Search results for: Thai Army nurse educators

Authors: Vitheejongjaroen P., Jaisin Y., Pachekrepapol U., Taweechotipatr M.

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Lactic acid bacteria (LAB) are the most common type of microorganisms that had been used as probiotics also known for many beneficial health effects. The antioxidant activity of LAB is associated with numerous health-protective effects. This research aimed to investigate the antioxidant activity of lactic acid bacteria isolated from Thai sour pork sausage for their application in fermented milk products. Antioxidant activity determined by DPPH (2,2-diphenyl-1-picrylhydrazyl) radical scavenging assay showed that the isolate FN33-7, as 1 of 8 isolated exhibited scavenging activity in intact cell 5-7%, and supernatant 13-16%, intracellular cell free extract 42-48% respectively. This isolate was identified using 16S ribosomal DNA sequence analysis as Lactobacillus plantarum. The effect of milk fermented with L. plantarum FN33-7 on microbial count, pH and syneresis was assessed during refrigerated storage period of 28 days. The strain showed increased viability, pH level decreased, while syneresis increased. These results are similar to dairy products fermented with commercial starter cultures. Additionally, microstructure analysis of fermented milk by fluorescent microscopy showed that curd structure appeared to be dense and less porous in this fermented milk than commercial yogurt. The results of this study indicated that L. plantarum FN33-7 was a good probiotic candidate to be used in cultured milk products to reduce the risk of diseases caused by oxidative stress.

Keywords: Lactobacillus plantarum, probiotics, free radical, antioxidant, oxidative stress, fermented milk products

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Authors: Farida Habib, Haya Alfozan, Eman Miligi, Najla Alotaibi

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Background: Women’s satisfaction with maternity services, especially care during labor and birth, has become highly significant to healthcare providers, administrators, and policymakers. Purpose: The aims of this study were to assess maternal satisfaction regarding the quality of care during labor and to compare the level of maternal satisfaction between women who delivered by physicians and those delivered by midwives. Methodology: A descriptive, cross-sectional, correlational design was used. A convenient sample of 180 low-risk cases of immediate postpartum women who delivered at King Abdul-Aziz medical city was recruited. Women whose babies were diagnosed with serious health problems were excluded from the study. Data were collected using a self-administered questionnaire. The validity and reliability of the questionnaire were ensured. The questionnaire included three parts, namely: demographics data, medical history, and obstetrical history, and the last part is the satisfaction assessment tool. Ethical confederations were ensured. Maternal satisfaction during labor was classified in terms of health care, health workers' communication, and the environment. Results: Regarding health care, women were highly satisfied with care received from nurse (M = 4.21 + 0.88), medical care received (M = 4.17 + 0.79), and comfort techniques (M = 4.04 + 0.91). Regarding health workers' communication, women were highly satisfied with the provider to treat with dignity and respect (M = 4.03 + 0.91) and orientation to the toilet, bathroom, washing area (M = 4.00 + 0.93). Regarding the environment, women were highly satisfied with the experience of their baby's birth (M = 4.18 + 0.98) and supplies with drugs and supplies (M = 4.09 + 0.97). There was no statistically significant difference in maternal satisfaction between women who delivered by physicians and those delivered by midwives. Conclusion: Women were generally satisfied with their labor and delivery experience. There was no difference in maternal satisfaction on the labor process between women who delivered by physicians and those delivered by midwives.

Keywords: maternity, satisfaction, labor, delivery

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Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Soldiers' physical rehabilitation and long term health status has been hindered due to limited investment in and access to rehabilitation services. Home-based rehabilitation programmes could offer a potentially feasible alternative to facilitate long-term recovery. Objectives: To explore Sri Lankan soldiers' perceptions of barriers and facilitators to a home-based physical rehabilitation programme.Methods and Materials: We conducted qualitative semi-structured interviews with community re-integrated army veterans who had undergone unilateral lower limb amputation following war related trauma. Veterans were identified from five districts of Sri Lanka, based on a priori knowledge of veteran community settlements (Disabled Category Registry) obtained from Directorate of Rehabilitation, MoD, Sri Lanka. Individuals were stratified for purposive selection. The interview guide was developed from existing methods and adapted for context. Verbatim transcripts of interviews were analyzed for emerging themes using an inductive approach. Following consent, participants met the researcher (AW- a trained physiotherapist fluent in Sinhalese). Results: Twenty-five Interviews were conducted, totaling 7.2 hours of new data (Mean±SD: 0.28±0.11). All participants were male, aged 30-55 years (Mean±SD: 46.1±7.4), and had experienced traumatic amputation as a result of conflict. Twenty-four sub themes were identified. Inadequate space for exercises, absence of equipment and assistance to conduct the exercises at home, alongside absence of community healthcare services were all barriers. Burden of comorbidities, including chronic pain and disability level, were also barriers. Social support systems, including soldier societies, family, and kinship with other amputees, were seen as facilitators to an at-home programme. Motivation for independence was a strong indicator of engagement. Conclusion: Environment, chronic pain, and absence of well-established community health services were key barriers. Family and soldier support was a facilitator. Engagement with community healthcare providers (physiotherapist and primary care physicians) will be essential to the success of an at-home rehabilitation program.

