Search results for: literature review in ATMs

Authors: Ronelle Prinsloo

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In South Africa, married retirement fund members can manipulate the legal framework to prevent their spouses from accessing shared retirement benefits during divorce proceedings. The current legal structure allows retirement fund members to accelerate the accrual of their benefits, often by resigning or purchasing living annuities before the finalization of a divorce. This action effectively places these benefits beyond the reach of their spouses, leading to substantial financial prejudice, particularly for financially weaker spouses, typically women. The research highlights that South African courts, including the Supreme Court of Appeal (SCA), have not adequately scrutinized the implications of these actions. Specifically, the SCA has ruled that the capital and proceeds from living annuities are not subject to division during divorce, which undermines the financial rights of non-member spouses. The court's failure to consider the source of the money used to purchase these annuities and its potential inclusion in the joint estate or accrual system is a significant concern. The South African Law Reform Commission has recognized this issue, noting the negative impact on financially weaker spouses. The article critiques the lack of legislative response to this problem despite its significant implications for the equitable distribution of marital assets. The current legal framework, particularly the definition of "pension interest" and the provisions under sections 7(7) and 7(8) of the Divorce Act, is inadequate in addressing the complexities surrounding the sharing of retirement benefits in divorce cases. The article argues for a comprehensive review and reform of the law to ensure that retirement benefits are treated as patrimonial assets, subject to division upon the occurrence of any trigger event, such as resignation, retirement, or retrenchment. The need for such reform is urgent to prevent economically disadvantaged spouses from being unjustly deprived of their fair share of retirement benefits. In conclusion, the article advocates for legislative amendments to the Divorce Act, specifically section 7(7), to clarify that pension interests automatically form part of the joint estate, regardless of whether divorce proceedings are underway. This change would safeguard the financial rights of non-member spouses and ensure a more equitable distribution of retirement benefits during divorce. Failure to address this issue perpetuates economic inequality and leaves financially weaker spouses vulnerable during divorce proceedings.

Keywords: Constitution of South Africa, non-member spouse, retirement benefits, spouse

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Authors: Farhat Imtiaz, Umar Farooq

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In this work, we developed a computational model to predict ply level failure in impacted composite laminates. Data obtained from physical testing from flat and round nose impacts of 8-, 16-, 24-ply laminates were considered. Routine inspections of the tested laminates were carried out to approximate ply by ply inflicted damage incurred. Plots consisting of load–time, load–deflection, and energy–time history were drawn to approximate the inflicted damages. Impact test generated unwanted data logged due to restrictions on testing and logging systems were also filtered. Conventional filters (built-in, statistical, and numerical) reliably predicted load thresholds for relatively thin laminates such as eight and sixteen ply panels. However, for relatively thick laminates such as twenty-four ply laminates impacted by flat nose impact generated clipped data which can just be de-noised using oscillatory algorithms. The literature search reveals that modern oscillatory data filtering and extrapolation algorithms have scarcely been utilized. This investigation reports applications of filtering and extrapolation of the clipped data utilising fast Fourier Convolution algorithm to predict load thresholds. Some of the results were related to the impact-induced damage areas identified with Ultrasonic C-scans and found to be in acceptable agreement. Based on consistent findings, utilizing of modern data filtering and extrapolation algorithms to data logged by the existing machines has efficiently enhanced data interpretations without resorting to extra resources. The algorithms could be useful for impact-induced damage approximations of similar cases.

Keywords: fibre reinforced laminates, fast Fourier algorithms, mechanical testing, data filtering and extrapolation

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Authors: Laura M. Espinoza, Karen A. Hernández, Diana B. Ledezma

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Currently, in Chile, migratory movements are generated, where the country receives constantly people from Latin America such as Colombia, Peru, Venezuela, Haiti, among others. This phenomenon has reached the schools of Chile, where immigrant children and adolescents are educated in a context of cultural diversity. However, education professionals face this recent phenomenon without prior preparation to carry out their pedagogical practices in the classroom. On the other hand, research on how to understand and guide the processes of cultural diversity especially within the school is even scarce and recent in Latin America and specifically in Chile. The general purpose of the study is to analyze the relationships between teaching efforts towards multiculturalism and inclusive pedagogical practices in the schools of the city of La Serena and Coquimbo, in Chile. The study refers to a quantitative approach, with a correlational design. The selection of the participants was not intentional probabilistic. It comprises 88 teachers of preschool, primary, secondary and special education, who work in two schools with similar characteristics. For the collection of information on the independent variable, the attitude scale towards Immigration and the attitude scale towards Multiculturalism in the school are applied. To obtain information on the independent variable, the guide for the evaluation of inclusive practices in the classroom is applied. Both instruments have statistical validation. A Spearman correlation analysis was made to achieve the objective of the study. Among the main findings, we will find the relationships between the positive perceptions of multiculturalism at school and inclusive practices such as the physical conditions of the classroom, planning, methodology, use of time and evaluation. These findings are relevant to the teaching and learning processes of students in Chilean classrooms and contribute to literature for the understanding of educational processes in contexts of cultural diversity.

Keywords: cultural diversity, immigration, inclusive pedagogical practices, multiculturalism

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Authors: Harini Aiyer, Kalyani Premkumar

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Health professionals are the key players who can help achieve the goals of population health equity. Social accountability (SA) of health professionals emphasizes their role in addressing issues of equity in the population they serve. Therefore, health professional education must focus on instilling SA in health professionals. There is limited literature offering a longitudinal perspective of how students sustain the practice of SA in later life. This project aims to identify the drivers of social accountability among physicians. This study employed an exploratory mixed methods design (QUAL-> Quant) to explore alumni perceptions and experiences. The qualitative data, collected via 20 in-depth, semi-structured interviews, provided an understanding of the perceptions of the alumni regarding the influence of their undergraduate learning environment on their SA. This was followed by a quantitative portion -a questionnaire designed from the themes identified from the qualitative data. Emerging themes from the study highlighted community-centered education and a focus on social and preventative medicine in both curricular and non-curricular facilitators of SA among physicians. Curricular components included opportunities to engage with the community, such as roadside clinics, community-orientation programs, and postings at a secondary hospital. Other facilitators that emerged were the faculty leading by example, a subsidized fee structure, and a system that prepared students for practice in rural and remote areas. The study offers a fresh perspective and dimension on how SA is addressed by medical schools. The findings may be adapted by medical schools to understand how their own SA initiatives have been sustained among physicians over the long run.

