individual interventions. In addition, mHealth is becoming essential in poor-resource settings due to the widespread use of smartphones in areas where access to professional healthcare is limited. In this work, we evaluate mHealth interventions in low-income countries with a focus on causal inference. Counterfactuals estimation and other causal computations are key to determining intervention success and assisting in empirical decision-making. Our main purpose is to personalize treatment recommendations and triage patients at the individual level in order to maximize the entire intervention's impact on the desired outcome. For this study, collected data includes mHealth individual logs from front-line healthcare workers, electronic health records (EHR), and external variables data such as environmental, demographic, and geolocation information.

Keywords: causal inference, mHealth, intervention, personalization

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Authors: Derrick Boakye Boadu, Zahra Fakhri

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Transformational leaders are the catalyst of change and focus more importantly on members or followers. Involvement of transformational leadership style in organizational structures can provide interesting nuances to the implementation and enhancement of citizen and customer participation mechanisms in an organization regardless of the time consuming, cost, and delaying process of analyzing the feedback of workers and citizens/customers which stifles good outcome of organization’s department performance. It posits that transformational leadership has a positive direct effect on organization-departmental performance and the intervening role of citizen and customer participation and internal communication. Using the NASP-IV 2007 data, the article finds support for the five hypotheses in a structural equation model, and the findings show that transformational leadership does have a direct impact on organizational-departmental performance a partial mediation effect of the relationship through the role of internal communication and citizen and customer participation.  

Keywords: transformational leaders, departmental performance, internal communication, citizen/customer participation

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Authors: Yasir Khan

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The continued growth in international students coming to China for higher education had a significant positive impact on trade and GDP in China. Student mobility may expend trade with their country of origin, owing to superior knowledge, or preferential access to market opportunities. We test this hypothesis using Chinese trade data from 1999 to 2017. In fully-modify (OLS) and dynamic (OLS) testing estimation, we find that a 1.24 percent increase in student inward mobility is associated with a 1 percent increase in Chinese export trade. On the other hand, we find that a 1.18 percent increase in the student inward mobility to China is associated with a 1 percent increase in import trade. In addition, we find that a 1.13 percent increase in international student inward mobility is associated with a 1 percent increase in the GDP. The outcome suggests that international students have a strong influence on Gross Domestic Product (GDP), exports and imports trade. However, the study holds that the government should attach great attachment and importance to the role of international students in the export and import trade.

Keywords: international student mobility, China, export, import, GDP, FMOLS, DOLS

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Authors: P. P. Chandrasekera, P. B. Hewavithana, S. Rosairo, M. H. M. N. Herath, D. M. R. D. Mirihella

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Periventricular Leukomalacia (PVL) is a White Matter Injury (WMI) of preterm neonatal brain. Objectives of the study were to assess the neuro-developmental outcome at one year of age and to determine a good protocol of cranial ultrasonography to detect PVL. Two hundred and sixty four preterm neonates were included in the study. Series of cranial ultrasound scans were done by using a dedicated neonatal head probe 4-10 MHz of Logic e portable ultrasound scanner. Clinical history of seizures, abnormal head growth (hydrocephalus or microcephaly) and developmental milestones were assessed and neurological examinations were done until one year of age. Among live neonates, 57% who had cystic PVL (Grades2 and 3) manifested as cerebral palsy. In conclusion cystic PVL has permanent neurological disabilities like cerebral palsy. Good protocol of real time cranial ultrasonography to detect PVL is to perform scans at least once a week until one month and at term (40 weeks of gestation).

Keywords: cerebral palsy, cranial ultrasonography, Periventricular Leukomalacia, preterm neonates

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Authors: Lip Vui Tshin

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Sabah, one of the thirteen Malaysian states, is located in the northern part of Malaysian Borneo. It is a melting pot of many different cultures and traditions, being home to about 2.9 million people with more than 30 ethic groups. It is also known as one of the twelve mega-diversity sites in the world with its rich living heritage; ethnic makes it ideal for the ecotourism industry. Sabah enjoys a steady flow of eco tourists from domestic and international markets with a gradual increase in the number of visitor arrival each year. Sabah’s ecotourism is categorized by its natural attraction, wildlife and wilderness habitats. This paper sets out to interpret and develop the indicators for success ecotourism sites in Sabah and measures its development stage. The long-term viability of tourism can be assured only when the limitations and favorable opportunities of the overall environment for tourism development are understood and ways to measure changes induced by tourism are identified and applied. This is a literature review of ecotourism site success indicators, and the outcome of this review is the identification of existing clusters and categorization of indicators and charting the way forward to develop a better understanding in ecotourism site success.