Keywords: physical rehabilitation, home-based, soldiers, disability, lower-limb amputation, qualitative

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Authors: Sagar R. Patil, Dinesh R. Gawade, Sudhir N. Divekar

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One of the medical devices we found when we visit a hospital care unit such device is ‘patient monitoring system’. This device (patient monitoring system) informs doctors and nurses about the patient’s physiological signals. However, this device (patient monitoring system) does not have a remote monitoring capability, which is necessitates constant onsite attendance by support personnel (doctors and nurses). Thus, we have developed a Remote Wireless Patient Monitoring System using some biomedical sensors and Android OS, which is a portable patient monitoring. This device(Remote Wireless Patient Monitoring System) monitors the biomedical signals of patients in real time and sends them to remote stations (doctors and nurse’s android Smartphone and web) for display and with alerts when necessary. Wireless Patient Monitoring System different from conventional device (Patient Monitoring system) in two aspects: First its wireless communication capability allows physiological signals to be monitored remotely and second, it is portable so patients can move while there biomedical signals are being monitor. Wireless Patient Monitoring is also notable because of its implementation. We are integrated four sensors such as pulse oximeter (SPO2), thermometer, respiration, blood pressure (BP), heart rate and electrocardiogram (ECG) in this device (Wireless Patient Monitoring System) and Monitoring and communication applications are implemented on the Android OS using threads, which facilitate the stable and timely manipulation of signals and the appropriate sharing of resources. The biomedical data will be display on android smart phone as well as on web Using web server and database system we can share these physiological signals with remote place medical personnel’s or with any where in the world medical personnel’s. We verified that the multitasking implementation used in the system was suitable for patient monitoring and for other Healthcare applications.

Keywords: patient monitoring, wireless patient monitoring, bio-medical signals, physiological signals, embedded system, Android OS, healthcare, pulse oximeter (SPO2), thermometer, respiration, blood pressure (BP), heart rate, electrocardiogram (ECG)

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Authors: Ruth Estrada Javier - Reyes

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The study assessed the status of HTM program of selected private higher education institutions for internationalization across the eleven regions of the country. The descriptive survey method of research was used in this study. A devised survey questionnaire was utilized to gather information about the status of Philippine Higher Education Institutions’ internationalization of hospitality and tourism management education programs. The respondents were 12 administrators, 17 deans and program heads, 104 faculty members and 860 HTM students. Frequency, percentage, mean, standard deviation, t-test and F-test were used to treat the data. The results of the study are as follows: HEIs’ HTM education had complied with the policies/standards of CHED as per CMO No. 30 S. 2006. The respondents of the HTM education program were qualified for internationalization as assessed both by administrators and faculty. The private HEIs are ready to apply for international certification of their HTM education programs. The curriculum of HTM education programs in private HEIs are enriched by internationalization requirements. The administrators and faculty of HTM education programs are qualified educators but have limited participation in collaborative international research and linkages. The HEIs are qualified to apply for the internationalization of the Hospitality and Tourism Management education program in preparation to the ASEAN 2015.

Keywords: status, Hospitality and Tourism Management Program, internationalization, Private Higher Education Institutions

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Authors: Gayathri Sadanala, Shibam Pokhrel, Owen Murphy

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In the ever-evolving landscape of education, Virtual Reality (VR) environments offer a promising avenue for enhancing student engagement and learning experiences. However, understanding and predicting student behavior within these immersive settings remain challenging tasks. This paper presents a comprehensive study on the predictive modeling of student behavior in VR using machine learning techniques. We introduce a rich data set capturing student interactions, movements, and progress within a VR orientation program. The dataset is divided into training and testing sets, allowing us to develop and evaluate predictive models for various aspects of student behavior, including engagement levels, task completion, and performance. Our machine learning approach leverages a combination of feature engineering and model selection to reveal hidden patterns in the data. We employ regression and classification models to predict student outcomes, and the results showcase promising accuracy in forecasting behavior within VR environments. Furthermore, we demonstrate the practical implications of our predictive models for personalized VR-based learning experiences and early intervention strategies. By uncovering the intricate relationship between student behavior and VR interactions, we provide valuable insights for educators, designers, and developers seeking to optimize virtual learning environments.

Keywords: interaction, machine learning, predictive modeling, virtual reality

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Authors: Ganetsou Evanthia, Koutsikos Emmanouil, Austin Anna Maria

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Information technology has long served the needs of individuals for learning and entertainment, but much less for children in sickness. The aim of the proposed online video game is to provide immersive learning opportunities as well as essential social and emotional scenarios for hospital-bound children with long-term illness. Online self-paced courses on chosen school subjects, including specialised software and multisensory assessments, aim at enhancing children’s academic achievement and sense of inclusion, while doctor minigames familiarise and educate young patients on their medical conditions. Online ethical dilemmas will offer children opportunities to contemplate on the importance of medical procedures and following assigned medication, often challenging for young patients; they will therefore reflect on their condition, reevaluate their perceptions about hospitalisation, and assume greater personal responsibility for their progress. Children’s emotional and psychosocial needs are addressed by engaging in social conventions, such as interactive, daily, collaborative mini games with other hospitalised peers, like virtual competitive sports games, weekly group psychodrama sessions, and online birthday parties or sleepovers. Social bonding is also fostered by having a virtual pet to interact with and take care of, as well as a virtual nurse to discuss and reflect on the mood of the day, engage in constructive dialogue and perspective taking, and offer reminders. Access to the platform will be available throughout the day depending on the patient’s health status. The program is designed to minimise escapism and feelings of exclusion, and can flexibly be adapted to offer post-treatment and a support online system at home.

