Search results for: international medical corps (IMC)

Authors: Diego de Almeida Pereira

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The roughness index of a road is considered the most important parameter about the quality of the pavement, as it has a close relation with the comfort and safety of the road users. Such condition can be established by means of functional evaluation of pavement surface deviations, measured by the International Roughness Index (IRI), an index that came out of the international evaluation of pavements, coordinated by the World Bank, and currently owns, as an index of limit measure, for purposes of receiving roads in Brazil, the value of 2.7 m/km. This work make use of the e.IRI parameter, obtained by the Roadroid app. for smartphones which use Android operating system. The choice of such application is due to the practicality for the user interaction, as it possesses a data storage on a cloud of its own, and the support given to universities all around the world. Data has been collected for six months, once in each month. The studies begun in March 2018, season of precipitations that worsen the conditions of the roads, besides the opportunity to accompany the damage and the quality of the interventions performed. About 350 kilometers of sections of four federal highways were analyzed, BR-020, BR-040, BR-060 and BR-070 that connect the Federal District (area where Brasilia is located) and surroundings, chosen for their economic and tourist importance, been two of them of federal and two others of private exploitation. As well as much of the road network, the analyzed stretches are coated of Hot Mix Asphalt (HMA). Thus, this present research performs a contrastive discussion between comfort conditions and safety of the roads under private exploitation in which users pay a fee to the concessionaires so they could travel on a road that meet the minimum requirements for usage, and regarding the quality of offered service on the roads under Federal Government jurisdiction. And finally, the contrast of data collected by National Department of Transport Infrastructure – DNIT, by means of a laser perfilometer, with data achieved by Roadroid, checking the applicability, the practicality and cost-effective, considering the app limitations.

Keywords: roadroid, international roughness index, Brazilian roads, pavement

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Authors: Lisa Fox, Jill Aylott

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There is a global need to identify ways to engage doctors in non-clinical matters such as medical leadership, service improvement and health system transformation. Using the core principles of Realistic Evaluation (RE), this study examined what works, for doctors of different grades, specialities and experience in an acute NHS Hospital Trust in the UK. Realistic Evaluation is an alternative to more traditional cause and effect evaluation models and seeks to understand the interdependencies of Context, Mechanism and Outcome proposing that Context (C) + Mechanism (M) = Outcome (O). In this study, the context, mechanism and outcome were examined from within individual medical leaders to determine what enables levels of medical engagement in a specific improvement project to reduce hospital inpatient mortality. Five qualitative case studies were undertaken with consultants who had regularly completed mortality reviews over a six month period. The case studies involved semi-structured interviews to test the theory behind the drivers for medical engagement. The interviews were analysed using a theory-driven thematic analysis to identify CMO configurations to explain what works, for whom and in what circumstances. The findings showed that consultants with a longer length of service became more engaged if there were opportunities to be involved in the beginning of an improvement project, with more opportunities to affect the design. Those that are new to a consultant role were more engaged if they felt able to apply any learning directly into their own settings or if they could use it as an opportunity to understand more about the organisation they are working in. This study concludes that RE is a useful methodology for better understanding the complexities of motivation and consultant engagement in a trust wide service improvement project. The study showed that there should be differentiated and bespoke training programmes to maximise each individual doctor’s propensity for medical engagement. The RE identified that there are different ways to ensure that doctors have the right skills to feel confident in service improvement projects.

Keywords: realistic evaluation, medical leadership, medical engagement, patient safety, service improvement

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Authors: Sonia Mannan, M. Jobair Alam

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The concept of palliative care in Bangladesh largely remained limited to the sympathetic caring of patients with a life-limiting illness. Quality of Life (QoL) issues are rarely practiced in Bangladesh. Furthermore, palliative medicine, in the perspective of holistic palliative care service, does not have its proper recognition in Bangladesh. Apart from those socio-medical aspects, palliative care patients face legal issues that impact their quality of life, including access to health services and social benefits and dealing with other life-transactions of the patients and their families (such as disposing of property; planning for children). This paper is an attempt to articulate these legal dimensions of the right to palliative care in the context of Bangladesh. The major focus of this paper will be founded on the doctrinal analysis of the constitutional provisions and other relevant legislation on the right to health and their judicial interpretation, which is argued to offer a meaningful space for the right to palliative care. This paper will also investigate the gaps in the said legal framework to better secure such care. In conclusion, a few recommendations are made so that the palliative care practices in Bangladesh are better aligned with international standards, and it can respond more humanely to the patients who need palliative care.

Keywords: Bangladesh, constitution, legal regime, palliative care, quality of life

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Authors: Cyril Ekuaze

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This paper was instigated by a set of assumption drawn at the introduction to a research work on alternative institutional arrangements for sustaining rural infrastructure in developing countries. Of one of such assumption is the one held that, a problem facing developing countries is the sustaining of infrastructural investment long enough to allow the facility to at least repay the cost of the development as been due to insufficient maintenance. On the contrary, this work argues that, most international partnerships relation with developing nations in developing infrastructures is “vertical modeling” with the hierarchical authority and command flow from top to bottom. The work argued that where international donor partners/agencies set out infrastructural development agenda in the developing nations without cognizance of design suitability and capacity for maintenance by the recipient nations; and where public administrative capacity building in the field of science, technology and engineering requisite for design, development and sustenance of infrastructure in the recipient countries are negated, prospective output becomes problematic.

