Search results for: motivational strategies

Authors: Hui Fang Huang Su, Jia Borror

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This study compared two interventions for teaching math to preschool-aged students with autism spectrum disorder (ASD). The first is considered the business as usual (BAU) intervention, which uses the Strategies for Teaching Based on Autism Research (STAR) curriculum and discrete trial teaching as the instructional methodology. The second is the Math is Not Difficult (Project MIND) activity-embedded, naturalistic intervention. These interventions were randomly assigned to four preschool students with ASD classrooms and implemented over three months for Project Mind. We used measurement gained during the same three months for the STAR intervention. In addition, we used A quasi-experimental, pre-test/post-test design to compare the effectiveness of these two interventions in building mathematical knowledge and skills. The pre-post measures include three standardized instruments: the Test of Early Math Ability-3, the Problem Solving and Calculation subtests of the Woodcock-Johnson Test of Achievement IV, and the Bracken Test of Basic Concepts-3 Receptive. The STAR curriculum-based assessment is administered to all Baudhuin students three times per year, and we used the results in this study. We anticipated that implementing these two approaches would improve the mathematical knowledge and skills of children with ASD. Still, it is crucial to see whether a behavioral or naturalistic teaching approach leads to more significant results.

Keywords: early learning, autism, math for pre-schoolers, special education, teaching strategies

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Authors: Chevonne Reynolds, Robert J. Fletcher, Jr, Celine M. Carneiro, Nicole Jennings, Alison Ke, Michael C. LaScaleia, Mbhekeni B. Lukhele, Mnqobi L. Mamba, Muzi D. Sibiya, James D. Austin, Cebisile N. Magagula, Themba’alilahlwa Mahlaba, Ara Monadjem, Samantha M. Wisely, Robert A. McCleery

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A key challenge for the developing world is reconciling biodiversity conservation with the growing demand for food. In these regions, agriculture is typically interspersed among other land-uses creating heterogeneous landscapes. A primary hypothesis for promoting biodiversity in agricultural landscapes is the habitat heterogeneity hypothesis. While there is evidence that landscape heterogeneity positively influences biodiversity, the application of this hypothesis is hindered by a need to determine which components of landscape heterogeneity drive these effects and at what spatial scale(s). Additionally, whether diverse taxonomic groups are similarly affected is central for determining the applicability of this hypothesis as a general conservation strategy in agricultural mosaics. Two major components of landscape heterogeneity are compositional and configurational heterogeneity. Disentangling the roles of each component is important for biodiversity conservation because each represents different mechanisms underpinning variation in biodiversity. We identified a priori independent gradients of compositional and configurational landscape heterogeneity within an extensive agricultural mosaic in north-eastern Swaziland. We then tested how bird, dung beetle, ant and meso-carnivore diversity responded to compositional and configurational heterogeneity across six different spatial scales. To determine if a general trend could be observed across multiple taxa, we also tested which component and spatial scale was most influential across all taxonomic groups combined, Compositional, not configurational, heterogeneity explained diversity in each taxonomic group, with the exception of meso-carnivores. Bird and ant diversity was positively correlated with compositional heterogeneity at fine spatial scales < 1000 m, whilst dung beetle diversity was negatively correlated to compositional heterogeneity at broader spatial scales > 1500 m. Importantly, because of these contrasting effects across taxa, there was no effect of either component of heterogeneity on the combined taxonomic diversity at any spatial scale. The contrasting responses across taxonomic groups exemplify the difficulty in implementing effective conservation strategies that meet the requirements of diverse taxa. To promote diverse communities across a range of taxa, conservation strategies must be multi-scaled and may involve different strategies at varying scales to offset the contrasting influences of compositional heterogeneity. A diversity of strategies are likely key to conserving biodiversity in agricultural mosaics, and we have demonstrated that a landscape management strategy that only manages for heterogeneity at one particular scale will likely fall short of management objectives.

Keywords: agriculture, biodiversity, composition, configuration, heterogeneity

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Authors: Vikrant Sinha, Himanshu Singh, Nitish Kumar Singh, Sujal Nag

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This research creates an urgent and complex challenge for marine ecosystems. Microplastics were primarily found on land, but now they are pervasive in marine environments as well, affecting a wide range of marine species, from zooplankton to larger mammals that live in those environments. These pollutants interfere with major biological processes like feeding and reproduction, causing disruption throughout the food web as microplastics are getting accumulated at different tropic levels. Meanwhile, climatic changes made these effects more accelerated, and the concentration of microplastics due to these occurrences is increasing day by day. Rising temperatures, melting ice, increased runoff due to rainfall, and shifting wind patterns are transforming marine life in a way that intensifies the burden on marine life. This dual stress is particularly present in fragile ecosystems of marine life, such as coral reefs and mangroves. Addressing this twisted crisis requires not only efforts to restrain plastic pollution but also adapts strategies for climate mitigation. This research emphasizes the critical need to combine approaches to save marine biodiversity and withstand the rapid changes in the environment.

Keywords: microplastic pollution, climate change impacts, marine ecosystems, biodiversity threats, zooplankton ingestion, trophic accumulation, coral reef degradation, ecosystem resilience, plastic pollution mitigation, climate adaptation strategies, SST, sea surface temperature

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Authors: Carmen Axisa, Louise Nash, Patrick Kelly, Simon Willcock

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Introduction: Doctors experience high levels of burnout, stress and psychiatric morbidity. This can affect the health of the doctor and impact patient care. Study Aims: To evaluate the effectiveness of a workshop intervention to promote wellbeing for Australian Physician Trainees. Methods: A workshop was developed in consultation with specialist clinicians to promote health and wellbeing for physician trainees. The workshop objectives were to improve participant understanding about factors affecting their health and wellbeing, to outline strategies on how to improve health and wellbeing and to encourage participants to apply these strategies in their own lives. There was a focus on building resilience and developing long term healthy behaviours as part of the physician trainee daily lifestyle. Trainees had the opportunity to learn practical strategies for stress management, gain insight into their behaviour and take steps to improve their health and wellbeing. The workshop also identified resources and support systems available to trainees. The workshop duration was four and a half hours including a thirty- minute meal break where a catered meal was provided for the trainees. Workshop evaluations were conducted at the end of the workshop. Sixty-seven physician trainees from Adult Medicine and Paediatric training programs in Sydney Australia were randomised into intervention and control groups. The intervention group attended a workshop facilitated by specialist clinicians and the control group did not. Baseline and post intervention measurements were taken for both groups to evaluate the impact and effectiveness of the workshop. Forty-six participants completed all three measurements (69%). Demographic, personal and self-reported data regarding work/life patterns was collected. Outcome measures include Depression Anxiety Stress Scale (DASS), Professional Quality of Life Scale (ProQOL) and Alcohol Use Disorders Identification Test (AUDIT). Results: The workshop was well received by the physician trainees and workshop evaluations showed that the majority of trainees strongly agree or agree that the training was relevant to their needs (96%) and met their expectations (92%). All trainees strongly agree or agree that they would recommend the workshop to their medical colleagues. In comparison to the control group we observed a reduction in alcohol use, depression and burnout but an increase in stress, anxiety and secondary traumatic stress in the intervention group, at the primary endpoint measured at 6 months. However, none of these differences reached statistical significance (p > 0.05). Discussion: Although the study did not reach statistical significance, the workshop may be beneficial to physician trainees. Trainees had the opportunity to share ideas, gain insight into their own behaviour, learn practical strategies for stress management and discuss approach to work, life and self-care. The workshop discussions enabled trainees to share their experiences in a supported environment where they learned that other trainees experienced stress and burnout and they were not alone in needing to acquire successful coping mechanisms and stress management strategies. Conclusion: These findings suggest that physician trainees are a vulnerable group who may benefit from initiatives that promote wellbeing and from a more supportive work environment.

