Search results for: guidance needs

Authors: Bing Xu, Kerry Lee, Jason M. Stephen

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Collaborative learning (CL) has been regarded as a way to facilitate students to gain knowledge and improve social skills. In China, lecturers in higher education institutions have commonly adopted CL in their daily practice. However, such a strategy could not be effective when it is designed and applied in an inappropriate way. Previous research hardly focused on how CL was applied in Chinese universities. This present study aims to gain a deep understanding of how Chinese lecturers design and implement CL tasks. The researchers interviewed ten lecturers from different faculties in various universities in China and usedGroup Learning Activity Instructional Design (GLAID) framework to analyse the data. We found that not all lecturers pay enough attention to eight essential components (proposed by GLAID) when they designed CL tasks, especially the components of Structure and Guidance. Meanwhile, only a small part of lecturers made formative assessment to help students improve learning. We also discuss the strengths and limitations and CL design and further provide suggestions to the lecturers who intend to use CL in class. Research Objectives: The aims of the present research are threefold. We intend to 1) gain a deep understanding of how Chinese lecturers design and implement collaborative learning (CL) tasks, 2) find strengths and limitations of CL design in higher education, and 3) give suggestions about how to improve the design and implement. Research Methods: This research adopted qualitative methods. We applied the semi-structured interview method to interview ten Chinese lecturers about how they designed and implemented CL tasks in their courses. There were 9 questions in the interview protocol focusing on eight components of GLAID. Then, underpinning the GLAID framework, we utilized the coding reliability thematic analysis method to analyse the research data. The coding work was done by two PhD students whose research fields are CL, and the Cohen’s Kappa was 0.772 showing the inter-coder reliability was good. Contribution: Though CL has been commonly adopted in China, few studies have paid attention to the details about how lecturers designed and implemented CL tasks in practice. This research addressed such a gap and found not lecturers were aware of how to design CL and felt it difficult to structure the task and guide the students on collaboration, and further ensure student engagement in CL. In summary, this research advocates for teacher training; otherwise, students may not gain the expected learning outcomes.

Keywords: collaborative learning, higher education, task design, GLAID framework

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Authors: Pandurang Balwant, Ashutosh Mishra, Jyothi V., Abhay Soni, Padmakar C., Rafat Quamar, Ramesh J.

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The sea water intrusion in the coastal aquifers has become one of the major environmental concerns. Although, it is a natural phenomenon but, it can be induced with anthropogenic activities like excessive exploitation of groundwater, seacoast mining, etc. The geological and hydrogeological conditions including groundwater heads and groundwater pumping pattern in the coastal areas also influence the magnitude of seawater intrusion. However, this problem can be remediated by taking some preventive measures like rainwater harvesting and artificial recharge. The present study is an attempt to identify suitable sites for rainwater harvesting in salt intrusion affected area near coastal aquifer of Jafrabad town, Amreli district, Gujrat, India. The physico-chemical water quality results show that out of 25 groundwater samples collected from the study area most of samples were found to contain high concentration of Total Dissolved Solids (TDS) with major fractions of Na and Cl ions. The Cl/HCO3 ratio was also found greater than 1 which indicates the salt water contamination in the study area. The geophysical survey was conducted at nine sites within the study area to explore the extent of contamination of sea water. From the inverted resistivity sections, low resistivity zone (<3 Ohm m) associated with seawater contamination were demarcated in North block pit and south block pit of NCJW mines, Mitiyala village Lotpur and Lunsapur village at the depth of 33 m, 12 m, 40 m, 37 m, 24 m respectively. Geospatial techniques in combination of Analytical Hierarchy Process (AHP) considering hydrogeological factors, geographical features, drainage pattern, water quality and geophysical results for the study area were exploited to identify potential zones for the Rainwater Harvesting. Rainwater harvesting suitability model was developed in ArcGIS 10.1 software and Rainwater harvesting suitability map for the study area was generated. AHP in combination of the weighted overlay analysis is an appropriate method to identify rainwater harvesting potential zones. The suitability map can be further utilized as a guidance map for the development of rainwater harvesting infrastructures in the study area for either artificial groundwater recharge facilities or for direct use of harvested rainwater.

Keywords: analytical hierarchy process, groundwater quality, rainwater harvesting, seawater intrusion

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Authors: Ross J. Maestas

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Biofuels are derived from multiple renewable bioenergy feedstocks including animal fats, wood, starchy grains, and oil seeds. Transportation agencies have considered growing the latter two on underutilized and nontraditional lands that they manage, such as in the Right of Way (ROW), abandoned weigh stations, and at maintenance yards. These crops provide the opportunity to generate revenue or supplement fuel once converted and offer a solution to increasing fuel costs and instability by creating a ‘home-grown’ alternative. Biofuels are non-toxic, biodegradable, and emit less Green House Gasses (GHG) than fossil fuels, therefore allowing agencies to meet sustainability goals and regulations. Furthermore, they enable land managers to achieve soil erosion and roadside aesthetic strategies. The research sought to understand if the cultivation of a biofuel feedstock within the Arkansas State Highway Transportation Department’s (AHTD) managed and marginalized lands is feasible by identifying potential land areas and crops. To determine potential plots the parcel data was downloaded from Arkansas’s GIS office. ArcGIS was used to query the data for all variations of the names of property owned by AHTD and a KML file was created that identifies the queried parcel data in Google Earth. Furthermore, biofuel refineries in the state were identified to optimize the harvest to transesterification process. Agricultural data was collected from federal and state agencies and universities to assess various oil seed crops suitable for conversion and suited to grow in Arkansas’s climate and ROW conditions. Research data determined that soybean is the best adapted biofuel feedstock for Arkansas with camelina and canola showing possibilities as well. Agriculture is Arkansas’s largest industry and soybean is grown in over half of the state’s counties. Successful cultivation of a feedstock in the aforementioned areas could potentially offer significant employment opportunity for which the skilled farmers already exist. Based on compiled data, AHTD manages 21,489 acres of marginalized land. The result of the feasibility assessment offer suggestions and guidance should AHTD decide to further investigate this type of initiative.

Keywords: Arkansas highways, biofuels, renewable energy initiative, marginalized lands

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Authors: Thair Mahmood Altaiee

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Because of the increasing population and the growing water requirements from the transboundary water resources within riparian countries in addition to un-proper management of these transboundary water resources, it is likely that a conflicts on the water will be occurred. So it is mandatory to search solutions to mitigate the action and probabilities of these undesired conflicts. One of the solutions for these crises may be sharing the riparian countries in the management of their transboundary water resources and share benefit. Effective cooperation on a transboundary river is any action by the riparian countries that lead to improve management of the river to their mutual acceptance. In principle, friendship dams constructed by riparian countries may play an important role in preventing conflicts like the Turkish-Syrian friendship dam on Asi river (Orontes), Iranian-Tukmenistan dam on Hariroud river, Bulgarian-Turkish dam on Tundzha river, Brazil-Paraguay dam on Parana river, and Aras dam between Iran and Azerbaijan. The objective of this study is to focus the light on the hydrological aspects of cooperation in constructing dams on the transboundary rivers, which may consider an option to prevent conflicts on water between the riparian countries. The various kinds of benefits and external impacts associated with cooperation in dams construction on the transboundary rivers with a real examples will be presented and analyzed. The hydrological benefit sharing from cooperation in dams construction, which type of benefit sharing mechanisms are applicable to dams, and how they vary were discussed. The study considered the cooperative applicability to dams on shared rivers according to selected case study of friendship dams in the world to illustrate the relevance of the cooperation concepts and the feasibility of such propose cooperation between Turkey and Iraq within the Tigris river. It is found that the opportunities of getting benefit from cooperation depend mainly on the hydrological boundary and location of the dam in relation to them. The desire to cooperate on dams construction on transboundary rivers exists if the location of a dam upstream will increase aggregate net benefits. The case studies show that various benefit sharing mechanisms due to cooperation in constructing friendship dams on the riparian countries border are possible for example when the downstream state (Iraq) convinces the upstream state (Turkey) to share building a dam on Tigris river across the Iraqi –Turkish border covering the cost and sharing the net benefit derived from this dam. These initial findings may provide guidance for riparian states engaged in and donors facilitating negotiation on dam projects on transboundary rivers.

