Search results for: nerve guidance conduit

Authors: Simone Tedeschi, Francesco Crespi, Paolo Liberati, Massimo Paradiso, Antonio Sciala

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This paper aims at contributing to the understanding of smokers’ responses to cigarette prices increases with a focus on heterogeneity, both across individuals and price levels. To do this, a stated preference quasi-experimental design grounded in a random utility framework is proposed to evaluate the effect on smokers’ utility of the price level and variation, along with social conditioning and health impact perception. The analysis is based on individual-level data drawn from a unique survey gathering very detailed information on Italian smokers’ habits. In particular, qualitative information on the individual reactions triggered by changes in prices of different magnitude and composition are exploited. The main findings stemming from the analysis are the following; the average price elasticity of cigarette consumption is comparable with previous estimates for advanced economies (-.32). However, the decomposition of this result across five latent-classes of smokers, reveals extreme heterogeneity in terms of price responsiveness, implying a potential price elasticity that ranges between 0.05 to almost 1. Such heterogeneity is in part explained by observable characteristics such as age, income, gender, education as well as (current and lagged) smoking intensity. Moreover, price responsiveness is far from being independent from the size of the prospected price increase. Finally, by comparing even and uneven price variations, it is shown that uniform across-brand price increases are able to limit the scope of product substitutions and downgrade. Estimated price-response heterogeneity has significant implications for tax policy. Among them, first, it provides evidence and a rationale for why the aggregate price elasticity is likely to follow a strictly increasing pattern as a function of the experienced price variation. This information is crucial for forecasting the effect of a given tax-driven price change on tax revenue. Second, it provides some guidance on how to design excise tax reforms to balance public health and revenue goals.

Keywords: smoking behaviour, preference heterogeneity, price responsiveness, cigarette taxation, random utility models

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Authors: Yelba Maria Carrillo

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The focus of this research study was to explore barriers, if any, faced by parents or legal guardians who are of Latinx background and speak Spanish as a primary language or are bilingual speakers of Spanish and English; barriers that limit their understanding of and involvement in their gifted child’s academic life. This study was guided by a qualitative case study design. The primary investigator hosted focus group interviews at a Magnet Middle School in Southern California. The groups consisted of 25 parents, or legal guardians of bilingual (English/Spanish) or former English learner students enrolled in a school serving 6th-8th grades. The primary investigator interviewed Latinx Spanish-speaking parents or legal guardians of gifted students regarding their perception of their child’s giftedness, parental involvement in schools, and fostering their child’s exceptional abilities. Parents and legal guardians described children as creative, intellectual, and highly intelligent. Key themes such as student performance, language proficiency, socio-emotional, and general intellectual ability were strong indicators of giftedness. Barriers such as language and education inhibited parent and legal guardian ability to understand their child’s giftedness, which resulted in their inability to adequately contribute to the development of their children’s talents and advocate for the appropriate services for their children. However, they recognized the importance of being involved in their child’s academic life and the importance of nurturing their ‘dón’ or ‘gift.’ La Familia is the foundation and core of Latinx culture; and, without a strong foundation, children lack guidance, confidence, and awareness to tap into their gifted abilities. Providing Latinx parents with the proper tools and resources to appropriately identify gifted characteristics and traits could lead to early identification and intervention for students in schools and at home.

Keywords: gifted education, gifted Latino students, Latino parent involvement, high ability students

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Authors: Marta Fonseca, Pedro Marvão, Beatriz Oliveira, Bruno Heleno, Pedro Carreiro-Martins, Nuno Neuparth, António Rendas

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Background: Concept maps (CMs) visually represent hierarchical connections among related ideas. They foster logical organization and clarify idea relationships, potentially aiding medical students in critical thinking (to think clearly and rationally about what to do or what to believe). However, there are inconsistent claims about the use of CMs in undergraduate medical education. Our three research questions are: 1) What studies have been published on concept mapping in undergraduate medical education? 2) What was the impact of CMs on students’ critical thinking? 3) How and why have these interventions had an educational impact? Methods: Eight databases were systematically searched (plus a manual and an additional search were conducted). After eliminating duplicate entries, titles, and abstracts, and full-texts were independently screened by two authors. Data extraction and quality assessment of the studies were independently performed by two authors. Qualitative and quantitative data were integrated using mixed-methods. The results were reported using the structured approach to the reporting in healthcare education of evidence synthesis statement and BEME guidance. Results: Thirty-nine studies were included from 26 journals (19 quantitative, 8 qualitative and 12 mixed-methods studies). CMs were considered as a tool to promote critical thinking, both in the perception of students and tutors, as well as in assessing students’ knowledge and/or skills. In addition to their role as facilitators of knowledge integration and critical thinking, CMs were considered both teaching and learning methods. Conclusions: CMs are teaching and learning tools which seem to help medical students develop critical thinking. This is due to the flexibility of the tool as a facilitator of knowledge integration, as a learning and teaching method. The wide range of contexts, purposes, and variations in how CMs and instruments to assess critical thinking are used increase our confidence that the positive effects are consistent.

Keywords: concept map, medical education, undergraduate, critical thinking, meaningful learning

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Authors: Peter Collett, Mike Pynn, Haseeb Ur Rahman

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For the last few years across the UK there has been a push towards implementing treatment escalation plans (TEP) for every patient admitted to hospital. This is a paper form which is completed by a junior doctor then countersigned by the consultant responsible for the patient's care. It is designed to address what level of care is appropriate for the patient in question at point of entry to hospital. It helps decide whether the patient would benefit for ward based, high dependency or intensive care. They are completed to ensure the patient's best interests are maintained and aim to facilitate difficult decisions which may be required at a later date. For example, a frail patient with significant co-morbidities, unlikely to survive a pathology requiring an intensive care admission is admitted to hospital the decision can be made early to state the patient would not benefit from an ICU admission. This decision can be reversed depending on the clinical course of the patient's admission. It promotes discussions with the patient regarding their wishes to receive certain levels of healthcare. This poster describes the steps taken in the Aneurin Bevan University Health Board (ABUHB) when implementing the TEP form. The team implementing the TEP form campaigned for it's use to the board of directors. The directors were eager to hear of experiences of other health boards who had implemented the TEP form. The team presented the data produced in a number of health boards and demonstrated the proposed form. Concern was raised regarding the legalities of the form and that it could upset patients and relatives if the form was not explained properly. This delayed the effectuation of the TEP form and further research and discussion would be required. When COVID 19 reached the UK the National Institute for Health and Clinical Excellence issued guidance stating every patient admitted to hospital should be issued a TEP form. The TEP form was accelerated through the vetting process and was approved with immediate effect. The TEP form in ABUHB has now been in circulation for a month. An audit investigating it's uptake and a survey gathering opinions have been conducted.