Keywords: doctors' health, physician burnout, physician resilience, wellbeing workshop

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Authors: Thao Nguyen, Maximiliano Hyon, Sany Rajagukguk, Anna Melkonyan

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Introduction: Type 2 Diabetes is a well-established risk factor for severe SARS-CoV-2 infection. Uncontrolled hyperglycemia in patients with established or newly diagnosed diabetes is associated with poor outcomes, including increased mortality and hospital length of stay. Objectives: Our study aims to compare three different glycemic management strategies and their association with clinical outcomes in patients hospitalized for moderate to severe SARS-CoV-2 infection. Identifying optimal glycemic management strategies will improve the quality of patient care and improve their outcomes. Method: This is a retrospective observational study on patients hospitalized at Adventist Health White Memorial with severe SARS-CoV-2 infection from 11/1/2020 to 02/28/2021. The following inclusion criteria were used: positive SARS-CoV-2 PCR test, age >18 yrs old, diabetes or random glucose >200 mg/dL on admission, oxygen requirement >4L/min, and treatment with glucocorticoids. Our exclusion criteria included: ICU admission within 24 hours, discharge within five days, death within five days, and pregnancy. The patients were divided into three glycemic management groups: Group 1, managed solely by the Primary Team, Group 2, by Pharmacy; and Group 3, by Endocrinologist. Primary outcomes were average glucose on Day 5, change in glucose between Days 3 and 5, and average insulin dose on Day 5 among groups. Secondary outcomes would be upgraded to ICU, inpatient mortality, and hospital length of stay. For statistics, we used IBM® SPSS, version 28, 2022. Results: Most studied patients were Hispanic, older than 60, and obese (BMI >30). It was the first CV-19 surge with the Delta variant in an unvaccinated population. Mortality was markedly high (> 40%) with longer LOS (> 13 days) and a high ICU transfer rate (18%). Most patients had markedly elevated inflammatory markers (CRP, Ferritin, and D-Dimer). These, in combination with glucocorticoids, resulted in severe hyperglycemia that was difficult to control. Average glucose on Day 5 was not significantly different between groups primary vs. pharmacy vs. endocrine (220.5 ± 63.4 vs. 240.9 ± 71.1 vs. 208.6 ± 61.7 ; P = 0.105). Change in glucose from days 3 to 5 was not significantly different between groups but trended towards favoring the endocrinologist group (-26.6±73.6 vs. 3.8±69.5 vs. -32.2±84.1; P= 0.052). TDD insulin was not significantly different between groups but trended towards higher TDD for the endocrinologist group (34.6 ± 26.1 vs. 35.2 ± 26.4 vs. 50.5 ± 50.9; P=0.054). The endocrinologist group used significantly more preprandial insulin compared to other groups (91.7% vs. 39.1% vs. 65.9% ; P < 0.001). The pharmacy used more basal insulin than other groups (95.1% vs. 79.5% vs. 79.2; P = 0.047). There were no differences among groups in the clinical outcomes: LOS, ICU upgrade, or mortality. Multivariate regression analysis controlled for age, sex, BMI, HbA1c level, renal function, liver function, CRP, d-dimer, and ferritin showed no difference in outcomes among groups. Conclusion: Given high-risk factors in our population, despite efforts from the glycemic management teams, it’s unsurprising no differences in clinical outcomes in mortality and length of stay.

Keywords: glycemic management, strategies, hospitalized, SARS-CoV-2, outcomes

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Authors: Eyup Bayram Guzel

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There have been growing awareness that technology offers unique and promising advantages by offering up-to-data educational materials in promoting teaching and learning materials, new strategies for building enhanced communication environment for people with disabilities and specifically for this study concentrated on the students with deafness and hearing impairments. Creating e-learning environment where teachers and students work in collaboration to develop better educational outcomes is the foremost reason of conducting this research. This study examined the perspectives of special education teachers’ regarding an application of e-learning software called Multimedia Builder on the students with deafness and hearing impairments. Initial and follow up interviews were conducted with 15 special education teachers around the scope of qualitative case study. Grounded approach has been used to analyse and interpret the data. The research results revealed that application of Multimedia Builder software were influential on reading, sign language, vocabulary improvements, computer and ICT usage developments and on audio-visual learning achievements for the advantages of students with deafness and hearing impairments. The implications of the study encouraged the ways of using e-learning tools and strategies to promote unique and comprehensive learning experiences for the targeted students and their teachers.

Keywords: e-learning, special education, deafness and hearing impairment, computer-ICT usage.

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Authors: S. K. Ashiquer Rahman

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The paper concentrates on the importance of Sustainable Campus Strategies, emphasizing the significance of mobilizing Innovative technological tools for constructing effectiveness of higher education strategy and institutional cooperation for sustainable campus at the university level and preparing the university’s authority to face the upcoming higher education strategy and institutional cooperation difficulties to the Sustainable Campus Plan. Within a framework of Sustainable Campus Strategies and institutional cooperation, the paper discusses the significance of a set of reference points that will lead to operational activities for multi-stakeholder multi-criteria evaluation of Higher Education and Research Institutions relative to the Sustainable Campus criteria and potential action plan for the University’s Strategy and Institutional Cooperation. It makes mention of the emergence of the effectiveness of Higher Education Strategy and Institutional Cooperation as well as the necessity of mobilizing innovative technological methods and tools for constructing the effectiveness of this Process. The paper outlines the conceptual framing of a Sustainable Campus Strategy, Institutional Cooperation and Action Plan for a sustainable campus. Optimistically, these will be a milestone in higher education, a pathway to meet the imminent Sustainable Campus Strategy and Institutional Cooperation of the completive world, and be able to manage the required criteria for a Sustainable University.

