Search results for: timely feedback

Authors: Cherif Y., Ghariani R., Derbal S., Farhati S., Ben Dahmen F., Abdallah M.

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Introduction: Tuberculosis (TBC) is a frequent infection and is still a major public health problem in Tunisia. The aim of this work is to focus on diagnostic and therapeutic characteristics of TBC in patients referred to our internal medicine department. Patients and Methods: The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2016 to December 2019, collecting patients with latent or patent TBC. Twenty-eight medical records of adults diagnosed with TBC were reviewed. Results: Twenty-eight patients, including 18 women and 10 men, were diagnosed with TBC. Their mean age is 48 years (range: 22-78 years). Five patients have a medical history of diabetes mellitus, 1 patient was followed for systemic lupus erythematosus treated with corticosteroids and immunosuppressant drugs, and another was treated with corticosteroids for Mac Duffy syndrome. The TBC is latent in 12 cases and patent in 16 cases. The most common symptoms were fever and weight loss and were found in 10 cases, a cough in 2 cases, sputum in 3 cases, lymph nodes in 4 cases, erythema nodosum in 2 cases, and neurological signs in 3 cases. Lymphopenia is noticed in 3 cases and a biological inflammatory syndrome in 18 of the cases. The purified protein derivate reaction was positive in 17 cases, anergic in 3 cases, negative in 5 cases, and not done in 3 cases. The acid-fast bacilli stain culture was strongly positive in one patient. The histopathological study was conclusive in 11 patients and showed granulomatosis with caseous necrosis. TBC was pulmonary in 7 patients, lymph node in 7 cases, peritoneal in 7 cases, digestive in 1 case, neuromeningeal in 3 cases, and thyroïd in 1 case. Seven patients had multifocal TBC. All the patients received anti-tuberculosis treatment with a mean duration of 8 months with no failure or relapse with an average follow-up time of 10.58 months. Conclusion: Diagnosis and management of TBC remain essential to avoid serious complications. The survey is necessary to ensure timely detection and treatment of infected adults to decrease its incidence. The best treatment remains preventive through vaccination and improving social and economic conditions.

Keywords: tuberculosis, infection, autoimmune disease, granulomatosis

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Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen

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Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.

Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric

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Authors: Jared Abuga, Wesley Too

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Medical error is the third leading cause of death in US, with approximately 98,000 deaths occurring every year as a result of medical errors. The world financial burden of medication errors is roughly USD 42 billion. Medication errors may lead to at least one death daily and injure roughly 1.3 million people every year. Medical error reporting is essential in creating a culture of accountability in our healthcare system. Studies have shown that attitudes and practice of healthcare workers in reporting medical errors showed that the major factors in under-reporting of errors included work stress and fear of medico-legal consequences due to the disclosure of error. Further, the majority believed that increase in reporting medical errors would contribute to a better system. Most hospitals depend on nurses to discover medication errors because they are considered to be the sources of these errors, as contributors or mere observers, consequently, the nurse’s perception of medication errors and what needs to be done is a vital feature to reducing incidences of medication errors. We sought to explore knowledge among nurses on medical errors and factors affecting or hindering reporting of medical errors among nurses working at the emergency unit, KNH. Critical care nurses are faced with many barriers to completing incident reports on medication errors. One of these barriers which contribute to underreporting is a lack of education and/or knowledge regarding medication errors and the reporting process. This study, therefore, sought to determine the availability and the use of reporting systems for medical errors in critical care unity. It also sought to establish nurses’ perception regarding medical errors and reporting and document factors facilitating timely identification and reporting of medical errors in critical care settings. Methods: The study used cross-section study design to collect data from 76 critical care nurses from Kenyatta Teaching & Research National Referral Hospital, Kenya. Data analysis and results is ongoing. By October 2022, we will have analysis, results, discussions, and recommendations of the study for purposes of the conference in 2023

Keywords: errors, medical, kenya, nurses, safety

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Authors: Saeed Sayyad Hagh Shomar

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Traffic congestion pricing in urban streets is one of the most suitable options for solving the traffic problems and environment pollutions in the cities of the country. Unlike its acceptable outcomes, there are problems concerning the necessity to pay by the mass. Regarding the fact that public response in order to succeed in this strategy is so influential, studying their response and behavior to get the feedback and improve the strategies is of great importance. In this study, a questionnaire was used to examine the public reactions to the traffic congestion pricing schemes at the center of Tehran metropolis and the factors involved in people’s decision making in accepting or rejecting the congestion pricing schemes were assessed based on the data obtained from the questionnaire as well as the international experiences. Then, by analyzing and comparing the schemes, guidelines to reduce public objections to them are discussed. The results of reviewing and evaluating the public reactions show that all the pros and cons must be considered to guarantee the success of these projects. Consequently, with targeted public education and consciousness-raising advertisements, prior to initiating a scheme and ensuring the mechanism of the implementation after the start of the project, the initial opposition is reduced and, with the gradual emergence of the real and tangible benefits of its implementation, users’ satisfaction will increase.