Keywords: vertical partnerships, responsive failure, infrastructural development, developing countries

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Authors: Rameshwar Dahal, S. Ping Ho

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Although the demand for infrastructure development forms a promising market opportunity for international firms, the dominance of informal institutions over formal ones, investors are facing extraordinary institutional challenges when investing in emerging Least Developed Countries (LDCs). We believe that, in emerging LDCs, the project performance heavily depends on how well the entrants respond to the challenges exerted by the host institutional environments. Which primarily depends on how much they learn about the host institution and what strategy they apply in response. In Nepal, almost all international or global infrastructure projects are financed by international financers, so the procurement process of the infrastructure projects financed by foreign agencies is guided by the policies and regulations of the financer. Because of limited resources and the financers’ demand, contractors and consults are procured internationally. Moreover, the resources, including but not limited to construction material, manpower, and equipment, also need to be imported. Therefore, the involvement of international companies as an entrant in global infrastructure projects of LDCs is obvious. In a global project (GP), participants from different geographical and institutional environments hold different beliefs and have disparate interests. Therefore, the entrants face the challenges exerted by the host institutional environments. The entrants must either adapt to the institutions prevailing in the environment or resist the institutional pressures. It is hypothesized that, in emerging LDCs, the project performance heavily depends on how much the entrants learn about the host institutional knowledge and how well they respond to the institutional environments. While it is impossible to generalize the phenomenon and contextual conditions because of their vast diversity, this study has answered why and how participants’ level of institutional knowledge impacts the project's implementation performance. To draw that conclusion, firstly, we explored two typical GPs from Nepal. For this study, the data were collected by conducting interviews and examining the secondary data, such as the project reports published by the financers, project data provided by interviewees, and news reports. In an event analysis, firstly, we identify the sources, causes, or nature of the institutional challenges; secondly, we analyze the entrant’s responses to the exerted challenges and evaluate the impacts of the responses on the overall project performance. In this study, at first, the events occurred during the project implementation process have a causal link with the local institutions that demand the entrants’ response are extracted. Secondly, each event is scrutinized as the critical success factor of the case project. Finally, it is crucially examined whether and what institutional knowledge in these events played a critical role in project success or failure. The results also provide insights into the crucial institutional knowledge in LDCs and the subsequent strategy implications for undertaking projects in LDCs.

Keywords: emerging countries, LDC, project management, project performance, institutional knowledge, institutional theory

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Authors: Dongguk Im, Gunfeel Moon, Younwoo Nam, Kangwoo Chun

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Recognition of the needs about protecting environment throughout worldwide is widespread. In the shipping industry, International Maritime Organization (IMO) has been regulating pollutants emitted from ships by MARPOL 73/78. Recently, the Marine Environment Protection Committee (MEPC) of IMO, at its 68th session, approved the definition of Black Carbon (BC) specified by the following physical properties (light absorption, refractory, insolubility and morphology). The committee also agreed to the need for a protocol for any voluntary measurement studies to identify the most appropriate measurement methods. Filter Smoke Number (FSN) based on light absorption is categorized as one of the IMO relevant BC measurement methods. EUROMOT provided a FSN measurement data (measured by smoke meter) of 31 different engines (low, medium and high speed marine engines) of member companies at the 3rd International Council on Clean Transportation (ICCT) workshop on marine BC. From the comparison of FSN, the results indicated that BC emission from low speed marine diesel engines was ranged from 0.009 to 0.179 FSN and it from medium and high speed marine diesel engine was ranged 0.012 to 3.2 FSN. In consideration of measured the low FSN from low speed engine, an experimental study was conducted using both a low speed marine diesel engine (2 stroke, power of 7,400 kW at 129 rpm) and a high speed marine diesel engine (4 stroke, power of 403 kW at 1,800 rpm) under E3 test cycle. The results revealed that FSN was ranged from 0.01 to 0.16 and 1.09 to 1.35 for low and high speed engines, respectively. The measurement equipment (smoke meter) ranges from 0 to 10 FSN. Considering measurement range of it, FSN values from low speed engines are near the detection limit (0.002 FSN or ~0.02 mg/m3). From these results, it seems to be modulated the measurement range of the measurement equipment (smoke meter) for enhancing measurement accuracy of marine BC and evaluation on performance of BC abatement technologies.

Keywords: black carbon, filter smoke number, international maritime organization, marine diesel engine (two and four stroke), particulate matter