Keywords: higher education strategy, institutional cooperation, sustainable campus, multi-criteria evaluation, innovative method and tools

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Authors: Fatemeh Yazdandoust, Derrick Mirrindi

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The excessive use of non-renewable fossil fuels has led to a pressing energy crisis that demands urgent attention. While renewable sources like solar, wind, and water have gained significant attention as alternatives, we must explore additional avenues. This study takes an interdisciplinary approach, investigating the potential of waste streams from energy production and other untapped natural sources as sustainable energy solutions. Through a review of case studies, this study demonstrates how these alternative sources, including human power, animal body heat, and noise, can seamlessly integrate into architecture and urban planning. This article first discusses passive design strategies integrating alternative energy sources into vernacular architecture. Then, it reviews the waste stream (exergy) and potential energy sources, such as human power, animal body heat, and noise, in contemporary proposals and case studies. It demonstrates how an alternative energy design strategy may easily incorporate these many sources into our architecture and urban planning through passive and active design strategies to increase the energy efficiency of our built environment.

Keywords: alternative energy sources, energy exchange, human and animal power, potential energy sources, waste stream

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Authors: María de los Ángeles Crespo López, Carmen García García

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The highly competitive nature of today's globalised marketplace requires that brands and stores develop effective commercial strategies to ensure their economic survival. Maintaining the loyalty of existing customers constitutes one key strategy that yields the best results. Although the relationship between consumers' self-congruity and their manifestations of loyalty towards a store has been investigated, the role of store personality in this relationship remains unclear. In this study, multiple parallel mediation analysis was used to examine the effect of Store Personality on the relationship between Self-Congruity of consumers and their Manifestations of Loyalty. For this purpose, 457 Spanish consumers of the Fnac store completed three self-report questionnaires assessing Store Personality, Self-Congruity, and Store Loyalty. The data were analyzed using the SPSS macro PROCESS. The results revealed that three dimensions of Store Personality, namely Exciting, Close and Competent Store, positively and significantly mediated the relationship between Self-Congruity and Manifestations of Loyalty. The indirect effect of Competent Store was the greatest. This means that a consumer with higher levels of Self-Congruity with the store will exhibit more Manifestations of Loyalty when the store is perceived as Exciting, Close or Competent. These findings suggest that more attention should be paid to the perceived personality of stores for the development of effective marketing strategies to maintain or increase consumers' manifestations of loyalty towards stores.

Keywords: multiple parallel mediation, PROCESS, self-congruence, store loyalty, store personality

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Authors: Kim Toyer, Belinda Thompson, Louise Koelmeyer

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Lymphoedema is a chronic condition caused by dysfunction of the lymphatic system, which limits the drainage of fluid and tissue waste from the interstitial space of the affected body part. The normal physiological changes in pregnancy cause an increased load on a normal lymphatic system which can result in a transient lymphatic overload (oedema). The interaction between lymphoedema and pregnancy oedema is unclear. Women with pre-existing lymphoedema require accurate information and additional strategies to manage their lymphoedema during pregnancy. Currently, no resources are available to guide women or their healthcare providers with accurate advice and additional management strategies for coping with lymphoedema during pregnancy until they have recovered postnatally. This study explored the experiences of Australian women with pre-existing lymphoedema during recent pregnancy and the early postnatal period to determine how their usual lymphoedema management strategies were adapted and what were their additional or unmet needs. Interactions with their obstetric care providers, the hospital maternity services, and usual lymphoedema therapy services were detailed. Participants were sourced from several Australian lymphoedema community groups, including therapist networks. Opportunistic sampling is appropriate to explore this topic in a small target population as lymphoedema in women of childbearing age is uncommon, with prevalence data unavailable. Inclusion criteria were aged over 18 years, diagnosed with primary or secondary lymphoedema of the arm or leg, pregnant within the preceding ten years (since 2012), and had their pregnancy and postnatal care in Australia. Exclusion criteria were a diagnosis of lipedema and if unable to read or understand a reasonable level of English. A mixed-method qualitative design was used in two phases. This involved an online survey (REDCap platform) of the participants followed by online semi-structured interviews or focus groups to provide the transcript data for inductive thematic analysis to gain an in-depth understanding of issues raised. Women with well-managed pre-existing lymphoedema coped well with the additional oedema load of pregnancy; however, those with limited access to quality conservative care prior to pregnancy were found to be significantly impacted by pregnancy, including many reporting deterioration of their chronic lymphoedema. Misinformation and a lack of support increased fear and apprehension in planning and enjoying their pregnancy experience. Collaboration between maternity and lymphoedema therapy services did not happen despite study participants suggesting it. Helpful resources and unmet needs were identified in the recent Australian context to inform further research and the development of resources to assist women with lymphoedema who are considering or are pregnant and their supporters, including health care providers.

Keywords: lymphoedema, management strategies, pregnancy, qualitative

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Authors: Shailaja Thakur

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Managerial literature abounds with discussions on business strategies, success stories as well as cases of failure, which provide an indication of the parameters that should be considered in gauging the dynamism of an entrepreneur. Neoclassical economics has reduced entrepreneurship to a mere factor of production, driven solely by the profit motive, thus stripping him of all creativity and restricting his decision making to mechanical calculations. His ‘dynamism’ is gauged simply by the amount of profits he earns, marginalizing any discussion on the means that he employs to attain this objective. With theoretical backing, we have developed an Index of Entrepreneurial Dynamism (IED) giving weights to the different moves that the entrepreneur makes during his business journey. Strategies such as changes in product lines, markets and technology are gauged as very important (weighting of 4); while adaptations in terms of technology, raw materials used, upgradations in skill set are given a slightly lesser weight of 3. Use of formal market analysis, diversification in related products are considered moderately important (weight of 2) and being a first generation entrepreneur, employing managers and having plans to diversify are taken to be only slightly important business strategies (weight of 1). The maximum that an entrepreneur can score on this index is 53. A semi-structured questionnaire is employed to solicit the responses from the entrepreneurs on the various strategies that have been employed by them during the course of their business. Binary as well as graded responses are obtained, weighted and summed up to give the IED. This index was tested on about 150 tribal entrepreneurs in Mizoram, a state of India and was found to be highly effective in gauging their dynamism. This index has universal acceptability but is devoid of the socio-cultural context, which is very central to the success and performance of the entrepreneurs. We hypothesize that a society that respects risk taking takes failures in its stride, glorifies entrepreneurial role models, promotes merit and achievement is one that has a conducive socio- cultural environment for entrepreneurship. For obtaining an idea about the social acceptability, we are putting forth questions related to the social acceptability of business to another set of respondents from different walks of life- bureaucracy, academia, and other professional fields. Similar weighting technique is employed, and index is generated. This index is used for discounting the IED of the respondent entrepreneurs from that region/ society. This methodology is being tested for a sample of entrepreneurs from two very different socio- cultural milieus- a tribal society and a ‘mainstream’ society- with the hypothesis that the entrepreneurs in the tribal milieu might be showing a higher level of dynamism than their counterparts in other regions. An entrepreneur who scores high on IED and belongs to society and culture that holds entrepreneurship in high esteem, might not be in reality as dynamic as a person who shows similar dynamism in a relatively discouraging or even an outright hostile environment.