Keywords: acute medicine, clinical governance, intensive care, patient centered decision making

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Authors: Elizabeth Perry, Jylana Sheats

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Scholars posit that there is an overlap between the fields of Behavioral Economics (BE) and Behavior Science (BSci)—and that consideration of concepts from both may facilitate a greater understanding of health decision-making processes. For example, the ‘intention-action gap’ is one BE concept to explain sup-optimal decision-making. It is described as having knowledge that does not translate into behavior. Complementary best BSci practices may provide insights into behavioral determinants and relevant behavior change techniques (BCT). Within the context of BSci, this exploratory study aimed to apply a BE concept with demonstrated effectiveness in financial decision-making to a health behavior: influenza (flu) vaccine uptake. Adults aged >18 years were recruited on Amazon’s Mechanical Turk, a digital labor market where anonymous users perform simple tasks at low cost. Eligible participants were randomized into 2 groups, reviewed a scenario, and then completed a survey on the likelihood of receiving a flu shot. The ‘usual care’ group’s scenario included standard CDC guidance that supported the behavior. The ‘intervention’ group’s scenario included messaging about people who did not receive the flu shot. The framing was such that participants could learn from others’ (strangers) mistakes and the subsequent health consequences: ‘Last year, other people who didn’t get the vaccine were about twice as likely to get the flu, and a number of them were hospitalized or even died. Don’t risk it.’ Descriptive statistics and chi-square analyses were performed on the sample. There were 648 participants (usual care, n=326; int., n=322). Among racial/ethnic minorities (n=169; 57% aged < 40), the intervention group was 22% more likely to report that they were ‘extremely’ or ‘moderately’ likely to get the flu vaccine (p = 0.11). While not statistically significant, findings suggest that framing messages from the perspective of learning from the mistakes of unknown others coupled with the BCT ‘knowledge about the health consequences’ may help influence flu vaccine uptake among the study population. With the widely documented disparities in vaccine uptake, exploration of the complementary application of these concepts and strategies may be critical.

Keywords: public health, decision-making, vaccination, behavioral science

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Authors: Miao Li, Mengyuan Xu

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As a low-carbon travel mode, bicycling has drawn increasing political interest in the contemporary Chinese urban context, and the public sharing bikes have become the most popular ways of bike usage in China now. This research aims to explore the spatial-temporal relationship between sharing bike usage and different characteristics of the urban street built environment. In the research, street segments were used as the analytic unit of the street built environment defined by street intersections. The sharing bike usage data in the research include a total of 2.64 million samples that are the entire sharing bike distribution data recorded in two days in 2018 within a neighborhood of 185.4 hectares in the city of Wuhan, China. And these data are assigned to the 97 urban street segments in this area based on their geographic location. The built environment variables used in this research are categorized into three sections: 1) street design characteristics, such as street width, street greenery, types of bicycle lanes; 2) condition of other public transportation, such as the availability of metro station; 3) Street function characteristics that are described by the categories and density of the point of interest (POI) along the segments. Spatial Lag Models (SLM) were used in order to reveal the relationships of specific urban streets built environment characteristics and the likelihood of sharing bicycling usage in whole and different periods a day. The results show: 1) there is spatial autocorrelation among sharing bicycling usage of urban streets in case area in general, non-working day, working day and each period of a day, which presents a clustering pattern in the street space; 2) a statistically strong association between bike sharing usage and several different built environment characteristics such as POI density, types of bicycle lanes and street width; 3) the pattern that bike sharing usage is influenced by built environment characteristics depends on the period within a day. These findings could be useful for policymakers and urban designers to better understand the factors affecting bike sharing system and thus propose guidance and strategy for urban street planning and design in order to promote the use of sharing bikes.

Keywords: big data, sharing bike usage, spatial statistics, urban street built environment

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Authors: Ryan Tao

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This paper analyzes the local context and effects of tourism on Placencia in Belize to identify key environmental and social impacts. Placencia was a small sleepy coastal fishing village at risk of losing its local identity to tourism. In the last decade, tourism has driven an economic shift from fishing to tourism. The consequence of this shift has eroded local environmental resources and diluted local cultural heritage. A key example is Harvest Caye, an island converted from a natural manatee breeding ground to a stereotypical sandy beach and palm tree resort complex. The incoming cruise ship-geared development of Harvest Caye reflects the urban tourist vision of Placencia’s local landscape, which indicates a “neo-colonial” rule. Consequently, this vision causes environmental destruction, replacing local memories of abundant manatee-filled waters. The paper will explore environmental and cultural damage from uncontrolled development by focusing on how Placencia has been affected by unmanaged tourism. It will then propose solutions to create a medium between tourism and the local community. New developments in other Belizean cities, such as Belmopan and Belize City, are planned at the time of approval to be sensitive to their setting. While Placencia is fully built out, there are opportunities to plan in advance for the future while preserving local integrity. As a consequence of time, shepherding tourist development, defining tourist areas, and planning these areas with an eye towards natural disasters (such as hurricanes) can act as a tool to craft a future vision that helps preserve the local identity of Placencia. This research will consist of personal observations, case studies, and synthesis of other source materials. These sources provide guidance for creating a framework to understand the local environment and culture and plan around it to ultimately protect Placencia from becoming “Your Private Paradise” for the rich.

Keywords: Placencia, coastal development, coastal protection, tourism, zoning, coastal zoning, Caribbean, Belize, small island developing states

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Authors: Munirah Alaboudi

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This paper discusses a research project carried out with 12 first-year graduate students enrolled in research methods course prior to undertaking a graduate thesis during the academic year 2019. The research was designed for the objective of creating research methods course structure that embraces an individualized and activity-based approach to learning in a highly engaging group environment. This approach targeted innovating the traditional research methods lecture-based, theoretical format where students reported less engagement and limited learning. This study utilized action research methodology in developing a different approach to research methods course instruction where student performance indicators and feedback were periodically collected to assess the new teaching method. Student learning was achieved through utilizing the flipped classroom approach where students learned the material at home and classroom activities were designed to implement and experiment with the newly acquired information, with the guidance of the course instructor. Student learning in class was practiced through a series of activities based on different research methods. With the goal of encouraging student engagement, a wide range of activities was utilized including workshops, role play, mind-mapping, presentations, peer evaluations. Data was collected through an open-ended qualitative questionnaire to establish whether students were engaged in the material they were learning, and to what degree were they engaged, and to test their mastery level of the concepts discussed. Analysis of the data presented positive results as around 91% of the students reported feeling more engaged with the active learning experience and learning research by “actually doing research, not just reading about it”. The students expressed feeling invested in the process of their learning as they saw their research “gradually come to life” through peer learning and practice during workshops. Based on the results of this study, the research methods course structure was successfully remodeled and continues to be delivered.