Keywords: long-term illness, children, hospital, interactive games, cognitive, socioemotional development

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Authors: Boularas El-Alia, Arbi Raja, Bachir Bouiadjra Sara, Rezk-Kallah Haciba, Rezkkallah Baghdad

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Objectives : To determine the handling practices of cytotoxic drugs and to describe clinical manifestations expressed by hospital personnel of Sidi Bel Abbes during the year 2014. Methods: Sectional descriptive study conducted in 3 center university hospital units (Hematology, Oncology and Urology) and Gynecology of EHS Sidi Bel Abbes. A questionnaire was administered to hospital workers regulary exposed to cytotoxic drugs. A work-place visit was performed to have an overview about working conditions. The Cytotoxic Contact Index (CCI) was calculated for each nurse on a period of 15 working days. Treatment of the results was done using SPSS software. Results: The survey reveals that 22 men and 58 women are exposed to cytotoxic drugs for an average of 7 years. Many symptoms such as ocular irritation (38,75%), throat irritation (56,25%), headache (68,75%), dizziness (43,75%), nausea (37,5%), metallic taste (30%), were reported with high frequency. Are noted in the offspring, 3 congenital anomalies,2 diaphragmatic hernia and a cleft palate. The Cytotoxic Contact Index (CCI) was higher than 3 among Oncology nurses and higher than 1 for most of the nurses of Hematology and Gynecology service. The wearing of personal protective clothing was not respected by all workers: (22/23) wear gloves and (20/23) wear a mask,(5/23) wear a cap, (2/23) wear glasses. Only 3 nurses have benefited from continuous training on handling cytotoxic drugs. Conclusion: This study shows a high occupational exposure risk to cytotoxic drugs among persons handling these drugs and the necessity to apply rigorously all measures related to personal protection awareness and training of personnel to minimize these exposure.

Keywords: cytotoxic drugs, handling, clinical manifestations, hospital staff

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Authors: M. Najib Osman, Hanafizan Hussain, Sri Kusuma Wati Mohd Daud

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Avatar was used as user’s symbol of identity in online communications such as Facebook, Twitter, online game, and portal community between unknown people. The development of this symbol is the use of animated character or avatar, which can engage learners in a way that draws them into the e-Learning experience. Immersive learning is one of the most effective learning techniques, and animated characters can help create an immersive environment. E-learning is an ideal learning environment using modern means of information technology, through the effective integration of information technology and the curriculum to achieve, a new learning style which can fully reflect the main role of the students to reform the traditional teaching structure thoroughly. Essential in any e-learning is the degree of interactivity for the learner, and whether the learner is able to study at any time, or whether there is a need for the learner to be online or in a classroom with other learners at the same time (synchronous learning). Ideally, e-learning should engage the learners, allowing them to interact with the course materials, obtaining feedback on their progress and assistance whenever it is required. However, the degree of interactivity in e-learning depends on how the course has been developed and is dependent on the software used for its development, and the way the material is delivered to the learner. Therefore, users’ accessibility that allows access to information at any time and places and their positive attitude towards e-learning such as having interacting with a good teacher and the creation of a more natural and friendly environment for e-learning should be enhanced. This is to motivate their learning enthusiasm and it has been the responsibility of educators to incorporate new technology into their ways of teaching.

Keywords: avatar, e-learning, higher education, students' perception

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Authors: Lahari Ramya Pa, Sudhakar Ib, Madhu Vc, Madhusudhan Reddy Gd, Srinivasa Rao E.

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Selection of suitable armor materials for defense applications is very crucial with respect to increasing mobility of the systems as well as maintaining safety. Therefore, determining the material with the lowest possible areal density that resists the predefined threat successfully is required in armor design studies. A number of light metal and alloys are come in to forefront especially to substitute the armour grade steels. AA5083 aluminium alloy which fit in to the military standards imposed by USA army is foremost nonferrous alloy to consider for possible replacement of steel to increase the mobility of armour vehicles and enhance fuel economy. Growing need of AA5083 aluminium alloy paves a way to develop supplement aluminium alloys maintaining the military standards. It has been witnessed that AA 2xxx aluminium alloy, AA6xxx aluminium alloy and AA7xxx aluminium alloy are the potential material to supplement AA5083 aluminium alloy. Among those cited aluminium series alloys AA7xxx aluminium alloy (heat treatable) possesses high strength and can compete with armour grade steels. Earlier investigations revealed that layering of AA7xxx aluminium alloy can prevent spalling of rear portion of armour during ballistic impacts. Hence, present investigation deals with fabrication of hard layer (made of boron carbide) i.e. layer on AA 7075 aluminium alloy using friction stir processing with an intention of blunting the projectile in the initial impact and backing tough portion(AA7xxx aluminium alloy) to dissipate residual kinetic energy. An analytical approach has been adopted to unfold the ballistic performance of projectile. Penetration of projectile inside the armour has been resolved by considering by strain energy model analysis. Perforation shearing areas i.e. interface of projectile and armour is taken in to account for evaluation of penetration inside the armour. Fabricated surface composites (targets) were tested as per the military standard (JIS.0108.01) in a ballistic testing tunnel at Defence Metallurgical Research Laboratory (DMRL), Hyderabad in standardized testing conditions. Analytical results were well validated with experimental obtained one.

Keywords: AA7075 aluminium alloy, friction stir processing, boron carbide, ballistic performance, target

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Authors: Arunporn Itharat, Kamonmas Srikwan, Srisopa Ruangnoo, Pakakrong Thongdeeying

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Background: The rhizomes of Smilax glabra (SG) has long been used in Traditional Chinese and Thai herbal medicine to treat a variety of infectious diseases and immunological disorders. Objective: To investigate the in vitro anti-allergic activities of crude extracts and pure isolated flavonoid compounds from SG by determination of inhibitory effects on antigen-induced release of β-hexosaminidase from RBL-2H3 cells. Methods: The in vitro inhibitory effects of crude aqueous and organic extracts on beta-hexosaminidase release in RBL-2H3 cells were evaluated as an in vitro indication of possible anti-allergic activity in vivo. Bioassay-guided fractionation of extracts was used to isolate flavonoid compounds from the ethanolic extracts. Results: The 95% and 50% ethanolic extracts of SG showed remarkably high anti-allergic activity, with IC50 values of 5.74 ± 2.44 and 23.54 ± 4.75 μg/ml, much higher activity than that for Ketotifen (IC50 58.90 μM). The water extract had negligible activity (IC50 > 100 μg/ml). The two isolated flavonols, Engeletin and Astilbin, showed weak anti-allergic activity, IC50 values 97.46 ± 2.04 and > 100 μg/ml, respectively. Conclusions: The 95% and 50% ethanolic extracts of SG showed strong anti-allergic activity but two flavonol constituents did not show any significant anti-allergic activity. These findings suggest that a combination of effects of various phytochemicals in crude extracts used in traditional medicine are responsible for the purported anti-allergic activity of SG herbal preparations. The plethora of constituents in crude extracts, as yet unidentified, are likely to be acting synergistically to account for the strong observed anti-allergic in vitro activity.