Keywords: community-based work, global health, health education, medical education, providing health in remote areas, social accountability

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Authors: Abhilash Sahu, Amit Priyadarshi

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In this paper, we will discuss the existence of weak solutions of the Kirchhoff type boundary value problem on the Sierpinski gasket. Where S denotes the Sierpinski gasket in R² and S₀ is the intrinsic boundary of the Sierpinski gasket. M: R → R is a positive function and h: S × R → R is a suitable function which is a part of our main equation. ∆p denotes the p-Laplacian, where p > 1. First of all, we will define a weak solution for our problem and then we will show the existence of at least two solutions for the above problem under suitable conditions. There is no well-known concept of a generalized derivative of a function on a fractal domain. Recently, the notion of differential operators such as the Laplacian and the p-Laplacian on fractal domains has been defined. We recall the result first then we will address the above problem. In view of literature, Laplacian and p-Laplacian equations are studied extensively on regular domains (open connected domains) in contrast to fractal domains. In fractal domains, people have studied Laplacian equations more than p-Laplacian probably because in that case, the corresponding function space is reflexive and many minimax theorems which work for regular domains is applicable there which is not the case for the p-Laplacian. This motivates us to study equations involving p-Laplacian on the Sierpinski gasket. Problems on fractal domains lead to nonlinear models such as reaction-diffusion equations on fractals, problems on elastic fractal media and fluid flow through fractal regions etc. We have studied the above p-Laplacian equations on the Sierpinski gasket using fibering map technique on the Nehari manifold. Many authors have studied the Laplacian and p-Laplacian equations on regular domains using this Nehari manifold technique. In general Euler functional associated with such a problem is Frechet or Gateaux differentiable. So, a critical point becomes a solution to the problem. Also, the function space they consider is reflexive and hence we can extract a weakly convergent subsequence from a bounded sequence. But in our case neither the Euler functional is differentiable nor the function space is known to be reflexive. Overcoming these issues we are still able to prove the existence of at least two solutions of the given equation.

Keywords: Euler functional, p-Laplacian, p-energy, Sierpinski gasket, weak solution

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Authors: Tomasz Kosicki

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The subject of the presentation will be the administrative and legal instruments of disciplining maintenance debtors adopted by the Polish legislator, the substantive legal bases of which were adopted in the Act of 7 September 2007 on assistance to persons entitled to maintenance (Journal of Laws of 2022, item 1205). These provisions are complemented by procedural regulations resulting from the Act of 14 June 1960 - Code of Administrative Procedure (Journal of Laws of 2021, item 735, as amended). The first part of the paper will focus on the administrative proceedings regarding the recognition of the debtor as evading maintenance obligations. The initiation of this procedure ex officio is preceded by a number of actions by public administration bodies, including Conducting a maintenance interview with the debtor, during which his health and professional situation and the reasons for non-payment of maintenance are determined, Professional activation in a situation where the lack of payment of maintenance results from the lack of employment. The reasons for initiating the above-mentioned administrative proceedings ex officio will be indicated, taking into account the current views of the judicial decisions. The second part of the paper will focus on the instrument of retaining the driving license of the debtor, who was previously found to be evading maintenance. The author points out that the detention of the driving license is one of the types of administrative sanctions of a very severe nature. Doubts of a constitutional nature will also be highlighted, as well as those concerning the effectiveness of this legal instrument and the protection of the debtor's rights. The thesis will be presented that the administrative procedure for the retention of a driving license does not fulfill its role and especially does not affect the collection of maintenance obligations from debtors. All the considerations will be based on the current and most representative views of the literature on the subject and the jurisprudence of Polish administrative courts.

Keywords: maintenance debtor, administrative proceedings, detention of driving license, administrative sanction, polish administrative law, public administration

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Authors: Hsin Hua He

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The purpose of this study is to strengthen the social cohesion of the local community by injecting the cultural and creative concept into the industrial heritage transformation. The paradigms of industrial heritage research tend to explore from the perspective of space analysis, which concerned less about the cultural regeneration and the development of local culture. The paradigms of cultural quarter research use to from the perspective of creative economy and urban planning, concerned less about the social impacts and the interaction between residents and industrial sites. This research combines these two research areas of industrial heritage and cultural quarter, and focus on the social and cultural aspects. The transformation from the industrial heritage into a cultural park not only enhances the cultural capital and the quality of residents’ lives, but also preserves the unique local values. Internally it shapes the local identity, while externally establishes the image of the city. This paper uses Westergasfabriek Cultural Park in Amsterdam as the case study, through literature analysis, field work, and depth interview to explore how the cultural regeneration transforms industrial heritage. In terms of the planners’ and residents’ point of view adopt the theory of community participation, social capital, and sense of place to analyze the social impact of the industrial heritage transformation. The research finding is through cultural regeneration policies like holding cultural activities, building up public space, social network and public-private partnership, and adopting adaptive reuse to fulfil the people’s need and desire and reach the social cohesion. Finally, the study will examine the transformation of Taiwan's industrial heritage into cultural and creative quarters. The results are expected to use the operating experience of the Amsterdam cases and provide directions for Taiwan’s industrial heritage management to meet the cultural, social, economic symbiosis.

Keywords: cultural regeneration, community participation, social capital, sense of place, industrial heritage transformation

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Authors: Balakrishna Shetty

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Introduction: Stem Cell Imaging is a challenging field since the advent of Stem Cell treatment in humans. Series of research on tagging and tracking the stem cells has not been very effective. The present study is an effort by the authors to track the stem cells injected into calf muscles by Magnetic Resonance Diffusion Weighted Imaging. Materials and methods: Stem Cell injection deep into the calf muscles of patients with peripheral vascular disease is one of the recent treatment modalities followed in our institution. 5 patients who underwent deep intramuscular injection of stem cells as treatment were included for this study. Pre and two hours Post injection MRI of bilateral calf regions was done using 1.5 T Philips Achieva, 16 channel system using 16 channel torso coils. Axial STIR, Axial Diffusion weighted images with b=0 and b=1000 values with back ground suppression (DWIBS sequence of Philips MR Imaging Systems) were obtained at 5 mm interval covering the entire calf. The invert images were obtained for better visualization. 120ml of autologous bone marrow derived stem cells were processed and enriched under c-GMP conditions and reduced to 40ml solution containing mixture of above stem cells. Approximately 40 to 50 injections, each containing 0.75ml of processed stem cells, was injected with marked grids over the calf region. Around 40 injections, each of 1ml normal saline, is injected into contralateral leg as control. Results: Significant Diffusion hyper intensity is noted at the site of injected stem cells. No hyper intensity noted before the injection and also in the control side where saline was injected conclusion: This is one of the earliest studies in literature showing diffusion hyper intensity in intramuscularly injected stem cells. The advantages and deficiencies in this study will be discussed during the presentation.