Keywords: research methods, higher education instruction, flipped classroom, graduate education

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Authors: Van Trieu, Shouhuai Xu, Yusheng Feng

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Tracking attack trajectories can be difficult, with limited information about the nature of the attack. Even more difficult as attack information is collected by Intrusion Detection Systems (IDSs) due to the current IDSs having some limitations in identifying malicious and anomalous traffic. Moreover, IDSs only point out the suspicious events but do not show how the events relate to each other or which event possibly cause the other event to happen. Because of this, it is important to investigate new methods capable of performing the tracking of attack trajectories task quickly with less attack information and dependency on IDSs, in order to prioritize actions during incident responses. This paper proposes a two-level graph causality framework for tracking attack trajectories in internet networks by leveraging observable malicious behaviors to detect what is the most probable attack events that can cause another event to occur in the system. Technically, given the time series of malicious events, the framework extracts events with useful features, such as attack time and port number, to apply to the conditional independent tests to detect the relationship between attack events. Using the academic datasets collected by IDSs, experimental results show that the framework can quickly detect the causal pairs that offer meaningful insights into the nature of the internet network, given only reasonable restrictions on network size and structure. Without the framework’s guidance, these insights would not be able to discover by the existing tools, such as IDSs. It would cost expert human analysts a significant time if possible. The computational results from the proposed two-level graph network model reveal the obvious pattern and trends. In fact, more than 85% of causal pairs have the average time difference between the causal and effect events in both computed and observed data within 5 minutes. This result can be used as a preventive measure against future attacks. Although the forecast may be short, from 0.24 seconds to 5 minutes, it is long enough to be used to design a prevention protocol to block those attacks.

Keywords: causality, multilevel graph, cyber-attacks, prediction

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Authors: Thomas Louis, Irina Primac, Florent Morfoisse, Tania Durre, Silvia Blacher, Agnes Noel

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In vitro and in vivo lymphangiogenesis assays are essential for the identification of potential lymphangiogenic agents and the screening of pharmacological inhibitors. In the present study, we analyse three biological models: in vitro lymphatic endothelial cell spheroids, in vivo ear sponge assay, and in vivo lymph node colonisation by tumour cells. These assays provide suitable 3D models to test pro- and anti-lymphangiogenic factors or drugs. 3D images were acquired by confocal laser scanning and light sheet fluorescence microscopy. Virtual scan microscopy followed by 3D reconstruction by image aligning methods was also used to obtain 3D images of whole large sponge and ganglion samples. 3D reconstruction, image segmentation, skeletonisation, and other image processing algorithms are described. Fixed and time-lapse imaging techniques are used to analyse lymphatic endothelial cell spheroids behaviour. The study of cell spatial distribution in spheroid models enables to detect interactions between cells and to identify invasion hierarchy and guidance patterns. Global measurements such as volume, length, and density of lymphatic vessels are measured in both in vivo models. Branching density and tortuosity evaluation are also proposed to determine structure complexity. Those properties combined with vessel spatial distribution are evaluated in order to determine lymphangiogenesis extent. Lymphatic endothelial cell invasion and lymphangiogenesis were evaluated under various experimental conditions. The comparison of these conditions enables to identify lymphangiogenic agents and to better comprehend their roles in the lymphangiogenesis process. The proposed methodology is validated by its application on the three presented models.

Keywords: 3D image segmentation, 3D image skeletonisation, cell invasion, confocal microscopy, ear sponges, light sheet microscopy, lymph nodes, lymphangiogenesis, spheroids

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Authors: Abhit Kumar

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The world is full of master slave Telemanipulator where the doctor’s masters the console and the surgical arm perform the operations, i.e. these robots are passive robots, what the world needs to focus is that in use of these passive robots we are acquiring doctors for operating these console hence the utilization of the concept of robotics is still not fully utilized ,hence the focus should be on active robots, Auto Surgical-Emissive Hand use the similar concept of active robotics where this anthropomorphic hand focuses on the autonomous surgical, emissive and scanning operation, enabled with the vision of 3 way emission of Laser Beam/-5°C < ICY Steam < 5°C/ TIC embedded in palm of the anthropomorphic hand and structured in a form of 3 way disc. Fingers of AS-EH (Auto Surgical-Emissive Hand) as called, will have tactile, force, pressure sensor rooted to it so that the mechanical mechanism of force, pressure and physical presence on the external subject can be maintained, conversely our main focus is on the concept of “emission” the question arises how all the 3 non related methods will work together that to merged in a single programmed hand, all the 3 methods will be utilized according to the need of the external subject, the laser if considered will be emitted via a pin sized outlet, this radiation is channelized via a thin channel which further connect to the palm of the surgical hand internally leading to the pin sized outlet, here the laser is used to emit radiation enough to cut open the skin for removal of metal scrap or any other foreign material while the patient is in under anesthesia, keeping the complexity of the operation very low, at the same time the TIC fitted with accurate temperature compensator will be providing us the real time feed of the surgery in the form of heat image, this gives us the chance to analyze the level, also ATC will help us to determine the elevated body temperature while the operation is being proceeded, the thermal imaging camera in rooted internally in the AS-EH while also being connected to the real time software externally to provide us live feedback. The ICY steam will provide the cooling effect before and after the operation, however for more utilization of this concept we can understand the working of simple procedure in which If a finger remain in icy water for a long time it freezes the blood flow stops and the portion become numb and isolated hence even if you try to pinch it will not provide any sensation as the nerve impulse did not coordinated with the brain hence sensory receptor did not got active which means no sense of touch was observed utilizing the same concept we can use the icy stem to be emitted via a pin sized hole on the area of concern ,temperature below 273K which will frost the area after which operation can be done, this steam can also be use to desensitized the pain while the operation in under process. The mathematical calculation, algorithm, programming of working and movement of this hand will be installed in the system prior to the procedure, since this AS-EH is a programmable hand it comes with the limitation hence this AS-EH robot will perform surgical process of low complexity only.

Keywords: active robots, algorithm, emission, icy steam, TIC, laser

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Authors: Dalila Chaid, Bennameur Fedilli, Mohammed Amine Bellelou

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The study focuses on the experience of lower-limb amputees, who face both physical and psychological challenges due to their disability. Chronic neuropathic pain and various types of limb pain are common in these patients. They often require orthopaedic interventions for issues such as dressings, infection, ulceration, and bone-related problems. Research Aim: The aim of this study is to determine the most suitable anaesthetic technique for lower-limb amputees, which can provide them with the greatest comfort and prolonged analgesia. The study also aims to demonstrate the effectiveness and cost-effectiveness of ultrasound-guided local regional anaesthesia (LRA) in this patient population. Methodology: The study is an observational analytical study conducted over a period of eight years, from 2010 to 2018. It includes a total of 955 cases of revisions performed on lower limb stumps. The parameters analyzed in this study include the effectiveness of the block and the use of sedation, the duration of the block, the post-operative visual analog scale (VAS) scores, and patient comfort. Findings: The study findings highlight the benefits of ultrasound-guided LRA in providing comfort by optimizing post-operative analgesia, which can contribute to psychological and bodily repair in lower-limb amputees. Additionally, the study emphasizes the use of alpha2 agonist adjuvants with sedative and analgesic properties, long-acting local anaesthetics, and larger volumes for better outcomes. Theoretical Importance: This study contributes to the existing knowledge by emphasizing the importance of choosing an appropriate anaesthetic technique for lower-limb amputees. It highlights the potential of ultrasound-guided LRA and the use of specific adjuvants and local anaesthetics in improving post-operative analgesia and overall patient outcomes. Data Collection and Analysis Procedures: Data for this study were collected through the analysis of medical records and relevant documentation related to the 955 cases included in the study. The effectiveness of the anaesthetic technique, duration of the block, post-operative pain scores, and patient comfort were analyzed using statistical methods. Question Addressed: The study addresses the question of which anaesthetic technique would be most suitable for lower-limb amputees to provide them with optimal comfort and prolonged analgesia. Conclusion: The study concludes that ultrasound-guided LRA, along with the use of alpha2 agonist adjuvants, long-acting local anaesthetics, and larger volumes, can be an effective approach in providing comfort and improving post-operative analgesia for lower-limb amputees. This technique can potentially contribute to the psychological and bodily repair of these patients. The findings of this study have implications for clinical practice in the management of lower-limb amputees, highlighting the importance of personalized anaesthetic approaches for better outcomes.

