Search results for: impacting student learning outcomes

Authors: Haidy Weliam Megaly Gouda

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Dermatology is often a neglected specialty in low-resource settings despite the high morbidity associated with skin disease. This becomes even more significant when associated with HIV infection, as dermatological conditions are more common and aggressive in HIV-positive patients. African countries have the highest HIV infection rates, and skin conditions are frequently misdiagnosed and mismanaged because of a lack of dermatological training and educational material. The frequent lack of diagnostic tests in the African setting renders basic clinical skills all the more vital. This project aimed to improve the diagnosis and treatment of skin disease in the HIV population in a district hospital in Malawi. A basic dermatological clinical tool was developed and produced in collaboration with local staff and based on available literature and data collected from clinics. The aim was to improve diagnostic accuracy and provide guidance for the treatment of skin disease in HIV-positive patients. A literature search within Embassy, Medline and Google Scholar was performed and supplemented through data obtained from attending 5 Antiretroviral clinics. From the literature, conditions were selected for inclusion in the resource if they were described as specific, more prevalent, or extensive in the HIV population or have more adverse outcomes if they develop in HIV patients. Resource-appropriate treatment options were decided using Malawian Ministry of Health guidelines and textbooks specific to African dermatology. After the collection of data and discussion with local clinical and pharmacy staff, a list of 15 skin conditions was included, and a booklet was created using the simple layout of a picture, a diagnostic description of the disease and treatment options. Clinical photographs were collected from local clinics (with full consent of the patient) or from the book ‘Common Skin Diseases in Africa’ (permission granted if fully acknowledged and used in a not-for-profit capacity). This tool was evaluated by the local staff alongside an educational teaching session on skin disease. This project aimed to reduce uncertainty in diagnosis and provide guidance for appropriate treatment in HIV patients by gathering information into one practical and manageable resource. To further this project, we hope to review the effectiveness of the tool in practice.

Keywords: prevalence and pattern of skin diseases, impact on quality of life, rural Nepal, interventions, quality switched ruby laser, skin color river blindness, clinical signs, circularity index, grey level run length matrix, grey level co-occurrence matrix, local binary pattern, object detection, ring detection, shape identification

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Authors: Fehmeada Bibi, Shafqat Nawaz Qaisrani, Masood Akhtar, Zulfiqar Ali

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Population trends learning is an important tool for conservation programs in rare as well as in common species of birds. A study was conducted to assess annual decline in species of birds and to identify the causes of this decline at Taunsa Barrage wildlife Sanctuary, Punjab, Pakistan. Data were collected by direct census method during wintering and breeding periods (2001 to 2002 and 2008 to 2011). The results indicated an increasing trend in 157, whereas a decreasing trend in 14 species of birds. Among the species with declining trend, there was a 92% decrease in White-backed Vulture (Gyps bengalensis), 60% in Greater Painted Snipe (Rostratula benghalensis), 57% in Garganey (Anas querquedula), Pallas’s Fish Eagle and Long-legged Buzzard (Buteo rufinus) 50% each, 41% in Grey Heron (Ardea cinerea), 39% in Little Cormorant (Phalacrocorax niger), 37% in Gadwall (Anas strepera), 33% in Marsh Harrier (Circus aeruginosus), 30% in Black Drongo (Dicrurus macrocercus) and 26% in Red-crested Pochard (Netta rufina) population. Habitat exploitation, hunting and grazing were found the main causes of this decline. In conclusion, conservation and management of the study area is foremost to interests of declining bird population. It is suggested, therefore, to take immediate steps for the protection of the sanctuary to conserve the declining population of birds.

Keywords: population trends, wildlife sanctuary, bird, habitat exploitation

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Authors: D. Mulligan, D. Casey

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Introductory Statement: Delegation is when a registered nurse (RN) transfers a task or activity that is normally within their scope of practice to another person (delegatee). RN delegation is common practice with unregistered staff, e.g., student nurses and health care assistants (HCAs). As the role of the HCA is increasingly embedded as a direct care and support role, especially in long-term residential care for older adults, there is RN uncertainty as to their role as a delegator. The assignment is when a task is transferred to a person that is within the role specification of the delegatee. RNs in long-term care (LTC) for older people are increasingly working in teams where there are less RNs and more HCAs providing direct care to the residents. The RN is responsible and accountable for their decision to delegate and assign tasks to HCAs. In an interpretive, multiple case studies to explore how delegation of tasks by RNs to HCAs occurred in long-term care settings in Ireland the importance of the RN understanding their scope of practice emerged. Methodology: Focus group interviews and individual interviews were undertaken as part of a multiple case study. Both cases, anonymized as Case A and Case B, were within the public health service in Ireland. The case study sites were long-term care settings for older adults located in different social care divisions, and in different geographical areas. Four focus group interviews with staff nurses and three individual interviews with CNMs were undertaken. The interactive data analysis approach was the analytical framework used, with within-case and cross-case analysis. The theoretical lens of organizational role theory, applying the role episode model (REM), was used to understand, interpret, and explain the findings. Study Findings: RNs and CNMs understood the role of the nurse regulator and the scope of practice. RNs understood that the RN was accountable for the care and support provided to residents. However, RNs and CNM2s could not describe delegation in the context of their scope of practice. In both cases, the RNs did not have a standardized process for assessing HCA competence to undertake nursing tasks or interventions. RNs did not routinely supervise HCAs. Tasks were assigned and not delegated. There were differences between the cases in relation to understanding which nursing tasks required delegation. HCAs in Case A undertook clinical vital sign assessments and documentation. HCAs in Case B did not routinely undertake these activities. Delegation and assignment were influenced by the organizational factors, e.g., model of care, absence of delegation policies, inadequate RN education on delegation, and a lack of RN and HCA role clarity. Concluding Statement: Nurse staffing levels and skill mix in long-term care settings continue to change with more HCAs providing more direct care and support. With decreasing RN staffing levels RNs will be required to delegate and assign more direct care to HCAs. There is a requirement to distinguish between RN assignment and delegation at policy, regulation, and organizational levels.

Keywords: assignment, delegation, registered nurse, scope of practice

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Authors: Mehrshad Khosraviani, Faramarz Abbaspour Leyl Abadi

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The fundamental component of the computer network of modern information society will be considered. These networks are connected to the network of the internet generally. Due to the fact that the primary purpose of the Internet is not designed for, in recent decades, none of these networks in many of the attacks has been very important. Today, for the provision of security, different security tools and systems, including intrusion detection systems are used in the network. A common diagnosis system based on artificial immunity, the designer, the Adhasaz Foundation has been evaluated. The idea of using artificial safety methods in the diagnosis of abnormalities in computer networks it has been stimulated in the direction of their specificity, there are safety systems are similar to the common needs of m, that is non-diagnostic. For example, such methods can be used to detect any abnormalities, a variety of attacks, being memory, learning ability, and Khodtnzimi method of artificial immune algorithm pointed out. Diagnosis of the common system of education offered in this paper using only the normal samples is required for network and any additional data about the type of attacks is not. In the proposed system of positive selection and negative selection processes, selection of samples to create a distinction between the colony of normal attack is used. Copa real data collection on the evaluation of ij indicates the proposed system in the false alarm rate is often low compared to other ir methods and the detection rate is in the variations.