Keywords: index of entrepreneurial dynamism, India, social acceptability, tribal entrepreneurs

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Authors: Vinu Elias Jacob, Manoj Kumar Kini

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Disasters of all types are occurring more frequently and are becoming more costly than ever due to various manmade factors including climate change. A better utilisation of the concept of governance and management within disaster risk reduction is inevitable and of utmost importance. There is a need to explore the role of pre- and post-disaster public policies. The role of urban planning/design in shaping the opportunities of households, individuals and collectively the settlements for achieving recovery has to be explored. Governance strategies that can better support the integration of disaster risk reduction and management has to be examined. The main aim is to thereby build the resilience of individuals and communities and thus, the states too. Resilience is a term that is usually linked to the fields of disaster management and mitigation, but today has become an integral part of planning and design of cities. Disaster resilience broadly describes the ability of an individual or community to 'bounce back' from disaster impacts, through improved mitigation, preparedness, response, and recovery. The growing population of the world has resulted in the inflow and use of resources, creating a pressure on the various natural systems and inequity in the distribution of resources. This makes cities vulnerable to multiple attacks by both natural and man-made disasters. Each urban area needs elaborate studies and study based strategies to proceed in the discussed direction. Cochin in Kerala is the fastest and largest growing city with a population of more than 26 lakhs. The main concern that has been looked into in this paper is making cities resilient by designing a framework of strategies based on urban design principles for an immediate response system especially focussing on the city of Cochin, Kerala, India. The paper discusses, understanding the spatial transformations due to disasters and the role of spatial planning in the context of significant disasters. The paper also aims in developing a model taking into consideration of various factors such as land use, open spaces, transportation networks, physical and social infrastructure, building design, and density and ecology that can be implemented in any city of any context. Guidelines are made for the smooth evacuation of people through hassle-free transport networks, protecting vulnerable areas in the city, providing adequate open spaces for shelters and gatherings, making available basic amenities to affected population within reachable distance, etc. by using the tool of urban design. Strategies at the city level and neighbourhood level have been developed with inferences from vulnerability analysis and case studies.

Keywords: disaster management, resilience, spatial planning, spatial transformations

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Authors: Ximena Rincon Castellanos

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The research target was analyzed the education public policy of Colombia according to the content of the right to education. One problematic element of that content is the principle of progressive implementation of economic, social and cultural rights. The research included a complete study of public documents and other papers; as well as, one focus group with former combatants in a city where is located one of some 'hogares de paz', which hosts these people after leaving the illegal group. This paper presents a critical approach to the public policy strategies to guarantee education to former combatants and its tension with the right to a progressive implementation. Firstly, education is understood as a technology level without considering higher education. Former combatant attends to SENA and private institutions, which offer technology education and it is counted by the Colombian Government as higher education. Therefore, statistics report a high level of attendance of excombatant to that education level, but actually, they do not expect to study a university carrier. Secondly, the budget approved has been invested in private institutions, despite public institutions are able to include this population and they need more money to strengthen the public offer, which has been considered as a better strategy to ensure education as a human right but not a good, by the special rapporteur on the right to education. As a consequence, the progressive implementation should be a guide to change and improve current strategies, invest the budget available into the public system of education in order to give former combatants the chance to access to universities.

Keywords: higher education, progressive implementation, public service, private offering and technology education

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Authors: Imran Hashmi, Sipkaduwa Arachchige Sashika Sureni Wickramasooriya

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Gene-drive technology has emerged as a promising tool for disease control by influencing the population dynamics of disease-carrying organisms. Various gene drive mechanisms, derived from global laboratory experiments, aim to strategically manage and prevent the spread of targeted diseases. One prominent strategy involves population replacement, wherein genetically modified mosquitoes are introduced to replace the existing local wild population. To enhance our understanding and aid in the design of effective release strategies, we employ a comprehensive mathematical model. The utilized approach employs agent-based modeling, enabling the consideration of individual mosquito attributes and flexibility in parameter manipulation. Through the integration of an agent-based model and a meta-population spatial approach, the dynamics of gene drive mosquito spreading in a released site are simulated. The model's outcomes offer valuable insights into future population dynamics, providing guidance for the development of informed release strategies. This research significantly contributes to the ongoing discourse on the responsible and effective implementation of gene drive technology for disease vector control.

Keywords: gene drive, agent-based modeling, disease-carrying organisms, malaria

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Authors: Kumalbeo Paul Kamani

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Marketing plays a very important role in the success of any firm since it represents the means through which a firm can reach its customers and also promotes its products and services. In fact, marketing aids the firm in identifying customers who the business can competitively serve, and tailoring product offerings, prices, distribution, promotional efforts, and services towards those customers. Unfortunately, in many firms, marketing has been reduced to merely advertisement. For effective marketing, firms must go beyond this often-limited function of advertisement. In the fashion industry in particular, marketing faces challenges due to its peculiar characteristics. Previous research for instance affirms the idiosyncrasy and peculiarities that differentiate the fashion industry from other industrial areas. It has been documented that the fashion industry is characterized seasonal intensity, short product life cycles, the difficulty of competitive differentiation, and long time for companies to reach financial stability. These factors are noted to pose obstacles to the fashion entrepreneur’s endeavours and can be the reasons that explain their low survival rates. In recent times, the fashion industry has been described as a market that is accessible market, has low entry barriers, both in terms of needed capital and skills which have all accounted for the burgeoning nature of startups. Yet as already stated, marketing is particularly challenging in the industry. In particular, areas such as marketing, branding, growth, project planning, financial and relationship management might represent challenges for the fashion entrepreneur but that have not been properly addressed by previous research. It is therefore important to assess marketing strategies of fashion firms and the factors influencing their success. This study generally sought to examine marketing strategies of fashion dealers in Ghana and their critical success factors. The study employed the quantitative survey research approach. A total of 120 fashion dealers were sampled. Questionnaires were used as instrument of data collection. Data collected was analysed using quantitative techniques including descriptive statistics and Relative Importance Index. The study revealed that the marketing strategies used by fashion apparels are text messages using mobile phones, referrals, social media marketing, and direct marketing. Results again show that the factors influencing fashion marketing effectiveness are strategic management, marketing mix (product, price, promotion etc), branding and business development. Policy implications are finally outlined. The study recommends among others that there is a need for the top management executive to craft and adopt marketing strategies that enable that are compatible with the fashion trends and the needs of the customers. This will improve customer satisfaction and hence boost market penetration. The study further recommends that the fashion industry in Ghana should seek to ensure that fashion apparels accommodate the diversity and the cultural setting of different customers to meet their unique needs.