Keywords: neuropathic pain, ultrasound-guided peripheral nerve block, DN4 quiz, EMG

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Authors: Yanqun Li, Hong Geng

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The rapid urbanization process taking big cities as the main body leads to the unequal configuration of urban and rural areas in the aspects of land supply, industrial division of labor, service supply and space allocation, and induces the shrinking characterization of service energy, industrial system and population vitality in small towns. As an important spatial unit in the spectrum of urbanization that serves, connects and couples urban and rural areas, the shrinking phenomenon faced by small towns has an important influence on the healthy development of urbanization. Based on the census of small towns in Wuhan metropolitan area, we have found that the shrinking of small towns is a passive contraction of elastic tension under the squeeze in cities. Once affected by the external forces such as policy regulation, planning guidance, and population return, small towns will achieve expansion and growth. Based on the theory of complex adaptive systems, this paper comprehensively constructs the development index evaluation system of small towns from five aspects of population, economy, space, society and ecology, measures the shrinking level of small towns, further analyzes the shrinking characteristics of small towns, and identifies whether the shrinking is elastic or not. And then this paper measures the resilience ability index of small town contract from the above-mentioned five aspects. Finally, this paper proposes an adaptive mechanism of urban-rural interaction evolution under fine division of labor to response the passive shrinking in small towns of Wuhan. Based on the above, the paper creatively puts forward the planning response measures of the small towns on the aspects of spatial layout, function orientation and service support, which can provide reference for other regions.

Keywords: complex adaptive systems, resiliency shrinking, adaptation mechanism, planning response

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Authors: Xiao Chen, Alice Ho, Mabel Tie, Xiaoheng Xu

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Background and Significance of the Study: School-enterprise cooperation has been the cornerstone of vocational education in China and many other countries. Researchers and policymakers have paid much attention to ensuring the implementation and improving the quality of school-enterprise cooperation. However, many problems still exist on the implementation level of the cooperation. On the one hand, the enterprises lack the motivation to participate in the cooperation. On the other hand, there is a lack of effective guidance and management during the cooperation. Furthermore, the current literature focuses greatly on policy recommendations on the national level while failing to provide a detailed practical understanding of how school-enterprise cooperation is carried out on the ground level. With emerging social problems, such as the aging population in China, there is an increasing need for diverse nursing services and better nursing quality. Methodology: To gain a deeper understanding of the influencing factors of the implementation of school-enterprise cooperation, this work conducted 37 exploratory interviews in four Chinese cities spanning first-tier to fourth-tier cities with hospital department directors, vocational school deans, nurses, and vocational students. Multiple critical policy documents that founded the current vocational education system in China were analyzed, along with the data collected from the interviews. Major Findings: Based on the policy and interview analyses, this work reveals a set of influencing factors for school-enterprise cooperation implementation. Findings from each region contribute to an overall model of influencing factors for implementing school-enterprise cooperation in vocational nursing education in China, which leads to practical insights for policy recommendation. The key influencing factors are found based on the policy, hospital, school, and social levels. Following practical policy recommendations were presented. Moving forward, further research on the implementation of school-enterprise cooperation in specific industries will become increasingly critical to improving the effectiveness of educational policies and the quality of vocational education.

Keywords: nursing, policy recommendation, school-enterprise cooperation, vocational education

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Authors: Jakub Vávra, Milan Valenta, Petr Kosek

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This article presents a perspective on the conduct of the dramatherapy process with persons with addictive behaviours with regard to the directiveness of the process. Although drama therapy as one of the creative arts approaches is rather non-directive in nature, depending on the clientele, there may be a need to structure the process more and, depending on the needs of the clients, to guide the process more directive. The specificity for people with addictive behaviours is discussed through the prism of the dramatherapeutic perspective, where we can find both a psychotherapeutic component as well as a component touching on expression and art, which is rather non-directive in nature. Within the context of practice with clients, this theme has repeatedly emerged and dramatherapists themselves have sought to find ways of coping with clients' demands and needs for structure and guidance within the dramatherapy process. Some of the outcomes from the supervision work also guided the research. Based on this insight, the research questions were approached. The first research question asks: in what ways is directive in dramatherapy manifested and manifested in the process? The second research question then complements the first and asks: to which phenomena are directivity in dramatherapy linked? In relation to the research questions, data were collected using focus groups and field notes. The qualitative approach of Content analysis and Relational analysis was chosen as the methodology. For analyzing qualitative research, we chose an Inductive coding scheme: Open coding, Axial coding, Pattern matching, Member checking, and Creating a coding scheme. In the presented partial research results, we find recurrent schemes related to directive coding in drama therapy. As an important element, directive leadership emerges in connection with safety for the client group, then in connection with the clients' order and also the department of the facility, and last but not least, to the personality of the drama therapist. By careful analysis and looking for patterns in the research results, we can see connections that are impossible to interpret at this stage but already provide clues to our understanding of the topic and open up further avenues for research in this area.

Keywords: dramatherapy, directivity, personal approach, aims of dramatherapy process, safetyness

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Authors: Paul Lam, Chi Him Chan, Alan Tse

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Language laboratories have been widely used in language learning, starting in the middle of the last century as one of the earliest forms of educational technology. They are designed to assist students’ language learning with technological innovations. Traditional language laboratories provide individual workstations that allow students to access multimedia language resources. In this type of facility, students can train their listening and speaking abilities, and teachers can also assess the performance of an individual student. Although such a setting promotes a student-centered pedagogy by encouraging students to work at their own pace and according to their own needs, it still favours a traditional, behaviourist language learning pedagogy which focuses on repetitive drilling. The change of pedagogies poses challenges to both the teachers and the facilities. The peer-learning pedagogy advocates that language learning should focus on the social aspect, which emphasizes the importance of everyday communication in language learning. The self-access, individual workstation language laboratories may not be able to provide the flexibility for interaction in the new pedagogies. Modern advancement in technology is another factor that drove our language laboratory renovation. In particular, mobile and wireless technology enabled the use of smaller and more flexible devices, making possible much clever use of space. The Chinese University of Hong Kong (CUHK) renovated nine existing language laboratories to provide lighter and more advanced equipment, movable tables, and round desks. These facilities allow more flexibility and encourage students’ interaction. It is believed that the renovated language laboratories can serve different peer learning activities and thus support peer-learning pedagogies in language teaching and learning. A survey has been conducted to collect comments from the teachers who have used the renovated language laboratories and received forty-four response. The teachers’ comments reveal that they experienced different challenges in using the renovated language laboratories, and there is a need to provide guidance to teachers during the technological and pedagogical transition. For example, teachers need instruction on using the newly installed devices such as touch-monitor and visualizer. They also need advice on planning new teaching and learning activities. Nevertheless, teachers appreciated that the renovated language laboratories are flexible and provide more spaces for different learning activities.