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Authors: Min Bae

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Hygiene had traditionally meant ways of healthy and right living. However, the nineteenth century was the time when a gradual shift in medical and hygienic paradigms took place from holism to reductionism. Against this medical and social background, E. W. Lane (MD, Edinburgh, 1853) formulated his own medical philosophies in his book Hydropathy: Or Hygienic Medicine (1859). Until the 1880s when he published his last book on the hygienic medicine, he consistently intended to raise the importance of hygienic holism in medicine, while adopting hydropathy as his main therapeutic measure. Lane’s case reflects the mid-nineteenth century trend in which since the 1840s, the rational and holistic facets in medicine had significantly transferred to hydropathy, which was the most naturalistic healing system in the medical market. Hygiene for Lane was no longer the ancient form of ‘six non-naturals’. He emphasised physiology as the rational grounds for his project of the medicalisation of hygiene. His medical philosophy was profoundly naturalistic and holistic against the opposite trend of the contemporary hygiene and medicine. Conflicting aspects may often be best embodied in persons who stood on the boundaries between inside and outside. Lane’s theories on hygienic medicine did not develop into a new medical system which he believed would reconciliate orthodox medicine and hydropathy of his time had also adopted increasingly reductionist approaches since 1860s. Nevertheless, the naturalistic philosophies and approaches in Lane’s hygienic medicine demonstrates a continuous effort for a theoretical reformulation of hydropathy during its stagnant and declining period to constantly fit into the holistic paradigm of medicine and hygiene. Considering the fact that the nature cure concept in hydropathy and its individualistic approach were succeeded by naturopathy at the end of the century, analysis of Lane’s medical thoughts reveals part of a ‘thin red line’ of naturalism in the battleground between reductionism and holism during the nineteenth century in the history of medicine and hygiene.

Keywords: E. W. Lane, hygienic medicine, hydropathy, naturopath

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Authors: Cleto J. Sauer Jr

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Introduction: Brazil’s new national curriculum guidelines (NCG) for medical education were published in 2014, presenting active learning methodologies as a cornerstone. Simulation was initially applied for aviation pilots’ training and is currently applied in health sciences. The high-fidelity simulator replicates human body anatomy in detail, also reproducing physiological functions and its use is increasing in medical schools. Realistic Simulation (RS) has pedagogical aspects that are aligned with Brazil’s NCG teaching concepts. The main objective of this study is to carry on a narrative review on RS’s aspects that are aligned with Brazil’s new NCG teaching concepts. Methodology: A narrative review was conducted, with search in three databases (PubMed, Embase and BVS) of studies published between 2010 and 2020. Results: After systematized search, 49 studies were selected and divided into four thematic groups. RS is aligned with new Brazilian medical curriculum as it is an active learning methodology, providing greater patient safety, uniform teaching, and student's emotional skills enhancement. RS is based on reflective learning, a teaching concept developed for adult’s education. Conclusion: RS is a methodology aligned with NCG teaching concepts and has potential to assist in the implementation of new Brazilian medical school’s curriculum. It is an immersive and interactive methodology, which provides reflective learning in a safe environment for students and patients.

Keywords: curriculum, high-fidelity simulator, medical education, realistic simulation

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Authors: Rihab Gamaoun, Cynthia El Hage, Laura Ruiz, Erin Prosk, Antonio Vigano

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Introduction: Santé Cannabis (SC), a Canadian medical cannabis-specialized group of clinics based in Montreal and in the province of Québec, has served more than 5000 patients seeking cannabis-based treatment prescription for medical indications over the past five years. Within a research frame, data on the use of medical cannabis products from all the above patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to gather information on the profiles of both patients and prescribed medical cannabis products at SC clinics and to assess the safety of medical cannabis among Canadian patients. Methods: Using a retrospective analysis of the database, records of 2585 patients who were prescribed medical cannabis products for therapeutic purposes between 01-November 2017 and 04-September 2019 were included. Patients’ demographics, primary diagnosis, route of administration, and chemovars recorded at the initial visits were investigated. Results: At baseline: 9% of SC patients were female, with a mean age of 57 (SD= 15.8, range= [18-96]); Cannabis products were prescribed mainly for patients with a diagnosis of chronic pain (65.9% of patients), cancer (9.4%), neurological disorders (6.5%), mood disorders (5.8 %) and inflammatory diseases (4.1%). Route of administration and chemovars of prescribed cannabis products were the following: 96% of patients received cannabis oil (51% CBD rich, 42.5% CBD:THC); 32.1% dried cannabis (21.3% CBD:THC, 7.4% THC rich, 3.4 CBD rich), and 2.1% oral spray cannabis (1.1% CBD:THC, 0.8% CBD rich, 0.2% THC rich). Most patients were prescribed simultaneously, a combination of products with different administration routes and chemovars. Safety analysis is undergoing. Conclusion: Our results provided initial information on the profile of medical cannabis products prescribed in a Canadian population and the experienced adverse events over the past three years. The Santé Cannabis database represents a unique opportunity for comparing clinical practices in prescribing and titrating cannabis-based medications across different centers. Ultimately real-world data, including information about safety and effectiveness, will help to create standardized and validated guidelines for choosing dose, route of administration, and chemovars types for the cannabis-based medication in different diseases and indications.

Keywords: medical cannabis, real-world data, safety, pharmacovigilance

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Authors: Hyeon Seok Kim, Inhoi Lee, Seong Baeg Kim, Kyunghee Ko, Kyung Eon Lee, Dong Sik Kang

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In the age of globalization, higher education institutions attempt to equip students with global competence. In response, most universities have been developing and running various international programs. However, teacher education has been a neglected area in this trend. Therefore, in this study, we suggest a program that offers a dual bachelor’s degree from both universities located on different countries, focusing on teacher education institutions with different policies and regulations of teacher education programs that may become obstacles to designing a dual degree program. We discuss a possible way to get a dual degree including a teaching certificate at a specialized college, college of secondary education. To be specific, this research presents a way to attain two diplomas from Jeju National University (JNU) in Korea and Boise State University (BSU) in the U.S. It attempts to build an effective plan for students to declare simultaneous degrees at both universities. From the study, we find that it takes about 5 years to fulfill requirements for the dual degree at the undergraduate level.