Keywords: artificial immune system, abnormality detection, intrusion detection, computer networks

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Authors: Rishabh Pandey, Umang Kumar Yadav

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In today’s era of technological advancement, we come across incalculable innovations, almost every day. No doubt that the society has developed a lot in learning and technology, but we should also take into account the problems and inflictions that are occurring. Focusing on the petroleum sector a trending global concern is toward lowering fuel consumption and emissions. It is well known that gasoline is non-renewable source of energy and its burning produces harmful emissions which are adversely affecting the environment, such issues are motivating us to seek alternative solutions that would not require much modification in engine design and help us come out with an outcome. Keeping in mind the importance of environment and human race, we present a factious idea of use of oxyhydrogen gas or HHO gas in place of gasoline in the vehicles and petroleum industry. This technology is prospering, highly efficient, could be used economically and safe, and it will be responsible for changing the future of oil and gas sector in accordance with protection to the environment. In the coming future, we will check the compatibility of HHO generator with fuel engine for production of oxyhydrogen gas with use of water and effect of introducing HHO gas to the combustion on both thermal efficiency and specific fuel consumption. We will also work on the comparison of HHO gas and commercially available gasoline fuel in support of their chemical structures; ignition rate; octane rating; knocking properties; storage; transportation and cost effectiveness and it is trusted that use of HHO gas will be ecofriendly as no harmful emissions are produced, rather the only emission is water. Additionally, this paper will include the use of HHO cell in fuel engines and challenges faced in installing it in the current period and provide effective solutions for the same.

Keywords: fuel, gas, generator, water

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Authors: Emily Toon

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Nurses play a critical role in the prevention of ventilator-associated pneumonia through the maintenance of endotracheal tubes and use of subglottic secretion drainage via subglottic suctioning endotracheal tubes. The purpose of this evidence based practice project is to develop a staff education program on subglottic suctioning endotracheal tubes for critical care nurses at Middlesex Health with the aim of determining and documenting increased knowledge and/or practice change. The setting included registered nurses within Middlesex Health’s critical care unit who were recruited to complete a pre-test (n=14), view a presentation, and complete a post-test (n=10). Average pre-test scores were compared to average post-test scores to determine an increase in knowledge and/or practice change. The overall mean pre-test score was 59.7 percent, compared with the mean post-test score of 88.1 percent. Pre- and post-test scores were unmatched, so statistical significance could not be determined. The hypothesis that a staff education program on subglottic suctioning endotracheal tubes would demonstrate an increase in knowledge was supported, but not statistically. By integrating a pre-test/post-test design into educational presentations to evaluate increased knowledge, data generated may be used to improve methods and practices of delivering education and enhance staff learning.

Keywords: endotracheal tubes, staff education, subglottic secretion drainage, ventilator-associated pneumonia

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Authors: Abhijit Trailokya

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Background: Cardiovascular diseases (CVD’s) are the major cause of morbidity and mortality in both developed and developing countries. Many clinical trials have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, reduces the incidence of coronary and cerebrovascular events across a broad spectrum of patients at risk. Guidelines for the management of patients at risk have been established in Europe and North America. The guidelines have advocated progressively lower LDL-C targets and more aggressive use of statin therapy. In Indian patients, comprehensive data on dyslipidemia management and its treatment outcomes are inadequate. There is lack of information on existing treatment patterns, the patient’s profile being treated, and factors that determine treatment success or failure in achieving desired goals. Purpose: The present study was planned to determine the lipid control status in high-risk dyslipidemic patients treated with lipid-lowering therapy in India. Methods: This cross-sectional, non-interventional, single visit program was conducted across 483 sites in India where male and female patients with high-risk dyslipidemia aged 18 to 65 years who had visited for a routine health check-up to their respective physician at hospital or a healthcare center. Percentage of high-risk dyslipidemic patients achieving adequate LDL-C level (< 70 mg/dL) on lipid-lowering therapy and the association of lipid parameters with patient characteristics, comorbid conditions, and lipid lowering drugs were analysed. Results: 3089 patients were enrolled in the study; of which 64% were males. LDL-C data was available for 95.2% of the patients; only 7.7% of these patients achieved LDL-C levels < 70 mg/dL on lipid-lowering therapy, which may be due to inability to follow therapeutic plans, poor compliance, or inadequate counselling by physician. The physician’s lack of awareness about recent treatment guidelines also might contribute to patients’ poor adherence, not explaining adequately the benefit and risks of a medication, not giving consideration to the patient’s life style and the cost of medication. Statin was the most commonly used anti-dyslipidemic drug across population. The higher proportion of patients had the comorbid condition of CVD and diabetes mellitus across all dyslipidemic patients. Conclusion: As per the European Society of Cardiology guidelines the ideal LDL-C levels in high risk dyslipidemic patients should be less than 70%. In the present study, 7.7% of the patients achieved LDL-C levels < 70 mg/dL on lipid lowering therapy which is very less. Most of high risk dyslipidemic patients in India are on suboptimal dosage of statin. So more aggressive and high dosage statin therapy may be required to achieve target LDLC levels in high risk Indian dyslipidemic patients.

Keywords: cardiovascular disease, diabetes mellitus, dyslipidemia, LDL-C, lipid lowering drug, statins

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Authors: Elyria Kemp, Kelly Cowart, My Bui