Keywords: language laboratories, language learning, peer-learning, student interaction

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Authors: Enrico Gugliandolo, Salvatore Cuzzocrea, Rosalia Crupi

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Osteoarthritis (OA) is one of the most common chronic pain conditions in dogs and cats. OA pain is currently viewed as a mixed phenomenon involving both inflammatory and neuropathic mechanisms at the peripheral (joint) and central (spinal and supraspinal) levels. Oxidative stress has been implicated in OA pain. Although nonsteroidal anti-inflammatory drugs are commonly prescribed for OA pain, they should be used with caution in pets because of adverse effects in the long term and controversial efficacy on neuropathic pain. An unmet need remains for safe and effective long-term treatments for OA pain. Palmitoyl-glucosamine (PGA) is an analogue of the ALIAamide palmitoylethanolamide, i.e., a body’s own endocannabinoid-like compound playing a sentinel role in nociception. PGA, especially in the micronized formulation, was shown safe and effective in OA pain. The aim of this study was to investigate the effect of a co-micronized formulation of PGA with the natural antioxidant curcumin (PGA-cur) on OA pain. Ten Sprague-Dawley male rats were used for each treatment group. The University of Messina Review Board for the care and use of animals authorized the study. On day 0, rats were anesthetized (5.0% isoflurane in 100% O2) and received intra-articular injection of MIA (3 mg in 25 μl saline) in the right knee joint, with the left being injected an equal volume of saline. Starting the third day after MIA injection, treatments were administered orally three times per week for 21 days, at the following doses: PGA 20 mg/kg, curcumin 10 mg/kg, PGA-cur (2:1 ratio) 30 mg/kg. On day 0 and 3, 7, 14 and 21 days post-injection, mechanical allodynia was measured using a dynamic plantar Von Frey hair aesthesiometer and expressed as paw withdrawal threshold (PWT) and latency (PWL). Motor functional recovery of the rear limb was evaluated on the same time points by walking track analysis using the sciatic functional index. On day 21 post-MIA injection, the concentration of the following inflammatory and nociceptive mediators was measured in serum using commercial ELISA kits: tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), nerve growth factor (NGF) and matrix metalloproteinase-1-3-9 (MMP-1, MMP-3, MMP-9). The results were analyzed by ANOVA followed by Bonferroni post-hoc test for multiple comparisons. Micronized PGA reduced neuropathic pain, as shown by the significant higher PWT and PWL values compared to vehicle group (p < 0.0001 for all the evaluated time points). The effect of PGA-cur was superior at all time points (p < 0.005). PGA-cur restored motor function already on day 14 (p < 0.005), while micronized PGA was effective a week later (D21). MIA-induced increase in the serum levels of all the investigated mediators was inhibited by PGA-cur (p < 0.01). PGA was also effective, except on IL-1 and MMP-3. Curcumin alone was inactive in all the experiments at any time point. The encouraging results suggest that PGA-cur may represent a valuable option in OA pain management and warrant further confirmation in well-powered clinical trials.

Keywords: ALIAmides, curcumin, osteoarthritis, palmitoyl-glucosamine

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Authors: Naveen Kumar B. T., Anuj Tyagi, Prabjeet Singh, Shanthanagouda A. H., Sumeet Rai

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Inland saline water resources are gaining the importance in expanding the aquaculture activities to mitigate the nutritional and food security issues of the world. For profitable and sustainable aquaculture practices, scientific farming, biosecurity measure, and best fish health management should be the integral part of developmental activities. Keeping in line with global awareness and trends, the Indian government has taken an innovative step to conduct disease surveillance and awareness programme for aquatic disease through network project. This ‘National Surveillance Programme for Aquatic Animal Diseases (NSPAAD)’ is being implemented in collaboration of national institutes and state agriculture universities with funding support from National Fisheries Development Board (NFDB), Govt. of India. Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, an NSPAAD collaborator, has been actively engaged in disease surveillance in the Indian state of Punjab. Shrimp farming in inland saline areas of Punjab is expanding at a tremendous pace under the guidance of GADVASU along with the support of State Fisheries Department. Under this national disease surveillance programme, we reported Enterocytozoon hepatopenaei (EHP) infection in the Litopenaeus vannamei cultured in the inland saline waters. Polymerase chain reaction (PCR) based diagnosis was carried out using the OIE (World Organisation for Animal Health) protocol. It was observed that out of 20 shrimp farms, two farms were 1st step PCR positive and two more farms were nested PCR positive. All the EHP positive ponds had shown the white faeces along with mortalities at very low rate. Therefore, implementation of biosecurity and continuous surveillance and monitoring program for finfish and shellfish aquaculture are in need of the hour to prevent and control the large-scale disease outbreaks and subsequent economic losses.

Keywords: disease, EHP, inland saline water, shrimp culture

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Authors: Robert E. Kenney, Richard B. Aguilar, Efrain Antunez, Gregory Schor-Haskin, Rafael Rey, Catie Falcon, Luis Arce

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This study sought to explore the effect of Sarapin injections on chronic knee pain (CKP). Many adults suffer from CKP which is most often attributed to osteoarthritis. Current treatment regimens for CKP involve the use NSAIDS medications, injections with steroids/analgesic, platelet rich plasma injections, or orthopedic surgical interventions. Sarapin is a commercially available homeopathic aqueous extract from the pitcher plant. Studies on the use of Sarapin as a treatment for cervical, thoracic, and lumbosacral facet joint nerve blocks have been performed with mixed results. There is little available evidence on the use of Sarapin in CKP. This study examines the effect of a series of 3 weekly injections of aqueous Sarapin in 95 elderly patients with CKP in a primary care setting. Cano Health, a primary care group, identified 95 successive patients with CKP from its multimodal physiotherapy program for chronic pain. Patients underwent evaluation by a clinician, underwent diagnostic Xrays of the knees, and the treatment plan with three weekly Sarapin injections was discussed. A pain and functional limitation survey (a modified Lower Extremity Functional Scale (mLEFS)) was administered prior to initiating treatment (Entry Survey (ES)). Each patient received an intraarticular injection of 2 cc of aqueous Sarapin with 1cc 1% lidocaine during weeks 1, 2 and 3. The mLEFS was administered again at week 4, one week after the third Sarapin injection (Exit Survey (ExS)). Demographics: Mean Age 62 +/- 9.8; 73% female; 89% Hispanic/Latino; mean time between ES and ExS was 27.5 +/-8.2 days. Survey: The mLEFS was based on a published Lower Extremity Functional Scale and each patient rated their pain or functional limitation from 0 (no difficulty) to 5 (severe difficulty) for 10 questions. Answers were summed and compared. Maximum score for severe difficulty would be 50 points. Results: Mean pain/functional scores: ES was 30.3 +/-12.1 and ExS was 19.5 +/- 12.5. This represents a relative improvement of 35.7% (P<0.00001). A total of 81% (77/95) of the patients showed improvement in symptoms at week four as assessed by the mLEFS. There were 11 patients who reported an increase in their survey scores while 7 patients reported no change. When evaluating the cohort that reported improvement, the ES was 30.9 +/-11.4 and ExS was 16.3 +/-9.8 yielding a 47.2% relative improvement (P<0.00001). Injections were well tolerated, and no adverse events were reported. Conclusions: In this cohort of 95 elderly patients with CKP, treatment with 3 weekly injections of Sarapin significantly improved pain and function as assessed by a mLEFS survey. The majority (81%) of patients responded positively to therapy, 12% had worsening symptoms and 7% reported no change. The use of intraarticular injections of Sarapin for CKP was shown to be an effective modality of treatment. Sarapin’s low cost, tolerability, and ease of use make it an attractive alternative to NSAIDS, steroids, PRP or surgical intervention for this common debilitating condition.