Keywords: dual degree, curriculum, teaching certificate, college of secondary education, international program

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Authors: Oyebade K. Oyedotun

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The cardiotocogram is a technical recording of the heartbeat rate and uterine contractions of a fetus during pregnancy. During pregnancy, several complications can occur to both the mother and the fetus; hence it is very crucial that medical experts are able to find technical means to check the healthiness of the mother and especially the fetus. It is very important that the fetus develops as expected in stages during the pregnancy period; however, the task of monitoring the health status of the fetus is not that which is easily achieved as the fetus is not wholly physically available to medical experts for inspection. Hence, doctors have to resort to some other tests that can give an indication of the status of the fetus. One of such diagnostic test is to obtain cardiotocograms of the fetus. From the analysis of the cardiotocograms, medical experts can determine the status of the fetus, and therefore necessary medical interventions. Generally, medical experts classify examined cardiotocograms into ‘normal’, ‘suspect’, or ‘pathological’. This work presents an artificial neural network based decision support system which can filter cardiotocograms data, producing the corresponding statuses of the fetuses. The capability of artificial neural network to explore the cardiotocogram data and learn features that distinguish one class from the others has been exploited in this research. In this research, feedforward and radial basis neural networks were trained on a publicly available database to classify the processed cardiotocogram data into one of the three classes: ‘normal’, ‘suspect’, or ‘pathological’. Classification accuracies of 87.8% and 89.2% were achieved during the test phase of the trained network for the feedforward and radial basis neural networks respectively. It is the hope that while the system described in this work may not be a complete replacement for a medical expert in fetus status evaluation, it can significantly reinforce the confidence in medical diagnosis reached by experts.

Keywords: decision support, cardiotocogram, classification, neural networks

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Authors: Laura Cochrane

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The United States Centers for Disease Control and Prevention has established three categories of biological agents based on their ease of spread and the severity of the disease they cause. Category A biological agents are the highest priority because of their high degree of morbidity and mortality, ease of dissemination, the potential to cause social disruption and panic, special requirements for public health preparedness, and past use as a biological weapon. Despite the threat of Category A biological agents, opportunities for medical intervention exist. This work summarizes public information, consolidated and reviewed across the situational usefulness and disease awareness to offer discussion to three specific Category A agents: anthrax (Bacillus anthracis), botulism (Clostridium botulinum toxin), and smallpox (variola major), and provides an overview on the management of medical countermeasures available to treat these three (3) different types of pathogens. The medical countermeasures are discussed in the setting of pre-exposure prophylaxis, post-exposure prophylaxis, and therapeutic treatments to provide a framework for requirements in public health preparedness.

Keywords: anthrax, botulism, smallpox, medical countermeasures

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Authors: Zainab Idrees Ahmad, Mahjabeen Qureshi, Zainab Hussain

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Standard precautions are a set of infection control practices used to prevent the transmission of diseases that can be acquired by contact with body fluids, non-intact skin, and mucous membranes. Lack of practice of SPs can result in a considerable increase in morbidity and mortality rates. Medical students (the future physicians) should have the highest knowledge of standard precautions to prevent the spread of nosocomial infections and ensure their safety as well. This study was designed. To assess the knowledge of medical students regarding standard precautions. And explore the attitude of medical students of MBBS in the third, fourth and final year towards standard precautions.: A descriptive cross-sectional study was conducted in the setting of Rawalpindi Medical University, Pakistan including the students of MBBS in their 3rd, 4th and final years. The study duration was from October 2022 to February 2023. The sample size calculated was 282 with a confidence interval of 95%. A questionnaire was structured utilizing the WHO guidelines on SPs assessing knowledge and attitude regarding hand hygiene, needle stick injury, use of gloves and mask, and sharp disposal. A total of 300 responses were received utilizing the technique of non-random convenience sampling. Data was analyzed using the latest version of SPSS.:Knowledge score regarding components of SPs, hand hygiene, and moments of hand hygiene was satisfactory. However, score regarding the use of PPE, needle stick injury, and sharp disposal was low. Almost all the students were compliant with the proper washing of hands but the observation of recommended time length was lacking. Compliance with the use of correct PPE and informing the supervisor upon getting a needle stick injury was low. This study signifies that medical students lack knowledge regarding standard precautions. This is alarming as this can be the vehicle for the spread of nosocomial infections. Proper training should be given to medical students to prevent the spread of hospital-acquired infections.

Keywords: attitude, knowledge, medical students, standard precautions

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Authors: Argyro Maria Skourmalla

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The present paper draws on the example of the University of Luxembourg as a multilingual and international setting. The University of Luxembourg, which is located between France, Germany, and Belgium, has adopted a new multilingualism policy in 2020, establishing English, French, German, and Luxembourgish as the official languages of the Institution. With around 7.000 students, more than half of which are international students, the University is a meeting point for languages and cultures. This paper includes data from an online survey that with undergraduate students from different disciplines at the University of Luxembourg. Students shared their personal experience and opinions regarding language use in this higher education context, as well as practices they use in learning in this multilingual context. Findings show the role of technology in assisting students in different aspects of learning this multilingual context. At the same time, more needs to be done to avoid an exclusively monolingual paradigm in higher education. Findings also show that some languages remain ‘unseen’ in this context. Overall, even though linguistic diversity in this University is seen as an asset, a lot needs to be done towards the recognition of staff and students’ linguistic repertoires for inclusion and education equity.