Keywords: Smilax glabra, anti-allergic activity, RBL-2H3 cells, flavonoid compounds

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Authors: M. A. Brown, K. Hugill, D. Meredith

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Since the establishment of midwifery, as a professional identity in its own right, in the early years of the 20th century, midwifery-led models of childbirth have prevailed in many parts of the world. However, in many locations midwives’ scope of practice remains underdeveloped or absent. In Qatar, all births take place in hospital and are under the professional jurisdiction of obstetricians, predominately supported by internationally trained nurse-midwives and obstetric nurses. The strategic vision for health services in Qatar endorsed a desire to provide women with the ‘Best Care Always’ and the introduction of midwifery was seen as a way to achieve this. In 2015 the process of recruiting postgraduate educated Clinical Midwife Specialists from international sources began. The midwives were brought together to initiate an in hospital and community service transformation plan. This plan set out a series of wide-ranging actions to transform maternity and neonatal services to make care safer and give women more health choices. Change in any organization is a complex and dynamic process. This is made even more complex when multifaceted professional and cross cultural factors are involved. This presentation reports upon the motivations and challenges that exist and the progress around introducing a multicultural midwifery model of childbirth care in the state of Qatar. The paper examines and reflects upon the drivers and unique features of childbirth in the country. Despite accomplishments, progress still needs to be made in order to fully implement sustainable changes to further improve care and ensure women and neonates get the ‘Best Care Always’. The progress within the transformation plan highlights how midwifery may coexist with competing models of maternity care to create an innovative, eclectic and culturally sensitive paradigm that can best serve women and neonatal health needs.

Keywords: culture, managing change, midwifery, neonatal, service transformation plan

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Authors: Kornanong Yuenyongchaiwat, Duangnate Pepatsitipong, Panthip Sangprasert

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High blood pressure and diabetes have been suggested as being non-communicable disease (NCDs), and there is one of the components of the definition of metabolic syndrome. Therefore, the purpose of this study was to evaluate the effect of a 12-week pedometer based community walking intervention on change in resting blood pressure and blood glucose in participants with overweight in the community setting. Method: Participants were recruited both males and females who had a sedentary lifestyle aged 35-59 years (mean aged 49.67 years). A longitudinal quasi-experimental study was designed with 35 overweight participants who had body mass index ≥ 25 kg/m2. These volunteers were assigned to the 12-week pedometer-based walking program (an accumulated at least 10,000 steps a day). Blood pressure and blood glucose were measured initially before and after 12-week intervention. Results: Systolic blood pressure and heart rate were significantly lower in 30 individuals who had accumulated 10,000 steps d-1 in the intervention group at 12 week follow-up (-13.74 mmHg and 5.3 bpm, respectively). In addition, reduction in blood glucose (-14.89 mmol) in the intervention participants was statistically significant (p < .001). A regression analysis indicated that reductions in systolic blood pressure were significantly related to the increase in steps per day. Conclusion: The accumulation of least 10,000 steps d-1 resulted in decreased resting systolic blood pressure and blood glucose in overweight participants. This has also shown that an increase in physical activity in overweight participants with sedentary lifestyle by accumulating at least 10,000 steps a day can reduce the risk of cardiovascular disease (e.g., hypertension and diabetes).

Keywords: blood glucose, blood pressure, diabetes, hypertension, physical activity, walking

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Authors: A. H. A. Hamid, N. A. Zainuddin, M. Y. M. Nor

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Millions of child refugees leave their countries in the hope of better and safer lives particularly in the aspect of education. However, the education access for the child refugees is strongly depending on the policies made by the federal and local governments. Malaysia, in particular, is a country which does not have a specific educational policy that is inclusive of child refugees. Hence, this study explores the feasibility of possible educational policy that specifically caters the needs of child refugees in Malaysia. These are preliminary findings of a case study which involved thirty-five postgraduate students in a local university who undertook Educational Policy coursework and five teachers in a refugee community centre in Kuala Lumpur, Malaysia. Interviews were recorded, transcribed and thematically analysed in relation to issues highlighted in the refugee education literature. The findings showed that most of the informants felt there is an urgent need of a systematic intervention put in place by the local government to cater to the needs of equal education access to the child refugees. A further large scale study is needed in the near future by integrating different perspectives of relevant stakeholders for an effective, efficient and sustainable policy formulation and implementation related to child refugees in Malaysia. The findings may be of interests to the educators, the ministry of education, state education office, district education office, teachers, parents and surrounding communities for their awareness about the needs of refugee education and the feasibility of educational policy for child refugees in the country.