Keywords: Sarapin, intraarticular, chronic knee pain, osteoarthritis

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Authors: Amir Sina Fouladi, Arul Arulrajah, Jian Chu, Suksun Horpibulsuk

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Waste generation is a growing concern in many countries across the world, particularly in urban areas with high rates of population growth and industrialization. The increasing amount of waste generated from human activities has led to environmental, economic, and health issues. Improper disposal of waste can result in air and water pollution, land degradation, and the spread of diseases. Waste generation also consumes large amounts of natural resources and energy, leading to the depletion of valuable resources and contributing to greenhouse gas emissions. To address these concerns, there is a need for sustainable waste management practices that reduce waste generation and promote resource recovery and recycling. Amongst these, developing innovative technologies such as Microbially Induced Calcite Precipitation (MICP) in construction materials is an effective approach to transforming waste into valuable and sustainable applications. MICP is an environmentally friendly microbial-chemical technology that applies microorganisms and chemical reagents to biological processes to produce carbonate mineral. This substance can be an energy-efficient, cost-effective, sustainable solution to environmental and engineering challenges. Recent research has shown that waste streams can replace several MICP-chemical components in the cultivation media of microorganisms and cementation reagents (calcium sources and urea). In addition to its effectiveness in treating hazardous waste streams, MICP has been found to be cost-effective and sustainable solution applicable to various waste media. This comprehensive review paper aims to provide a thorough understanding of the environmental advantages and engineering applications of MICP technology, with a focus on the contribution of waste streams. It also provides researchers with guidance on how to identify and overcome the challenges that may arise applying the MICP technology using waste streams.

Keywords: waste stream, microbially induced calcite precipitation, construction materials, sustainability

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Authors: Sylvie Studente

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Despite the increase in international students migrating to the UK, the transition from home environment to a host institution abroad can be overwhelming for many students due to acculturative stressors. These stressors are reported to peak within the first six months of transitioning into study abroad which has determinantal impacts for Higher Education Institutions. These impacts include; increased drop-out rates and overall decreases in academic performance. Research suggests that belongingness can negate acculturative stressors through providing opportunities for students to form necessary social connections. In response to this universities have focussed on utilising technology to create learning communities with the most commonly deployed being social media, blogs, and discussion forums. Despite these attempts, the application of technology in supporting international students is still ambiguous. With the reported growing popularity of mobile devices among students and accelerations in learning technology owing to the COVID-19 pandemic, the potential is recognised to address this challenge via the use of chatbot technology. Whilst traditionally, chatbots were deployed as conversational agents in business domains, they have since been applied to the field of education. Within this emerging area of research, a gap exists in addressing the educational value of chatbots over and above the traditional service orientation categorisation. The proposed study seeks to extend upon current understandings by investigating the challenges faced by international students in studying abroad and exploring the potential of chatbots as a solution to assist students’ acculturation. There has been growing interest in the application of chatbot technology to education accelerated by the shift to online learning during the COVID-19 pandemic. Although interest in educational chatbots has surged, there is a lack of consistency in the research area in terms of guidance on the design to support international students in HE. This gap is widened when considering the additional challenge of supporting multicultural international students with diverse. Diversification in education is rising due to increases in migration trends for international study. As global opportunities for education increase, so does the need for multiculturally inclusive learning support.

Keywords: chatbots, education, international students, acculturation

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Authors: Narissa Lewis, Susan Geertshuis

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The global and national employability agenda is changing the higher education landscape as academic staff are faced with the responsibility of developing employability capabilities and attributes in addition to delivering discipline specific content and skills. They realise that the shift towards teaching sustainable capabilities means a shift in the way they teach. But what that shift should be or how they should bring it about is unclear. As part of a national funded project, representatives from several New Zealand (NZ) higher education institutions and the NZ Association of Graduate Employers partnered to discover, trial and disseminate means of embedding employability in the curriculum. Findings from four focus groups (n=~75) and individual interviews (n=20) with staff from several NZ higher education institutions identified factors that enable or hinder embedded employability development within their respective institutions. Participants believed that higher education institutions have a key role in developing graduates for successful lives and careers however this requires a significant shift in culture within their respective institutions. Participants cited three main barriers: lack of strategic direction, support and guidance; lack of understanding and awareness of employability; and lack of resourcing and staff capability. Without adequate understanding and awareness of employability, participants believed it is difficult to understand what employability is let alone how it can be embedded in the curriculum. This presentation will describe some of the impacts that the employability agenda has on staff as they try to move from traditional to contemporary forms of teaching to develop employability attributes of students. Changes at the institutional level are required to support contemporary forms of teaching, however this is often beyond the sphere of influence at the teaching staff level. The study identified that small changes to teaching practices were necessary and a simple model to facilitate change from traditional to contemporary forms of teaching was developed. The model provides a framework to identify small but impactful teaching practices and exemplar teaching practices were identified. These practices were evaluated for transferability into other contexts to encourage small but impactful changes to embed employability in the curriculum.