Keywords: higher education, learning, linguistic diversity, multilingual practices

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Authors: Omer Livvarcin, Mary Kay Park, Michael Miles

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The current literature includes a few studies that mention the impact of relations between teams, the business environment, and experiences from previous projects. There is, however, limited research that treats the phenomenon of project atmosphere (PA) as a whole. This is especially true of research identifying parameters and sub-parameters, which allow project management (PM) teams to build a project culture that ultimately imbues project success. This study’s findings identify a number of key project atmosphere parameters and sub-parameters that affect project management success. One key parameter identified in the study is a cluster related to cultural concurrence, including artifacts such as policies and mores, values, perceptions, and assumptions. A second cluster centers on motivational concurrence, including such elements as project goals and team-member expectations, moods, morale, motivation, and organizational support. A third parameter cluster relates to experiential concurrence, with a focus on project and organizational memory, previous internal PM experience, and external environmental PM history and experience). A final cluster of parameters is comprised of those falling in the area of relational concurrence, including inter/intragroup relationships, role conflicts, and trust. International and intercultural project management data was collected and analyzed from the following countries: Canada, China, Nigeria, South Korea and Turkey. The cross-cultural nature of the data set suggests increased confidence that the findings will be generalizable across cultures and thus applicable for future international project management success. The intent of the identification of project atmosphere as a critical project management element is that a clear understanding of the dynamics of its sub-parameters upon projects may significantly improve the odds of success of future international and intercultural projects.

Keywords: project management, project atmosphere, cultural concurrence, motivational concurrence, relational concurrence

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Authors: Cristina Costa-Lobo, Ana Martins, Maria Das Dores Formosinho, Ana Campina, Filomena Ponte

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This paper is a report on the findings of a study conducted at an international leading food group. Documentary analysis and discourse analysis techniques were used to examine how corporate social responsibility and career education are valued by this international group. The Survey on Corporate Social Responsibility and Career Education was used, with 18 open-ended questions, the first six related to Corporate Social Responsibility and the last 12 related to Education for the Career. The Survey on the Social Emergency Fund was made up of 16 open-ended questions. The Social Welfare Survey was used to investigate the contribution of social workers in this area, as well as to understand their status. The sample of this investigation is composed by the Director of the development area, by the Coordinator and two Social Assistants of the Social Emergency Fund. Their collaboration was the provision of information in the form of an interview where the two main axes of this study were explored: Corporate Social Responsibility and Career Education. With regard to the analysis of data obtained from interviews, it was accomplished through the content analysis according to the Bardin's method (2004), through the pre-analytical, exploratory and qualitative treatment and interpretation of responses. Critical review of documents was also used. The success and effectiveness of this international group are marked by ambition, ability to resist difficulties, sharing of values, spirit of unity and team sense that is shared in its different companies, its leadership position is also due to the concern to see reinforced and developed values of work, discipline, rigor and competence, its management is geared towards responding to immediate challenges from a Corporate Social Responsibility perspective that is characteristic of it, incorporating concerns about impacts both in the medium and long term. In addition to internal training, it directs investments for external training by promoting actions such as participation in seminars and congresses worldwide and the creation of partnerships in various areas of management with prestigious teaching entities. Findings indicate the creation of a training school, with initiatives for internal and external training, in partnerships with prestigious teaching entities. Of particular note is the Management Trainees Program, developed for more than 25 years, characterized by building a career by obtaining knowledge and skills acquired in the combination of on-the-job experience and a training program.

Keywords: career education, corporate social responsibility, training school, management trainees program

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Authors: Muhammad Naveed, Yang Caixia

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The need for national space legislation is pivotal, particularly in light of the fact that in recent years space activities have grown immensely both in volume and diversity. Countries are progressively developing capabilities in space exploration and scientific discoveries, market their capabilities to manufacture satellites, provide launch services from their facilities and are looking to privatize and commercialize their space resources. Today, nations are also seeking to comprehend the technological and financial potential of the private sector and are considering to share their financial burdens with them and to limit their exposures to risks, but they are lagging behind in legal framework in this regard. In the perspective of these emerging developments, it is therefore, felt that national space legislation should be enacted with the goal of building and implementing a vibrant and transparent legal framework at the national level to hasten investments and to ensure growth in this capital intensive - highly yield strategic sector. This study looks at (I) the international legal framework that governs space activities; (II) motivation behind making national space laws; and (III) the need for national space legislation. The paper concludes with some recommendations with regards to the conceivable future direction for national space legislation, in particular space empowered sub-areas for countries.