Keywords: stem cells, imaging, DWI, peripheral vascular disease

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Authors: Robin C. Ladwig

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Diversity Management, as a substantial element of Human Resource Management, aims to secure the economic benefit that assumingly comes with a diverse workforce. Consequently, diversity managers focus on the protection of employees and securing equality measurements to assure organisational gender diversity. Gender diversity as one aspect of Diversity Management seems to adhere to gender binarism and cis-normativity. Workplaces are gendered spaces which are echoing the binary gender-normativity presented in Diversity Management, sold under the label of gender diversity. While the expectation of Diversity Management implies the inclusion of a multiplicity of marginalised groups, such as trans and gender diverse people, in current literature and practice, the reality is curated by gender binarism and cis-normativity. The qualitative multi-method research showed a lack of knowledge about trans and gender diverse matters within the profession of Diversity Management and Human Resources. The semi-structured interviews with trans and gender diverse individuals from various backgrounds and occupations in Australia exposed missing considerations of trans and gender diverse experiences in the inclusivity and gender equity of various workplaces. Even if practitioners consider trans and gender diverse matters under gender diversity, the practical execution is limited to gender binary structures and cis-normative actions as the photo-elicit questionnaire with diversity managers, human resource officers, and personnel management demonstrates. Diversity Management should approach a broader source of informed practice by extending their business focus to the knowledge of humanity studies. Humanity studies could include diversity, queer, or gender studies to increase the inclusivity of marginalised groups such as trans and gender diverse employees and people. Furthermore, the definition of gender diversity should be extended beyond the gender binary and cis-normative experience. People may lose trust in Diversity Management as a supportive ally of marginalised employees if the understanding of inclusivity is limited to a gender binary and cis-normativity value system that misrepresents the richness of gender diversity.

Keywords: cis-normativity, diversity management, gender binarism, trans and gender diversity

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Authors: Ameer A. Jebur, William Atherton, Rafid M. Alkhaddar, Edward Loffill

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Superstructures like offshore platforms, tall buildings, transition towers, skyscrapers and bridges are normally designed to resist compression, uplift and lateral forces from wind waves, negative skin friction, ship impact and other applied loads. Better understanding and the precise simulation of the response of batter piles under the action of independent uplift loads is a vital topic and an area of active research in the field of geotechnical engineering. This paper investigates the use of finite element code (FEC) to examine the behaviour of model batter piles penetrated in dense sand, subjected to pull-out pressure by means of numerical modelling. The concept of the Winkler Model (beam on elastic foundation) has been used in which the interaction between the pile embedded depth and adjacent soil in the bearing zone is simulated by nonlinear p-y curves. The analysis was conducted on different pile slenderness ratios (lc⁄d) ranging from 7.5, 15.22 and 30 respectively. In addition, the optimum batter angle for a model steel pile penetrated in dense sand has been chosen to be 20° as this is the best angle for this simulation as demonstrated by other researcher published in literature. In this numerical analysis, the soil response is idealized as elasto-plastic and the model piles are described as elastic materials for the purpose of simulation. The results revealed that the applied loads affect the pullout pile capacity as well as the lateral pile response for dense sand together with varying shear strength parameters linked to the pile critical depth. Furthermore, the pile pull-out capacity increases with increasing the pile aspect ratios.

Keywords: slenderness ratio, soil-pile interaction, winkler model (beam on elastic foundation), pull-out capacity

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Authors: Raju K. Thadikkaran

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Introduction: The IPR have come to the centre stage of development discourse today for a variety of reasons: It ranges from the arbitrariness in the enforcement, overlapping and mismatch with various international agreements and conventions, divergence in the definition, nature and content and the duration as well as severe adverse consequences to technologically weak developing countries. In turn, the IPR have acquired prominence in the foreign policy making as well as in the relations among nations. Quite naturally, there is ample scope for an examination of the correlation between Technology, IPR and International Relations in the contemporary world. Nature and Scope: A cursory examination of the realm of IPR and its protection shall reveals the acute divergence that exists in the perspectives, on all matters related to the very definition, nature, content, scope and duration. The proponents of stronger protection, mostly technologically advanced countries, insist on a stringent IP Regime whereas technologically weak developing countries seem to advocate for flexibilities. From the perspective of developing countries like India, one of the most crucial concerns is related to the patenting of life forms and the protection of TK and BD. There have been several instances of Bio-piracy and Bio-prospecting of the resources related to BD and TK from the Bio-rich Global South. It is widely argued that many provisions in the TRIPS are capable of offsetting the welcome provisions in the CBD such as the Access and Benefit Sharing and Prior Informed Consent. The point that is being argued out is as to how the mismatch between the provisions in the TRIPS Agreement and the CBD could be addressed in a healthy manner so that the essential minimum legitimate interests of all stakeholders could be secured thereby introducing a new direction to the international relations. The findings of this study reveal that the challenges roused by the TRIPS Regime over-weigh the opportunities. The mismatch in the provisions in this regard has generated various crucial issues such as Bio-piracy and Bio-prospecting. However, there is ample scope for managing and protecting IP through institutional innovation, legislative, executive and administrative initiative at the global, national and regional levels. The Indian experience is quite reflective of the same and efforts are being made through the new national IPR policy. This paper, employing Historical Analytical Method, has Three Sections. The First Section shall trace the correlation between the Technology, IPR and international relations. The Second Section shall review the issues and potential concerns in the protection and management of IP related to the BD and TK in the developing countries in the wake of the TRIPS and the CBD. The Final Section shall analyze the Indian Experience in this regard and the experience of the bio-rich Kerala in particular.