Keywords: ecotourism, ecotourism indicators, ecotourism success, Sabah

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Authors: Alok Bapatla, Pamela Lutting, Mariastella Serrano

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Background: Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain associated with altered bowel habits in the absence of an underlying organic cause. Although the exact etiology of IBS is not fully understood, one of the leading theories postulates a pathology within the Brain-Gut Axis that leads to an overall increase in gastrointestinal sensitivity and pejorative changes in gastrointestinal motility. Research and clinical practice have shown that Gut Directed Hypnotherapy (GDH) has a beneficial clinical role in improving Mind-Gut control and thereby comorbid conditions such as anxiety, abdominal pain, constipation, and diarrhea. Aims: This study presents a 17-year old male with underlying anxiety and a one-year history of IBS-Constipation Predominant Subtype (IBS-C), who has demonstrated impressive improvement of symptoms following GDH treatment following refractory trials with medications including bisacodyl, senna, docusate, magnesium citrate, lubiprostone, linaclotide. Method: The patient was referred to a licensed clinical psychologist specializing in clinical hypnosis and cognitive-behavioral therapy (CBT), who implemented “The Standardized Hypnosis Protocol for IBS” developed by Dr. Olafur S. Palsson, Psy.D at the University of North Carolina at Chapel Hill. The hypnotherapy protocol consisted of a total of seven weekly 45-minute sessions supplemented with a 20-minute audio recording to be listened to once daily. Outcome variables included the GAD-7, PHQ-9 and DCI-2, as well as self-ratings (ranging 0-10) for pain (intensity and frequency), emotional distress about IBS symptoms, and overall emotional distress. All variables were measured at intake prior to administration of the hypnosis protocol and at the conclusion of the hypnosis treatment. A retrospective IBS Questionnaire (IBS Severity Scoring System) was also completed at the conclusion of the GDH treatment for pre-and post-test ratings of clinical symptoms. Results: The patient showed improvement in all outcome variables and self-ratings, including abdominal pain intensity, frequency of abdominal pain episodes, emotional distress relating to gut issues, depression, and anxiety. The IBS Questionnaire showed a significant improvement from a severity score of 400 (defined as severe) prior to GDH intervention compared to 55 (defined as complete resolution) at four months after the last session. IBS Questionnaire subset questions that showed a significant score improvement included abdominal pain intensity, days of pain experienced per 10 days, satisfaction with bowel habits, and overall interference of life affected by IBS symptoms. Conclusion: This case supports the existing research literature that GDH has a significantly beneficial role in improving symptoms in patients with IBS. Emphasis is placed on the numerical results of the IBS Questionnaire scoring, which reflects a patient who initially suffered from severe IBS with failed response to multiple medications, who subsequently showed full and sustained resolution

Keywords: pediatrics, constipation, irritable bowel syndrome, hypnotherapy, gut-directed hypnosis

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Authors: Elvira Wahyuni

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This study is a classroom action research. The general objective of this study was to find out students’ speaking ability through teaching English by using video and to find out the effectiveness of using video in teaching English to improve students’ speaking ability. The subjects of this study were 34 of the first-year students of SMAN 12 Pekanbaru who were learning English as a foreign language (EFL). Students were given pre-test before the treatment and post-test after the treatment. Quantitative data was collected by using speaking test requiring the students to respond to the recorded questions. Qualitative data was collected through observation sheets and field notes. The research finding reveals that there is a significant improvement of the students’ speaking ability through the use of video in speaking class. The qualitative data gave a description and additional information about the learning process done by the students. The research findings indicate that the use of video in teaching and learning is good in increasing learning outcome.