Keywords: friendship dams, transboundary rivers, water cooperation, benefit sharing

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Authors: Kamal Kaushik, Dandpani Epili, Ajay G. V., Ashutosh, S. Pradhaan

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Introduction: Radiation therapy has come a long way over a period of decades, from 2-dimensional radiotherapy to intensity-modulated radiation therapy (IMRT) or VMAT. For advanced radiation therapy, we need better patient position reproducibility to deliver precise and quality treatment, which raises the need for better image guidance technologies for precise patient positioning. This study presents a two tattoo simulation with roll correction technique which is comparable to other advanced patient positioning techniques. Objective: This is a site-specific study is aimed to perform a comparison between various treatment positioning techniques used for the treatment of patients of Ca- Breast undergoing radiotherapy. In this study, we are comparing 5 different positioning methods used for the treatment of ca-breast, namely i) Vacloc with 3 tattoos, ii) Breast board with three tattoos, iii) Thermoplastic cast with three fiducials, iv) Breast board with a thermoplastic mask with 3 tattoo, v) Breast board with 2 tattoos – A roll correction method. Methods and material: All in one (AIO) solution immobilization was used in all patient positioning techniques for immobilization. The process of two tattoo simulations includes positioning of the patient with the help of a thoracic-abdomen wedge, armrest & knee rest. After proper patient positioning, we mark two tattoos on the treatment side of the patient. After positioning, place fiducials as per the clinical borders markers (1) sternum notch (lower border of clavicle head) (2) 2 cm below from contralateral breast (3) midline between 1 & 2 markers (4) mid axillary on the same axis of 3 markers (Marker 3 & 4 should be on the same axis). During plan implementation, a roll depth correction is applied as per the anterior and lateral positioning tattoos, followed by the shifts required for the Isocentre position. The shifts are then verified by SSD on the patient surface followed by radiographic verification using Cone Beam Computed Tomography (CBCT). Results: When all the five positioning techniques were compared all together, the produced shifts in Vertical, Longitudinal and lateral directions are as follows. The observations clearly suggest that the Longitudinal average shifts in two tattoo roll correction techniques are less than every other patient positioning technique. Vertical and lateral Shifts are also comparable to other modern positioning techniques. Concluded: The two tattoo simulation with roll correction technique provides us better patient setup with a technique that can be implemented easily in most of the radiotherapy centers across the developing nations where 3D verification techniques are not available along with delivery units as the shifts observed are quite minimal and are comparable to those with Vacloc and modern amenities.

Keywords: Ca. breast, breast board, roll correction technique, CBCT

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Authors: Ying Shi, June Zhang, Lu Shao, Xiyan Xie, Aidi Lao, Zhangan Wang

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Background: Low levels of physical activity are associated with poorer health outcomes, and this situation is more critical in older adults living in long‐term care facilities. Objectives: To systematically identify, appraise, and synthesize current qualitative research evidence regarding the barriers and facilitators to physical activity as reported by older adults and care staff in long‐term care facilities. Design: This is a systematic review with qualitative evidence synthesis adhering to PRISMA guidelines. Methods: We conducted a systematic search on PubMed, Science Citation Index Expanded, Social Sciences Citation Index, EMBASE, CINAHL, and PsychInfo databases from inception until 30 June 2023. Thematic synthesis was undertaken to identify the barriers and facilitators relating to physical activity. Then, we mapped them onto the Capability, Opportunity, Motivation, and Behavior model and Theoretical Domains Framework. Methodological quality was assessed using the CASP Qualitative Studies Checklist, and confidence in review findings was assessed using the GRADE-CERQual approach. Results: We included 32 studies after screening 10496 citations and 177 full texts. Seven themes and 17 subthemes were identified relating to barriers and facilitators influencing physical activity in elderly residents. The main themes were mapped onto COM-B) model-Capability (physical activity knowledge gaps and individual health issues), Opportunity (social support and macro-level resources) and Motivation (health beliefs, fear of falling or injury, and personal and social incentives to physical activity). Most subthemes were graded as high (n = 9) or moderate (n = 3) confidence. Conclusions and Implications: Our comprehensive synthesis of 32 studies provides a wealth of knowledge of barriers and facilitators to physical activity from both residents and care staff’s perspectives. Intervention components were also suggested within the context of long‐term care facilities. End users such as older residents, care staff, and researchers can have confidence in our findings when formulating policies and guidance on promoting physical activity among elderly residents in long‐term care facilities.

Keywords: long‐term care, older adults, physical activity, qualitative, systematic review

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Authors: Orit Shamir Balderman, Shamir Michal

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Israel often deals with crisis situations, but most have been characterized as security crises (e.g., war). This is the first time that the Israel has dealt with a health and social emergency as part of a global crisis. The crisis began in January 2020 with the emergence of the novel coronavirus (Covid-19), which was defined as a pandemic (World Health Organization, 2020) and arrived in Israel in early March 2020. This study examined how single mothers by choice (SMBC) experience state anxiety (SA), social support, work–family conflict (WFC), and happiness. This group has not been studied in the context of crises in general or a global crisis. Using a snowball sample, 386 SMBCanswered an online questionnaire. The findings show a negative relationship between income and level of state anxiety. State anxiety was also negatively associated with social support, level of happiness, and WFC. Finally, a stepwise regression analysis indicated that happiness explained 34% of the variance in SA. We also found that most of the women did not turn to formal support agencies such as social workers, other Government Ministries, or municipal welfare. A positive and strong correlations was also found between SA and WFC. The findings of the study reinforce the understanding that although these women made a conscious and informed decision regarding the choice of their family cell, their situation is more complex in the absence of a spouse support. Therefore, this study, as other future studies in the field of SMBC, may contribute to the improvement of their social status and the understanding that they are a unique group. Although SMBC are a growing sector of society in the past few years, there are still special needs and special attention that is needed from the formal and informal supports systems. A comparative study of these two groups and in different countries would shed light on SA among mothers in general, regardless of their relationship status and location.Researchers should expand this study by comparing mothers in relationships and exploring how SMBC coped in other countries. In summary, the findings of the study contribute knowledge on three levels: (a) knowledge about SMBC in general and during crisis situations; (b) examination of social support using tools assessing receipt of assistance and support, some of which were developed for the present study; and (c) insights regarding counseling, accompaniment, and guidance of welfare mechanisms.