Keywords: IPR, technology and international relations, bio-diversity, traditional knowledge

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Authors: S. Sadhu, M. Ramgopal, S. Bhattacharyya

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Natural circulation loops (NCLs) are buoyancy driven flow systems without any moving components. NCLs have vast applications in geothermal, solar and nuclear power industry where reliability and safety are of foremost concern. Due to certain favorable thermophysical properties, especially near supercritical regions, carbon dioxide can be considered as an ideal loop fluid in many applications. In the present work, a high temperature NCL that uses supercritical carbon dioxide as loop fluid is analysed. The effects of relevant design and operating variables on loop performance are studied. The system operating under steady state is modelled taking into account the axial conduction through loop fluid and loop wall, and heat transfer with surroundings. The heat source is considered to be a heater with controlled heat flux and heat sink is modelled as an end heat exchanger with water as the external cold fluid. The governing equations for mass, momentum and energy conservation are normalized and are solved numerically using finite volume method. Results are obtained for a loop pressure of 90 bar with the power input varying from 0.5 kW to 6.0 kW. The numerical results are validated against the experimental results reported in the literature in terms of the modified Grashof number (Gr_m) and Reynolds number (Re). Based on the results, buoyancy and friction dominated regions are identified for a given loop. Parametric analysis has been done to show the effect of loop diameter, loop height, ambient temperature and insulation. The results show that for the high temperature loop, heat loss to surroundings affects the loop performance significantly. Hence this conjugate heat transfer between the loop and surroundings has to be considered in the analysis of high temperature NCLs.

Keywords: conjugate heat transfer, heat loss, natural circulation loop, supercritical carbon dioxide

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Authors: E. J. Cilliers, Z. Goosen

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The impact that urban green spaces have on sustainability and quality of life is phenomenal. This is also true for the local South African environment. However, in reality green spaces in urban environments are decreasing due to growing populations, increasing urbanization and development pressure. This further impacts on the provision of child-friendly spaces, a concept that is already limited in local context. Child-friendly spaces are described as environments in which people (children) feel intimately connected to, influencing the physical, social, emotional, and ecological health of individuals and communities. The benefits of providing such spaces for the youth are well documented in literature. This research therefore aimed to investigate the concept of child-friendly spaces and its applicability to the South African planning context, in order to guide the planning of such spaces for future communities and use. Child-friendly spaces in the urban environment of the city of Durban, was used as local case study, along with two international case studies namely Mullerpier public playground in Rotterdam, the Netherlands, and Kadidjiny Park in Melville, Australia. The aim was to determine how these spaces were planned and developed and to identify tools that were used to accomplish the goal of providing successful child-friendly green spaces within urban areas. The need and significance of planning for such spaces was portrayed within the international case studies. It is confirmed that minimal provision is made for green space planning within the South African context, when there is reflected on the international examples. As a result international examples and disciples of providing child-friendly green spaces should direct planning guidelines within local context. The research concluded that child-friendly green spaces have a positive impact on the urban environment and assist in a child’s development and interaction with the natural environment. Regrettably, the planning of these child-friendly spaces is not given priority within current spatial plans, despite the proven benefits of such.

Keywords: built environment, child-friendly spaces, green spaces, public places, urban area

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Authors: Bouhouf Atef, Beloulou Mohamed Lamine

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Introduction: Outpatient surgery is continually developing compared to conventional inpatient surgery; its rate is constantly increasing every year due to global socio-economic pressure. Most hospitals continue to perform proctologic surgery in conventional hospitalization. Purpose: As part of a monocentric prospective descriptive study, we examined the feasibility of proctologic surgery under saddle block on an outpatient basis with the same safety conditions as in traditional hospitalization. Material and methods: This is a monocentric prospective descriptive study spread over a period of 24 months, from December 2018 to December 2020 including 150 patients meeting the medico-surgical and socio-environmental criteria of eligibility for outpatient surgery, operated for proctological pathologies under saddle block in outpatient mode, in the surgery department of the regional military hospital of Constantine Algeria. The data were collected and analyzed by the biomedical statistics software Epi-info and Microsoft Excel, then compared with other related studies. Results: This study involved over a period of two years, 150 male patients with an average age of 32 years (20-64). Most patients (95,33%) were ASA I class, and 4,67% ASA II class. All patients received saddle blocks. The average length of stay of patients was six hours. The quality indicators in outpatient surgery in our study were: zero (0)% of deprogrammings, three (3)% of conversions to full hospitalization, 0,7% of readmissions, an average waiting time before access to the operating room of 83 minutes without delay of discharge, a satisfaction rate of 90,8% and a reduction in the cost compared to conventional inpatient surgery in proportions ranging from – 32,6% and – 48,75%. Conclusions: The outpatient management of proctological surgery under saddle block is very beneficial in terms of safety, efficiency, simplicity, and economy. Our results are in line with those of the literature and our work deserves to be continued to include many patients.

Keywords: outpatient surgery, proctological surgery, saddle block, satisfaction, cost

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Authors: Rohit Kothari, Muneer Mohamed, Vivekanandh K., Sunmeet Sandhu, Preema Sinha, Anuj Bhatnagar

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Introduction: Hyper-IgE syndrome is a rare primary immunodeficiency syndrome characterised by triad of severe atopic dermatitis, recurrent pulmonary infections, and recurrent staphylococcal skin infections. The diagnosis requires a high degree of suspicion, typical clinical features, and not mere rise in serum-IgE levels, which may be seen in multiple conditions. Genetic studies are not always possible in a resource poor setting. This study highlights various presentations of Hyper-IgE syndrome in skin of color children. Case-series: Our study had six children of Hyper-IgE syndrome aged twomonths to tenyears. All had onset in first ten months of life except one with a late-onset at two years. All had recurrent eczematoid rash, which responded poorly to conventional treatment, secondary infection, multiple episodes of hospitalisation for pulmonary infection, and raised serum IgE levels. One case had occasional vesicles, bullae, and crusted plaques over both the extremities. Genetic study was possible in only one of them who was found to have pathogenic homozygous deletions of exon-15 to 18 in DOCK8 gene following which he underwent bone marrow transplant (BMT), however, succumbed to lower respiratory tract infection two months after BMT and rest of them received multiple courses of antibiotics, oral/ topical steroids, and cyclosporine intermittently with variable response. Discussion: Our study highlights various characteristics, presentation, and management of this rare syndrome in children. Knowledge of these manifestations in skin of color will facilitate early identification and contribute to optimal care of the patients as representative data on the same is limited in literature.