Keywords: marketing, fashion, industry, success factors

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Authors: Baikunthanath Sahoo, Santosh Kumar Sahu, Krishna Malakar

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With the essence of global environmental sustainability and green business management, the wind of business research moved towards Corporate Social Responsibility. In addition to international and national treaties, businesses have also started realising environmental protection and energy efficiency through CSR as part of business strategy in response to climate change. Considering the ambitious emission reduction target and rapid economic development of India, this study is an attempt to explore the effect of CSR on the energy efficiency management of manufacturing firms in India. By using firm-level data, the panel fixed effect model shows that the CSR dummy variable is negatively influencing the energy intensity or technically, they are energy efficient. The result demonstrates that in the presence of CSR, all the production economic variables are significant. The result also shows that doing environmental expenditure does not improve energy efficiency might be because very few firms are motivated to do such expenditure and also not common to all sectors. The interactive effect model result conforms that without considering CSR dummy as an intervening variable only Manufacturers of Chemical and Chemical products, Manufacturers of Pharmaceutical, medical chemical, and botanical products firms energy intensity low but after considering CSR in their business practices all six sub-sector firms become energy efficient. The empirical result also validate that firms are continuously engaged in CSR activities they are highly energy efficient. It is an important motivational factor for firms to become economically and environmentally sustainable in the corporate world. This analysis would help business practitioners to know how to manage today’s profitability and tomorrow’s sustainability to achieve a comparative advantage in the emerging market economy. The paper concludes that reducing energy consumption as part of their social responsibility to care for the environment, will need collaborative efforts of business society and policy bodies.

Keywords: CSR, Energy Efficiency, Indian manufacturing Sector, Business strategy

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Authors: Abdulmajeed Almansour

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Learning a foreign language with the assistant of technological tools has become an interest of learners and educators. Increased use of smartphones among undergraduate students has made them popular for not only social communication but also for entertainment and educational purposes. Smartphones have provided remarkable advantages in language learning process. Learning vocabulary is an important part of learning a language. The use of smartphone applications for English vocabulary learning provides an opportunity for learners to improve vocabulary knowledge beyond the classroom wall anytime anywhere. Recently, various smartphone applications were created specifically for vocabulary learning. This paper aims to explore the use of smartphone application Memrise designed for vocabulary learning to enhance academic vocabulary among undergraduate students. It examines whether the use of a Memrise smartphone application designed course enhances the academic vocabulary learning among ESL learners. The research paradigm used in this paper followed a mixed research model combining quantitative and qualitative research. The study included two hundred undergraduate students randomly assigned to the experimental and controlled group during the first academic year at the Faculty of English Language, Imam University. The research instruments included an attitudinal questionnaire and an English vocabulary pre-test administered to students at the beginning of the semester whereas post-test and semi-structured interviews administered at the end of the semester. The findings of the attitudinal questionnaire revealed a positive attitude towards using smartphones in learning vocabulary. The post-test scores showed a significant difference in the experimental group performance. The results from the semi-structure interviews showed that there were positive attitudes towards Memrise smartphone application. The students found the application enjoyable, convenient and efficient learning tool. From the study, the use of the Memrise application is seen to have long-term and motivational benefits to students. For this reason, there is a need for further research to identify the long-term optimal effects of learning a language using smartphone applications.

Keywords: second language vocabulary learning, academic vocabulary, mobile learning technologies, smartphone applications

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Authors: Susan Dodd

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This presentation details the methodology for teachers to identify and support a population of students who have historically been overlooked in regards to their educational needs. The twice exceptional (2e) student is a learner who is considered gifted and also has a learning disability, as defined by the Individuals with Disabilities Education Act (IDEA). Many of these students remain underserved throughout their educational careers because their exceptionalities may mask each other, resulting in a special population of students who are not achieving to their fullest potential. There are three common scenarios that may make the identification of a 2e student challenging. First, the student may have been identified as gifted, and her disability may go unnoticed. She could also be considered an under-achiever, or she may be able to compensate for her disability under the school works becomes more challenging. In the second scenario, the student may be identified as having a learning disability and is only receiving remedial services where his giftedness will not be highlighted. His overall IQ scores may be misleading because they were impacted by his learning disability. In the third scenario, the student is able to compensate for her ability well enough to maintain average scores, and she goes undetected as both gifted and learning disabled. Research in the area identifies the complexity involved in identifying 2e students, and how multiple forms of assessment are required. It is important for teachers to be aware of the common characteristics exhibited by many 2e students, so these learners can be identified and appropriately served. Once 2e students have been identified, teachers are then challenged to meet the varying needs of these exceptional learners. Strength-based teaching entails simultaneously providing gifted instruction as well as individualized accommodations for those students. Research in this field has yielded strategies that have proven helpful for teaching 2e students, as well as other students who may be struggling academically. Differentiated instruction, while necessary in all classrooms, is especially important for 2e students, as is encouragement for academic success. Teachers who take the time to really know their students will have a better understanding of each student’s strengths and areas for growth, and therefore tailor instruction to extend the intellectual capacities for optimal achievement. Teachers should also understand that some learning activities can prove very frustrating to students, and these activities can be modified based on individual student needs. Because 2e students can often become discouraged by their learning challenges, it is especially important for teachers to assist students in recognizing their own strengths and maintaining motivation for learning. Although research on the needs of 2e students has spanned across two decades, this population remains underserved in many educational institutions. Teacher awareness of the identification of and the support strategies for 2e students is critical for their success.

Keywords: gifted, learning disability, special needs, twice exceptional

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Authors: Samatha Ss Sutton, Kaouther Kooli

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In recent years social media influences (SMI) have become integrated into many companies marketing strategies to create buzz, target new and younger markets and further expand social media coverage in business (Lim et al 2017). SMI’s can be defined as online personalities with a substantial number of followers, across one or more social media platforms, with influence on their followers (Lou and Yuan 2018). Recently expenditure on influencer marketing has increased exponentially becoming an important area for marketing opportunities and strategies in the future (Lou and Yuan 2018). In order to market products and brands effectively through SMI’s it is important for business to understand the attributes of SMI that effect purchase intention (Lim et al 2017) of their followers and whether or not these attributes vary across generations so to market effectively to their specific segment or target market. The present study involves quantitative research to understand the attributes by which influence differs across generations namely Generation X and Millennials and its effects on purchase intentions of these generational groups. A survey will be conducted using an online questionnaire. Structural Equation Modelling and Multi group analysis will be applied. The study provides insight to marketers/decision makers on how to use influencers accordingly with their target consumer.