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According to the National Institute of Mental Health, an estimated 31.9% of adolescents have had an anxiety disorder. Several environmental factors may help to contribute to high levels of anxiety and depression in young people (i.e., Generation Z, Millennials). However, as young people negotiate life on social media, they may begin to evaluate themselves using excessively high standards and adopt self-perfectionism tendencies. Broadly defined, self-perfectionism involves very critical evaluations of the self. Perfectionism may also come from others and may manifest as socially prescribed perfectionism, and young adults are reporting higher levels of socially prescribed perfectionism than previous generations. This rising perfectionism is also associated with anxiety, greater physiological reactivity, and a sense of social disconnection. However, theories from psychology suggest that improvement in emotion regulation can contribute to enhanced psychological and emotional well-being. Emotion regulation refers to the ways people manage how and when they experience and express their emotions. Cognitive reappraisal and expressive suppression are common emotion regulation strategies. Cognitive reappraisal involves changing the meaning of a stimulus that involves construing a potentially emotion-eliciting situation in a way that changes its emotional impact. By contrast, expressive suppression involves inhibiting the behavioral expression of emotion. The purpose of this research is to examine the efficacy of social marketing initiatives which promote emotion regulation strategies to help young adults regulate their emotions. In Study 1 a single factor (emotional regulation strategy: a cognitive reappraisal, expressive, control) between-subjects design was conducted using an online, non-student consumer panel (n=96). Sixty-eight percent of participants were male, and 32% were female. Study participants belonged to the Millennial and Gen Z cohort, ranging in age from 22 to 35 (M=27). Participants were first told to spend at least three minutes writing about a public speaking appearance which made them anxious. The purpose of this exercise was to induce anxiety. Next, participants viewed one of three advertisements (randomly assigned) which promoted an emotion regulation strategy—cognitive reappraisal, expressive suppression, or an advertisement non-emotional in nature. After being exposed to one of the ads, participants responded to a measure composed of two items to access their emotional state and the efficacy of the messages in fostering emotion management. Findings indicated that individuals in the cognitive reappraisal condition (M=3.91) exhibited the most positive feelings and more effective emotion regulation than the expressive suppression (M=3.39) and control conditions (M=3.72, F(1,92) = 3.3, p<.05). Results from this research can be used by institutions (e.g., schools) in taking a leadership role in attacking anxiety and other mental health issues. Social stigmas regarding mental health can be removed and a more proactive stance can be taken in promoting healthy coping behaviors and strategies to manage negative emotions.

Keywords: emotion regulation, anxiety, social marketing, generation z

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Authors: Ade Dwi Utami

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Pedagogic competence is the basic competence of teachers to perform their tasks as educators. The ability to assess has become one of the demands in teachers pedagogic competence. Teachers ability to assess is related to curriculum instructions and applications. This research is aimed at obtaining data concerning teachers ability to assess that comprises of understanding assessment, determining assessment type, tools and procedure, conducting assessment process, and using assessment result information. It uses mixed method of explanatory technique in which qualitative data is used to verify the quantitative data obtained through a survey. The technique of quantitative data collection is by test whereas the qualitative data collection is by observation, interview and documentation. Then, the analyzed data is processed through a proportion study technique to be categorized into high, medium and low. The result of the research shows that teachers ability to assess can be grouped into 3 namely, 2% of high, 4% of medium and 94% of low. The data shows that teachers ability to assess is still relatively low. Teachers are lack of knowledge and comprehension in assessment application. The statement is verified by the qualitative data showing that teachers did not state which aspect was assessed in learning, record children’s behavior, and use the data result as a consideration to design a program. Teachers have assessment documents yet they only serve as means of completing teachers administration for the certification program. Thus, assessment documents were not used with the basis of acquired knowledge. The condition should become a consideration of the education institution of educators and the government to improve teachers pedagogic competence, including the ability to assess.

Keywords: assessment, early childhood education, pedagogic competence, teachers

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Authors: Zahra Alimorad

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There is a strong belief that language teachers' actual practices in the classroom context are largely determined by the underlying perceptions they hold about the nature of language and language learning. That being so, it can be envisaged that teaching procedures of ESP (English for Specific Purposes) teachers teaching reading comprehension will mainly be driven by their perceptions about the nature of reading. To examine this issue, four Iranian university professors holding Ph.D. in either TEFL (Teaching English as a Foreign Language) or English Literature who were teaching English to Engineering and Sciences students were recruited to participate in this study. To collect the necessary data, classroom observations and follow-up semi-structured interviews were used. Furthermore, the materials utilized by the teachers such as textbooks, syllabuses, and tests were also examined. Although it can be argued that their perceptions were partially compatible with the established principles, results of the study pointed to a lack of congruence between these teachers' perceptions and their practices, on the one hand, and between the established principles and the practices, on the other. While the literature mostly supports a metacognitive-strategy approach to reading comprehension, the teachers were mainly adopting a skills-based approach to the teaching of reading. That is, they primarily focused on translation as the core activity in the classroom followed by reading aloud, defining words, and explaining grammatical structures. This divergence was partly attributed to the contextual constraints and partly to students' lack of motivation by the teachers.

Keywords: English teachers, perceptions, practice, principles, reading comprehension

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Authors: Ahuva Even-Zohar

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Context: Families living in poverty often struggle with poor financial management and accumulating debts. Social workers play a crucial role in assisting these families, but they typically receive no formal training in financial management. Research Aim: The aim of this study was to assess the impact of a voluntary organization called Paamonim on social work students' attitudes toward providing material support and assistance in financial management to families living in poverty. Additionally, the study aimed to evaluate the students' perception of the workshop's contribution and their actual use of the tools acquired during the training. Methodology: The study involved 134 social work students, with 55 in a regular program and 79 in a retraining program. The first stage of the study involved the students receiving an explanation of the research, ensuring confidentiality, and signing informed consent. The students completed two questionnaires: The Student Attitudes Questionnaire and a sociodemographic questionnaire. In the second stage, three months after the workshop, the students completed the questionnaires again, along with a feedback questionnaire. Findings: The study found that there were no significant differences in the students' attitudes toward providing material support and proper financial management to families living in poverty before and after the workshop. However, their attitudes remained positive, at a medium level or higher. The students reported that the workshop provided them with tools to assist families in poverty, and they used these tools to some extent in their practical training. They found the workshop interesting and acknowledged its importance in raising awareness about budget management and enriching their knowledge of money management. The students acknowledged the workshop's effectiveness but mentioned that it was too short. Theoretical Importance: This study highlights the importance of developing programs to help families living in poverty manage their household finances. The workshop enriched the students' knowledge and skills, which are vital for their role as social workers working with families in poverty to rehabilitate their financial situations. Data Collection and Analysis Procedures: The students completed self-report questionnaires before and after the workshop, providing insights into their attitudes and perception about the role of social workers in providing material support for families living in poverty and helping them manage their household finances. Statistical analysis was conducted to compare the students' attitudes pre and post-workshop, and a feedback questionnaire assessed the students' perception of the contribution of the workshop. Question Addressed: This study addressed the question of whether a workshop on financial management can positively impact social work students' attitudes and skills in assisting families living in poverty with their household finances. Conclusion: Despite being short and consisting of only one session, the workshop proved to be valuable in enriching the students' knowledge and providing them with important tools for their role as social workers. The students reported positive attitudes toward providing material support and financial assistance to families in need. The practical recommendation is to continue offering such workshops as part of the social work curriculum to further enhance students' abilities to help families manage their finances effectively.