Keywords: absolute eosinophil count, atopic dermatitis, eczematous rash, hyper-immunoglobulin E syndrome, pulmonary infection, serum IgE, skin of color

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Authors: Neringa Bagdonaite

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Study Aims: The current study aimed to systematically analyse various research done in the area of female post-traumatic stress disorder (PTSD) and alcohol abuse, and to critically review these results on the basis of theoretical models as well as answer following questions: (I) What is the reciprocal relationship between PTSD and problem alcohol use among females; (II) What are the moderating/mediating factors of this relationship? Methods: The computer bibliographic databases Ebsco, Scopus, Springer, Web of Science, Medline, Science Direct were used to search for scientific articles. Systematic analyses sample consisted of peer-reviewed, English written articles addressing mixed gender and female PTSD and alcohol abuse issues from Jan 2012 to May 2017. Results: Total of 1011 articles were found in scientific databases related to searched keywords of which 29 met the selection criteria and were analysed. The results of longitudinal studies indicate that (I) various trauma, especially interpersonal trauma exposure in childhood is linked with increased risk of revictimization in later life and problem alcohol use; (II) revictimization in adolescence or adulthood, rather than victimization in childhood has a greater impact on the onset and progression of problematic alcohol use in adulthood. Cross-sectional and epidemiological studies also support significant relationships between female PTSD and problem alcohol use. Regards to the negative impact of alcohol use on PTSD symptoms results are yet controversial; some evidence suggests that alcohol does not exacerbate symptoms of PTSD over time, while others argue that problem alcohol use worsens PTSD symptoms and is linked to chronicity of both disorders, especially among women with previous alcohol use problems. Analysis of moderating/mediating factors of PTSD and problem alcohol use revealed, that higher motives/expectancies, specifically distress coping motives for alcohol use significantly moderates the relationship between PTSD and problematic alcohol use. Whereas negative affective states mediate relationship between symptoms of PTSD and alcohol use, but only among woman with alcohol use problems already developed. Conclusions: Interpersonal trauma experience, especially in childhood and its reappearance in lifetime is linked with PTSD symptoms and problem drinking among women. Moreover, problem alcohol use can be both a cause and a consequence of trauma and PTSD, and if used for coping it, increases the likelihood of chronicity of both disorders. In order to effectively treat both disorders, it’s worthwhile taking into account this dynamic interplay of women's PTSD symptoms and problem drinking.

Keywords: female, trauma, post-traumatic stress disorder, problem alcohol use, systemic analysis

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Authors: Akaash Tawade, Manan Khattar, Lucas Spangher, Costas J. Spanos

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Many grids are increasing the share of renewable energy in their generation mix, which is causing the energy generation to become less controllable. Buildings, which consume nearly 33% of all energy, are a key target for demand response: i.e., mechanisms for demand to meet supply. Understanding the behavior of office workers is a start towards developing demand response for one sector of building technology. The literature notes that dynamic computational modeling can be predictive of individual action, especially given that occupant behavior is traditionally abstracted from demand forecasting. Recent work founded on Social Cognitive Theory (SCT) has provided a promising conceptual basis for modeling behavior, personal states, and environment using control theoretic principles. Here, an adapted linear dynamical system of latent states and exogenous inputs is proposed to simulate energy demand amongst office workers engaged in a social energy shifting game. The energy shifting competition is implemented in an office in Singapore that is connected to a minigrid of buildings with a consistent 'price signal.' This signal is translated into a 'points signal' by a reinforcement learning (RL) algorithm to influence participant energy use. The dynamic model functions at the intersection of the points signals, baseline energy consumption trends, and SCT behavioral inputs to simulate future outcomes. This study endeavors to analyze how the dynamic model trains an RL agent and, subsequently, the degree of accuracy to which load deferability can be simulated. The results offer a generalizable behavioral model for energy competitions that provides the framework for further research on transfer learning for RL, and more broadly— transactive control.

Keywords: energy demand forecasting, social cognitive behavioral modeling, social game, transfer learning

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Authors: Basavaraj R. Endigeri, S. G. Sarganachari

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Steel is widely used in machine parts, structural equipment and many other applications. In many steel structural elements, holes of different shapes and orientations are made with a view to satisfy the design requirements. The presence of holes in steel elements creates stress concentration, which eventually reduce the mechanical strength of the structure. Therefore, it is of great importance to investigate the state of stress around the holes for the safety and properties design of such elements. By literature survey, it is known that till date, there is no analytical solution to reduce the stress concentration by providing auxiliary holes at a definite location and radii in a steel plate. The numerical method can be used to determine the optimum location and radii of auxiliary holes. In the present work plate with an elliptical hole, for a steel material subjected to uniaxial load is analyzed and the effect of stress concentration is graphically represented .The introduction of auxiliary holes at a optimum location and radii with its effect on stress concentration is also represented graphically. The finite element analysis package ANSYS 11.0 is used to analyse the steel plate. The analysis is carried out using a plane 42 element. Further the ANSYS optimization model is used to determine the location and radii for optimum values of auxiliary hole to reduce stress concentration. All the results for different diameter to plate width ratio are presented graphically. The results of this study are in the form of the graphs for determining the locations and diameter of optimal auxiliary holes. The graph of stress concentration v/s central hole diameter to plate width ratio. The Finite Elements results of the study indicates that the stress concentration effect of central elliptical hole in an uniaxial loaded plate can be reduced by introducing auxiliary holes on either side of the central circular hole.

Keywords: finite element method, optimization, stress concentration factor, auxiliary holes

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Authors: Joseph F. Cabrera, Rachael Dela Cruz

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This study specifically examines patterns that define ethnoracially diverse neighborhoods. Ethnoracial diversity is important as it facilitates cross-racial interactions within neighborhoods which have been theorized to be associated with such outcomes as intergroup harmony, the reduction of racial and ethnic prejudice and discrimination, and increases in racial tolerance. Los Angeles (LA) is an ideal location to study ethnoracial spatial patterns as it is one of the most ethnoracially diverse cities in the world. A large influx of Latinos, as well as Asians, have contributed to LA’s urban landscape becoming increasingly diverse over several decades. Our dataset contains all census tracts in Los Angeles County in 2016 and incorporates Census and ACS demographic and spatial data. We quantify ethnoracial diversity using a derivative of Simpson’s Diversity Index and utilize this measure to test previous literature that suggests Latinos are one of the key drivers of changing ethnoracial spatial patterns in Los Angeles. Preliminary results suggest that there has been an overall increase in ethnoracial diversity in Los Angeles neighborhoods over the past sixteen years. Patterns associated with this trend include decreases in predominantly white and black neighborhoods, increases in predominantly Latino and Asian neighborhoods, and a general decrease in the white populations of the most diverse neighborhoods. A similar pattern is seen in neighborhoods with large Latino increases- a decrease in white population, but with an increase in Asian and black populations. We also found support for previous research that suggests increases in Latino and Asian populations act as a buffer, allowing for black population increases without a sizeable decrease in the white population. Future research is needed to understand the underlying causes involved in many of the patterns and trends highlighted in this study.