Keywords: social media marketing, social media influencers, attitude towards social media influencers, intention to purchase

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Authors: A. Maghoul, A. Rostampouryasouri, MR. Maghami

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The development of an urban design and power network planning has been gaining momentum in recent years. The integration of renewable energy with urban design has been widely regarded as an increasingly important solution leading to climate change and energy security. Through the use of passive strategies and solar integration with Urban Building Energy Modeling (UBEM) tools, architects and designers can create high-quality designs that meet the needs of clients and stakeholders. To determine the most effective ways of combining renewable energy with urban development, we analyze the relationship between urban form and renewable energy production. The procedure involved in this practice include passive solar gain (in building design and urban design), solar integration, location strategy, and 3D models with a case study conducted in Tehran, Iran. The study emphasizes the importance of spatial and temporal considerations in the development of sector coupling strategies for solar power establishment in arid and semi-arid regions. The substation considered in the research consists of two parallel transformers, 13 lines, and 38 connection points. Each urban load connection point is equipped with 500 kW of solar PV capacity and 1 kWh of battery Energy Storage (BES) to store excess power generated from solar, injecting it into the urban network during peak periods. The simulations and analyses have occurred in EnergyPlus software. Passive solar gain involves maximizing the amount of sunlight that enters a building to reduce the need for artificial lighting and heating. Solar integration involves integrating solar photovoltaic (PV) power into smart grids to reduce emissions and increase energy efficiency. Location strategy is crucial to maximize the utilization of solar PV in an urban distribution feeder. Additionally, 3D models are made in Revit, and they are keys component of decision-making in areas including climate change mitigation, urban planning, and infrastructure. we applied these strategies in this research, and the results show that it is possible to create sustainable and energy-efficient urban environments. Furthermore, demand response programs can be used in conjunction with solar integration to optimize energy usage and reduce the strain on the power grid. This study highlights the influence of ancient Persian architecture on Iran's urban planning system, as well as the potential for reducing pollutants in building construction. Additionally, the paper explores the advances in eco-city planning and development and the emerging practices and strategies for integrating sustainability goals.

Keywords: energy-efficient urban planning, sustainable architecture, solar energy, sustainable urban design

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Authors: Jui-Hsueh Hu

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This study investigated various models of refusal speech acts among three target groups: French learners of Mandarin Chinese (FM), Taiwanese native Mandarin speakers (TM), and native French speakers (NF). The refusal responses were analyzed in terms of their options, frequencies, and sequences and the contents of their semantic formulas. This study also examined differences in refusal strategies, as determined by social status and social distance, among the three groups. The difficulties of refusal speech acts encountered by FM were then generalized. The results indicated that Mandarin instructors of NF should focus on the different reasons for the pragmatic failure of French learners and should assist these learners in mastering refusal speech acts that rely on abundant cultural information. In this study, refusal policies were mainly classified according to the research of Beebe et al. (1990). Discourse completion questionnaires were collected from TM, FM, and NF, and their responses were compared to determine how refusal policies differed among the groups. This study not only emphasized the dissimilarities of refusal strategies between native Mandarin speakers and second-language Mandarin learners but also used NF as a control group. The results of this study demonstrated that regarding overall strategies, FM were biased toward NF in terms of strategy choice, order, and content, resulting in pragmatic transfer under the influence of social factors such as 'social status' and 'social distance,' strategy choices of FM were still closer to those of NF, and the phenomenon of pragmatic transfer of FM was revealed. Regarding the refusal difficulties among the three groups, the F-test in the analysis of variance revealed statistical significance was achieved for Role Playing Items 13 and 14 (P < 0.05). A difference was observed in the average number of refusal difficulties between the participants. However, after multiple comparisons, it was found that item 13 (unrecognized heterosexual junior colleague requesting contacts) was significantly more difficult for NF than for TM and FM; item 14 (contacts requested by an unrecognized classmate of the opposite sex) was significantly more difficult to refuse for NF than for TM. This study summarized the pragmatic language errors that most FM often perform, including the misuse or absence of modal words, hedging expressions, and empty words at the end of sentences, as the reasons for pragmatic failures. The common social pragmatic failures of FM include inaccurately applying the level of directness and formality.

Keywords: French Mandarin, interlanguage refusal, pragmatic transfer, speech acts

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Authors: Wei-Hwa Chiang, Wei-Ting Hsu, Yuan-Chi Liu, Cheng-Che Tsai

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A sustainable built environment aims for minimizing both regional and global environmental impact while maintaining a healthy living for individuals. Sustainability of performing venues has rarely been discussed when compared with residential, office, and other popular building types. Life-cycle carbon emission due to the high standard requirements in acoustics, stage engineering, HVAC, and building structure need to be carefully examined. This can be complicated by social-economic and cultural concerns in addition to technical excellence. This paper reported case-based study and statistics of performing venues regarding urban connectivity and spatial layouts in enhancing facility usage and promoting cultural vitality. Interviews conducted for a major venue at Taipei indicated high linkage with surrounding leisure activity and the need for quality pedestrian and additional spaces open to the general public. Statistics of venues with various size and function suggested the possibility and strategies limit the size and height of reception and foyer spaces, and to maximize their use when there are no performances. Design strategies are identified to increase visual contact or facility sharing between the artists and the audience or the general public in reducing facility size and promoting potential involvement in cultural activities.