Keywords: child refugees, educational policy, inclusive education, Malaysia

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Authors: David Barney, Francis Pleban, Muna Muday

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The purpose of this study was to explore gender differences of former physical education students related to reflective experiences of competition in physical education learning environment. In the school environment, students are positioned in competitive situations, including in the physical education context. Therefore it is important to prepare future physical educators to address the role of competition in physical education. Participants for this study were 304 college-aged students and young adults (M = 1.53, SD = .500), from a private university and local community located in the western United States. When comparing gender, significant differences (p < .05) were reported for four (questions 5, 7, 12, and 14) of the nine scaling questions. Follow-up quantitative findings reported that males (41%) more than females (27%) witnessed fights in physical education environment during competitive games. Qualitative findings reported fighting were along the lines of verbal confrontation. Female participants tended to experience being excluded from games, when compared to male participants. Both male and female participants (total population; 95%, males; 98%; and females 92%) were in favor of including competition in physical education for students. Findings suggest that physical education teachers and physical education teacher education programs have a responsibility to develop gender neutral learning experiences that help students better appreciate the role competition plays, both in and out of the physical education classroom.

Keywords: competition, physical education, physical education teacher education, gender

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Authors: Preeyarach Whisetkhan, Malai Taweechotipatr, Ulisa Pachekrepapol

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Elevated level of blood cholesterol or hypercholesterolemia may lead to atherosclerosis and poses a major risk for cardiovascular diseases. Probiotics play a crucial role in human health, and probiotic bacteria that possesses bile salt hydrolase (BSH) activity can be used to lower cholesterol level of the host. The aim of this study was to investigate whether lactic acid bacteria (LAB) isolated from traditional Thai fermented foods were able to exhibit bile salt hydrolase activity and their use in fermented milk. A total of 28 isolates were tested for BSH activity by plate method on MRS agar supplemented with 0.5% sodium salt of taurodeoxycholic acid and incubated at 37°C for 48 h under anaerobic condition. The results showed that FN1-1 and FN23-3 isolates possessed strong BSH activity. FN1-1 and FN23-3 isolates were then identified for phenotype, biochemical characteristics, and genotype (16S rRNA sequencing). FN1-1 isolate showed 99.92% similarity to Lactobacillus pentosus DSM 20314(T), while FN23-3 isolate showed 99.94% similarity to Enterococcus faecium CGMCC1.2136 (T). Lactobacillus pentosus FN1-1 and Enterococcus faecium FN23-3 were tolerant of pH 3-4 and 0.3 and 0.8% bile. Bacterial count and pH of milk fermented with Lactobacillus pentosus FN1-1 at 37°C and 43°C were investigated. The results revealed that Lactobacillus pentosus FN1-1 was able to grow in milk, which led to decrease in pH level. Fermentation at 37°C resulted in faster growth rate than at 43 °C. Lactobacillus pentosus FN1-1 was a candidate probiotic to be used in fermented milk products to reduce the risk of high-cholesterol diseases.

Keywords: probiotics, lactic acid bacteria, bile salt hydrolase, cholesterol

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Authors: Aline Giardin, Ana Fontoura, Thomas Anderson

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Transsexuality is a condition that requires the work of professionals from various fields for diagnosis and treatment. The correct diagnosis is very important because the surgery is irreversible. Diagnostic elements are essentially clinical and an observation period of two years prior to surgery is recommended. In this review article, we discuss the importance of psychiatric nursing for the care of transgender patients, as well as their mental health. Transsexuality is a phenomenon that contrasts our common understandings of sexuality, but it is not a sexual issue. Also called gender dysphoria is a mismatch between the anatomical sex of an individual and their gender identity. In relation to mental health, among transsexuals, we find variations ranging from psychoses to total normality. As the etiology is still controversial, there is no biological marker and only the clinical criteria can be used. Portaria nº 2803, of November 19, 2013, Brazil, regulates the surgical reassignment of sex by the SUS and the nurse started to work also in operational groups (transsexuals who wish to perform surgery and other procedures of reassignment of sex). Health and education, establishes links and guides the care that female and male transsexual patients will have to have before and after surgery. It is also important to say that the work of health education is not only concerned with aspects related to the sexual reassignment surgery, but also with the mental health of its patients and with the family. One of the main complaints of patients is the impression that professionals seem to find them strange and feel extremely uncomfortable when they talk about their desire to undergo sex-change surgery: Investigate the role of nursing in the process of change sexual. Our methodology was a review of articles produced between 1994 and 2015. It was concluded that nursing should specialize for this new demand, which is growing more and more in our health services. We believe that nursing is specializing to enter this context and the expectations are good for the professionals and for the reception of the transsexual patient.

Keywords: transex, nursing, importance, patient

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Authors: Saheed A. Gbadegeshin

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Lean Commercialization (LC) is a transformation of new technologies and knowledge to products and services through application of lean/agile principle. This principle focuses on how resources can be minimized on development, manufacturing, and marketing new products/services, which can be accepted by customers. To understand how the LC has been employed by the technology-based companies, a case study approach was employed by interviewing the founders, observing their high technologies, and interviewing the commercialization experts. Two serial entrepreneurs were interviewed in 2012, and their commercialized technologies were monitored from 2012 till 2016. Some results were collected, but to validate the commercialization strategies of these entrepreneurs, four commercialization experts were interviewed in 2017. Initial results, observation notes, and experts’ opinions were analyzed qualitatively. The final findings showed that the entrepreneurs applied the LC unknowingly, and the experts were aware of the LC. Similarly, the entrepreneurs used the LC due to the financial constraints, and their need for success. Additionally, their commercialization practices revealed that LC appeared to be one of their commercialization strategies. Thus, their practices were analyzed, and a framework was developed. Furthermore, the experts noted that LC is a new dawn, which technologists and scientists need to consider for their high technology commercialization. This article contributes to the theory and practice of commercialization. Theoretically, the framework adds value to the commercialization discussion. And, practically the framework can be used by the technology entrepreneurs (technologists and scientists), technology-based enterprises, and technology entrepreneurship educators as a guide in their commercialization adventures.

Keywords: lean commercialization, high technologies, lean start-up, technology-based companies

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Authors: Annette G. Walters Ph.D.