Keywords: race, race and interaction, racial harmony, social interaction

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Authors: Abuzar Baloach

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Spinal cord stimulators (SCS) are increasingly used for managing chronic pain, but their presence requires careful anesthetic planning. This review explores critical anesthetic considerations for patients with SCS, encompassing preoperative, intraoperative, and acute pain management, as well as specific considerations for obstetric and out-of-operating-room procedures. Preoperative Evaluation: Thorough assessment is essential, including a detailed medical history of the SCS device, such as type, manufacturer, and settings. Additionally, a complete pain history and a physical exam are necessary to understand the patient’s baseline neurological function and assess mobility, which can impact anesthesia management. Intraoperative Considerations: Electrocautery poses a risk for patients with SCS due to potential interference. Monopolar electrocautery is discouraged, but if needed, the grounding pad should be positioned away from the device, and the device itself should be turned off. The SCS device can introduce ECG artifacts and potentially interfere with pacemakers and defibrillators (ICD), which may result in inappropriate pacing or shocks. Precautions, including baseline ECG and interrogation, are recommended if both devices are present. Furthermore, lithotripsy, though generally avoided, can be performed under certain conditions with caution. Obstetric Anesthesia: While SCS devices are generally turned off during pregnancy, they have shown no interference with fetal cardiotocography, and epidural placement can be safely achieved with a sterile technique below the SCS leads. Acute Pain Considerations: SCS placement is taken into account in pain management plans, especially with neuraxial anesthesia, as potential risks include infection, limited spread due to fibrous sheaths, and damage to the SCS leads. Out-of-Operating Room Procedures: MRI, previously contraindicated, is now conditionally safe with SCS devices, depending on manufacturer specifications. CT scans are generally safe, though radiation should be minimized to prevent device malfunction. For radiation therapy, specific safety measures are recommended, such as keeping the beam at least 1 cm away from the device and limiting the dose to prevent damage. In conclusion, anesthetic management for SCS patients requires meticulous planning across all stages of care. By understanding the unique interactions and potential risks associated with SCS and other devices, healthcare providers can enhance patient safety and improve outcomes. Further research and the establishment of standardized guidelines are essential to optimize perioperative care for this growing patient population.

Keywords: anesthesia, chronic pain, spinal cord stimulator, SCS

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Authors: Maria Del Pino, Pablo Rivero, Rafael Gabriel

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Introduction: Depression is a significant mental health condition that not only affects emotional well-being but also has far-reaching implications for physical health, particularly in patients with chronic conditions like atrial fibrillation (AF). Despite substantial evidence linking depression to cardiovascular diseases, its role in the development and progression of cognitive impairment (CI) in AF patients remains underexplored. This dissertation aims to investigate how depression contributes to the onset and severity of cognitive decline among individuals with AF, focusing on the pathways through which mental health can influence cognitive outcomes in this population. Methodology: The study employs a systematic review and meta-analysis methodology to synthesize data from multiple studies on depression, AF, and cognitive impairment. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, studies were identified, screened, and selected based on predefined eligibility criteria. The meta-analysis integrates quantitative data from these studies to estimate the overall effect size of depression on cognitive decline in AF patients, while subgroup analyses explore how factors like age, sex, and severity of depression might influence the observed associations. Results: The study demonstrates that AF patients, with coexisting depression, have a significantly higher risk of developing cognitive impairment compared to those without depression (OR: 2.23, 95 % CI: 1.54–3.21, p < 0.01; I2=99 %). The findings also suggest that depressive symptoms may exacerbate cognitive decline through mechanisms such as chronic inflammation, neurotoxicity, and alterations in cerebral hemodynamics, which impair cerebral blood flow and contribute to neurodegeneration. Conclusions: This work emphasizes the critical importance of integrating mental health assessments into standard AF management protocols, highlighting how addressing depressive symptoms could mitigate cognitive decline and improve overall patient outcomes. This work is particularly relevant to the field of psychological science, as it underscores the profound impact of mental health on physical health outcomes and advocates for a more holistic approach to managing AF. The findings of this dissertation, published in a peer-reviewed journal, offer valuable insights for healthcare professionals, policymakers, and researchers, and provide a foundation for developing clinical guidelines that promote the integration of mental and physical health care.

Keywords: Dementia, depression, Atrial fibrillaton, meta-analysis

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Authors: Jang-Hwan Jo

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The supply management of ecosystem services of local forests is an essential issue as it is linked to the ecological welfare of local residents. This study aims to estimate the supply, trade-offs, and synergies of local forest regulating ecosystem services using a land cover classification map (LCCM) and a forest types map (FTM). Rigorous literature reviews and Expert Delphi analysis were conducted using the detailed variables of 1:5,000 LCCM and FTM. Land-use scoring method and Getis-Ord Gi* Analysis were utilized on detailed variables to propose a method for estimating supply, trade-offs, and synergies of the local forest regulating ecosystem services. The analysis revealed that the rank order (1st to 5th) of supply of regulating ecosystem services was Erosion prevention, Air quality regulation, Heat island mitigation, Water quality regulation, and Carbon storage. When analyzing the correlation between defined services of the entire city, almost all services showed a synergistic effect. However, when analyzing locally, trade-off effects (Heat island mitigation – Air quality regulation, Water quality regulation – Air quality regulation) appeared in the eastern and northwestern forest areas. This suggests the need to consider not only the synergy and trade-offs of the entire forest between specific ecosystem services but also the synergy and trade-offs of local areas in managing the regulating ecosystem services of local forests. The study result can provide primary data for the stakeholders to determine the initial conditions of the planning stage when discussing the establishment of policies related to the adjustment of the supply of regulating ecosystem services of the forests with limited access. Moreover, the study result can also help refine the estimation of the supply of the regulating ecosystem services with the availability of other forms of data.