Keywords: sustainability, performing venue, design, operation

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Authors: Marco Sewald

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Due to the current enforcement of exterritorial U.S. legislation, up to 9 million U.S. (dual) citizens residing abroad are subject to U.S. double and surcharge taxation and at risk of losing access to otherwise basic financial services and investment opportunities abroad. The United States is the only OECD country that taxes non-resident citizens, lawful permanent residents and other non-resident aliens on their worldwide income, based on local U.S. tax laws. To enforce these policies the U.S. has implemented ‘saving clauses’ in all tax treaties and implemented several compliance provisions, including the Foreign Account Tax Compliance Act (FATCA), Qualified Intermediaries Agreements (QI) and Intergovernmental Agreements (IGA) addressing Foreign Financial Institutions (FFIs) to implement these provisions in foreign jurisdictions. This policy creates systematic cases of double and surcharge taxation. The increased enforcement of compliance rules is creating additional report burdens for U.S. persons abroad and FFIs accepting such U.S. persons as customers. FFIs in Europe react with a growing denial of specific financial services to this population. The numbers of U.S. citizens renouncing has dramatically increased in the last years. A case study is chosen as an appropriate methodology and research method, as being an empirical inquiry that investigates a contemporary phenomenon within its real-life context; when the boundaries between phenomenon and context are not clearly evident; and in which multiple sources of evidence are used. This evaluative approach is testing whether the combination of policies works in practice, or whether they are in accordance with desirable moral, political, economical aims, or may serve other causes. The research critically evaluates the financial and non-financial consequences and develops sufficient strategies. It further discusses these strategies to avoid the undesired consequences of exterritorial U.S. legislation. Three possible strategies are resulting from the use cases: (1) Duck and cover, (2) Pay U.S. double/surcharge taxes, tax preparing fees and accept imposed product limitations and (3) Renounce U.S. citizenship and pay possible exit taxes, tax preparing fees and the requested $2,350 fee to renounce. While the first strategy is unlawful and therefore unsuitable, the second strategy is only suitable if the U.S. citizen residing abroad is planning to move to the U.S. in the future. The last strategy is the only reasonable and lawful way provided by the U.S. to limit the exposure to U.S. double and surcharge taxation and the limitations on financial products. The results are believed to add a perspective to the current academic discourse regarding U.S. citizenship based taxation, currently dominated by U.S. scholars, while providing sufficient strategies for the affected population at the same time.

Keywords: citizenship based taxation, FATCA, FBAR, qualified intermediaries agreements, renounce U.S. citizenship

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Authors: Khawar Naeem, Adel Elomri, Adel Zghibi

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Contamination leakage from municipal solid waste (MSW) landfills is a serious environmental challenge that poses a threat to interconnected ecosystems. It not only contaminates the soil of the saturated zone, but it also percolates down the earth and contaminates the groundwater (GW). In this concise literature review, an effort is made to understand the environmental hazards posed by this contamination to the soil and groundwater, the type of contamination, and possible solutions proposed in the literature. In the study’s second phase, the MSW management practices are explored as the landfill site dump rate and type of MSW into the landfill site directly depend on the MSW management strategies. Case studies from multiple developed and underdeveloped countries are presented, and the complex MSW management system is investigated from an operational perspective to minimize the contamination of GW. One of the significant tools used in the literature was found to be Systems Dynamic Modeling (SDM), which is a simulation-based approach to study the stakeholder’s approach. By employing the SDM approach, the risk of GW contamination can be reduced by devising effective MSW management policies, ultimately resulting in water resource sustainability and regional sustainable development.

Keywords: groundwater contamination, environmental risk, municipal solid waste management, system dynamic modeling, water resource sustainability, sustainable development

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Authors: Joelle Hawa, Michael Gilding

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The role of interest as a driver of action has been an on-going debate in the sociological sciences. This paper shows evidence as to how economic actors frame their environment in terms of interests and goals to take action. It introduces the concept of 'dynamic actor compass', a cognitive tool that is socially contingent and allows economic actors to navigate their environment, evaluate the level of alignment of interests and goals with other players, and decide whether or not they are willing to rely on, collaborate or partner with others in the field. The paper builds on Kaplan’s model of framing contests and integrates Max Weber’s interests, and ideas construct as well as Beckert’s concept of fictional expectations. The author illustrates this conceptual framework in the case of MedTech entrepreneurs’ capital raising activities in Australia. The study adopts a grounded theory methodology, running in-depth interviews with 24 MedTech entrepreneurs in order to examine their decision-making processes and actions to finance their innovation trajectory. The findings show that participants take into account material and ideal interests and goals that they impose adapt or negotiate with other actors in their environment. These interactions affect the way MedTech entrepreneurs perceive other funders in the field, influencing their capital raising strategies.

Keywords: expectations, financing innovation, frames, goals, interest-oriented action, managerial cognition

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Authors: Ebru Acuner, Gulgun Kayakutlu, M. Ozgur Kayalica, Sermin Onaygil

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In Turkey, emigration, especially from Syria, has been continuously increasing together with rapid urbanization. In parallel to this, total energy consumption has been growing, rapidly. Unfortunately, domestic energy sources could not meet this energy demand. Hence, there is a need for reliable predictions. For this reason, before making a survey study for the migrated people, an informative questionnaire was prepared to take the opinions of the experts on the main drivers that shape the energy consumption behavior of the migrated people. Totally, 17 experts were answered, and they were analyzed by means of Netica program considering Bayesian belief analysis method. In the analysis, factors affecting energy consumption behaviors as well as strategies, institutions, tools and financing methods to change these behaviors towards efficient consumption were investigated. On the basis of the results, it can be concluded that changing the energy consumption behavior of the migrated people is crucial. In order to be successful, electricity and natural gas prices and tariffs in the market should be arranged considering energy efficiency. In addition, support mechanisms by not only the government but also municipalities should be taken into account while preparing related policies. Also, electric appliance producers should develop and implement strategies and action in favor of the usage of more efficient appliances. Last but not least, non-governmental organizations should support the migrated people to improve their awareness on the efficient consumption for the sustainable future.

Keywords: Bayesian belief, behavior, energy consumption, energy efficiency, migrated people

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Authors: Chante J. De Klerk

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The potential of music to facilitate superior performance during high to elite level gymnastics conditioning instigated this research. A team of seven gymnasts completed a fixed conditioning programme eight times, alternating the two variable conditions. Four sessions of each condition were conducted: without music (session 1), with music (session 2), without music (3), with music (4), without music (5), and so forth. Quantitative data were collected in both conditions through physiological monitoring of the gymnasts, and administration of the Situational Motivation Scale (SIMS). Statistical analysis of the physiological data made it possible to quantify the presence as well as the magnitude of the musical intervention’s impact on various aspects of the gymnasts' physiological functioning during conditioning. The SIMS questionnaire results were used to evaluate if their motivation towards conditioning was altered by the intervention. Thematic analysis of qualitative data collected through semi-structured interviews revealed themes reflecting the gymnasts’ sentiments towards the data collection process. Gymnast-specific descriptions and experiences of the team as a whole were integrated with the quantitative data to facilitate greater dimension in establishing the impact of the intervention. The results showed positive physiological, motivational, and emotional effects. In the presence of music, superior sympathetic nervous activation, and energy efficiency, with more economic breathing, dominated the physiological data. Fatigue and arousal levels (emotional and physiological) were also conducive to improved conditioning outcomes compared to conventional conditioning (without music). Greater levels of positive affect and motivation emerged in analysis of both the SIMS and interview data sets. Overall, the intervention was found to promote psychophysiological coherence during the physical activity. In conclusion, a strategically constructed musical intervention, designed to accompany a gymnastics conditioning session for high to elite level gymnasts, has ergogenic potential.