Keywords: financial literacy, poverty, social work students, workshop

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Authors: Ilham Zaidi, P. Sankara Sarma, Quazi Taufique Ahmed, V. Raman Kutty, Khalid Umer Khayyam, Gurpreet Singh, Abhishek Royal

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Introduction: Tuberculosis is a global public health emergency, but it is particularly acute in India, which has the world's highest tuberculosis burden. Due to overpopulation, lack of sanitation, malnutrition, low living standards, and poor socioeconomic status, among other factors, it is India's most common infectious disease. The long period of treatment is one of the main reasons for considering it as a public health emergency. Consequently, there is an increase in patient noncompliance, which leads to treatment failure, adverse treatment outcomes, and deaths. This could lead to the growth of anti-TB drug resistance. According to the WHO, approximately 558 thousand new cases of Multi-Drug Resistance Tuberculosis were diagnosed worldwide, with 8.5 percent developed Extensively Drug Resistance Tuberculosis. Methodology: This study is a program-based cross-sectional descriptive survey of adult tuberculosis patients enrolled in the Delhi-based Revised National Tuberculosis Program. The study setting was 27 NTEP districts of Delhi. (N=65,893) and Sample size- was 200; the sampling method which is used in the study was the systemic random sampling method. Results: Most of the demographic factors (age, gender, residence, and family type) were not significantly associated with adherence; marital status was found statistically significant with the treatment compliance. Hesitation while telling people about the disease and motivation to strictly follow drug schedule by healthcare workers were other factors where a significant association with drug adherence was observed. The study findings also suggest that provision of food, minimal financial and other moral support from family, counseling, discussion and politeness by healthcare providers might also facilitate adherence. Discussion and Conclusions: For TB treatment, adherence, age, sex, socioeconomic status, types of accommodations, malnutrition, and personal hygiene should all be considered; similar results were observed in previous studies. In the care of TB patients, DOTS services, health workers, and family support play a significant role. According to the country's National Strategic Plan, the Indian government has set a goal of eliminating tuberculosis by 2025 and patients' compliance with TB care and treatment adherence is very crucial to achieve this aim. A cohort study will be able to give a better understanding of factors associated with adherence since this study may have missed some defaulters who were absconding and could not be reached. Important Terms: RNTCP, NTEP, DOTS, DS-TB, DR-TB, RR-TB, MDR-TB, XDR-TB, Treatment failure, Treatment relapse, Treatment adherence.

Keywords: treatment adherence, treatment relapse, treatment failure, drug resistance tuberculosis

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Authors: Anđelka Stojanović, Ivan Mihajlović, Ivica Nikolić

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In the past years, due to the financial crisis and the tightening of conditions on the labor market, young people are facing great challenges in achieving financial independence and finding their place in society. Higher unemployment rates, poorer living conditions, separation from the labor market, and longer school-to-work transitions particularly affect rural youth and make significant differences between youth groups in rural and urban areas. Improving employability skills and development of instruments for further learning among young people “Not in Education, Employment, or Training” (NEET) should not be only the concerns of these people, already adequately be directed and supported by the institutions. According to the World Bank data, the share of youth not in education, employment or training (NEET), in the European Union in the past few years decreases but still shows a significant share in the total percentage of the youth population. In 2017 rate was 10.96% while in 2018 that value was 10.38%. When observing individual countries in Europe, especially those with lower incomes, this rate is much higher. It was concluded that this topic was not sufficiently elaborated and presented in the social and scientific environment. Therefore, the aim of this paper is to identify and systematize the problems of school-to-work transition among young NEETs living in rural areas as well as the initiatives for addressing their problems.

Keywords: NEET youth, risks and initiatives, rural youth, school-to-work transition

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Authors: Mubeshera Tufail

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The purpose of the study was to explore the experiences and challenges faced by teachers and students with Flipped Classroom Instruction (FCI) for an undergraduate course at university level. The Flipped Classroom lesson plan consisted of two components: one was out-of-class component consisting of learning material for reading for students and other was within-class component involving a class quiz, class activity and the feedback/further reading task. Besides, experiences, the research study also covered the adaptations made to improve their experiences with Flipped Classroom during the study. The phenomenological research strategy was used for this research study. The data consisted of weekly reflective journals documented by class teacher and students. The reflective journals were recorded by teacher and students while working in Flipped Classroom for an undergraduate course at university level. The main challenges highlighted by teacher were related to effort and time required for planning, time management and students' guidance for shift of their role from passive to independent learner. The main challenges found in reflective journals of students were personal computers issue, electricity and internet speed issue. It is recommended to adapt to some locally useful lesson planning and classroom management techniques to enhance the effectiveness of Flipped Classroom Instruction in an undergraduate university level course.

Keywords: flipped classroom instruction, undergraduate students, independent learner, technology-integrated classroom

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Authors: Shosh Shahrabani, Sharon Teitler-Regev, Helena Desivilya Syna, Fotini Voulgaris, Evangelos Tsoukatos, Vitor Ambrosio, Sandra M. Correia Loureiro

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International crises that affect tourism, such as terror attacks, political unrest, and economic crises have become more frequent, and their influence has become broader. The influence of such extreme events depends on their salience in the tourists' awareness. Hence, it is important to understand the mechanisms underlying tourists' selection of travel destinations, especially their perceptions of crisis-related events and the impact of the sociopolitical and economic context in their countries of origin. The current study examined how the socio-political and economic context in the home countries of potential young tourists affected their selection of travel destinations. The objective was to elucidate how the salience of various crises (economic and political) in the tourists' perceptions, due to their experiences at home, color their construal of destinations affected by similar hazards and influence their travel intentions. The study focused on student tourists from Israel, Greece, and Portugal. Today about a fifth of international tourism is based on young people, especially students. These countries were chosen since Greece and Portugal are in the midst of economic crises. In addition, Greece and Portugal have experienced political instability, while Israel has security-related problems (including terrorist incidents). In 2013, a total of 648 students, responded to a questionnaire that included questions concerning attitudes and risk perceptions regarding travel to destinations with various risk hazards as well as socio-demographic details. The results indicate that over half of the Israelis intend to visit Greece or Portugal. The majority of the Portuguese intend to visit Greece, while less than a third of them intend to visit Israel. About half of the Greeks intend to visit Portugal, and most of them do not intend to visit Israel. The results indicate that greater perceived importance of economic crises mitigates the intention to travel to destinations with economic crises for tourists from origin countries that are also marked by economic crises, such as Greece and Portugal. However, for tourists from Israel, a country with a relatively stable economy, issues related to the economy barely affect their intention to travel to the other two countries. The findings also suggest that Greeks and Portuguese who are highly concerned about political unrest are unlikely to select Israel as a tourist destination. In addition, strong apprehension regarding terrorism impedes the intention to travel to destinations marked by terrorist incidents, such as Israel. The current research contributes to the existing literature by highlighting the impact of travelers' personal previous experience with crisis on their risk perceptions and in turn on their intentions to travel to countries with similar risks. Therefore, in a world where such incidents are on the rise, understanding tourists' risk perceptions and behavior and the factors influencing their destination-related decisions are crucial for countries that wish to increase the numbers of incoming tourists.