Keywords: single mothers by choice, state anxiety, social support, happiness, work–family conflict

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Authors: Johannes Gantner, Michael Held, Matthias Fischer

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The refurbishment of the building stock in terms of energy supply and efficiency is one of the major challenges of the German turnaround in energy policy. As the building sector accounts for 40% of Germany’s total energy demand, additional insulation is key for energy efficient refurbished buildings. Nevertheless the energetic benefits often the environmental and economic performances of insulation materials are questioned. The methods Life Cycle Assessment (LCA) as well as Life Cycle Costing (LCC) can form the standardized basis for answering this doubts and more and more become important for material producers due efforts such as Product Environmental Footprint (PEF) or Environmental Product Declarations (EPD). Due to increasing use of LCA and LCC information for decision support the robustness and resilience of the results become crucial especially for support of decision and policy makers. LCA and LCC results are based on respective models which depend on technical parameters like efficiencies, material and energy demand, product output, etc.. Nevertheless, the influence of parameter uncertainties on lifecycle results are usually not considered or just studied superficially. Anyhow the effect of parameter uncertainties cannot be neglected. Based on the example of an exterior wall the overall lifecycle results are varying by a magnitude of more than three. As a result simple best case worst case analyses used in practice are not sufficient. These analyses allow for a first rude view on the results but are not taking effects into account such as error propagation. Thereby LCA practitioners cannot provide further guidance for decision makers. Probabilistic analyses enable LCA practitioners to gain deeper understanding of the LCA and LCC results and provide a better decision support. Within this study, the environmental and economic impacts of an exterior wall system over its whole lifecycle are illustrated, and the effect of different uncertainty analysis on the interpretation in terms of resilience and robustness are shown. Hereby the approaches of error propagation and Monte Carlo Simulations are applied and combined with statistical methods in order to allow for a deeper understanding and interpretation. All in all this study emphasis the need for a deeper and more detailed probabilistic evaluation based on statistical methods. Just by this, misleading interpretations can be avoided, and the results can be used for resilient and robust decisions.

Keywords: uncertainty, life cycle assessment, life cycle costing, Monte Carlo simulation

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Authors: Gavin Quibell, Martin Kleynhans, Margot Soler

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The Sendai Framework notes that disaster risk reduction is essential for sustainable development, and Disaster Risk Reduction is included in 3 of the Sustainable Development Goals (SDGs), and 4 of the SDG targets. However, apart from promoting better governance and resourcing of disaster management agencies, little guidance is given how low-income nations can balance investments across the SDGs to achieve sustainable development in an increasingly climate vulnerable world with increasing prevalence of flood and drought disasters. As one of the world’s poorest nations, Malawi must balance investments across all the SDGs. This paper explores how Malawi’s National Guidelines for Community-based Flood Risk Management integrate sustainable development and flood management objectives at different administrative levels. While Malawi periodically suffers from large, widespread flooding, the greatest impacts are felt through the smaller annual floods and flash floods. The Guidelines address this through principles that recognize that while the protection of human life is the most important priority for flood risk management, addressing the impacts of floods on the rural poor and the economy requires different approaches. The National Guidelines are therefore underpinned by the following; 1. In the short-term investments in flood risk management must focus on breaking the poverty – vulnerability cycle; 2. In the long-term investments in the other SDGs will have the greatest flood risk management benefits; 3. If measures are in place to prevent loss of life and protect strategic infrastructure, it is better to protect more people against small and medium size floods than fewer people against larger floods; 4. Flood prevention measures should focus on small (1:5 return period) floods; 5. Flood protection measures should focus on small and medium floods (1:20 return period) while minimizing the risk of failure in larger floods; 6. The impacts of larger floods ( > 1:50) must be addressed through improved preparedness; 7. The impacts of climate change on flood frequencies are best addressed by focusing on growth not overdesign; and 8. Manage floods and droughts conjunctively. The National Guidelines weave these principles into Malawi’s approach to flood risk management through recommendations for planning and implementing flood prevention, protection and preparedness measures at district, traditional authority and village levels.

Keywords: flood risk management in low-income countries, sustainable development, investments in prevention, protection and preparedness, community-based flood risk management, Malawi

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Authors: Bi Xiao Fang, Tan Bao Zhen

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Soft skills, core competencies, and generic competencies are exchangeable terminologies often used to represent a similar concept. In the Singapore context, such skills are currently being referred to as Critical Core Skills (CCS). In 2019, SkillsFuture Singapore (SSG) reviewed the Generic Skills and Competencies (GSC) framework that was first introduced in 2016, culminating in the development of the Critical Core Skills (CCS) framework comprising 16 soft skills classified into three clusters. The CCS framework is part of the Skills Framework, and whose stated purpose is to create a common skills language for individuals, employers and training providers. It is also developed with the objectives of building deep skills for a lean workforce, enhance business competitiveness and support employment and employability. This further helps to facilitate skills recognition and support the design of training programs for skills and career development. According to SSG, every job role requires a set of technical skills and a set of Critical Core Skills to perform well at work, whereby technical skills refer to skills required to perform key tasks of the job. There has been an increasing emphasis on soft skills for the future of work. A recent study involving approximately 80 organizations across 28 sectors in Singapore revealed that more enterprises are beginning to recognize that soft skills support their employees’ performance and business competitiveness. Though CCS is of high importance for the development of the workforce’s employability, there is little attention paid to the CCS use and profiling across occupations. A better understanding of how CCS is distributed across the economy will thus significantly enhance SSG’s career guidance services as well as training providers’ services to graduates and workers and guide organizations in their hiring for soft skills. This CCS profiling study sought to understand how CCS is demanded in different occupations. To achieve its research objectives, this study adopted a quantitative method to measure CCS use across different occupations in the Singaporean workforce. Based on the CCS framework developed by SSG, the research team adopted a formative approach to developing the CCS profiling tool to measure the importance of and self-efficacy in the use of CCS among the Singaporean workforce. Drawing on the survey results from 2500 participants, this study managed to profile them into seven occupation groups based on the different patterns of importance and confidence levels of the use of CCS. Each occupation group is labeled according to the most salient and demanded CCS. In the meantime, the CCS in each occupation group, which may need some further strengthening, were also identified. The profiling of CCS use has significant implications for different stakeholders, e.g., employers could leverage the profiling results to hire the staff with the soft skills demanded by the job.

Keywords: employability, skills profiling, skills measurement, soft skills

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Authors: Pedro Mario Gonzalez Jimenez