Keywords: English teaching, fun learning, speaking ability, video

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Authors: Talat Ghomashchi, Zahra Akbari, Shirin Malekpour, Marjan Alimirzaee

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Mixing the waste water of industries with natural water has caused environmental pollution. So researcher try to obtain methods and optimum conditions for waste water treatment. One of important stage in waste water treatment is dissolved air flotation. DAF is used for the removal of suspended solids and oils from waste water. In this paper, the effect of several parameters on flotation efficiency with Cationic polyacrylamide as flocculant, was examined, namely, (a) concentration of cationic flocculants, (b) pH (c) fast mixing time, (d) fast mixing speed,(e) slow mixing time,(f) retention time and temperature. After design of experiment, in each trial turbidity of waste water was measured by spectrophotometer. Results show that contribution of pH and concentration of flocculant on flotation efficiency are 75% and 9% respectively. Cationic polyacrylamide led to a significant increase in the settling speed and effect of temperature is negligible. In the optimum condition, the outcome of the DAF unit is increased and amount of suspended solid and oil in waste water is decreased effectively.

Keywords: dissolved air flotation, oil industry, waste water, treatment

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Authors: Yassir Mohammed

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The study examines the impact of skilled parental migration on left-behind children. It uses the SCOPUS database to evaluate the existing literature from 1972 to 2022 and synthesizes data using the PRISMA framework and bibliometric method of analysis. 49 articles out of 202 papers were involved in the synthesis. International migration, outcome migration, consequence, parental migration, high-skill and left-behind children, and left-behind preschool were all searched. The research found that mental health issues, self-isolation, and physical harm have negative impacts, while sending children to good schools, having good academic records, and better medical care have positive impacts. The study also found that gender gaps increase in some countries while decreasing in others. Further research is needed on child maltreatment, academic performance, subjective well-being, societal effects, behavioral difficulties, and quality of life. The study only included peer-reviewed English publications in the final analysis.

Keywords: parental migration, impact of migration, systematic review, left-behind children

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Authors: S. K. Subah, R. Tasnim, M. I. Jahan, M. R. Islam

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While talking about how comfortable and convenient Dhaka's bus service is, the minimum emphasis is placed on the female commuters of the Dhaka city. Recognizing the contemporary situation, the supreme focus is to develop experimental model based on statistical methods. SEM has been adopted to quantify passenger satisfaction, which is affected by the perceived service quality. The study deals with 16 observed variables and three latent variables, which were correlated to identify their significance on the regulation of perceived SQ (Service Quality). To calibrate the model, a dataset of 250 responses from female users of local buses has been utilized through survey. A questionnaire structured with SQ variables was prepared in consultation with prevailing literature, practitioners, academicians, and users. The result concludes that the attributes of safe and secured environment have the most significant impact on the overall bus service quality according to the insight of female respondents. The study outcome might be a great help for the policymakers, women's organizations, and NGOs to formulate transport policy that will ensure a women-friendly public bus service.

Keywords: bus service quality, female perception, structural equation modelling, safety-security, women friendly bus

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Authors: Sagardeep Talukdar, Gautam Kumar Saharia, Riki Dutta, Sudipta Nandy

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In non-linear optics, the Fokas-Lenells equation (FLE) is a well-known integrable equation that describes how ultrashort pulses move across optical fiber. It admits localized wave solutions, just like any other integrable equation. We apply the Hirota bilinearization method to obtain the soliton solution of FLE. The proposed bilinearization makes use of an auxiliary function. We apply the method to FLE with a vanishing boundary condition, that is, to obtain bright soliton. We have obtained bright 1-soliton, 2-soliton solutions and propose the scheme for obtaining N-soliton solution. We have used an additional parameter which is responsible for the shift in the position of the soliton. Further analysis of the 2-soliton solution is done by asymptotic analysis. We discover that the suggested bilinearization approach, which makes use of the auxiliary function, greatly simplifies the process while still producing the desired outcome. We think that the current analysis will be helpful in understanding how FLE is used in nonlinear optics and other areas of physics.

Keywords: asymptotic analysis, fokas-lenells equation, hirota bilinearization method, soliton

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Authors: Eisa M. Al-Balhan, Mamdouh M. Soliman

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This study introduced learning styles techniques into mathematics teaching to improve mathematics achievement and motivation among Kuwaiti fourth- and fifth-grade low achievers. The study consisted of two groups. The control group (N = 212) received traditional math tutoring based on a textbook and the tutor’s knowledge of math. The experimental group (N = 209) received math tutoring from instructors trained in the Learning Style™ approach. Three instruments were used: Motivation Scale towards Mathematics; Achievement in Mathematics Test; and the manual of learning style approach indicating the individual’s preferred learning style: AKV, AVK, KAV, KVA, VAK, or VKA. The participating teachers taught to the detected learning style of each student or group. The findings show significant improvement in achievement and motivation towards mathematics in the experimental group. The outcome offers information to variables affecting achievement and motivation towards mathematics and demonstrates the leading role of Kuwait in education within the region.