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With a global shortage of qualified educational professionals, school systems continue to struggle with adequate staffing. How might learning communities meet the needs of all students, in particular those with specialized needs. While the task may seem foreboding and certain factors may seem divergent, all are connected in the education of students. Special education has a significant impact on the teaching and learning experience of all students in an educational community. Even when there are concerted efforts at embracing learners with diverse aptitude and abilities, there are often many important local factors that are misaligned, overlooked, or misunderstood. Working with learners with diverse abilities, often requires intentional services and supports for students to achieve success. Developing and implementing specialized instruction requires a multifaceted approach to supports the entire learning community, which includes educational providers, learners, and families, all while being mindful of fiscal and natural resources. This research explores the implications and complexities of special education instruction and specializing instruction, as well as leading and teaching diverse learners. This work is separated into three sections: the state of special education, teaching and leading diverse learners, and developing educational competencies through collaborative engagement. This structured analysis extrapolates historical and current research on special education practices and the role of educators in ensuring diverse students meet success.

Keywords: - diverse learners, - special education, - modification and supports, - curriculum and instruction, - classroom management, - formal and informal assessments

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Authors: Marianne Vardalos

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Many students are returning to school after years of rich, lived experiences as parents, employees, volunteers, and in various other roles outside the university. While in the workforce or at home raising a family, they have gained authentic, personal observations of the power dynamics referred to as racism, classism, sexism, heteronormativity, and ableism. Encouraging your students to apply their own realities to course material that interrogates power structures and privilege not only facilitates student learning and understanding but also reveals that you, as a teacher, respect the experiences of your students as valuable and valid teaching tools. Though there is general recognition of the pedagogical value of having students share their experiences, facilitating such discussion can be a harrowing challenge for faculty. Additionally, for some students, the classroom can be very strange and too intimidating to share personal stories of injustice or inequality. In larger classroom settings, an attempt to integrate story-telling can turn into a cacophony of emotional testimonials. Not wanting to lose control of the class and feeling unqualified to respond to students' emotional confessions from their past, educators are often tempted to minimize the personal comments of students and avoid altogether an impromptu free-for-all. Knowing how and when to draw on the personal experience of your students involves a systematic plan for eliciting the most useful information at the right time. The trick is to design methods that induce student self-reflection in a way that is relevant to the course material and to then effectively incorporate these methods into lesson plans.

Keywords: pedagogy, story-telling, power and inequality, hierarchies of power

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Authors: Johann Van Niekerk

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The disciplines of conducting (instrumental or choral) and of singing presume a willingness toward an open posture and, in many cases, demand it for effective communication and technique. Yet, this very openness, with the "spread-eagle" gesture as an extreme, is oftentimes counterintuitive for musicians and within the trajectory of human evolution. Conversely, it is in this very gesture of "taking up space" that confidence-gaining techniques such as the popular "power pose" are based. This paper consists primarily of a literature review, exploring the topics of physical openness and vulnerability, considering the semiotics of the "spread-eagle" and its accompanying letter X. A major finding of this research is the discrepancy between evolutionary instinct towards physical self-protection and “folding in” and the demands of the discipline of physical and gestural openness, expansiveness and vulnerability. A secondary finding is ways in which encouragement of confidence-gaining techniques may be more effective in obtaining the required results than insistence on vulnerability, which is influenced by various cultural contexts and socialization. Choral conductors and music educators are constantly seeking ways to promote engagement and healthy singing. Much of the information and direction toward this goal is gleaned by students from conducting gestures and other pedagogies employed in the rehearsal. The findings of this research provide yet another avenue toward reaching the goals required for sufficient and effective teaching and artistry on the part of instructors and students alike.

Keywords: conducting, gesture, music, pedagogy, posture, vulnerability

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Authors: Layla Albdr

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Saudi Arabia instituted the policy of Sensitizing and Training Stakeholders for E-learning and witnessed wide adoption in many institutions. However, it is at the infancy stage and needs time to develop to mirror the US and UK. The majority of the higher education institutions in Saudi Arabia have adopted E-learning as an alternative to traditional methods to advance education. Conversely, effective implementation of the policy of sensitization and training of stakeholders for E-learning implementation has not been attained because of various challenges. The objectives included determining the challenges and opportunities of the E-learning policy of sensitization and training of stakeholders in Saudi Arabia's higher education and examining if sensitization and training of stakeholder's policy will help promote the implementation of E-learning in institutions. The study employed a descriptive research design based on qualitative analysis. The researcher recruited 295 students and 60 academic staff from four Saudi Arabian universities to participate in the study. An online questionnaire was used to collect the data. The data was then analyzed and reported both quantitatively and qualitatively. The analysis provided an in-depth understanding of the opportunities and challenges of E-learning policy in Saudi Arabian universities. The main challenges identified as internal challenges were the lack of educators’ interest in adopting the policy, and external challenges entailed lack of ICT infrastructure and Internet connectivity. The study recommends encouraging, sensitizing, and training all stakeholders to address these challenges and adopt the policy.

Keywords: e-learning, educational policy, Saudi Arabia, policy of sensitization and training

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Authors: Nattapol Pourprasert, Siriwan Manowan

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This study aims to find out what budget problems Thailand is facing with and how the results from the comparison between the budgeting reform by Thailand and the reforms by OECD member countries can be used for carrying out budgeting reform of Thailand. The findings from the study on the budget problems that Thailand is facing with reveal that the budgeting system of Thailand lacks of the assessment for the cost-effectiveness of the expenditure of borrowed money and budgets in order to determine whether the expenses are worth the taxes collected from people or not. This is because most popularity policies have unlimited budgets which can lead to the financial risks. Also, these policies create great tax burdens for the descendants in the future and affect the fair distribution of incomes but the Parliament of Thailand never considers these facts. The findings from the comparison between Thai budgeting reform and those by OECD member countries manifest that the traditional budgeting system of Thailand is the department-based budgeting, which is still used without being changed or adjusted in order to fit the new administrative regimes. This traditional budgeting system suggests that a department is responsible for budgeting tasks. Meanwhile, in OECD member countries, budgeting reforms are carried out simultaneously with the reforms of civil service systems so that they are driven in the same directions. The budgeting reforms that rely only on the analyses on economic or technical dimension can hardly lead to success. The budgeting systems of OECD member countries are designed to deal with the unique problems that each of the member countries is facing with rather than adopting the modern system developed by other countries. The budgeting system that has a complicated concept and practice has to be implemented under a flexible strategy so that the departments that implement it can learn about and adjust itself to the system. Continuous and consistent development and training for staff members are also necessary.