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The novelties introduced by the last Notice on agreements of minor importance tighten the application of the ‘De minimis’ safe harbour in the European Union. However, the undetermined legal concept of effect on trade between the Member States becomes importance at the same time. Therefore, the current analysis that the jurist should carry out in the European Union to determine if an agreement appreciably restrict competition under Article 101 of the Treaty on the Functioning of the European Union is double. Hence, it is necessary to know how to balance the significance in competition and the significance in effect on trade between the Member States. It is a crucial issue due to the negative delimitation of restriction of competition affects the positive one. The methodology of this research is rather simple. Beginning with a historical approach to the ‘De Minimis Rule’, their main problems and uncertainties will be found. So, after the analysis of normative documents and the jurisprudence of the Court of Justice of the European Union some proposals of ‘Lege ferenda’ will be offered. These proposals try to overcome the contradictions and questions that currently exist in the European Union as a consequence of the current legal regime of agreements of minor importance. The main findings of this research are the followings: Firstly, the effect on trade is another way to analyze the importance of an agreement different from the ‘De minimis rule’. In point of fact, this concept is singularly adapted to go through agreements that have as object the prevention, restriction or distortion of competition, as it is observed in the most famous European Union case-law. Thanks to the effect on trade, as long as the proper requirements are met there is no a restriction of competition under article 101 of the Treaty on the Functioning of the European Union, even if the agreement had an anti-competitive object. These requirements are an aggregate market share lower than 5% on any of the relevant markets affected by the agreement and turnover lower than 40 million of Euros. Secondly, as the Notice itself says ‘it is also intended to give guidance to the courts and competition authorities of the Member States in their application of Article 101 of the Treaty, but it has no binding force for them’. This reality makes possible the existence of different statements among the different Member States and a confusing perception of what a restriction of competition is. Ultimately, damage on trade between the Member States could be observed for this reason. The main conclusion is that the significant effect on trade between Member States is irrelevant in agreements that restrict competition because of their effects but crucial in agreements that restrict competition because of their object. Thus, the Member States should propose the incorporation of a similar concept in their legal orders in order to apply the content of the Notice. Otherwise, the significance of the restrictive agreement on competition would not be properly assessed.

Keywords: De minimis rule, effect on trade, minor importance agreements, safe harbour

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Authors: Ana Carolina Kogawa, Selma Gutierrez Antonio, Hérida Regina Nunes Salgado

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Rifaximin is an oral antimicrobial, gut - selective and not systemic with adverse effects compared to placebo. It is used for the treatment of hepatic encephalopathy, travelers diarrhea, irritable bowel syndrome, Clostridium difficile, ulcerative colitis and acute diarrhea. The crystalline form present in the rifaximin with minimal systemic absorption is α, being the amorphous form significantly different. Regulators are increasingly attention to polymorphisms. Polymorphs can change the form by altering the drug characteristics compromising the effectiveness and safety of the finished product. International Conference on Harmonization issued the ICH Guidance Q6A, which aim to improve the control of polymorphism in new and existing pharmaceuticals. The objective of this study was to obtain polymorphic forms of rifaximin employing recrystallization processes and characterize them by thermal analysis (thermogravimetry - TG and differential scanning calorimetry - DSC), X-ray diffraction, scanning electron microscopy and solubility test. Six polymorphic forms of rifaximin, designated I to VI were obtained by the crystallization process by evaporation of the solvent. The profiles of the TG curves obtained from polymorphic forms of rifaximin are similar to rifaximin and each other, however, the DTG are different, indicating different thermal behaviors. Melting temperature values of all the polymorphic forms were greater to that shown by the rifaximin, indicating the higher thermal stability of the obtained forms. The comparison of the diffractograms of the polymorphic forms of rifaximin with rifaximin α, β and γ constant in patent indicate that forms III, V and VI are formed by mixing polymorph β and α and form III is formed by polymorph β. The polymorphic form I is formed by polymorph β, but with a significant amount of amorphous material. Already, the polymorphic form II consists of polymorph γ, amorphous. In scanning electron microscope is possible to observe the heterogeneity of morphological characteristics of crystals of polymorphic forms among themselves and with rifaximin. The solubility of forms I and II was greater than the solubility of rifaximin, already, forms III, IV and V presented lower solubility than of rifaximin. Similarly, the bioavailability of the amorphous form of rifaximin is considered significantly higher than the form α, the polymorphic forms obtained in this work can not guarantee the excellent tolerability of the reference medicine. Therefore, studies like these are extremely important and they point to the need for greater requirements by the regulatory agencies competent about polymorphs analysis of the raw materials used in the manufacture of medicines marketed globally. These analyzes are not required in the majority of official compendia. Partnerships between industries, research centers and universities would be a viable way to consolidate researches in this area and contribute to improving the quality of solid drugs.

Keywords: electronic microscopy, polymorphism, rifaximin, solubility, X-ray diffraction

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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: Sa'ad Ali

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This study explores wasta as an example of a social network and how it impacts business practice in the Arab Middle East, drawing links with social network impact in different regions of the world. In doing so, particular attention will be paid to the socio-economic and cultural influences on business practice. In exploring relationships in business, concepts such as social network analysis, social capital and group identity are used to explore the different forms of social networks and how they influence business decisions and practices in the regions and countries where they prevail. The use of social networks to achieve objectives is known as guanxi in China, wasta in the Arab Middle East and blat in ex-Soviet countries. Wasta can be defined as favouritism based on tribal and family affiliation and is a widespread practice that has a substantial impact on political, social and business interactions in the Arab Middle East. Within the business context, it is used in several ways, such as to secure a job or promotion or to cut through bureaucracy in government interactions. The little research available is fragmented, and most studies reveal a negative attitude towards its usage in business. Paradoxically, while wasta is widely practised, people from the Arab Middle East often deny its influence. Moreover, despite the regular exhibition of a negative opinion on the practice of wasta, it can also be a source of great pride. This paper addresses this paradox by conducting a positional literature review, exploring the current literature on wasta and identifying how the identified paradox can be explained. The findings highlight how wasta, to a large extent, has been treated as an umbrella concept, whilst it is a highly complex practice which has evolved from intermediary wasta to intercessory wasta and therefore from bonding social capital relationships to more bridging social capital relationships. In addition, the research found that Islam, as the predominant religion in the region and the main source of ethical guidance for the majority of people from the region, plays a substantial role in this paradox. Specifically, it is submitted that wasta can be viewed positively in Islam when it is practised to aid others without breaking Islamic ethical guidelines, whilst it can be viewed negatively when it is used in contradiction with the teachings of Islam. As such, the unique contribution to knowledge of this study is that it ties together the fragmented literature on wasta, highlighting and helping us understand its complexity. In addition, it sheds light on the role of Islam in wasta practices, aiding our understanding of the paradoxical nature of the practice.

Keywords: Islamic ethics, social capital, social networks, Wasta

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Authors: Shamir Balderman Orit, Shamir Michal

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Israel often deals with crisis situations, but most have been characterized as security crises (e.g., war). This is the first time that the Israel has dealt with a health and social emergency as part of a global crisis. The crisis began in January 2020 with the emergence of the novel coronavirus (Covid-19), which was defined as a pandemic (World Health Organization, 2020) and arrived in Israel in early March 2020. This study examined how single mothers by choice (SMBC) experience state anxiety (SA), social support, work–family conflict (WFC), and happiness. This group has not been studied in the context of crises in general or a global crisis. Using a snowball sample, 386 SMBCanswered an online questionnaire. The findings show a negative relationship between income and level of state anxiety. State anxiety was also negatively associated with social support, level of happiness, and WFC. Finally, a stepwise regression analysis indicated that happiness explained 34% of the variance in SA. We also found that most of the women did not turn to formal support agencies such as social workers, other Government Ministries, or municipal welfare. A positive and strong correlations was also found between SA and WFC. The findings of the study reinforce the understanding that although these women made a conscious and informed decision regarding the choice of their family cell, their situation is more complex in the absence of a spouse support. Therefore, this study, as other future studies in the field of SMBC, may contribute to the improvement of their social status and the understanding that they are a unique group. Although SMBC are a growing sector of society in the past few years, there are still special needs and special attention that is needed from the formal and informal supports systems. A comparative study of these two groups and in different countries would shed light on SA among mothers in general, regardless of their relationship status and location. Researchers should expand this study by comparing mothers in relationships and exploring how SMBC coped in other countries. In summary, the findings of the study contribute knowledge on three levels: (a) knowledge about SMBC in general and during crisis situations; (b) examination of social support using tools assessing receipt of assistance and support, some of which were developed for the present study; and (c) insights regarding counseling, accompaniment, and guidance of welfare mechanisms.