Keywords: elementary school, learning style, math low achievers, SmartWired™, math instruction, motivation

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Authors: Hamisu Idi

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The present study focuses on studying the impact of influencer recommendation in the quality of cement production. Exploratory research was done on monthly basis, where data were obtained from secondary source i.e. the record kept by an automated recompilation machine. The machine keeps all the records of the mills downtime which the process manager checks for validation and refer the fault (if any) to the department responsible for maintenance or measurement taking so as to prevent future occurrence. The findings indicated that the product of the Ashaka Cement Plc. were considered as qualitative, since all the production processes were found to be in control (preset specifications) with the exception of the natural cause of variation which is normal in the production process as it will not affect the outcome of the product. It is reduced to the bearest minimum since it cannot be totally eliminated. It is also hopeful that the findings of this study would be of great assistance to the management of Ashaka cement factory and the process manager in particular at various levels in the monitoring and implementation of statistical process control. This study is therefore of great contribution to the knowledge in this regard and it is hopeful that it would open more research in that direction.

Keywords: cement, quality, variation, assignable cause, common cause

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Authors: M. Sadeghi, H. Pezeshk, R. Tusserkani, A. Sharifi Zarchi, A. Malekpour, M. Foroughmand, S. Goliaei, M. Totonchi, N. Ansari–Pour

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The role and relative importance of intrinsic and extrinsic factors in the development of complex diseases such as cancer still remains a controversial issue. Determining the amount of variation explained by these factors needs experimental data and statistical models. These models are nevertheless based on the occurrence and accumulation of random mutational events during stem cell division, thus rendering cancer development a stochastic outcome. We demonstrate that not only individual genome sequencing is uninformative in determining cancer risk, but also assigning a unique genome sequence to any given individual (healthy or affected) is not meaningful. Current whole-genome sequencing approaches are therefore unlikely to realize the promise of personalized medicine. In conclusion, since genome sequence differs from cell to cell and changes over time, it seems that determining the risk factor of complex diseases based on genome sequence is somewhat unrealistic, and therefore, the resulting data are likely to be inherently uninformative.

Keywords: cancer risk, extrinsic factors, genome sequencing, intrinsic factors

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Authors: Budiman Budiman

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This research aimed at describing and testing whether the students’ ability in writing analytical exposition text is increased by using comic strips at SMAN 12 Pekanbaru. The respondents of this study were the second-grade students, especially XI Science 3 academic year 2011-2012. The total number of students in this class was forty-two (42) students. The quantitative and qualitative data was collected by using writing test and observation sheets. The research finding reveals that there is a significant increase of students’ writing ability in writing analytical exposition text through comic strips. It can be proved by the average score of pre-test was 43.7 and the average score of post-test was 65.37. Besides, the students’ interest and motivation in learning are also improved. These can be seen from the increasing of students’ awareness and activeness in learning process based on observation sheets. The findings draw attention to the use of comic strips in teaching and learning is beneficial for better learning outcome.

Keywords: analytical exposition, comic strips, secondary school students, writing ability

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Authors: Riam Almaqrn, Abdulrahman Alshabeb

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The study aims to examine the attitudes of Saudi students of English towards proper pronunciation and towards podcasts as a facilitator for proper pronunciation. In order to fulfill the purpose of the study, twenty-three students participated in this study. The study used a questionnaire as the main data collection instrument. The questionnaire included two parts, one or proper pronunciation and the other for podcasts. Data analysis showed that the participants, in spite of the low rate of improvement in their pronunciation, had positive attitudes towards proper pronunciation of English. This outcome is compatible with previous studies` results that assert the fact that having a positive attitude towards a particular language and its speakers can improve pronunciation. As for podcasts, students received a total of five podcasts related to their listening and speaking textbook. At the end of the project, students showed high rate of acceptance for podcasts and positive attitudes towards them. The findings proved the usefulness of examining learners` attitudes towards new CALL applications before using them in a practical way. In the light of the findings, pedagogical implications and suggestions were presented for language instructors and academics.