Keywords: economic crises, political instability, risk perception, young tourists

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Authors: Malab Sana Balouch, Meenakshi Nayar

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Hemispatial Neglect is a common disorder primarily associated with right hemispheric stroke, in the acute phase of which it can occur up to 82% of the time. Such individuals fail to acknowledge or respond to people and objects in their left field of vision due to deficits in attention and awareness. Persistent hemispatial neglect significantly impedes post-stroke recovery, leading to longer hospital stays post-stroke, increased functional dependency, longer-term disability in ADLs and increased risk of falls. Recently, evidence has emerged for the use of dopamine agonist Rotigotine in neglect. The aim of our Quality Improvement Project (QIP) is to evaluate and better the current protocols and practice in assessment, documentation and management of neglect and rotigotine use at the Neurorehabilitation unit at Charing Cross Hospital (CNRU). In addition, it brings light to rotigotine use in the management of hemispatial neglect and paves the way for future research in the field. Our QIP was based in the CNRU. All patients admitted to the CNRU suffering from a right-sided stroke from 2nd of February 2018 to the 2nd of February 2021 were included in the project. Each patient’s multidisciplinary team report and hospital notes were searched for information, including bio-data, fulfilment of the inclusion criteria (having hemispatial neglect) and data related to rotigotine use. This includes whether or not the drug was administered, any contraindications to drug in patients that did not receive it, and any therapeutic benefits(subjective or objective improvement in neglect) in those that did receive the rotigotine. Data was simultaneously entered into excel sheet and further statistical analysis was done on SPSS 20.0. Out of 80 patients suffering from right sided strokes, 72.5% were infarcts and 27.5% were hemorrhagic strokes, with vast majority of both types of strokes were in the middle cerebral artery territory (MCA). A total of 31 (38.8%) of our patients were noted to have hemispatial neglect, with the highest number of cases being associated with MCA strokes. Almost half of our patients with MCA strokes suffered from neglect. Neglect was more common in male patients. Out of the 31 patients suffering from visuospatial neglect, only 16% actually received rotigotine and 80% of them were noted to have an objective improvement in their neglect tests and 20% revealed subjective improvement. After thoroughly going through neglect-associated documentation, the following recommendations/plans were put in place for the future. We plan to liaise with the occupational therapy team at our rehab unit to set a battery of tests that would be done on all patients presenting with neglect and recommend clear documentation of outcomes of each neglect screen under it. Also to create two proformas; one for the therapy team to aid in systematic documentation of neglect screens done prior to and after rotigotine administration and a second proforma for the medical team with clear documentation of rotigotine use, its benefits and any contraindications if not administered.

Keywords: hemispatial Neglect, right hemispheric stroke, rotigotine, neglect, dopamine agonist

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Authors: Konysbek Aksaule

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The purpose of this work is to explore new and effective ways of teaching English to students who are studying a foreign language since the timeliness of the problem disclosed in this article is due to the high level of English proficiency that potential specialists must have due to high competition in the context of global globalization. The article presents an analysis of the feasibility and effectiveness of using an authentic feature film in teaching English to students. The methodological basis of the study includes an assessment of the level of students' proficiency in a foreign language, the stage of evaluating the film, and the method of selecting the film for certain categories of students. The study also contains a list of practical tasks that can be applied in the process of viewing and perception of an original feature film in a foreign language, and which are aimed at developing language skills such as speaking and listening. The results of this study proved that teaching English to students through watching an original film is one of the most effective methods because it improves speech perception, speech reproduction ability, and also expands the vocabulary of students and makes their speech fluent. In addition, learning English through watching foreign films has a huge impact on the cultural views and knowledge of students about the country of the language being studied and the world in general. Thus, this study demonstrates the high potential of using authentic feature film in English lessons for pedagogical science and methods of teaching English in general.

Keywords: university, education, students, foreign language, feature film

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Authors: Vanessa Bennemann, Gabriela Laste, Márcia Inês Goettert

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The gestational period is a phase in which the pregnant woman undergoes constant physiological and hormonal changes, which are part of the woman’s biological cycle, the development of the fetus, childbirth, and lactation. These are factors of response to the immunological adaptation of the human reproductive process that is directly related to the pregnancy’s well-being and development. Although most pregnancies occur without complications, about 15% of pregnant women will develop potentially fatal complications, implying maternal and fetal risk. Therefore, requiring specialized care for high-risk pregnant women (HRPW) with obstetric interventions for the survival of the mother and/or fetus. Among the risk factors that characterize HRPW are the women's age, gestational diabetes mellitus (GDM), autoimmune diseases, infectious diseases such as syphilis and HIV, hypertension (SAH), preeclampsia, eclampsia, HELLP syndrome, uterine contraction abnormalities, and premature placental detachment (PPD), thyroid disorders, among others. Thus, pregnancy has an impact on the thyroid gland causing changes in the functioning of the mother's thyroid gland, altering the thyroid hormone (TH) profiles and production as pregnancy progresses. Considering, throughout the gestational period, the interpretation of the results of the tests to evaluate the thyroid functioning depends on the stage in which the pregnancy is. Thyroid disorders are directly related to adverse obstetric outcomes and in child development. Therefore, the adequate release of TH is important for a pregnancy without complications and optimal fetal growth and development. Objective: Investigate the physiological effects caused by thyroid disorders in the gestational period. Methods: A search for articles indexed in PubMed, Scielo, and MDPI databases, was performed using the term “AND”, with the descriptors: Pregnancy, Thyroid. With several combinations that included: Melatonin, Thyroidopathy, Inflammatory processes, Cytokines, Anti-inflammatory, Antioxidant, High-risk pregnancy. Subsequently, the screening was performed through the analysis of titles and/or abstracts. The criteria were: including clinical studies in general, randomized or not, in the period of 10 years prior to the research, in the English literature; excluded: experimental studies, case reports, research in the development phase. Results: In the preliminary results, a total of studies (n=183) were found, (n=57) excluded, such as studies of cancer, diabetes, obesity, and skin diseases. Conclusion: To date, it has been identified that thyroid diseases can impair the fetus’s brain development. Further research is suggested on this matter to identify new substances that may have a potential therapeutic effect to aid the gestational period with thyroid diseases.