Keywords: curriculum design, change management, employability, teaching exemplars

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Authors: Antonio M. Oliveira, Patricia Oliveira-Silva, Jose Matias Alves, Gary McPherson

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The music teaching is oriented towards offering formal music training. Due to its specificities, this vocational program starts at a very young age. Although provided by the State, the offer is limited to 6 schools throughout the country, which means that the vacancies for prospective students are very limited every year. It is therefore crucial that these vacancies be taken by especially motivated children grown within households that offer the ideal setting for success. Some of the instruments used to evaluate musical performance are highly sensitive to specific previous training, what represents a severe validity problem for testing children who have had restricted opportunities for formal training. Moreover, these practices may be unfair because, for instance, they may not reflect the candidates’ music aptitudes. Based on what constitutes a prerequisite for making an excellent music student, researchers in this field have long argued that motivation, task commitment, and parents’ support are as important as ability. Thus, the aim of this study is: (1) to prepare an inventory of admission requirements in Australia, Portugal and Ireland; (2) to examine whether the candidates to music conservatories and parents’ level of motivation, assessed at three evaluation points (i.e., admission, at the end of the first year, and at the end of the second year), correlates positively with the candidates’ progress in learning a musical instrument (i.e., whether motivation at the admission may predict student musicianship); (3) an adaptation of an existing instrument to assess the motivation (i.e., to adapt the items to the music setting, focusing on the motivation for playing a musical instrument). The inclusion criteria are: only children registered in the administrative services to be evaluated for entrance to the conservatory will be accepted for this study. The expected number of participants is fifty (5-6 years old) in all the three frequency schemes: integrated, articulated and supplementary. Revisiting musical admission procedures is of particular importance and relevance to musical education because this debate may bring guidance and assistance about the needed improvement to make the process of admission fairer and more transparent.

Keywords: music learning, music admission requirements, student’s motivation, parent’s motivation

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Authors: Zhaopeng Zhu, Xianzhi Song, Gensheng Li

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Transports of solid particles through the drill pipe, drill string-hole annulus and hydraulically generated fractures are important dynamic processes encountered in oil and gas well drilling and completion operations. Different from particle transport in infinite space, the transports of cuttings, proppants and formation sand are hindered by a finite boundary. Therefore, an accurate description of the particle transport behavior under the bounded wall conditions encountered in drilling and hydraulic fracturing operations is needed to improve drilling safety and efficiency. In this study, the particle settling experiments were carried out to investigate the particle settling behavior in the pipe, annulus and between the parallel plates filled with power-law fluids. Experimental conditions simulated the particle Reynolds number ranges of 0.01-123.87, the dimensionless diameter ranges of 0.20-0.80 and the fluid flow behavior index ranges of 0.48-0.69. Firstly, the wall effect of the annulus is revealed by analyzing the settling process of the particles in the annular geometry with variable inner pipe diameter. Then, the geometric continuity among the pipe, annulus and parallel plates was determined by introducing the ratio of inner diameter to an outer diameter of the annulus. Further, a unified dimensionless diameter was defined to confirm the relationship between the three different geometry in terms of the wall effect. In addition, a dimensionless term independent from the settling velocity was introduced to establish a unified explicit settling velocity model applicable to pipes, annulus and fractures with a mean relative error of 8.71%. An example case study was provided to demonstrate the application of the unified model for predicting particle settling velocity. This paper is the first study of annulus wall effects based on the geometric continuity concept and the unified model presented here will provide theoretical guidance for improved hydraulic design of cuttings transport, proppant placement and sand management operations.

Keywords: wall effect, particle settling velocity, cuttings transport, proppant transport in fracture

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Authors: James Britton, Vijaya Krishna, Manus Biggs, Abhay Pandit

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Regeneration of the spinal cord after injury remains a great challenge due to the complexity of this organ. Inflammation and gliosis at the injury site hinder the outgrowth of axons and hence prevent synaptic reconnection and reinnervation. Hyaluronic acid (HA) is the main component of the spinal cord extracellular matrix and plays a vital role in cell proliferation and axonal guidance. In this study, we have synthesized and characterized a photo-cross-linkable HA-tyramine (tyr) hydrogel from a chemical, mechanical, electrical, biological and structural perspective. From our experimentation, we have found that HA-tyr can be synthesized with controllable degrees of tyramine substitution using click chemistry. The complex modulus (G*) of HA-tyr can be tuned to mimic the mechanical properties of the native spinal cord via optimization of the photo-initiator concentration and UV exposure. We have examined the degree of tyramine-tyramine covalent bonding (polymerization) as a function of UV exposure and photo-initiator use via Photo and Nuclear magnetic resonance spectroscopy. Both swelling and enzymatic degradation assays were conducted to examine the resilience of our 3D printed hydrogel constructs in-vitro. Using a femtosecond 780nm laser, the two-photon polymerization of HA-tyr hydrogel in the presence of riboflavin photoinitiator was optimized. A laser power of 50mW and scan speed of 30,000 μm/s produced high-resolution spatial patterning within the hydrogel with sustained mechanical integrity. Using dorsal root ganglion explants, the cytocompatibility of photo-crosslinked HA-tyr was assessed. Using potentiometry, the electrical conductivity of photo-crosslinked HA-tyr was assessed and compared to that of native spinal cord tissue as a function of frequency. In conclusion, we have developed a biocompatible hydrogel that can be used for photolithographic 3D printing to fabricate tissue engineered constructs for neural tissue regeneration applications.

Keywords: 3D printing, hyaluronic acid, photolithography, spinal cord injury

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Authors: Ilirian Laçi, Alketa Spahiu

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Big strums of thyroid glandule observed by a simple viewing can be witnessed in everyday life. Medical cabinets evidence patients withpalpablenodes of thyroid glandule, mainly nodes of the size of 10 millimeters. Further, more cases which have resulted in negative under palpation have resulted in positive at ultrasound examination. Therefore, the use of ultrasound for diagnosing has increased the number of patients with nodes of thyroid glandule in the last couple of decades in all countries, Albania included. Thus, there has been evidence of an increased number of patients affected by this pathology, where female patients dominate. Demographically, the capital shows high numbers due to the high population, but of interest is the high incidence of those areas distanced from the sea. While regarding related pathologies, no significant link was evidenced, an element of ancestry was evident in the nodes of the thyroid glandule. When we talk of nodes of the thyroid glandule, we should consider hyperplasia, neoplasia, and inflammatory diseases that cause nodes of the thyroid glandule. This increase parallels the world’s increase of the incidence of thyroid glandule, with malign cases, which are at about 5% and are not depended on size. Given the numbers, with most thyroid glandule nodes being benign, the main objective of the examination of the nodes was the determination of benign and malign cases to avoid undue surgery. Subject of this study were 212 patients that underwent fine-needle aspiration (FNA) under ultrasound guidance at the Medical University Center of Tirana. All the patients came to the Mother Teresa University Hospital from public and private hospitals and other polyclinics. These patients had an ultrasound examination before visiting the Center of Nuclear Medicine for a scintigraph of thyroid glandule in the period September 2016 and September 2017. To correlate, all patients had been examined via ultrasound of the thyroid glandule prior to the scintigraph. The ultrasound included evaluation of the number of nodes, their size, their solid, cystic, or solid-cystic structure, echogenicity according to the gray scale, the presence of calcification, the presence of lymph nodes, the presence of adenopathy, and the correlation of the cytology results from the Laboratory of Pathological Anatomy of Medical University Center of Tirana.