Keywords: CALL, MALL, podcast, learning English

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Authors: Kailash Ghimire, Manoj Thapa

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This study focuses on early identification of deficiencies in pre-required areas of students who are enrolled in College Algebra and Calculus I classes. The students were given pre-diagnostic tests on the first day of the class before they are provided with the syllabus. The tests consist of prerequisite, uniform and advanced content outlined by the University System of Georgia (USG). The results show that 48% of students in College Algebra are lacking prerequisite skills while 52% of Calculus I students are lacking prerequisite skills but, interestingly these students are prior exposed to uniform content and advanced content. The study is still in progress and this paper contains the outcome from Fall 2017 and Spring 2018. In this paper, early intervention used in these classes: two days vs three days meeting a week and students’ self-assessment using exam wrappers and their effectiveness on students’ learning will also be discussed. A result of this study shows that there is an improvement on Drop, Fail and Withdraw (DFW) rates by 7%-10% compared to those in previous semesters.

Keywords: student at risk, diagnostic tests, identification, intervention, normalization gain, validity of tests

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Authors: B. S. Premalatha, Kausalya Sahani

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Background: Glomus jugulare tumors arise within the jugular foramen and are commonly seen in females particularly on the left side. Surgical excision of the tumor may cause lower cranial nerve deficits. Cranial nerve involvement produces hoarseness of voice, slurred speech, and dysphagia along with other physical symptoms, thereby affecting the quality of life of individuals. Though oncological clearance is mainly emphasized on while treating these individuals, little importance is given to their communication, voice and swallowing problems, which play a crucial part in daily functioning. Objective: To examine the functions of voice, speech and swallowing outcomes of the subjects, following excision of glomus jugulare tumor. Methods: Two female subjects aged 56 and 62 years had come with a complaint of change in voice, inability to swallow and reduced clarity of speech following surgery for left glomus jugulare tumor were participants of the study. Their surgical information revealed multiple cranial nerve palsies involving the left facial, left superior and recurrent branches of the vagus nerve, left pharyngeal, left soft palate, left hypoglossal and vestibular nerves. Functional outcomes of voice, speech and swallowing were evaluated by perceptual and objective assessment procedures. Assessment included the examination of oral structures and functions, dysarthria by Frenchey dysarthria assessment, cranial nerve functions and swallowing functions. MDVP and Dr. Speech software were used to evaluate acoustic parameters of voice and quality of voice respectively. Results: The study revealed that both the subjects, subsequent to excision of glomus jugulare tumor, showed a varied picture of affected oral structure and functions, articulation, voice and swallowing functions. The cranial nerve assessment showed impairment of the vagus, hypoglossal, facial and glossopharyngeal nerves. Voice examination indicated vocal cord paralysis associated with breathy quality of voice, weak voluntary cough, reduced pitch and loudness range, and poor respiratory support. Perturbation parameters as jitter, shimmer were affected along with s/z ratio indicative of voice fold pathology. Reduced MPD(Maximum Phonation Duration) of vowels indicated that disturbed coordination between respiratory and laryngeal systems. Hypernasality was found to be a prominent feature which reduced speech intelligibility. Imprecise articulation was seen in both the subjects as the hypoglossal nerve was affected following surgery. Injury to vagus, hypoglossal, gloss pharyngeal and facial nerves disturbed the function of swallowing. All the phases of swallow were affected. Aspiration was observed before and during the swallow, confirming the oropharyngeal dysphagia. All the subsystems were affected as per Frenchey Dysarthria Assessment signifying the diagnosis of flaccid dysarthria. Conclusion: There is an observable communication and swallowing difficulty seen following excision of glomus jugulare tumor. Even with complete resection, extensive rehabilitation may be necessary due to significant lower cranial nerve dysfunction. The finding of the present study stresses the need for involvement of as speech and swallowing therapist for pre-operative counseling and assessment of functional outcomes.