Keywords: single mothers by choice, state anxiety, social support, happiness, work-family conflict

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Authors: H. Pegram, R. Stevens, L. De Girolamo

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Aligned electrospun nanofibres act as effective neuronal and glial cell scaffolds that can be layered to contain multiple sheets harboring different cell populations. This allows personalised biofunctional prostheses to be manufactured with both acellular and cellularised layers for the treatment of spinal cord injury. Additionally, the manufacturing route may be configured to produce in-vitro 3D cell based model of spinal cord injury to aid drug development and enhance prosthesis performance. The goal of this investigation was to optimise the multi-layer scaffold design parameters for prosthesis manufacture, to enable the development of multi-layer patient specific implant therapies. The work has also focused on the fabricating aligned nanofibre scaffolds that promote in-vitro neuronal and glial cell population growth, cell-to-cell interaction and long-term survival following trauma to mimic an in-vivo spinal cord lesion. The approach has established reproducible lesions and has identified markers of trauma and regeneration marked by effective neuronal migration across the lesion with glial support. The investigation has advanced the development of an in-vitro model of traumatic spinal cord injury and has identified a route to manufacture prostheses which target the repair spinal cord injury. Evidence collated to investigate the multi-layer concept suggests that physical cues provided by nanofibres provide both a natural extra-cellular matrix (ECM) like environment and controls cell proliferation and migration. Specifically, aligned nanofibre layers act as a guidance system for migrating and elongating neurons. On a larger scale, material type in multi-layer systems also has an influence in inter-layer migration as cell types favour different material types. Results have shown that layering nanofibre membranes create a multi-level scaffold system which can enhance or prohibit cell migration between layers. It is hypothesised that modifying nanofibre layer material permits control over neuronal/glial cell migration. Using this concept, layering of neuronal and glial cells has become possible, in the context of tissue engineering and also modelling in-vitro induced lesions.

Keywords: electrospinning, layering, lesion, modeling, nanofibre

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Authors: M. L. W. P. De Silva, R. A. C. Rabel, N. Smith, L. McIntyre, T. J Parkinson, K. A. N. Wijayawardhane

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Curricular integration is an important concept in medical education for developing students’ ability to create connections between different medical disciplines. Problem-Based Learning (PBL) is one of the vehicles through which such integration can be achieved. During the recent review of the veterinary curriculum at the University of Peradeniya, a series of courses in Integrative Veterinary Science (IVS) were introduced, in which PBL was the primary teaching methodology. The objectives of this study were to evaluate students’ opinions on PBL as a teaching method: it should be noted that, within the context of secondary and tertiary education in Sri Lanka, this would be an entirely novel learning experience for the students. Opinions were sought at the conclusion of IVS sessions where students of semesters 2, 4, 6, and 7 (of an 8-semester program) were exposed to a two, 2-hour PBL-based case scenario. The PBL-based case scenario in semesters 2, 4, and 7 were delivered using material previously developed by an experienced PBL practitioner, whilst material for semester 6 was prepared de novo by a less experienced practitioner. Each student (semesters 2: n=38, 4: n=37, 6: n=55, and 7: n=40) completed a questionnaire which asked whether: (i) the course had improved their critical thinking skills; (ii) the learning environment was sufficiently comfortable to express/share student’s opinion; (iii) there was sufficient facilitator guidance; (iv) the online study environment enhanced learning; and (v) the students were overall satisfied with the PBL approach and IVS concept. Responses were given on a 5-point Likert-scale (strongly agree (SA), agree (A), neutral (N), disagree (D), and strongly disagree (SD)). SA and A responses were summed to provide an overall ‘satisfactory’ response. Results were subjected to frequency-distribution statistical analysis. A total of 88.5% of students gave SA+A scores to their overall satisfaction. The proportion of SA+A scores differed between different semesters, such that 95% of semester 2, 4, and 7 students gave SA+A scores, whereas only 69% of semester 6 students did so for their respective sessions. Overall, 96% of the students gave SA+A scores to the question relating to the improvement of critical thinking skills: semester 6 students’ scores were marginally, but not significantly, lower (91% SA+A) than those in other semesters. The difference of scores between semester 6 and the other semesters may be attributed to the different PBL-material used and/or the different experience levels of the practitioners that developed the study material. The use of PBL as a means of teaching IVS curriculum-integration courses was well-received by the students in terms of their overall satisfaction and their perceptions of improved critical thinking skills. Importantly, this was achieved in the face of a methodology that was entirely novel to the students. Finally, the delivery of the PBL medium was readily mastered by the practitioner to whom it was also a novel methodology.

Keywords: critical thinking skills, integration, problem based learning, veterinary education

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Authors: Puneet Goyal, Aarti Agarwal

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Background and Objective: Nutritional support is an integral part of palliative care of advanced non-resectable abdominal malignancy patients, though is frequently neglected aspect. Non-Healing high output Entero-cutaneous fistulas sometimes require long term parenteral nutrition, to take care of catabolism and replacement of nutrients. We present a case of inoperable pancreatic malignancy with high output entero-cutaneous fistula, which was provided parenteral nutritional support with the use of Totally Implantable Venous Access Device (TIVAD). Method and Results: 55 year old man diagnosed with carcinoma pancreas had developed high entero-cutaneous fistula. His tumor was found to be inoperable and was on total parenteral nutrition through routine central line. This line was difficult to maintain as he required it for a long term TPN. He was planned to undergo Totally Implantable Venous Access Device (TIVAD) implantation. 8Fr single lumen catheter with Groshong non-return Valve (Bard Access Systems, Inc. USA) was inserted through right internal jugular vein, under fluoroscopic guidance. The catheter was tunneled subcutaneously and brought towards infraclavicular pocket, cut at appropriate length and connected to port and locked. Port was sutured in floor of pocket. Free flow of blood aspirated, flushed with heparinized saline. There was no kink observed in entire length of catheter under fluoroscopy. Skin over infraclavicular pocket was sutured. Long term catheter care and associated risks were explained to patient and relatives. Patient continued to receive total parenteral nutrition as well as other supportive therapy though TIVAD for next 6 weeks, till his demise. Conclusion: TIVADs are standard of care for long term venous access solutions in cancer patients requiring chemotherapy. In this case, we extended its use for providing parenteral nutrition and other supportive therapy. TIVADs can be implanted in advanced cancer patients for providing venous access solution required for various palliative treatments and medications. This will help in improving quality of life and satisfaction amongst terminally ill cancer patients.