Keywords: international conventions, national legislation, space faring nations, space law

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Authors: Ting Shen, Spyros Konstantopoulos

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During the past three decades, class size effects have been a focal debate in education. The idea of having smaller class is enormously popular among parents, teachers and policy makers. The rationale of its popularity is that small classroom could provide a better learning environment in which there would be more teacher-pupil interaction and more individualized instruction. This early stage benefits would also have a long-term positive effect. It is a common belief that reducing class size may result in increases in student achievement. However, the empirical evidence about class-size effects from experimental or quasi-experimental studies has been mixed overall. This study sheds more light on whether class size reduction impacts reading achievement in eight European countries: Bulgaria, Germany, Hungary, Italy, Lithuania, Romania, Slovakia, and Slovenia. We examine class size effects on reading achievement using national probability samples of fourth graders. All eight European countries had participated in the Progress in International Reading Literacy Study (PIRLS) in 2001, 2006 and 2011. Methodologically, the quasi-experimental method of instrumental variables (IV) has been utilized to facilitate causal inference of class size effects. Overall, the results indicate that class size effects on reading achievement are not significant across countries and years. However, class size effects are evident in Romania where reducing class size increases reading achievement. In contrast, in Germany, increasing class size seems to increase reading achievement. In future work, it would be valuable to evaluate differential class size effects for minority or economically disadvantaged student groups or low- and high-achievers. Replication studies with different samples and in various settings would also be informative. Future research should continue examining class size effects in different age groups and countries using rich international databases.

Keywords: class size, reading achievement, instrumental variables, PIRLS

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Authors: Cruz, G. P., Nagamatsu, R. N., Scacchetti, F. A. P., Merlin, F. K.

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This study aims to assess a set of technical parameters that provide quality products to the companies that produce caps, APL Apucarana / PR, the city that produces most Brazilian caps, in order to verify the potential of Brazilian caps to compete with international brands, recognized by the standard of excellence when it comes to quality of its products. The determination of the technical parameters was arbitrated from textile ABNT, a total of six technical parameters, providing eight tests for cotton caps. For the evaluation, we used as reference a leading brand recognized worldwide (based on their sales volume in $) for comparison with 3 companies of the APL Apucarana. The results showed that, of the 8 tests, of 8 tests, the companies Apucarana did not obtain better performance than the competitor. They obtained the same results in three tests and lower performance in 5. Given these values, it is concluded that local caps are not far from reaching the quality of leading brand. It is recommended that the APL companies use the parameters to evaluate their products, using this information to support decision-making that seek to improve both the product design and its production process, enabling the feasibility for faster international recognition . Thus, they may have an edge over its main competitor.

Keywords: technical parameters, making caps, quality, evaluation

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Authors: Nidesh Sapkota, Garima Pudasaini, Dikshya Agrawal, Binav Baral, Umesh Bhagat, Dharanidhar Baral

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Background: Medical and Dental students are vulnerable to higher levels of Psychological distress than other age matched peers. Many studies reveals that there is high prevalence of psychoactive substance use and Psychiatric co-morbidities among them. Objectives: -To study the prevalence of substance use among medical and dental students of a Medical University. -To study the prevalence of depression and anxiety in medical and dental students of a Medical University. Materials and Method: A cross-sectional descriptive study in which simple random sampling was done. Semi-structured questionnaire, AUDIT for alcohol use, Fagerstrom test for Nicotine dependence, Cannabis screening test (CAST), Beck’s Depression Inventory (BDI), Beck’s Anxiety Inventory (BAI) were used for the assessment. Results: Total sample size was 588 in which the mean age of participants was 22±2years. Among them the prevalence of alcohol users was 47.75%(281) in which 32%(90) were harmful users. Among 19.55%(115) nicotine users 56.5%(65), 37.4%(43), 6.1%(7) had low, low to moderate and moderate dependence respectively. The prevalence of cannabis users was 9%(53) with 45.3%(24), 18.9%(10) having low and high addiction respectively. Depressive symptoms were recorded in 25.3%(149) out of which 12.6%(74), 6.5%(38), 5.3%(31), 0.5%(3), 0.5%(3) had mild, borderline, moderate, severe and extreme depressive symptoms respectively. Similarly anxiety was recorded among 7.8%(46) students with 42 having moderate and 4 having severe anxiety symptoms. Among them 6.3%(37) had suicidal thoughts and 4(0.7%) of them had suicide attempt in last one year. Statistically significant association was noted with harmful alcohol users, Depression and suicidal attempts. Similar association was noted between Depression and suicide with moderate use of nicotine. Conclusion: There is high prevalence of Psychoactive substance use and psychiatric co-morbidities noted in the studies sample. Statistically significant association was noted with Psychiatric co-morbidities and substance use.

Keywords: alcohol, cannabis, dependence, depression, medical students

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Authors: Sunday Ofum Ogon

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The 1648 Westphalia Conference in Europe ushered in the state as the only legal entity with powers to engage in interstate relations on matters that bothers on the development need of her citizens. This epochal entry of the state reshaped global relations with the curtailment of the powers of individual and groups in external relations as the state became the only entity that acted on behalf of any individual or non-state actors like NGOs residing within the parameters of such a country. Thus, the paper interrogated the extent at which the state determines her Politico-Economic relations with regards to development and growth within the state. To achieve these objectives, the paper relied on documentary evidences wherein the qualitative descriptive method was used for data collection and analysis. The paper exploited the facilities of the Rentier State theory as a guide to the study. It was revealed at the end of the study that the 21st century global economic relations is largely determine by international organizations as exemplified by the World Bank and the International Monitory Fund (IMF) where their activities in the continent has undermined state sovereignty. Hence the paper recommended amongst others that states should look inward for development strategies rather than relying on handout from supra-national organizations which has infringe on their sovereignty.