Keywords: pregnancy, thyroid, melatonin, high-risk pregnancy

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Authors: Shazia Almas, Jaffar Iqbal, Nazia Almas

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In most of the South Asian countries like Pakistan medical profession is one the most valued and respectful professions yet being a medical professional requires an enormous amount of responsibilities and work overload at the same time which possibly can be in contrast with family role of a doctor. Job and family are two primary spheres of a person's life no matter whatever the profession one adopts and the type of family one is running. There is a bi-directional relationship between job and family. The type and nature of work, time schedules, working shifts in medical profession are very demanding in the countries like Pakistan where number of patients is far more higher than the number of doctors available. The work life also have significant impact on family life and vice versa. Because of the sensitivity and interdependency of these relations, today’s overarching and competing demands remain dissatisfactory. The main objective of the current research is to investigate how interpersonal relationships affect work and work affects interpersonal relationships of medical professionals. In line with identifying these facts, the current study aimed to examine the predictive role of psychological capital (self-efficacy, hope, optimism, and resilience), in organizational outcome (job satisfaction) and personal outcome (family satisfaction) amongst male and medical professionals. A total of 350 participants from public and private sector hospitals of Pakistan were recruited through simple random and stratified sampling techniques, with age ranges from 26-50 years. The questionnaire including established and certified self-report measures of Psychological Capital Questionnaire, Job Satisfaction, and Family Satisfaction were adopted to collect the data. The reliability and validity of mentioned instruments were established through Cronbach’s alpha and factor analyses (exploratory and confirmatory) respectively using Structural Equation Modeling (SEM) by AMOS. The proposed hypotheses were tested using Pearson’s Correlation and Regression analyses for predicting effect whereas, t-Test was deployed to verify the difference between male and female health professionals. The results revealed that self-efficacy and optimism predicted job satisfaction while, self-efficacy, hope, and resilience predicted family satisfaction. Moreover, the results depicted significant gender differences in job satisfaction where females were higher on job satisfaction as compared to male medical professionals but no significant differences were observed in levels of family satisfaction between both genders. The study has implications for social, organizational and work policy designers. The study also paves for more researches with positive psychological approach to promote work-family harmony.

Keywords: family satisfaction, job satisfaction, medical professionals, psychological capital

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Authors: Xian Chen

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In recent years, the tendency that the decline of material and social vitality of old city in China becomes more and more serious. Nowadays, transformation and renewal of the old city have become a hot topic in urban research. The traditional mode of large-scale promotion has been criticized. Thus, exploration of new ways to update the city turns to be a necessity on the way of sustainable urban development. Pocket Park is a small city open space, its location choose is based on abandoned or idle lands on urban structure, is scattered or hidden in corner of the urban. It has a great significance on improving the old city environment. Based on the theory of ‘pocket park’, this paper summarizes the successful experience of domestic and foreign practice, and discusses the update strategies which are suitable for China's national conditions according to the characteristics and predicament of the old city in China. The main methods and results are as follows: 1)Based on the conception of ‘pocket park’, though describing the research status in domestic and foreign, summarizing the experience which is worth learning and existing problems. 2) From the analysis of ‘pocket park’ function, general design principles and types of the deep-seated difficulties in renewal the old city and the possibility of the application of ‘pocket park’,the varied implementation of ‘pocket park’ form are established, and application value in the old city renewal are summed up. 3) It can’t be denied that pocket park plays an irreplaceable role in solving the recession and renewing the vitality of the old city. Anymore, It is recommended to develop corresponding supportive development policies.

Keywords: sustainable development, strategy, old city renewal, pocket park

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Authors: Salako Emmanuel Adekunle

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Computer education is referred to as the knowledge and ability to use computers and related technology efficiently, with a range of skills covering levels from basic use to advance. Computer continues to make an ever-increasing impact on all aspect of human endeavours such as education. With numerous benefits of computer education, what are the insights of students on computer education? This study investigated the perception of senior secondary school students on computer education in Federal Capital Territory (FCT), Abuja, Nigeria. A sample of 7500 senior secondary schools students was involved in the study, one hundred (100) private and fifty (50) public schools within FCT. They were selected by using simple random sampling technique. A questionnaire [PSSSCEQ] was developed and validated through expert judgement and reliability co-efficient of 0.84 was obtained. It was used to gather relevant data on computer education. Findings confirmed that the students in the FCT had positive perception on computer education. Some factors were identified that affect students’ perception on computer education. The null hypotheses were tested using t-test and ANOVA statistical analyses at 0.05 level of significance. Based on these findings, some recommendations were made which include competent teachers should be employed into all secondary schools; this will help students to acquire relevant knowledge in computer education, technological supports should be provided to all secondary schools; this will help the users (students) to solve specific problems in computer education and financial supports should be provided to procure computer facilities that will enhance the teaching and the learning of computer education.

Keywords: computer education, perception, secondary school, students

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Authors: Mariam Anwaar, Kiran B. Ahmad

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Borderline Personality Disorder (BPD) is an invasive presence of affect instability, disturbance in self-concept and attachment in relationships. The profound indicator is the dichotomous approach of the world in which the ego categorizes individuals, especially their significant others, into secure or threatful beings, leaving little room for a complex combination of characteristics in one person. This defense mechanism of splitting their world has been described through the explanatory model of unconscious conflict theorized by Sigmund Freud’s Electra Complex in the Phallic Stage. The central role is of the father with whom the daughter experiences penis envy, thus identifying with the mother’s characteristics to receive the father’s attention. However, Margret Mahler, an object relation theorist, elucidates the central role of the mother and that the split occurs during the pre-Electra complex stage. Amid the 14 and 24 months of the infant, it acknowledges the world away from the mother as they have developed milestones such as crawling. In such novelty, the infant crawls away from the mother creating a sense of independence (individuation). On the other hand, being distant causes anxiety, making them return to their original object of security (separation). In BPD, the separation-individuation stage is disrupted, due to contradictory actions of the caregiver, which results in splitting the object into negative and positive aspects, repressing the former and adhering to the latter for survival. Thus, with time, the ego distorts the reality into dichotomous categories, using the splitting defenses, and the mental representation of the self is distorted due to the internalization of the negative objects. The explanatory model was recognized in the case study of Fizza, at 21-year-old Pakistani female, residing in Karachi. Her marital status is single with an occupation being a dental student. Fizza lives in a nuclear family but is surrounded by her extended family as they all are in close vicinity. She came with the complaints of depressive symptoms for two-years along with self-harm due to severe family conflicts. Through the intervention of Dialectical Behavior Therapy (DBT), the self-harming actions were reduced, however, this libidinal energy transformed into claustrophobic symptoms and, along with this, Fizza has always experienced vivid dreams. A retrospective method of Jungian dream-analysis was applied to locate the origins of the splitting in the unconscious. The result was the revelation of a sexual harassment trauma at the age of six-years which was displaced in the form of self-harm. In addition to this, the presence of a conflict at the separation-individuation stage was detected during the dream-analysis, and it was the underlying explanation of the claustrophobic symptoms. This qualitative case study implicates the use of a patient’s subjective experiences, such as dreams, to journey through the spiral of the unconscious in order to not only detect repressed memories but to use them in psychotherapy as a means of healing the patient.