Keywords: parenteral nutrition, totally implantable venous access device, long term venous access, interventions in anesthesiology

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Authors: Yuanyuan Liu, Yuanqing Wang, Di Li

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Carbon dioxide (CO2) emissions mitigation from road construction activities is one of the potential pathways to deal with climate change due to its higher use of materials, machinery energy consumption, and high quantity of vehicle and equipment fuels for transportation and on-site construction activities. Aiming to assess the environmental impact of the road infrastructure construction activities and to identify hotspots of emissions sources, this study developed a life-cycle CO2 emissions assessment framework covering three stages of material production, to-site and on-site transportation under the guidance of the principle of LCA ISO14040. Then streamlined inventory analysis on sub-processes of each stage was conducted based on the budget files from cases of highway projects in China. The calculation results were normalized into functional unit represented as ton per km per lane. Then a comparison between the amount of emissions from each stage, and sub-process was made to identify the major contributor in the whole highway lifecycle. In addition, the calculating results were used to be compared with results in other countries for understanding the level of CO2 emissions associated with Chinese road infrastructure in the world. The results showed that materials production stage produces the most of the CO2 emissions (for more than 80%), and the production of cement and steel accounts for large quantities of carbon emissions. Life cycle CO2 emissions of fuel and electric energy associated with to-site and on-site transportation vehicle and equipment are a minor component of total life cycle CO2 emissions from highway project construction activities. Bridges and tunnels are dominant large carbon contributor compared to the road segments. The life cycle CO2 emissions of road segment in highway project in China are slightly higher than the estimation results of highways in European countries and USA, about 1500 ton per km per lane. In particularly, the life cycle CO2 emissions of road pavement in majority cities all over the world are about 500 ton per km per lane. However, there is obvious difference between the cities when the estimation on life cycle CO2 emissions of highway projects included bridge and tunnel. The findings of the study could offer decision makers a more comprehensive reference to understand the contribution of road infrastructure to climate change, especially understand the contribution from road infrastructure construction activities in China. In addition, the identified hotspots of emissions sources provide the insights of how to reduce road carbon emissions for development of sustainable transportation.

Keywords: carbon dioxide emissions, construction activities, highway, life cycle assessment

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Authors: Friman Hen, Banner Ifaa, Shalom-Tuchin Bosmat, Einav Yulia

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The action learning course is an academic course which involves academic learning and social activities. The courses deal with processes and social challenges, reveal different ideologies, and develop critical thinking and pragmatic ideas. Students receive course credits and a grade for being part of such courses. Participating students enroll in courses that involve action and activities to engage in the experiential learning process, thereby creating a dialogue and cross-fertilization between being taught in the classroom and experiencing the reality in the real world. A learning experience includes meeting with social organizations, institutions, and state authorities and carrying out practical work with diverse populations. Through experience, students strengthen their academic skills, formulate ethical attitudes toward reality, develop professional and civilian perspectives, and realize how they can influence their surrounding in the present and the hereafter. Under the guidance and supervision of Dr. Hen Friman, H.I.T. has built an innovative course that combines action and activities to increase the awareness and accessibility of the community in an experiential way. The end goal is to create Green Ambassadors—children with a high level of environmental awareness. This course is divided into two parts. The first part, focused on frontal teaching, delivers knowledge from extensive environmental fields to students. These areas include introduction to ecology, the process of electricity generation, air pollution, renewable energy, water economy, waste and recycling, and energy efficiency (first stage). In addition to the professional content in the environment field, students learn the method of effective and experiential teaching to younger learners (4 to 8 years old). With the attainment of knowledge, students are divided into operating groups. The second part of the course shows how the theory becomes practical and concrete. At this stage, students are asked to introduce to the first- and second-graders of ‘Revivim’ School in Holon a lesson of 90 minutes focused on presenting the issues and their importance during the course (second stage). This course is the beginning of a paradigm shift regarding energy usage in the modern society in Israel. The objective of the course is to expand worldwide and train the first and second-graders, and even pre-schoolers, in a wide scope to increase population awareness rate, both in Israel and all over the world, for a green future.

Keywords: air pollution, green ambassador, recycling, renewable energy

Procedia PDF Downloads 242

Authors: Hsing Yuan Liu

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Background: Considerable theoretical and empirical work has identified a relationship between collaboration interactions and creativity in an organizational context. The mechanisms underlying this link, however, are not well understood in healthcare education. Objectives: The aims of this study were to explore the impact of collaboration interactions on team creativity and its underlying mechanism and to verify a moderated mediation model. Design, setting, and participants: This study utilized a cross-sectional, quantitative, descriptive design. The survey data were collected from 177 nursing students who enrolled in 18-week capstone courses of small interdisciplinary groups collaborating to design healthcare products in Taiwan during 2018 and 2019. Methods: Questionnaires assessed the nursing students' perceptions about their teams' swift trust (of cognition- and affect-based), conflicts (of task, process, and relationship), interaction behaviors (constructive controversy, helping behaviors, and spontaneous communication), and creativity. This study used descriptive statistics to compare demographics, swift trust scores, conflict scores, interaction behavior scores, and creativity scores for interdisciplinary teams. Data were analyzed using Pearson’s correlation coefficient and simple and hierarchical multiple regression models. Results: Pearson’s correlation analysis showed the cognition-based team swift trust was positively correlated with team creativity. The mediation model indicated constructive controversy fully mediated the effect of cognition-based team swift trust on student teams’ creativity. The moderated mediation model indicated that task conflict negatively moderates the mediating effect of the constructive controversy on the link between cognition-based team swift trust and team creativity. Conclusion: Our findings suggest nursing student teams’ interaction behaviors and task conflict are crucial mediating and moderated mediation variables on the relationship between collaboration interactions and team creativity, respectively. The empirical data confirms the validity of our proposed moderated mediation models of team creativity. Therefore, this study's validated moderated mediation model could provide guidance for nursing educators to improve collaboration interaction outcomes and creativity on nursing student teams.

Keywords: team swift trust, team conflict, team interaction behavior, moderated mediating effects, interdisciplinary education, nursing students

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Authors: Nicole Harley, Mahmoud Eid, Abdurahman Tarmal, Vishal Dey

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Histological sampling plays an integral role in the diagnostic process of renal diseases. Percutaneous native renal biopsy is typically performed under ultrasound guidance, with this service usually being provided by nephrologists. In some centers, there is a role for radiologists in performing renal biopsies. Previous comparative studies have demonstrated non-inferiority between outcomes of percutaneous native renal biopsies performed by nephrologists compared with radiologists. We sought to compare biopsy adequacy between nephrologists and radiologists in University Hospital Crosshouse. The online system SERPR (Scottish Electronic Renal Patient Record) contains information pertaining to patients who have undergone renal biopsies. An online search was performed to acquire a list of all patients who underwent renal biopsy between 2013 and 2020 in University Hospital Crosshouse. 355 native renal biopsies were performed in total across this 7-year period. A retrospective analysis was performed on these cases, with records and reports being assessed for: the total number of glomeruli obtained per biopsy, whether the number of glomeruli obtained was adequate for diagnosis, as per an internationally agreed standard, and whether a histological diagnosis was achieved. Nephrologists performed 43.9% of native renal biopsies (n=156) and radiologists performed 56.1% (n=199). The mean number of glomeruli obtained by nephrologists was 17.16+/-10.31. The mean number of glomeruli obtained by radiologists was 18.38+/-10.55. T-test demonstrated no statistically significant difference between specialties comparatively (p-value 0.277). Native renal biopsies are required to obtain at least 8 glomeruli to be diagnostic as per internationally agreed criteria. Nephrologists met these criteria in 88.5% of native renal biopsies (n=138) and radiologists met this criteria in 89.5% (n=178). T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.663 and 0.922, respectively). Biopsies performed by nephrologists yielded tissue that was diagnostic in 91.0% (n=142) of sampling. Biopsies performed by radiologists yielded tissue that was diagnostic in 92.4% (n=184) of sampling. T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.625 and 0.889, respectively). This project demonstrates that at University Hospital Crosshouse, there is no statistical difference between radiologists and nephrologists in terms of glomeruli acquisition or samples achieving a histological diagnosis. Given the non-inferiority between specialties demonstrated by previous studies and this project, this evidence could support the restructuring of services to allow more renal biopsies to be performed by renal services and allow reallocation of radiology department resources.