Keywords: budgeting reforms, Thailand, OECD member countries, budget problems

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Authors: Melissa C. Ingram

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This literature review sought to explore the dimensions of diversity that can affect classroom learning. This review is significant as it can aid educators in reaching more of their diverse student population and creating supportive classrooms for teachers and students. For this study, peer-reviewed articles were found and compiled using Google Scholar. Key terms used in the search include student individuality, classroom equality, student development, teacher development, and teacher individuality. Relevant educational standards such as Common Core and Partnership for the 21st Century were also included as part of this review. Student and teacher individuality and equality is discussed as well as methods to grow both within educational settings. Embracing student and teacher individuality was found to be key as it may affect how each person interacts with given information. One method to grow individuality and equality in educational settings included drafting and employing revised teaching standards which include various Common Core and U.S. State standards. Another was to use educational theories such as constructivism, cognitive learning, and Experiential Learning Theory. However, barriers to growing individuality, such as not acknowledging differences in a population’s dimensions of diversity, still exist. Studies found preserving the dimensions of diversity owned by both teachers and students yielded more positive and beneficial classroom experiences.

Keywords: classroom equality, student development, student individuality, teacher development, teacher individuality

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Authors: Thidarat Duangyod, Chanida Palanuvej, Nijsiri Ruangrungsi

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Pentace burmanica Kurz., belonging to the Malvaceae family, is commonly used for anti-diarrhea in Thai traditional medicine. A method for quantification of (+)-catechin and (-)-epicatechin in P. burmanica stem bark from 12 different Thailand markets by reverse-phase high performance liquid chromatography (HPLC) was investigated and validated. The analysis was performed by a Shimadzu DGU-20A3 HPLC equipped with a Shimadzu SPD-M20A photo diode array detector. The separation was accomplished with an Inersil ODS-3 column (5 µm x 4.6 x 250 mm) using 0.1% formic acid in water (A) and 0.1% formic acid in acetonitrile (B) as mobile phase at the flow rate of 1 ml/min. The isocratic was set at 20% B for 15 min and the column temperature was maintained at 40 ºC. The detection was at the wavelength of 280 nm. Both (+)-catechin and (-)-epicatechin existed in the ethanolic extract of P. burmanica stem bark. The content of (-)-epicatechin was found as 59.74 ± 1.69 µg/mg of crude extract. In contrast, the quantitation of (+)-catechin content was omitted because of its small amount. The method was linear over a range of 5-200 µg/ml with good coefficients (r2 > 0.99) for (+)-catechin and (-)-epicatechin. Limit of detection values were found to be 4.80 µg/ml for (+)-catechin and 5.14 µg/ml for (-)-epicatechin. Limit of quantitation of (+)-catechin and (-)-epicatechin were of 14.54 µg/ml and 15.57 µg/ml respectively. Good repeatability and intermediate precision (%RSD < 3) were found in this study. The average recoveries of both (+)-catechin and (-)-epicatechin were obtained with good recovery in the range of 91.11 – 97.02% and 88.53 – 93.78%, respectively, with the %RSD less than 2. The peak purity indices of catechins were more than 0.99. The results suggested that HPLC method proved to be precise and accurate and the method can be conveniently used for (+)-catechin and (-)-epicatechin determination in ethanolic extract of P. burmanica stem bark. Moreover, the stem bark of P. burmanica was found to be a rich source of (-)-epicatechin.

Keywords: pentace burmanica, (+)-catechin, (-)-epicatechin, high performance liquid chromatography

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Authors: Amani Alsaqqaf, Frederick W. B. Li

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Field trips are essential methods of learning in different subjects, and in recent times, there has been a reduction in the number of field trips (FTs) across all learning levels around the world. Virtual field trips (VFTs) in game environments provide FT experience based on the experiential learning theory (ELT). A conceptual framework for designing virtual field trip games (VFTGs) is developed with an aim to support game designers and educators to produce an effective FT experience where technology would enhance education. The conceptual framework quantifies ELT as an internal economy to link learning elements to game mechanics such as feedback loops which leads to facilitating VFTGs design and implementation. This study assesses the conceptual framework for designing VFTGs by investigating the possibility of applying immersive VFTGs in a secondary classroom and compare them with traditional learning that uses video clips and PowerPoint slides from the viewpoint of students’ perceived motivation, presence, and learning. The assessment is achieved by evaluating the learning performance and learner experience of a prototype VFT game, Island of Volcanoes. A quasi-experiment was conducted with 60 secondary school students. The findings of this study are that the VFTG enhanced learning performance to a better level than did the traditional way of learning, and in addition, it provided motivation and a general feeling of presence in the VFTG environment.