Keywords: functional outcome, glomus jugulare tumor excision, multiple cranial nerve impairment, speech and swallowing

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Authors: S. MacDougall-Davis, S. Wysling, R. Willmore

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Background: The application of good non-technical skills, also known as crew resource management (CRM), is central to the delivery of safe, effective healthcare. The authors have been running remote trauma courses for over 10 years, primarily focussing on developing participants’ CRM in time-critical, high-stress clinical situations. The course has undergone an iterative process over the past 10 years. We employ a number of experiential learning techniques for improving CRM, including small group workshops, military command tasks, high fidelity simulations with reflective debriefs, and a ‘flipped classroom’, where participants are asked to create their own simulations and assess and debrief their colleagues’ CRM. We created a randomised simulation study to assess the impact of our course on UK medical students’ CRM, both at an individual and a teams level. Methods: Sixteen students took part. Four clinical scenarios were devised, designed to be of similar urgency and complexity. Professional moulage effects and experienced clinical actors were used to increase fidelity and to further simulate high-stress environments. Participants were block randomised into teams of 4; each team was randomly assigned to one pre-course simulation. They then underwent our 5 day remote trauma CRM course. Post-course, students were re-randomised into four new teams; each was randomly assigned to a post-course simulation. All simulations were videoed. The footage was reviewed by two independent CRM-trained assessors, who were blinded to the before/after the status of the simulations. Assessors used the internationally validated team emergency assessment measure (TEAM) to evaluate key areas of team performance, as well as a global outcome rating. Prior to the study, assessors had scored two unrelated scenarios using the same assessment tool, demonstrating 89% concordance. Participants also completed pre- and post-course questionnaires. Likert scales were used to rate individuals’ perceived NTS ability and their confidence to work in a team in time-critical, high-stress situations. Results: Following participation in the course, a significant improvement in CRM was observed in all areas of team performance. Furthermore, the global outcome rating for team performance was markedly improved (40-70%; mean 55%), thus demonstrating an impact at Level 4 of Kirkpatrick’s hierarchy. At an individual level, participants’ self-perceived CRM improved markedly after the course (35-70% absolute improvement; mean 55%), as did their confidence to work in a team in high-stress situations. Conclusion: Our study demonstrates that with a short, cost-effective course, using easily reproducible teaching sessions, it is possible to significantly improve participants’ CRM skills, both at an individual and, perhaps more importantly, at a teams level. The successful functioning of multi-disciplinary teams is vital in a healthcare setting, particularly in high-stress, time-critical situations. Good CRM is of paramount importance in these scenarios. The authors believe that these concepts should be introduced from the earliest stages of medical education, thus promoting a culture of effective CRM and embedding an early appreciation of the importance of these skills in enabling safe and effective healthcare.

Keywords: crew resource management, non-technical skills, training, simulation

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Authors: Gamze Atay, Altay Colak

Abstract:

It is a fact that today's technology shapes the change and development of architectural forms by creating different perspectives. The research is an experimental study that explores the integration of architectural forms in this process of change/development into design education through traditional design tools. An examination of the practices in the studio environment shows that the students who just started architectural education have difficulty accessing the form. The main objective of this study has been to enable students to use and interpret different disciplines in the design process to improve their perception of form. In this sense, the origami, which is defined as "the art of paper folding", and isomorphous (equally formed) approaches have been used with design studio students at the beginning stage as methods in the process of 3-dimensional thinking and creating the form. These two methods were examined with students in three stages: analysis, creation, and outcome. As a result of the study, it was seen that the use of different disciplines as a method during form creation gave the designs of the student originality, freedom, and dynamism.

Keywords: architectural form, design education, isomorphic approach, origamic approach

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Authors: Panagiota Katsikouli, William Hamilton Byrne, Thomas Gammeltoft-Hansen, Tijs Slaats

Abstract:

An individual who demonstrates a well-founded fear of persecution or faces real risk of being subjected to torture is eligible for asylum. In Danish law, the exact legal thresholds reflect those established by international conventions, notably the 1951 Refugee Convention and the 1950 European Convention for Human Rights. These international treaties, however, remain largely silent when it comes to how states should assess asylum claims. As a result, national authorities are typically left to determine an individual’s legal eligibility on a narrow basis consisting of an oral testimony, which may itself be hampered by several factors, including imprecise language interpretation, insecurity or lacking trust towards the authorities among applicants. The leaky ground, on which authorities must assess their subjective perceptions of asylum applicants' credibility, questions whether, in all cases, adjudicators make the correct decision. Moreover, the subjective element in these assessments raises questions on whether individual asylum cases could be afflicted by implicit biases or stereotyping amongst adjudicators. In fact, recent studies have uncovered significant correlations between decision outcomes and the experience and gender of the assigned judge, as well as correlations between asylum outcomes and entirely external events such as weather and political elections. In this study, we analyze a publicly available dataset containing approximately 8,000 summaries of asylum cases, initially rejected, and re-tried by the Refugee Appeals Board (RAB) in Denmark. First, we look for variations in the recognition rates, with regards to a number of applicants’ features: their country of origin/nationality, their identified gender, their identified religion, their ethnicity, whether torture was mentioned in their case and if so, whether it was supported or not, and the year the applicant entered Denmark. In order to extract those features from the text summaries, as well as the final decision of the RAB, we applied natural language processing and regular expressions, adjusting for the Danish language. We observed interesting variations in recognition rates related to the applicants’ country of origin, ethnicity, year of entry and the support or not of torture claims, whenever those were made in the case. The appearance (or not) of significant variations in the recognition rates, does not necessarily imply (or not) bias in the decision-making progress. None of the considered features, with the exception maybe of the torture claims, should be decisive factors for an asylum seeker’s fate. We therefore investigate whether the decision can be predicted on the basis of these features, and consequently, whether biases are likely to exist in the decisionmaking progress. We employed a number of machine learning classifiers, and found that when using the applicant’s country of origin, religion, ethnicity and year of entry with a random forest classifier, or a decision tree, the prediction accuracy is as high as 82% and 85% respectively. tentially predictive properties with regards to the outcome of an asylum case. Our analysis and findings call for further investigation on the predictability of the outcome, on a larger dataset of 17,000 cases, which is undergoing.

Keywords: asylum adjudications, automated decision-making, machine learning, text mining

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Authors: Bharti Chogtu Magazine, Dhanya Soodana Mohan, Shruti Nair, Tanwi Trushna

Abstract:

The study was undertaken to analyse the cardiovascular drugs being prescribed in patients with concomitant reactive airway disease and hypertension or ischemic heart diseases (IHD). Also, the effect of beta-blockers on respiratory symptoms in these patients was recorded. Data was collected from medical records of patients with reactive airway disease and concomitant hypertension and IHD. It included demographic details of the patients, diagnosis, drugs prescribed and the patient outcome regarding the exacerbation of asthma symptoms with intake of beta blockers. Medical records of 250 patients were analysed.13% of patients were prescribed beta-blockers. 12% of hypertensive patients, 16.6% of IHD patients and 20% of patients with concomitant hypertension and IHD were prescribed beta blockers. Of the 33 (13%) patients who were on beta-blockers, only 3 patients had an exacerbation of bronchial asthma symptoms. Cardioselective beta-blockers under supervision appear to be safe in patients with reactive airway disease and concomitant hypertension and IHD.

Keywords: beta blockers, hypertension, ischemic heart disease, asthma

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Authors: Afiq Juazer Rizal, Siti Zaleha Misnan, M. Zairi M. Yusof

Abstract:

Seismic data is the fundamental tool utilized by exploration companies to determine potential hydrocarbon. However, the importance of seismic trace data will be undermined unless the geo-spatial component of the data is understood. Deriving a proposed well to be drilled from data that has positional ambiguity will jeopardize business decision and millions of dollars’ investment that every oil and gas company would like to avoid. Spatial integrity QC workflow has been introduced in PETRONAS to ensure positional errors within the seismic data are recognized throughout the exploration’s lifecycle from acquisition, processing, and seismic interpretation. This includes, amongst other tests, quantifying that the data is referenced to the appropriate coordinate reference system, survey configuration validation, and geometry loading verification. The direct outcome of the workflow implementation helps improve reliability and integrity of sub-surface geological model produced by geoscientist and provide important input to potential hazard assessment where positional accuracy is crucial. This workflow’s development initiative is part of a bigger geospatial integrity management effort, whereby nearly eighty percent of the oil and gas data are location-dependent.

Keywords: oil and gas exploration, PETRONAS, seismic data, spatial integrity QC workflow

Procedia PDF Downloads 202