Keywords: biopsy, medical imaging, nephrology, radiology

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Authors: Neil Bar, Andrew Heweston

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Probability of failure (PF) often appears alongside factor of safety (FS) in design acceptance criteria for rock slope, underground excavation and open pit mine designs. However, the design acceptance criteria generally provide no guidance relating to how PF should be calculated for homogeneous and heterogeneous rock masses, or what qualifies a ‘reasonable’ PF assessment for a given slope design. Observational and kinematic methods were widely used in the 1990s until advances in computing permitted the routine use of numerical modelling. In the 2000s and early 2010s, PF in numerical models was generally calculated using the point estimate method. More recently, some limit equilibrium analysis software offer statistical parameter inputs along with Monte-Carlo or Latin-Hypercube sampling methods to automatically calculate PF. Factors including rock type and density, weathering and alteration, intact rock strength, rock mass quality and shear strength, the location and orientation of geologic structure, shear strength of geologic structure and groundwater pore pressure influence the stability of rock slopes. Significant engineering and geological judgment, interpretation and data interpolation is usually applied in determining these factors and amalgamating them into a geotechnical model which can then be analysed. Most factors are estimated ‘approximately’ or with allowances for some variability rather than ‘exactly’. When it comes to numerical modelling, some of these factors are then treated deterministically (i.e. as exact values), while others have probabilistic inputs based on the user’s discretion and understanding of the problem being analysed. This paper discusses the importance of understanding the key aspects of slope design for homogeneous and heterogeneous rock masses and how they can be translated into reasonable PF assessments where the data permits. A case study from a large open pit gold mine in a complex geological setting in Western Australia is presented to illustrate how PF can be calculated using different methods and obtain markedly different results. Ultimately sound engineering judgement and logic is often required to decipher the true meaning and significance (if any) of some PF results.

Keywords: probability of failure, point estimate method, Monte-Carlo simulations, sensitivity analysis, slope stability

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Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

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Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

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Authors: Lynnette Lyzwinski, Liam Caffery, Matthew Bambling, Sisira Edirippulige

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Introduction: A novel method of delivering mindfulness interventions for populations at risk of weight gain and stress-related eating, in particular, college students, is through mHealth. While there have been qualitative studies on mHealth for weight loss, there has not been a study on mHealth for weight loss using mindfulness that has explored student perspectives on a student centred mindfulness app and mindfulness-based text messages for eating and stress. Student perspective data will provide valuable information for creating a specific purpose weight management app and mindfulness-based text messages (for the Mindfulness App study). Methods: A qualitative focus group study was undertaken at St Lucia campus at the University of Queensland in March 2017. Students over the age of 18 were eligible to participate. Interviews were audiotaped and transcribed. One week following the focus group, students were sent sample mindfulness-based text messages based on their responses. Students provided written feedback via email. Data were analysed using N Vivo software. Results: The key themes in a future mindfulness-based app are a simple design interface, a focus on education/practical tips, and real-life practical exercises. Social media should be avoided. Key themes surrounding barriers include the perceived difficulty of mindfulness and a lack of proper guidance or knowledge. The mindfulness-based text messages were received positively. Key themes were creating messages with practical tips about how to be mindful and how to integrate mindful reflection of both one’s body and environment while on campus. Other themes including creating positive, inspirational messages. There was lack of agreement on the ideal timing for messages. Discussion: This is the first study that explored student perspectives on a mindfulness-app and mindfulness-based text messages for stress and weight management as a pre-trial study for the Mindfulness App trial for stress, lifestyle, and weight in students. It is important to consider maximizing the potential facilitators of use and minimize potential identified barriers when developing and designing a future mHealth mindfulness-based intervention tailored to the student consumer. Conclusion: Future mHealth studies may consider integrating mindfulness-based text messages in their interventions for weight and stress as this is a novel feature that appears to be acceptable for participants. The results of this focus group provide the basis to develop content for a specific purpose student app for weight management.

Keywords: mindfulness, college students, mHealth, weight loss

Procedia PDF Downloads 198

Authors: Kieren Wilson, Gulnaz Majeed

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NHS constitution gives rights to the patient with suspected cancer to be seen by a cancer specialist within 2 weeks of referral. Guys and St Thomas Hospital (GSTT) is one of the largest cancer centres in London. NICE guidelines have provided guidance for health professionals to refer patients appropriately to RAC. In GSTT suspected gynae cancer referrals are mostly by NHS e-Referral Service with some fax, emails as well as paper referrals. The objective of this study was to evaluate compliance with 2-week referral pathway with emphasis on one stop diagnostic service with supporting efficient pathways. A prospective evaluation over 3 months (1 Jan 2017 to 31 Mar 2017) was undertaken. There were 26 clinics, 761 patients were booked in the clinics with a DNA rate of 13% (n=101) hence 606 patients were seen. Majority of referrals were for post menopausal bleeding (PMB) 25% (n=194) followed by cervical, vaginal, vulval reasons 23% (n=179) (abnormal cytology excluded as patients directly referred to colposcopy unit in GSTT), ovarian 7% (n=54) and endometrial 5% (n=41). Women with new or previous established diagnosis of cancer were 24, cervical (n=17), vulva (n=6) and vagina (n=1). Multifocal preinvasive disease vulva (VIN), vagina (VAIN) and cervix (CIN) was confirmed in twenty-six patients 4% (high prevalence in HIV patients). Majority of cervical referrals: PCB (n=14), cervical erosion (n=7), polyps (n=9) and cervical cyst were benign. However, two women with PMB had cervical cancer. Only 2 out of 13 referrals with vaginal concerns had VAIN. One case with non-cervical glandular cytology was confirmed to have endometrial cancer. One stop service based on the diagnostic support of ultrasound, colposcopy and hysteroscopy was achieved in 54% (n=359). Patients were discharged to GP, benign gynaecology, endometriosis, combined vulval/dermatology clinic or gynae oncology. 33% (n=202) required a second visit, 12% (n=70) third visit, 3% (n=19) fourth visit, 1% (n=4) fifth visit and 1% (n=6) sixth visit. Main reasons for follow ups were the unavailability of diagnostic slots, patient choice, need for interpreters, the discussion following gynae MDM review for triage to benign gynae, delay in availability of diagnostic results like histology/MRI/CT. Recommendations following this study are multi disciplinary review of pathways with the availability of additional diagnostic procedure slots to aim for one stop service. Furthermore, establishment of virtual and telephone consultations to reduce follow ups.