Keywords: borderline personality disorder, dream-analysis, Electra complex, separation-individuation, splitting, unconscious

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Authors: Kyung Bae Park, Sung Ho Ha

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Online user-generated contents (UGC) significantly change the way customers behave (e.g., shop, travel), and a pressing need to handle the overwhelmingly plethora amount of various UGC is one of the paramount issues for management. However, a current approach (e.g., sentiment analysis) is often ineffective for leveraging textual information to detect the problems or issues that a certain management suffers from. In this paper, we employ text mining of Latent Dirichlet Allocation (LDA) on a popular online review site dedicated to complaint from users. We find that the employed LDA efficiently detects customer complaints, and a further inspection with the visualization technique is effective to categorize the problems or issues. As such, management can identify the issues at stake and prioritize them accordingly in a timely manner given the limited amount of resources. The findings provide managerial insights into how analytics on social media can help maintain and improve their reputation management. Our interdisciplinary approach also highlights several insights by applying machine learning techniques in marketing research domain. On a broader technical note, this paper illustrates the details of how to implement LDA in R program from a beginning (data collection in R) to an end (LDA analysis in R) since the instruction is still largely undocumented. In this regard, it will help lower the boundary for interdisciplinary researcher to conduct related research.

Keywords: latent dirichlet allocation, R program, text mining, topic model, user generated contents, visualization

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Authors: Fella Lahmar

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This chapter investigates the educational reforms in Algeria, highlighting the challenges and complexities that arise in the context of globalization, equity, and decolonization. While Algeria’s education system historically had a socialist-economic model grounded in Islamic values, contemporary reforms reflect global influences and aspirations for cultural authenticity. The study employed a qualitative approach, utilizing semi-structured interviews with a diverse sample of 15 participants intimately involved in the Algerian education system. Analysis of the data reveals a discrepancy between the educational system’s pedagogical practices and students’ diverse learning needs, implying ramifications for educational equity and social justice. Furthermore, a critical tension was evident between global influences, local cultural authenticity, and the endeavor to decolonize education. In conclusion, the chapter advocates for reforms that prioritize the students’ holistic development and well-being while fostering intrinsic motivation and engagement. This entails re-evaluating curriculum frameworks, assessment strategies, and pedagogies in light of Algeria’s cultural and religious heritage. The chapter also calls for future research to explore methods for innovatively integrating cultural heritage into education in ways to cultivate learners who are both locally grounded and globally aware.

Keywords: impact of globalization on education, parental involvement in education, marketization of education, policy enactment and reform, curriculum overload, holistic approach, shadow education

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Authors: Prakash Singh

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Schools throughout the world are facing increasing challenges in dealing with school violence and drug abuse by pupils. Therefore, the question of the fear of failure to meet the aims and objectives of education inevitably surfaces as it places increasing and challenging demands on educators and all other stakeholders to address this malaise. Multiple studies on the construct tobephobia (TBP) simply define TBP as the fear of failure in education. This study is a continuation of the exploratory studies on the manifestation of fear in education. The primary purpose of this study was to establish how TBP, caused by school violence and drug abuse affects teaching and learning in our schools. The qualitative research method was used for this study. Teachers admitted that they fear for their safety at school. Working in a fearful situation places a high rate of stress and anxiety on them. Tobephobic educators spend most of their time worrying about their fear of violence and drug abuse by pupils and are too frightened to carry out their normal duties. They prefer to stay in familiar surroundings for fear of being attacked by inebriated learners. This study, therefore, contributes to our understanding of the effects of TBP in our schools caused by school violence and drug abuse. Also, this study supplements the evidence accumulated over the past fifteen years that TBP is not a figment of someone’s imagination; it is a gruesome reality affecting the very foundation of our educational system globally to provide quality and equal education to all our learners in a harmonious, collegial school environment.

Keywords: tobephobia, tobephobic educators, fear of failure in education, school violence, drug abuse

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Authors: Mengping Cheng, John Everatt, Alison Arrow, Amanda Denston

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Based on the available evidence, Chinese heritage language learners have a basic level of Chinese language proficiency with lower capability in literacy compared to speaking. Low levels of literacy are likely related to the lack of reading activities in current textbook-based pedagogy used in Chinese community schools. The present study aims to use Reading to Learn pedagogy which is a top-down language learning model and test the effectiveness of Reading to Learn on Chinese heritage learners’ written vocabulary acquisition. A quasi-experiment with the pre-test/post-test non-equivalent group design was conducted. The experimental group received Reading to Learn instructions and the control group had traditional textbook-based instructions. Participants were given Chinese characters tasks (a recognize-and-read task and a listen-and-point task), vocabulary tasks (a receptive vocabulary task and a productive vocabulary task) and a sentence cloze test in pre-tests and post-tests. Data collection is in progress and results will be available shortly. If the results show more improvement of Chinese written vocabulary in the experimental group than in the control group, it will be recommended that Reading to Learn pedagogy is valuable to be used to maintain and develop Chinese heritage language literacy.

Keywords: Chinese heritage language, experimental research, Reading to Learn pedagogy, vocabulary acquisition

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Authors: Marco Castagna

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Proposed paper is aimed to inquire about the relation between text and reader, focusing on the concept of ‘attestation’. Indeed, despite being widely accepted in semiotic research, even today the concept of text remains uncertainly defined. So, it seems to be undeniable that what is called ‘text’ offers an image of internal cohesion and coherence, that makes it possible to analyze it as an object. Nevertheless, this same object remains problematic when it is pragmatically activated by the act of reading. In fact, as for the T.A.R:D.I.S., that is the unique space-temporal vehicle used by the well-known BBC character Doctor Who in his adventures, every text appears to its own readers not only “bigger inside than outside”, but also offering spaces that change according to the different traveller standing in it. In a few words, as everyone knows, this singular condition raises the questions about the gnosiological relation between text and reader. How can a text be considered the ‘same’, even if it can be read in different ways by different subjects? How can readers can be previously provided with knowledge required for ‘understanding’ a text, but at the same time learning something more from it? In order to explain this singular condition it seems useful to start thinking about text as a device more than an object. In other words, this unique status is more clearly understandable when ‘text’ ceases to be considered as a box designed to move meaning from a sender to a recipient (marking the semiotic priority of the “code”) and it starts to be recognized as performative meaning hypothesis, that is discursively configured by one or more forms and empirically perceivable by means of one or more substances. Thus, a text appears as a “semantic hanger”, potentially offered to the “unending deferral of interpretant", and from time to time fixed as “instance of Discourse”. In this perspective, every reading can be considered as an answer to the continuous request for confirming or denying the meaning configuration (the meaning hypothesis) expressed by text. Finally, ‘attestation’ is exactly what regulates this dynamic of request and answer, through which the reader is able to confirm his previous hypothesis on reality or maybe acquire some new ones.Proposed paper is aimed to inquire about the relation between text and reader, focusing on the concept of ‘attestation’. Indeed, despite being widely accepted in semiotic research, even today the concept of text remains uncertainly defined. So, it seems to be undeniable that what is called ‘text’ offers an image of internal cohesion and coherence, that makes it possible to analyze it as an object. Nevertheless, this same object remains problematic when it is pragmatically activated by the act of reading. In fact, as for the T.A.R:D.I.S., that is the unique space-temporal vehicle used by the well-known BBC character Doctor Who in his adventures, every text appears to its own readers not only “bigger inside than outside”, but also offering spaces that change according to the different traveller standing in it. In a few words, as everyone knows, this singular condition raises the questions about the gnosiological relation between text and reader. How can a text be considered the ‘same’, even if it can be read in different ways by different subjects? How can readers can be previously provided with knowledge required for ‘understanding’ a text, but at the same time learning something more from it? In order to explain this singular condition it seems useful to start thinking about text as a device more than an object. In other words, this unique status is more clearly understandable when ‘text’ ceases to be considered as a box designed to move meaning from a sender to a recipient (marking the semiotic priority of the “code”) and it starts to be recognized as performative meaning hypothesis, that is discursively configured by one or more forms and empirically perceivable by means of one or more substances. Thus, a text appears as a “semantic hanger”, potentially offered to the “unending deferral of interpretant", and from time to time fixed as “instance of Discourse”. In this perspective, every reading can be considered as an answer to the continuous request for confirming or denying the meaning configuration (the meaning hypothesis) expressed by text. Finally, ‘attestation’ is exactly what regulates this dynamic of request and answer, through which the reader is able to confirm his previous hypothesis on reality or maybe acquire some new ones.