Keywords: arousal, fatigue, gymnastics conditioning, motivation, musical intervention, psychophysiological coherence

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Authors: Clara T. Fatoye, April Betts, Abayomi Odeyemi, Francis A. Fatoye, Isaac O. Odeyemi

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Background: The post-launch stage is the last stage in the development of a pharmaceutical product. It is important to involve patients in the development of pharmaceutical products at the post-launch stage, as patients are the end-users of pharmaceutical products. It is expected that involving them might ensure an effective working relationship among the various stakeholders. However, involving patients in the development of pharmaceutical products comes with its problems. Hence, this study examined how to resolve problems experienced by involving patients in the developments of pharmaceutical products’ at post-launch consisting of Positioning of pharmaceutical products (POPP), detailing of pharmaceutical products (DOPP) and reimbursement and Formulary Submission (R&FS). Methods: A questionnaire was used for the present study. It was administered at the ISPOR Glasgow 2017 to 104 participants, all of which were professionals from Market access (MA) and health economics and outcomes research (HEOR) backgrounds. They were asked how the issues experienced by patients can be resolved. Participants responded under six domains as follows: communication, cost, effectiveness, external factors, Quality of life (QoL) and safety. Thematic analysis was carried out to identify strategies to resolve issues experienced by patients at the post-launch stage. Results: Three (3) factors cut across at POPP, DOPP, and R&FS that is (external factors, communication and QoL). The first resolution method was an external factor that is, the relationship with stakeholders and policymakers. Communication was also identified as a resolution method that can help to resolve problems experienced by patients at the post-launch stage. The third method was QoL as perceived by the patients based on professionals’ opinions. Other strategies that could be used to resolve problems experienced were the effectiveness of pharmaceutical products at the DOPP level and cost at R&FS. Conclusion: The study showed that focusing on external factors, communication, and patients’ QoL are methods for resolving issues experienced by involving patients at the post-launch stage of pharmaceutical product development. Hence, effective working relationships between patients, policymakers and stakeholders may help to resolve problems experienced at the post-launch stage. Healthcare policymakers are to be aware of these findings as they may help them to put appropriate strategies in place to enhance the involvement of patients in pharmaceutical product development at the post-launch stage, thereby improving the health outcomes of the patients.

Keywords: patients, pharmaceutical products, post-launch stage, quality of life, QoL

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Authors: E. Steen, B. Dewulf, N. Müller, C. Vandycke, Y. Vandekerckhove

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Introduction: The care for a ST-elevation myocardial infarction (STEMI) patient is time-critical. Reperfusion therapy within 90 minutes of initial medical contact is mandatory in the improvement of the outcome. Primary percutaneous coronary intervention (PCI) without previous fibrinolytic treatment, is the preferred reperfusion strategy in patients with STEMI, provided it can be performed within guideline-mandated times. Aim of the study: During a one year period (January 2013 to December 2013) the files of all consecutive STEMI patients with urgent referral from non-PCI facilities for primary PCI were reviewed. Special attention was given to a subgroup of patients with prior out-of-hospital medical contact generated by the 112-system. In an effort to reduce out-of-hospital system delay to definitive care a change in pre-hospital 112 dispatch strategies is proposed for these time-critical patients. Actual time recordings were compared with travel time simulations for two suggested scenarios. A first scenario (SC1) involves the decision by the on scene ground EMS (GEMS) team to transport the out-of-hospital diagnosed STEMI patient straight forward to a PCI centre bypassing the nearest non-PCI hospital. Another strategy (SC2) explored the potential role of helicopter EMS (HEMS) where the on scene GEMS team requests a PCI-centre based HEMS team for immediate medical transfer to the PCI centre. Methods and Results: 49 (29,1% of all) STEMI patients were referred to our hospital for emergency PCI by a non-PCI facility. 1 file was excluded because of insufficient data collection. Within this analysed group of 48 secondary referrals 21 patients had an out-of-hospital medical contact generated by the 112-system. The other 27 patients presented at the referring emergency department without prior contact with the 112-system. The table below shows the actual time data from first medical contact to definitive care as well as the simulated possible gain of time for both suggested strategies. The PCI-team was always alarmed upon departure from the referring centre excluding further in-hospital delay. Time simulation tools were similar to those used by the 112-dispatch centre. Conclusion: Our data analysis confirms prolonged reperfusion times in case of secondary emergency referrals for STEMI patients even with the use of HEMS. In our setting there was no statistical difference in gain of time between the two suggested strategies, both reducing the secondary referral generated delay with about one hour and by this offering all patients PCI within the guidelines mandated time. However, immediate HEMS activation by the on scene ground EMS team for transport purposes is preferred. This ensures a faster availability of the local GEMS-team for its community. In case these options are not available and the guideline-mandated times for primary PCI are expected to be exceeded, primary fibrinolysis should be considered in a non-PCI centre.

Keywords: STEMI, system delay, HEMS, emergency medicine

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Authors: Mastoor Qubra

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Cyber-attacks have frequently disrupted the critical infrastructures of the major global states and now, cyber threat has become one of the dire security risks for the states across the globe. Recently, ransomware cyber-attacks, wannacry and petya, have affected hundreds of thousands of computer servers and individuals’ private machines in more than hundred countries across Europe, Middle East, Asia, United States and Australia. Although, states are rapidly becoming aware of the destructive nature of this new security threat and counter measures are being taken but states’ isolated efforts would be inadequate to deal with this heinous security challenge, rather a global coordination and cooperation is inevitable in order to develop a credible cyber deterrence policy. Hence, the paper focuses that coordinated global approach is required to deter posed cyber threat. This paper intends to analyze the cyber security counter measures in four dimensions i.e. evaluation of prevalent strategies at bilateral level, initiatives and limitations for cooperation at global level, obstacles to combat cyber terrorism and finally, recommendations to deter the threat by applying tools of deterrence theory. Firstly, it focuses on states’ efforts to combat the cyber threat and in this regard, US-Australia Cyber Security Dialogue is comprehensively illustrated and investigated. Secondly, global partnerships and strategic and analytic role of multinational organizations, particularly United Nations (UN), to deal with the heinous threat, is critically analyzed and flaws are highlighted, for instance; less significance of cyber laws within international law as compared to other conflict prone issues. In addition to this, there are certain obstacles and limitations at national, regional and global level to implement the cyber terrorism counter strategies which are presented in the third section. Lastly, by underlining the gaps and grey areas in the current cyber security counter measures, it aims to apply tools of deterrence theory, i.e. defense, attribution and retaliation, in the cyber realm to contribute towards formulating a credible cyber deterrence strategy at global level. Thus, this study is significant in understanding and determining the inevitable necessity of counter cyber terrorism strategies.

Keywords: attribution, critical infrastructure, cyber terrorism, global cooperation

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