Keywords: multifocal disease, post menopausal bleeding, preinvasive disease, rapid access clinic

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Authors: Binay Pattanayak

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Multilingual state, Jharkhand is home to more than 19 tribal and regional languages. These are used by more than 33 communities in the state. The state has declared 12 of these languages as official languages of the state. However, schools in the state do not recognize any of these community languages even in early grades! Children, who speak in their mother tongues at home, local market and playground, find it very difficult to understand their teacher and textbooks in school. They fail to acquire basic literacy and numeracy skills in early grades. Out of frustration due to lack of comprehension, the majority of children leave school. Jharkhand sees the highest dropout in early grades in India. To address this, the state under the guidance of the author designed a mother tongue based pre-school education programme named Bhasha Puliya and bilingual picture dictionaries in 9 tribal and regional mother tongues of children. This contributed significantly to children’s school readiness in the school. Followed by this, the state designed a mother-tongue based multilingual education programme (MTB-MLE) for multilingual context. The author guided textbook development in 5 tribal (Santhali, Mundari, Ho, Kurukh and Kharia) and two regional (Odia and Bangla) languages. Teachers and community members were trained for MTB-MLE in around 1,000 schools of the concerned language pockets. Community resource groups were constituted along with their academic calendars in each school to promote story-telling, singing, painting, dancing, riddles, etc. with community support. This, on the one hand, created rich learning environments for children. On the other hand, the communities have discovered a great potential in the process of developing a wide variety of learning materials for children in own mother-tongue using their local stories, songs, riddles, paintings, idioms, skits, etc. as a process of their literary, cultural and technical enrichment. The majority of children are acquiring strong early grade reading skills (basic literacy and numeracy) in grades I-II thereby getting well prepared for higher studies. In a phased manner they are learning Hindi and English after 4-5 years of MTB-MLE using the foundational language learning skills. Community members have started designing new books, audio-visual learning materials in their mother-tongues seeing a great potential for their cultural and technological rejuvenation.

Keywords: community resource groups, MTB-MLE, multilingual, socio-linguistic survey, learning

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Authors: Li-Jia Chiu

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The purpose of this study is to integrate the content of professional ethics curriculum into life education. This course is a required course for the third-year students of the university. The curriculum is based on professional ethics, which can help students gain insights into a conceptual understanding of professional theory, learning the meaning and the value of life. This study enhances students' attitude toward learning through multi-teaching methods. It takes ‘professionalism’ as the subject of discussion. Additionally, the course combines the connotation and issues of the student's career development. Using the world cafe discussion method, students can think about the role of the future career, and inspire students to integrate their career development and life value reflection and connection. This study recruited the third-year undergraduate students as samples to collect data. This study was conducted in the course of the fall semester in 2016 for thematic discussions, classroom observations, course study forms, coursework, and results in publication reports, etc. The researcher conducted induction data analysis to reflect the practice and reflection of the course. The subjects included 117 students from two classes, including 54 male and 63 female students. The findings of this study comprised the following two parts: the student’s learning and teacher’s teaching reflection. The students’ gains were that: 1) The curriculum design is different from that of other subjects; 2) The curriculum is highly interactive with teachers and classmates; 3) These students are willing to actively participate and share ideas in group discussions; 4 ) They thought the possibility of further discussions with other groups of students through table-to-table discussions; 5) They experienced the respect from other students in the learning process and their appreciation of other students in the same group. The instruction reflections were as follows: 1) Students learned to get link to the value of life and future development through topical discussions; 2) After the main course design guided through gradual guidance, the students’ psychology reached a certain degree of cognition, and further themes then added would cause more sensuous learning effects; 3) Combining students’ expertise in drawing in this department (digital media design department) into curriculum design is effective in stimulating learning motivation and sense of accomplishment; 4) In order to compare and explore learning benefits, future researches are recommended to conduct the similar studies with different departments. Finally, the researcher looks forward to providing research results and findings to the related curriculum teachers as a reference for practical curriculum planning and teaching methods.

Keywords: life education, World Cafe, professional ethics, professionalism

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Authors: Per Blomqvist

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The overall aim of this study is to highlight how the degree project-course in teacher education has developed over time at Swedish universities, above all regarding changes in the formative assessment practices in relation to student's opportunities to take part in writing processes that can develop both their independent critical thinking, subject knowledge, and academic writing skills. Theoretically, the study is based on deliberative and transformative perspectives of teaching academic writing in higher education. The deliberative perspective is motivated by the fact that it is the universities and their departments' responsibility to give the students opportunities to develop their academic writing skills, while there is little guidance on how this can be implemented. The transformative perspective is motivated by the fact that education needs to be adapted to the student's prior knowledge and developed in relation to the student group. Given the academisation of education and the new student groups, this is a necessity. The empirical data consists of video recordings of teacher groups' conversations at three Swedish universities. The conversations were conducted as so-called collective remembering interviews, a method to stimulate the participants' memory through social interaction, and focused on addressing issues on how the degree project-course in teacher education has changed over time. Topic analysis was used to analyze the conversations in order to identify common descriptions and expressions among the teachers. The result highlights great similarities in how the degree project-course has changed over time, both from a deliberative and a transformative perspective. The course is characterized by a “strong framing,” where the teachers have great control over the work through detailed instructions for the writing process and detailed templates for the text. This is justified by the fact that the education has been adapted based on the student teachers' lack of prior subject knowledge. The strong framing places high demands on continuous discussions between teachers about, for example, which tools the students have with them and which linguistic and textual tools are offered in the education. The teachers describe that such governance often leads to conflicts between teachers from different departments because reading and writing are always part of cultural contexts and are linked to different knowledge, traditions, and values. The problem that is made visible in this study raises questions about how students' opportunities to develop independence and make critical judgments in academic writing are affected if the writing becomes too controlled and if passing students becomes the main goal of education.

Keywords: formative assessment, academic writing, degree project, higher education, deliberative perspective, transformative perspective

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Authors: Binay Pattanayak

Abstract:

More than 9 out of every 10 children in Jharkhand struggle to understand the texts and teachers in public schools. The medium of learning in the schools is Hindi, which is very different in structure and vocabulary than those in children’s home languages. Hence around 3 out of 10 children enrolled in early grades drop out in these schools. The state realized the cause of children’s high dropout in 2013-14 when the M-TALL, the language research shared the findings of a state-wide socio-linguistic study. The study findings suggested that there was a great need for initiating a mother-tongue based multilingual education (MTB-MLE) programme for the state in early grades starting from pre-school level. Accordingly, M-TALL in partnership with department of education designed two learning packages: Bhasha Puliya pre-school education programme for 3-6-year-old children for their school readiness with bilingual picture dictionaries in 9 tribal and regional languages. This was followed by a plan for MTB-MLE programme for early primary grades. For this textbooks in five tribal and two regional languages were developed under the guidance of the author. These books were printed and circulated in the 1000 schools of the state for each child. Teachers and community members were trained for facilitating culturally sensitive mother-tongue based learning activities in and around the schools. The mother-tongue based approach of learning has worked very effectively in enabling them to acquire the basic literacy and numeracy skills in own mother-tongues. Using this basic early grade reading skills, these children are able to learn Hindi and English systematically. Community resource groups were constituted in each school for promoting storytelling, singing, painting, dancing, acting, riddles, humor, sanitation, health, nutrition, protection, etc. and were trained. School academic calendar was designed in each school to enable the community resource persons to visit the school as per the learning plan to assist children and teacher in facilitating rich cultural activities in mother-tongue. This enables children to take part in plethora of learning activities and acquire desired knowledge, skills and interest in mother-tongues. Also in this process, it is attempted to promote 21st Century learning skills by enabling children to apply their new knowledge and skills to look at their local issues and address those in a collective manner through team work, innovations and leadership.

Keywords: community resource groups, learning, MTB-MLE, multilingual, socio-linguistic survey

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