Keywords: attestation, meaning, reader, text

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Authors: Piyush Hajela

Abstract:

Public spaces within Indian markets are vibrant, colorful and contain dimensions that make them attractive and therefore act as popular gathering spaces. Most of these public spaces emerge as squares, plazas of varied shapes and sizes spread at different locations within the market. These public spaces grow organically and are discovered by the people themselves as they respond positively to the collective human senses. On the other hand, there are the planned and designed public spaces as well that are less active. This research evaluates both the planned and the organically transformed public spaces in Indian markets from an Urban Design point of view. The purpose of such research is to provide a basis for design solutions to ensure the success of designed public spaces. The evaluation is done for identified Attributes, namely Comfort, Protection, Familiarity, Activities, Form, Legibility, Engagement, Safety, Accessibility, Environment and Transformations by which a Public Space attains its recognition. The evaluation is based on a rating done for forty-four parameters falling under eleven attributes of public space. An opinion survey of professionals is conducted for their priorities of attributes while designing Public spaces. A comparison is made to rank these attributes between Planned and Organically transformed Public spaces and, opinion of the professionals. After dues analysis, the research suggests the learning from the organically transformed Public spaces for ensuring the success of designed public spaces. The suggestions may be in the form of Design decisions or administrative regulations, or both for achieving the desirables.

Keywords: assessment, attributes, engagement, interaction

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Authors: Dauda Ibrahim Adagye

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Effective internal control system in the bursary unit of tertiary educational institutions is geared toward achieving quality teaching, learning, and research environment and as well assist the management of the institutions, particularly when decisions are to be made. While internal control system exists in all institutions, the outlined objectives above are far from being achieved. The paper; therefore, assesses the effectiveness of internal control system in tertiary educational institutions in Nasarawa State, Nigeria with the specific focus on the Nasarawa state Polytechnic, Lafia. The study is survey; hence, a simple closed-ended questionnaire was developed and administered to a sample of twenty-seven (27) member staff from the Bursary and the internal audit unit of the Nasarawa State Polytechnic, Lafia to obtain data for analysis purposes and to test the study hypothesis. Responses from the questionnaire were analyzed using a simple percentage and chi-square. Findings shows that the right people are not assigned to the right job in the department, budget, and management accounting were never used in the institution’s operations and checking of subordinate by their superior officers is not regular. This renders the current internal control structure of the Polytechnic as ineffective and weak. The paper therefore, recommends that: transparency should be seen as significant, as the institution work toward meeting its objectives, therefore, it means that the right staff is assigned to the right job and regular checking of the subordinates by their ensued superiors.

Keywords: internal control, tertiary educational intuitions, efficiency

Procedia PDF Downloads 183

Authors: Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem

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Objective: To determine incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Design and setting: Retrospective cohort study in trauma patients during anesthesia for emergency surgery at a university hospital in northern Thailand country. Patients and methods: This study was permitted by the medical ethical committee, Faculty of Medicine at Maharaj Nakorn Chiang Mai Hospital, Thailand. We clarified data of 19,683 trauma patients receiving anesthesia within a decade between January 2007 to March 2016. The data analyzed patient characteristics, traumas surgery procedures, anesthesia information such as ASA physical status classification, anesthesia techniques, anesthetic drugs, location of anesthesia performed, and cardiac arrest outcomes. This study excluded the data of trauma patients who had received local anesthesia by surgeons or monitoring anesthesia care (MAC) and the patient which missing more information. The factor associated with perioperative cardiac arrest was identified with univariate analyses. Multiple regressions model for risk ratio (RR) and 95% confidence intervals (CI) were used to conduct factors correlated with perioperative cardiac arrest. The multicollinearity of all variables was examined by bivariate correlation matrix. A stepwise algorithm was chosen at a p-value less than 0.02 was selected to further multivariate analysis. A P-value of less than 0.05 was concluded as statistically significant. Measurements and results: The occurrence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were age being more than 65 years (RR=1.41, CI=1.02–1.96, p=0.039), ASA physical status 3 or higher (RR=4.19–21.58, p < 0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each p < 0.001), cardiopulmonary comorbidities (RR=1.55, CI=1.10–2.17, p < 0.012), hemodynamic instability with shock prior to receiving anesthesia (RR=1.60, CI=1.21–2.11, p < 0.001) , special techniques for surgery such as cardiopulmonary bypass (CPB) and hypotensive techniques (RR=5.55, CI=2.01–15.36, p=0.001; RR=6.24, CI=2.21–17.58, p=0.001, respectively), and patients who had a history of being alcoholic (RR=5.27, CI=4.09–6.79, p < 0.001). Conclusion: Incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with many factors, especially age of patient and cardiopulmonary comorbidities, patient having a history of alcoholic addiction, increasing ASA physical status, preoperative shock, special techniques for surgery, and sites of surgery including brain, thorax, abdomen, and major vascular region. Anesthesiologists and multidisciplinary teams in pre- and perioperative periods should remain alert for warning signs of pre-cardiac arrest and be quick to manage the high-risk group of surgical trauma patients. Furthermore, a healthcare policy should be promoted for protecting against accidents in high-risk groups of the population as well.

Keywords: perioperative cardiac arrest, trauma patients, emergency surgery, anesthesia, factors risk, incidence

Procedia PDF Downloads 148