Keywords: State , Global , Rentier state, Twenty-First Century

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Authors: Ferissa B. Ablola

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The two learning theories which were evidently used in medical education include cognitive and sociocultural frameworks. The interplay of different learning theories in education is vital since most of the existing theories have specific focus of development. In addition, a certain theory is best fit with a particular learning outcome and audience profile. The application of learning theories is education is said to be dynamic and becomes more complex with increasing educational level. This systematic review aims to describe the possible shift from integration of cognitive learning theory to employment of socio-cultural approach in medical and health-allied education over the years among students, educators and the learning institution through systematic review following the PRISMA guidelines. In addition, the changes in teaching modality and individual acceptance of the shift of learning framework among cognitive constructivist and social constructivist will also be documented. This present review may serve as baseline information on the connection of two widely used theories in medical education in different year levels. Further, this study emphasizes the significance of the alignment of different learning theories and combination of insights from several educational frameworks, would permit the creation of a teaching/learning design with real theoretical depth. A more inclusive systematic review is necessary to involve more related studies, and exploration of interaction among other learning theories in health and other fields of study is encouraged.

Keywords: learning theory, cognitive, sociocultural, medical education

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Authors: Khalid Abdelghany

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Additive Manufacturing (AM) is the manufacturing technology that is used to fabricate fast products direct from CAD models in very short time and with minimum operation steps. Jointly with the advancement in medical computer modeling, AM proved to be a very efficient tool to help physicians, orthopedic surgeons and dentists design and fabricate patient-tailored surgical guides, templates and customized implants from the patient’s CT / MRI images. AM jointly with computer-assisted designing/computer-assisted manufacturing (CAD/CAM) technology have enabled medical practitioners to tailor physical models in a patient-and purpose-specific fashion and helped to design and manufacture of templates, appliances and devices with a high range of accuracy using biocompatible materials. In developing countries, there are some technical and financial limitations of implementing such advanced tools as an essential portion of medical applications. CMRDI institute in Egypt has been working in the field of Medical Additive Manufacturing since 2003 and has assisted in the recovery of hundreds of poor patients using these advanced tools. This paper focuses on the surgical and dental use of 3D printing technology in Egypt as a developing country. The presented case studies have been designed and processed using the software tools and additive manufacturing machines in CMRDI through cooperative engineering and medical works. Results showed that the implementation of the additive manufacturing tools in developed countries is successful and could be economical comparing to long treatment plans.

Keywords: additive manufacturing, dental and orthopeadic stents, patient specific surgical tools, titanium implants

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Authors: Elnaz Entezar, Reza Ezzati

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In recent decades, trade flows, capital, workforce, technology and information have increased between international borders and the globalization has turned to an undeniable process in international economics. Meanwhile, despite the positive aspects of globalization, the critics of globalization opine that the risks and costs of globalization for developing vulnerable economies and the world's impoverished people are high and significant. In this regard, this study by using the data of KOF Economic Institute and the World Bank for 113 different countries during the period 2002-2012, by taking advantage of panel smooth transition regression, and by taking the gross domestic product as transmission variables discuss the nonlinear relationship between research variables. The results have revealed that globalization in low regime (countries with low GDP) has negative impact whereas in high regime (countries with high GDP) has a positive impact. In spite of the fact that in the early stages of growth, control of corruption has a positive impact on economic growth, after a threshold has a negative impact on economic growth.

Keywords: globalization, corruption, panel smooth transition model, economic growth, threshold, economic convergence

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Authors: Daniel Bulanda, Janusz A. Starzyk, Adrian Horzyk

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The electrocardiogram (ECG) is one of the most commonly used medical tests, essential for correct diagnosis and treatment of the patient. While ECG devices generate a huge amount of data, only a small part of them carries valuable medical information. To deal with this problem, many compression algorithms and filters have been developed over the past years. However, the rapid development of new machine learning techniques poses new challenges. To address this class of problems, we created the FlexPoints algorithm that searches for characteristic points on the ECG signal and ignores all other points that do not carry relevant medical information. The conducted experiments proved that the presented algorithm can significantly reduce the number of data points which represents ECG signal without losing valuable medical information. These sparse but essential characteristic points (flex points) can be a perfect input for some modern machine learning models, which works much better using flex points as an input instead of raw data or data compressed by many popular algorithms.

Keywords: characteristic points, electrocardiogram, ECG, machine learning, signal compression

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Authors: Siyuan Cai

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This paper takes community segregation during major infectious diseases as the background, based on the physiological needs and safety needs of citizens during home segregation, and based on the selection of convenient facilities and medical facilities as the main research objects. Based on the POI data of public facilities in Chongqing, the spatial distribution characteristics of the convenience and medical facilities in the 15-minute living circle centered on three neighborhoods in Shapingba, namely Shengwei Community, Anju Commmunity and Fengtian Garden Community, were explored by means of GIS spatial analysis. The results show that the spatial distribution of convenience and medical facilities in this area has significant clustering characteristics, with a point-like distribution pattern of "dense in the west and sparse in the east", and a grouped and multi-polar spatial structure. The spatial structure is multi-polar and has an obvious tendency to the intersections and residential areas with dense pedestrian flow. This study provides a preliminary exploration of the distribution of medical and convenience facilities within the 15-minute living circle of a segregated community, which makes up for the lack of spatial research in this area.