Keywords: conceptual framework, game-based learning, game design, virtual field trip game

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Authors: Claudia Koby, Merav Boaz, Meirav Zaiger Kober

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Krembo Wings is an all-inclusive youth movement which brings children and youth with any disability together with their able-bodied peers (counselors) for weekly fun and educational social activities. Krembo Wings utilizes a socio-educational framework to create and lead social change through members with and without disabilities. All the work that Krembo Wings engages in stems from its central goal of promoting inclusion and integration using social and psychological theories to develop its unique model and approach. The key to Krembo Wings' approach in promoting inclusion is active participation – each member, with and without disabilities, is enabled to participate to their fullest capacity in the youth movement and its activities. In order for this to be achieved, all activities are adjustable and are modified to fit the abilities of each member. Additionally, youth counselors – most of whom are members without disabilities – go through extensive training in order to act as 'intermediaries' for their partner with disabilities, enabling and facilitating their partner's participation in a way that allows them to be as independent and active as possible. The relationship is one of friendship and not of caretaking. There is always a nurse on-hand to tend to any caretaking needs. Two essential elements of Krembo Wings' model is the broadening of concepts – shifting and changing the understanding of certain concepts such as what it means to be 'independent' or 'able' – and the development of a unique language – creating a language which both reflects and shapes reality. These elements of Krembo Wings' model foster the development of the values of acceptance and appreciation of those who are 'different'. It instills in members and counselors a new way of perceiving the world, one in which inclusion and integration are achievable and natural. Krembo Wings is certain that implementation of this model will promote the participation and inclusion of individuals with disabilities in society while promoting diversity. This model can serve as a platform which can be replicated and adjusted to suit any environment.

Keywords: innovative model for inclusion, socio-educational movement, youth leadership, youth with and without disabilities

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Authors: Mamta Thakur, Dr. Shashi Mawar, Ms. Levis Murry, Dr. D.k.sharma

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Aim: The aim of this study is to develop nephrology nursing procedure protocol after clinical audit of current nephrology nursing practices. Materials and methods: This descriptive observational study was conducted on 40 nurses who were working in Nephrology Department of AIIMS, New Delhi to observe their current practices to assess the existing gaps in the practice. The nurses were enrolled through total enumerative sampling. Sociodemographic profile of nurses and clinical profile for site of procedure was collected. Observation checklist was formed on the basis of standard nursing practices, which included 7 dimensions for hemodialysis procedure and 3 dimensions for procedure of assisting renal biopsy. Based on the gaps identified, nephrology nursing procedure protocol will be developed. Nurses were observed during two shifts, and each nurse was observed once. Scoring of items were done in each dimension, and for acceptable practices, nurses have to score ≥80% in each dimension. Results: Data was analyzed using descriptive statistics. Majority of nurses (73.7%) in nephrology ward and (80.9%) in hemodialysis unit have not undergone any special training in nephrology. Most of nurses (80.9%) followed the acceptable nursing practices for procedure of connection for hemodialysis. None of nurses followed the acceptable level (≥80%) of nursing practices for the procedure of predialysis assessment, the procedure for site preparation, during dialysis assessment and post dialysis assessment. None (100%) showed the acceptable level of nursing practices for all the dimensions of assisting renal biopsy procedure. Nephrology nursing procedure protocol was developed by researcher following a rigorous process, and this will reduce the gaps in the nursing practice. Conclusion: Clinical audit found that there were gaps in the existing nursing practices compared to the standardised nursing practices for procedure of hemodialysis and assisting renal biopsy, and these gaps have been addressed by the development of the protocol.

Keywords: nursing practice, nephrology nursing procedure, nursing protocol, renal biopsy, hemodialysis

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Authors: Athira M., Prakasha G. S.

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The rising prevalence of academic entitlement among school and college students necessitates a comprehensive investigation. This study focuses on discovering gender differentials in academic entitlement and their nexus with diverse grade negotiation behaviors within the undergraduate (UG) student cohort. Grade negotiation behaviors, encompassing a range from amicable discussions to more assertive tactics, are influenced by students' perceptions of their academic entitlement. The research delves into the broader significance of academic entitlement, considering its implications for student-teacher conflicts and the dynamics it introduces into the educational field. Employing a quantitative research approach, data from UG students is meticulously analyzed. Mann-Whitney U tests unveil pronounced gender difference in academic entitlement, with females demonstrating higher entitlement levels. Furthermore, the study unearths significant correlations between academic entitlement and specific negotiation styles, notably yielding and forcing strategies, albeit with minimal impact on academic performance. These findings provide a foundational understanding for educators and institutions to foster equitable learning environments and formulate effective conflict resolution strategies, ultimately elevating the quality of the educational experience. Moreover, this study opens avenues for future research, exploring interventions to enhance negotiation skills and diving deeper into the intricate dimensions of academic entitlement within academic life.

Keywords: academic entitlement, grade negotiation, negotiation styles, student-teacher conflict

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Authors: Stephen Hernandez, Nikita Sharma

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The Coronavirus disease (COVID-19) emerged as a worldwide pandemic at the beginning of 2020. The pandemic and its impact reached the shores of the United States by the second week of March. Once infections started to grow in numbers, early intervention programs, including those providing home-based services, recognized that to reduce the spread of the virus, many traditional in-person therapeutic interventions were going to be impossible due to social distancing and self-quarantine requirements. Initially, infants, toddlers, and their families were left without any services from their educators and therapists, but within a few weeks of the public health emergency, various states, including New York, approved the use of teletherapy/virtual visits for early intervention service provision. This paper will detail the results of a survey from over 400 E.I. service providers about their experiences utilizing teletherapy to deliver services to children in early intervention programs. The survey questions focused on how did COVID-19 stay-at-home orders impact E.I. services for young children with special needs? Sub-questions included topics such as availability of the parents, the amount of time that babies remained engaged, as well as the perceived success of teletherapy as a viable option to provide service by both parent and professional. The results of this study found that therapists found teletherapy to be a viable manner of providing services and could be very effective on a case by case basis.

Keywords: early intervention, teletheraphy, telehealth, COVID-19

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