Keywords: ecosystem service, getis ord gi* analysis, land use scoring method, regional forest, regulating service, synergies, trade-offs

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Authors: Emilia A. Campayo-Munoz, Alberto Cabedo-Mas

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Music students have to face the challenges of musical practice -such as discipline in study, competitiveness, or performance anxiety- that require good emotional management to enable successful performance. However, few rigorous implementations focused on studying the influence of emotional skills in student's musical performance. Responding to this gap in the literature, this study aims to explore the relationship between emotional skills and musical performance in the context of elementary music education in conservatoires. Given the individual nature of the instrumental studies and the difficult availability of teachers to be trained in emotional education, it was decided to conduct a multiple case study in a Spanish music conservatoire. Author 1 carried out the implementation of the research with three 10-year-old students who were selected from her piano class. All of them attended the third year of their piano studies. The research processes consisted of the implementation of a set of specific and cross-sectional activities designed 'ad hoc' to be articulated in the subjects of individual instrument -piano- and ensemble in parallel to the contents of musical nature. The CE-360º questionnaire was used to measure different aspects of the students' emotional skills from a multi-angle perspective, each of the questionnaires being responded by oneself, three teachers and three peers, before and after the implementation. The data from the questionnaire were compared with the grades that the students obtained during the first and last quarter of the school year in the attended subjects. Acknowledging the complexity of emotional development, the results indicate possible relations between emotional skills and musical performance in music education in conservatoires. The results show that for the cases explored; there exists a relationship between emotional skills and musical performance. Although generalizations cannot be made, this study reinforces the need to further explore emotional development in instrumental teaching and suggest the importance of inviting teachers to reflect on the pedagogical practices extended in the conservatoires and to develop and implement those that promote the work of the students' emotions.

Keywords: conservatoires, emotional skills, music education, musical performance

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Authors: Xiaoqian Cheng, Jon Kleppe, Ole Torsaeter

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One objective of this work is to analyze the effects of surfactant properties (viscosity, concentration, and adsorption) on surfactant enhanced oil recovery at laboratory scale. The other objective is to obtain the functional relationships between surfactant properties and the ultimate oil recovery and oil recovery rate. A core is cut into two parts from the middle to imitate the matrix with a horizontal fracture. An injector and a producer are at the left and right sides of the fracture separately. The middle slice of the core is used as the model in this paper, whose size is 4cm x 0.1cm x 4.1cm, and the space of the fracture in the middle is 0.1 cm. The original properties of matrix, brine, oil in the base case are from Ekofisk Field. The properties of surfactant are from literature. Eclipse is used as the simulator. The results are followings: 1) The viscosity of surfactant solution has a positive linear relationship with surfactant oil recovery time. And the relationship between viscosity and oil production rate is an inverse function. The viscosity of surfactant solution has no obvious effect on ultimate oil recovery. Since most of the surfactant has no big effect on viscosity of brine, the viscosity of surfactant solution is not a key parameter of surfactant screening for surfactant flooding in fractured reservoirs. 2) The increase of surfactant concentration results a decrease of oil recovery rate and an increase of ultimate oil recovery. However, there are no functions could describe the relationships. Study on economy should be conducted because of the price of surfactant and oil. 3) In the study of surfactant adsorption, assume that the matrix wettability is changed to water-wet when the surfactant adsorption is to the maximum at all cases. And the ratio of surfactant adsorption and surfactant concentration (Cads/Csurf) is used to estimate the functional relationship. The results show that the relationship between ultimate oil recovery and Cads/Csurf is a logarithmic function. The oil production rate has a positive linear relationship with exp(Cads/Csurf). The work here could be used as a reference for the surfactant screening of surfactant enhanced oil recovery from fractured reservoirs. And the functional relationships between surfactant properties and the oil recovery rate and ultimate oil recovery help to improve upscaling methods.

Keywords: fractured reservoirs, surfactant adsorption, surfactant concentration, surfactant EOR, surfactant viscosity

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Authors: Shanika Y. Koreshi

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Sri Lanka housed the lingerie product development and manufacturing subsidiary to renowned brands such as La Senza, Marks & Spencer, H&M, Etam, Lane Bryant, and George. Over the last few years, they have produced local brands such as Amante to cater to the local and regional customers. Past research has identified factors such as quality, price, and design to be vital when marketing lingerie to consumers. However, there has been minimum research that looks into the ethnically targeted market and skin colour within the Asian population. Therefore, the main aim of the research was to identify whether consumer preference for lingerie is influenced by the skin tone of the model wearing it. Moreover, the secondary aim was to investigate if the consumer preference for lingerie is influenced by the consumer’s ethnic identification with the skin tone of the model. An experimental design was used to explore the above aims. The participants constituted of 66 females residing in the western province of Sri Lanka and were gathered via convenience sampling. Six computerized images of a real model were used in the study, and her skin tone was digitally manipulated to express three different skin tones (light, tan and dark). Consumer preferences were measured through a ranking order scale that was constructed via a focus group discussion and ethnic identity was measured by the Multigroup Ethnic Identity Measure-Revised. Wilcoxon signed-rank test, Friedman test, and chi square test of independence were carried out using SPSS version 20. The results indicated that majority of the consumers ethnically identified and preferred the tan skin over the light and dark skin tones. The findings support the existing literature that states there is a preference among consumers when models have a medium skin tone over a lighter skin tone. The preference for a tan skin tone in a model is consistent with the ethnic identification of the Sri Lankan sample. The study implies that lingerie brands should consider the model's skin tones when marketing the brand to different ethnic backgrounds.

Keywords: consumer preference, ethnic identification, lingerie, skin tone

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Authors: Adebowale Olukayode Efunnowo

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This study was carried out to assess the awareness and utilization of Social Network Tools (SNTs) among agricultural science students in Colleges of Education in Ogun State, Nigeria. Simple random sampling techniques were used to select 280 respondents from the study area. Descriptive statistics was used to describe the objectives while Pearson Product Moment Correlation was used to test the hypothesis. The result showed that the majority (71.8%) of the respondents were single, with a mean age of 20 years. Almost all (95.7%) the respondents were aware of Facebook and 2go as a Social Network Tools (SNTs) while 85.0% of the respondents were not aware of Blackplanet, LinkedIn, MyHeritage and Bebo. Many (41.1%) of the respondents had views that using SNTs can enhance extensive literature survey, increase internet browsing potential, promote teaching proficiency, and update on outcomes of researches. However, 51.4% of the respondents perceived that SNTs usage as what is meant for the lecturers/adults only while 16.1% considered it as mainly used by internet fraudsters. Findings revealed that about 50.0% of the respondents browsed Facebook and 2go daily while more than 80% of the respondents used Blackplanet, MyHeritage, Skyrock, Bebo, LinkedIn and My YearBook as the need arise. Major constraints to the awareness and utilization of SNTs were high cost and poor quality of ICTs facilities (77.1%), epileptic power supply (75.0%), inadequate telecommunication infrastructure (71.1%), low technical know-how (62.9%) and inadequate computer knowledge (61.1%). The result of PPMC analysis showed that there was an inverse relationship between constraints and utilization of SNTs at p < 0.05. It can be concluded that constraints affect efficient and effective utilization of SNTs in the study area. It is hereby recommended that management of colleges of education and agricultural institutes should provide good internet connectivity, computer facilities, and alternative power supply in order to increase the awareness and utilization of SNTs among students.