Keywords: ArcGIS, community segregation, convenient facilities; distribution pattern, medical facilities, POI, 15-minute community life circle

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Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

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Introduction: An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavored to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learners. Aim: Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Methods: Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Results: Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. Discussion: After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Conclusion: Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: ethics, medical student, doubt, medical education, faith

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Authors: Nadezhda Kvatashidze, Elena Kharabadze

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It is broadly known that lease is a flexible means of funding enterprises. Lease reduces the risk related to access and possession of assets, as well as obtainment of funding. Therefore, it is important to refine lease accounting. The lease accounting regulations under the applicable standard (International Accounting Standards 17) make concealment of liabilities possible. As a result, the information users get inaccurate and incomprehensive information and have to resort to an additional assessment of the off-balance sheet lease liabilities. In order to address the problem, the International Financial Reporting Standards Board decided to change the approach to lease accounting. With the deficiencies of the applicable standard taken into account, the new standard (IFRS 16 ‘Leases’) aims at supplying appropriate and fair lease-related information to the users. Save certain exclusions; the lessee is obliged to recognize all the lease agreements in its financial report. The approach was determined by the fact that under the lease agreement, rights and obligations arise by way of assets and liabilities. Immediately upon conclusion of the lease agreement, the lessee takes an asset into its disposal and assumes the obligation to effect the lease-related payments in order to meet the recognition criteria defined by the Conceptual Framework for Financial Reporting. The payments are to be entered into the financial report. The new lease accounting standard secures supply of quality and comparable information to the financial information users. The International Accounting Standards Board and the US Financial Accounting Standards Board jointly developed IFRS 15: ‘Revenue from Contracts with Customers’. The standard allows the establishment of detailed revenue recognition practical criteria such as identification of the performance obligations in the contract, determination of the transaction price and its components, especially price variable considerations and other important components, as well as passage of control over the asset to the customer. IFRS 15: ‘Revenue from Contracts with Customers’ is very similar to the relevant US standards and includes requirements more specific and consistent than those of the standards in place. The new standard is going to change the recognition terms and techniques in the industries, such as construction, telecommunications (mobile and cable networks), licensing (media, science, franchising), real property, software etc.

Keywords: assessment of the lease assets and liabilities, contractual liability, division of contract, identification of contracts, contract price, lease identification, lease liabilities, off-balance sheet, transaction value

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Authors: Jorge Anibal Restrepo Morales, Sonia Martín Gómez

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A model based on a logical framework was developed to quantify SMEs' internationalization capacity. To do so, linguistic variables, such as human talent, infrastructure, innovation strategies, FTAs, marketing strategies, finance, etc. were integrated. It is argued that a company’s management of international markets depends on internal factors, especially capabilities and resources available. This study considers internal factors as the biggest business challenge because they force companies to develop an adequate set of capabilities. At this stage, importance and strategic relevance have to be defined in order to build competitive advantages. A fuzzy inference system is proposed to model the resources, skills, and capabilities that determine the success of internationalization. Data: 157 linguistic variables were used. These variables were defined by international trade entrepreneurs, experts, consultants, and researchers. Using expert judgment, the variables were condensed into18 factors that explain SMEs’ export capacity. The proposed model is applied by means of a case study of the textile and clothing cluster in Medellin, Colombia. In the model implementation, a general index of 28.2 was obtained for internationalization capabilities. The result confirms that the sector’s current capabilities and resources are not sufficient for a successful integration into the international market. The model specifies the factors and variables, which need to be worked on in order to improve export capability. In the case of textile companies, the lack of a continuous recording of information stands out. Likewise, there are very few studies directed towards developing long-term plans, and., there is little consistency in exports criteria. This method emerges as an innovative management tool linked to internal organizational spheres and their different abilities.

Keywords: business strategy, exports, internationalization, fuzzy set methods

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Authors: Murad A. Bein

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This paper empirically examines the time-varying relationship and spillover effects between the international crude oil price and ten emerging equity markets, namely three oil-exporting countries (Brazil, Mexico, and Russia) and seven Central and Eastern European (CEE) countries (Bulgaria, Croatia, Czech Republic, Hungary, Poland, Romania, and Slovakia). The results revealed that there are spillover effects from oil markets into almost all emerging equity markets save Slovakia. Besides, the oil supply glut had a homogenous effect on the emerging markets, both net oil-exporting, and oil-importing countries (CEE). Further, the time variance drastically increased during financial turmoil. Indeed, the time variance remained high from 2009 to 2012 in response to aggregate demand shocks (global financial crisis and Eurozone debt crisis) and quantitative easing measures. Interestingly, the time variance was slightly higher for the oil-exporting countries than for some of the CEE countries. Decision-makers in emerging economies should therefore seek policy coordination when dealing with financial turmoil.

Keywords: crude oil, spillover effects, emerging equity, time-varying, aggregate demand shock

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