Keywords: thyroid nodes, fine needle aspiration, ultrasound, scintigraphy

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Authors: Matthew Heidman, Susan Dallabrida, Analice Costa

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Background:Accuracy of caregiver reported outcomes is essential for infant growth and tolerability study success. Crying/fussiness, stool consistencies, and other gastrointestinal characteristics are important parameters regarding tolerability, and inter-caregiver reporting can see a significant amount of subjectivity and vary greatly within a study, compromising data. This study sought to elucidate how caregiver reported questions related to stool frequency are answered before and after a short amount of training and how training impacts caregivers’ understanding, and how they would answer the question. Methods:A digital survey was issued for 90 daysin the US (n=121) and 30 days in Mexico (n=88), targeting respondents with children ≤4 years of age. Respondents were asked a question in two formats, first without a line of training text and second with a line of training text. The question set was as follows, “If your baby had stool in his/her diaper and you changed the diaper and 10 min later there was more stool in the diaper, how many stools would you report this as?” followed by the same question beginning with “If you were given the instruction that IF there are at least 5 minutes in between stools, then it counts as two (2) stools…”.Four response items were provided for both questions, 1) 2 stools, 2) 1stool, 3) it depends on how much stool was in the first versus the second diaper, 4) There is not enough information to be able to answer the question. Response frequencies between questions were compared. Results: Responses to the question without training saw some variability in the US, with 69% selecting “2 stools”,11% selecting “1 stool”, 14% selecting “it depends on how much stool was in the first versus the second diaper”, and 7% selecting “There is not enough information to be able to answer the question” and in Mexico respondents selected 9%, 78%, 13%, and 0% respectively. However, responses to the question after training saw more consolidation in the US, with 85% of respondents selecting“2 stools,” representing an increase in those selecting the correct answer. Additionally in Mexico, with 84% of respondents selecting “1 episode” representing an increase in the those selecting the correct response. Conclusions: Caregiver reported outcomes are critical for infant growth and tolerability studies, however, they can be highly subjective and see a high variability of responses without guidance. Training is critical to standardize all caregivers’ perspective regarding how to answer questions accurately in order to provide an accurate dataset.

Keywords: infant nutrition, clinical trial optimization, stool reporting, decentralized clinical trials

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Authors: Asif Khaliq, Sayeeda A. Sayed

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The drug information centers provide drug related information to the requesters that include physicians, pharmacist, nurses and other allied health care professionals. The International Pharmacist Federation (FIP) describes basic functions of a drug and poison information centers as drug evaluation, therapeutic counseling, pharmaceutical advice, research, pharmaco-vigilence and toxicology. Continuous advancement in the field of medicine has expanded the medical literature, which has increased demand of a drug and poison information center for the guidance, support and facilitation of physicians. The objective of the study is to determine the need of drug and poison information centers in public and private hospitals of Karachi, Pakistan. A cross sectional study was conducted during July 2013 to April 2014 using a self-administered, multi-itemed questionnaire. Non Probability Convenient sampling was used to select the study participants. A total of 307 physicians from public and private hospitals of Karachi participated in the study. The need for 24/7 Drug and poison information center was highlighted by 92 % of physicians and 67% physicians suggested opening a drug information center at the hospital. It was reported that 70% physicians take at least 15 minutes for searching the information about the drug while managing a case. Regarding the poisoning case management, 52% physicians complaint about the unavailability of medicines in hospitals; and mentioned the importance of medicines for safe and timely management of patients. Although 73% physicians attended continued medical education (CME) sessions, 92 % physicians insisted on the need of 24/7 Drug and poison information center. The scarcity of organized channel for obtaining the information about drug and poisons is one of the most crucial problems for healthcare workers in Pakistan. The drug and poison information center is an advisory body that assists health care professional and patients in provision of appropriate drug and hazardous substance information. Drug and poison information center is one of the integral needs for running an effective health care system. Provision of a 24 /7 drug information centers with specialized staff offer multiple benefits to the hospitals while reducing treatment delays, addressing awareness gaps of all stakeholders and ensuring provision of quality health care.

Keywords: drug and poison information centers, Pakistan, physicians, public and private hospitals

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Authors: Aikaterini Tavoulari, Michael Proulx, Karin Petrini

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Objective: This study aims to explore the unique challenges faced by young individuals with vision impairment (VI) during key life transitions, utilizing a community-based participatory research (CBPR) approach to identify limitations and positive aspects of existing support systems, with a focus on accessibility and diversity. Design: The study employs a qualitative CBPR design, engaging young participants with VI through online and in-person working groups over six months, prioritizing their active involvement and diverse perspectives. Methods: Twenty-one young individuals with VI from across the UK and with different VI conditions were recruited to participate in the study via a climbing and virtual reality event and stakeholders’ support. Data collection methods included open discussions, forum exchanges, and qualitative questionnaires. The data were analyzed with NVivo using inductive thematic analysis to identify key themes and patterns related to the challenges and experiences of life transitions for this diverse population. Results: The analysis revealed barriers to accessibility, such as assumptions about what a person with VI can do, inaccessibility to material, noisy environments, and insufficient training with assistive technologies. Enablers included guidance from diverse professionals and peers, multisensory approaches (beyond tactile), and peer collaborations. This study underscores the need for developing accessible and tailored strategies together with these young people to address the specific needs of this diverse population during critical life transitions (e.g., to independent living, employment and higher education). Conclusion: Engaging and co-designing effective approaches and tools with young people with VI is key to tackling the specific accessibility barriers they encounter. These approaches should be targeted at different transitional periods of their life journey, promoting diversity and inclusion.

Keywords: vision impairement, life transitions, qualitative research, community-based participatory design, accessibility

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Authors: Sophia Yakhlef

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Norm-critical pedagogy is an approach originating from intersectional gender pedagogy, feminist pedagogy, queer pedagogy, and critical pedagogy. In the Swedish context, the norm critical approach is rising in popularity, and norms that are highlighted or challenged are, for example, various dimensions of power such as ’whiteness norm’, discourses of ’Swedishness’, ’middle class norm’, heteronormativity, and body functionality. Instead of seeing students as a homogenous group, intersectional pedagogy focuses on the consequences of differences and on critically paying attention to differences. The perspective encourages teachers to assess their teaching methods, material, and the course literature provided in their education. The classical sociological literature that most students encounter when studying behaviour science or sociology has, in recent years, been referred to as the sociological canon. The sociological perspectives of the classical scholars included in the canon have, in many ways, shaped how we perceive the history of sociology and theories of the modern world in general. The sociological canon has, in recent decades, been challenged by, amongst others, feminist, post-colonial, and queer theorists. This urges us to further investigate the implications that this might have on sociological and behavioural science education, as well as on pedagogical considerations and teaching methods. This qualitative case study focuses on the experiences of implementing a norm critical pedagogical perspective in an online behavioural science programme at Kristianstad University in Sweden. Interviews and informal conversations were conducted in 2022 with teachers regarding their experiences of teaching online, of implementing a student-centred learning approach, and their experiences of implementing a norm critical perspective in sociology and criminology courses. The study demonstrates the inclusion aspect of online education, the benefits of adopting a norm critical perspective, the challenges that arise when updating course literature, and the urgent need for guidance and education for teachers regarding inclusion and paying attention to power asymmetry.

Keywords: norm critical pedagogy, online-education, sociological canon, sweden

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