Keywords: awareness, utilization, social network tools, constraints, students

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Authors: Abdullah Kattan, Khalid Alzahrani, Saud Alsaleh, Loui Ezzat, Khalid Murad, Bader Alghamdi

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Background and Significance: Patients are often bothered by the excess skin laxity and redundancy that they are left with after losing weight. Body-contouring surgery offers a solution to this problem; however, there is scarce literature on the psychological and social effects of these surgeries. This study was conducted to assess the psychosocial impact of body-contouring surgery on patients after weight loss. Methodology: In this cross-sectional study, a specifically designed questionnaire was administered to forty three patients whom have undergone body-contouring surgery. All included patients had lost no less than 20 Kg before body-contouring surgery, and were interviewed at least 6 months after surgery. The twenty-question interviewer based questionnaire was used to assess the psychosocial status of the patients before and after undergoing body-contouring surgery. The questionnaire assessed the quality of life (social life, job performance and sexual activity), presence of symptoms of depression and overall satisfaction. Data was analyzed as paired variables in SPSS using McNemar’s test. Results: Among the 43 participants, 19 (44.2%) have undergone mammoplasty, 12 (27.9%) have undergone abdominoplasty and the remainder of the patients have undergone other various procedures including brachioplasty, thigh lifts and nick liposuction. The mean age of patients was 34 +/- 10, the sample included 24 (55.8%) females and 19 (44.2%) males. The patients’ quality of life significantly improved in the following areas; social life (P<0.001), job performance (P<0.002) and sexual activity (P<0.001). Moreover, 17 (39.5%) patients suffered symptoms of depression before body-contouring surgery; however, only 1 (2.3%) patient suffered symptoms of depression after surgery. Overall satisfaction rate was found to be 62.8%; with mammoplasty being the highest satisfaction rate procedure (66.6 %). Conclusion: Body-contouring surgery after weight loss has shown to improve the psychological and social aspects in patients. These findings have been found to be consistent with the majority of relevant published studies, further increasing reliability of our study.

Keywords: abdominoplasty, body-contouring, mammoplasty, psychosocial

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Authors: Bahram Soltani, Louai Ghazieh

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The responsibility has a big importance further to the financial crisis and the various pressures, which companies face their duties. The main objective of this study is to explain the variation of mechanisms of the responsibility of the manager in the company among the advanced capitalist economies. Then we study the impact of these mechanisms on the performance and the value creation in European companies. To reach our goal, we established a final sample composed on average of 284 French, British and German companies quoted in stock exchanges with 2272 annual reports examined during the period from 2005 to 2012. We examined at first the link of causalities between the determining-mechanisms bound to the company such as the characteristics of the board of directors, the composition of the shareholding and the ethics of the company on one side and the profitability of the company on the other side. The results show that the smooth running of the board of directors and its specialist committees are very important determinants of the responsibility of the managers who impact positively the performance and the value creation in the company. Furthermore, our results confirm that the presence of a solid ethical environment within the company will be effective to increase the probability that the managers realize ethical choices in the organizational decision-making. At the second time, we studied the impact of the determining mechanisms bound to the function and to the profile of manager to know its relational links, his remuneration, his training, his age and his experiences about the performance and the value creation in the company. Our results highlight the existence of a negative relation between the relational links of the manager, his very high remuneration and the general profitability of the company. This study is a contribution to the literature on the determining mechanisms of company director's responsibility (Accountability). It establishes an empirical and comparative analysis between three influential countries of Europe, to know France, the United Kingdom and Germany.

Keywords: leaders, company’s performance, accountability mechanisms, corporate governance, value creation of firm, financial crisis

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Authors: Chukwuka Justus Iwegbu

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Background: A major concern facing the world is providing senior citizens, individuals with disabilities, and other vulnerable groups with high-quality care. This issue is more serious in Nigeria's North Eastern area, where the burden of disease and disability is heavy, and access to care is constrained. This study aims to fill this gap by exploring the roles, challenges and support needs of caregivers, care home management, funding and administration in challenged communities in North Eastern Nigeria. The study will also provide a comprehensive understanding of the current situation and identify opportunities for improving the quality of care and support for caregivers and care recipients in these communities. Methods: A mixed-methods design, including both quantitative and qualitative data collection methods, will be used, and it will be guided by the stress process model of caregiving. The qualitative stage approach will comprise a survey, In-depth interviews, observations, and focus group discussion and the quantitative analysis will be used in order to comprehend the variations between caregiver's roles and care home management. A review of relevant documents, such as care home policies and funding reports, would be used to gather quantitative data on the administrative and financial aspects of care. The data collected will be analyzed using both descriptive statistics and thematic analysis. A sample size of around 200-300 participants, including caregivers, care recipients, care home managers and administrators, policymakers and health care providers, would be recruited. Findings: The study revealed that caregivers in challenged communities in North Eastern Nigeria face significant challenges, including lack of training and support, limited access to funding and resources, and high levels of burnout. Care home management and administration were also found to be inadequate, with a lack of clear policies and procedures and limited oversight and accountability. Conclusion: There is a need for increased investment in training and support for caregivers, as well as a need for improved care home management and administration in challenged communities in North Eastern Nigeria. It also highlights the importance of involving community members in decision-making and planning processes related to care homes and services. The study would contribute to the existing body of knowledge by providing a detailed understanding of the challenges faced by caregivers, care home managers and administrators.

Keywords: caregivers, care home management, funding, administration, challenge communities, North Eastern Nigeria

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Authors: Ahmed Al Ansari, Khalid Al Khalifa

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

Keywords: MSF system, emergency, validity, generalizability

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