Keywords: demand management, international experiences, traffic congestion pricing, public acceptance, public reactions, public objection

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Authors: Kausar Harun, Ahmad Azmin Mohamad

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Zinc oxide (ZnO) has been extensively used in optoelectronic devices, with recent interest as photoanode material in dye-sensitize solar cell. Numerous methods employed to experimentally synthesized ZnO, while some are theoretically-modeled. Both approaches provide information on ZnO properties, but theoretical calculation proved to be more accurate and timely effective. Thus, integration between these two methods is essential to intimately resemble the properties of synthesized ZnO. In this study, experimentally-grown ZnO nanoparticles were prepared by sol-gel storage method with zinc acetate dihydrate and methanol as precursor and solvent. A 1 M sodium hydroxide (NaOH) solution was used as stabilizer. The optimum time to produce ZnO nanoparticles were recorded as 12 hours. Phase and structural analysis showed that single phase ZnO produced with wurtzite hexagonal structure. Further work on quantitative analysis was done via Rietveld-refinement method to obtain structural and crystallite parameter such as lattice dimensions, space group, and atomic coordination. The lattice dimensions were a=b=3.2498Å and c=5.2068Å which were later used as main input in first-principles calculations. By applying density-functional theory (DFT) embedded in CASTEP computer code, the structure of synthesized ZnO was built and optimized using several exchange-correlation functionals. The generalized-gradient approximation functional with Perdew-Burke-Ernzerhof and Hubbard U corrections (GGA-PBE+U) showed the structure with lowest energy and lattice deviations. In this study, emphasize also given to the modification of valence electron energy level to overcome the underestimation in DFT calculation. Both Zn and O valance energy were fixed at Ud=8.3 eV and Up=7.3 eV, respectively. Hence, the following electronic and optical properties of synthesized ZnO were calculated based on GGA-PBE+U functional within ultrasoft-pseudopotential method. In conclusion, the incorporation of Rietveld analysis into first-principles calculation was valid as the resulting properties were comparable with those reported in literature. The time taken to evaluate certain properties via physical testing was then eliminated as the simulation could be done through computational method.

Keywords: density functional theory, first-principles, Rietveld-refinement, ZnO nanoparticles

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Authors: Achim Kampker, Heiner Hans Heimes, Mathias Ordung, Jan-Philip Ganser

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In the past years, the automotive industry has changed significantly. Innovative mobility concepts have become more important, and electric vehicles see a chance of replacing vehicles with combustion engines in the long term. However, the coming years will be characterized by coexistence. In this context, there are two possible production scenarios: One the one hand, electric vehicles could be manufactured in bespoke assembly lines. Concerning the uncertainty regarding sales figures development, this alternative boasts a high investment risk. Therefore, an integrated assembly building upon existing structures also seems a feasible solution. This empirical study aims at validating hypotheses concerning theoretical and practical challenges of the integrated production in the final assembly. In order to take a test of approaches of the research by analyzing censored feedback of professionals, these hypotheses are validated in the framework of an expert study. For this purpose, hypotheses have been generated on the basis of a requirements analysis and a concept specification. Thereupon, a list of question has been implemented and deduced from the hypotheses to execute an online- and written-survey and interviews with professionals. The interpretation and evaluation of the findings includes an inter-component comparison for the electric drivetrain. Furthermore, key drivers for a sufficient integrated product and process design are presented.

Keywords: automotive industry, final assembly, integrated manufacturing, product and process development

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Authors: Wei Hu, Wenguang Chen, Chong Dong

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In order to improve the efficiency and safety of photovoltaic power generation devices, this photovoltaic power generation system combines Artificial Intelligence (AI) and the Internet of Things (IoT) to control the chasing photovoltaic power generation device to track the sun to improve power generation efficiency and then convert energy management. The system uses artificial intelligence as the control terminal, the power generation device executive end uses the Linux system, and Exynos4412 is the CPU. The power generating device collects the sun image information through Sony CCD. After several power generating devices feedback the data to the CPU for processing, several CPUs send the data to the artificial intelligence control terminal through the Internet. The control terminal integrates the executive terminal information, time information, and environmental information to decide whether to generate electricity normally and then whether to convert the converted electrical energy into the grid or store it in the battery pack. When the power generation environment is abnormal, the control terminal authorizes the protection strategy, the power generation device executive terminal stops power generation and enters a self-protection posture, and at the same time, the control terminal synchronizes the data with the cloud. At the same time, the system is more intelligent, more adaptive, and longer life.

Keywords: photo-voltaic power generation, the pursuit of light, artificial intelligence, internet of things, photovoltaic array, power management

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Authors: Majid Bahramian, Kaan Yetilmezsoy

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Environmental performance of residential buildings been a hotspot for the research community, however, the indoor environmental quality significantly overlooked in the literature. The paper is motivated by the understanding of the occupants from the indoor environmental qualities and seeks to find the satisfaction level in two high-rise green-certified residential buildings. Views of more than 250 respondents in each building were solicited on 15 Indoor Environmental Qualities (IEQ) parameters. Findings suggest that occupants are generally satisfied with five critical aspects of IEQ, but some unsatisfaction exists during operation phase. The results also indicate that the green build certification systems for new buildings have some deficiencies which affect the actual environmental performance of green buildings during operation. Some reasons were suggested by the occupants of which the design-focus construction and lack of monitoring after certification were the most critical factors. Among the crucial criteria for environmental performance assessment of green buildings, energy saving, reduction of Greenhouse Gases (GHG) emissions, environmental impacts on neighborhood area, waste reduction and IEQs, were the most critical factors dominating the performance, in a descending order. This study provides valuable information on the performance of IEQ parameters of green building and gives a deeper understanding for stakeholders and companies involved in construction sector with the relevant feedback for their decision-making on current and future projects.

Keywords: indoor environmental qualities, green buildings, occupant satisfaction, environmental performance

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Authors: Anna Ching-Yu Wong

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This study aims to identify the quality and effectiveness of the adult programs provided by the public library using the ServQUAL Method and the National Library Public Programs Assessment guidelines (NIPPA, June 2019). ServQUAl covers several variables, namely: tangible, reliability, responsiveness, assurance, and empathy. NIPPA guidelines focus on program characteristics, particularly on the outcomes – the level of satisfaction from program participants. The reached populations were adults who participated in library adult programs at a small-town public library in Kansas. This study was designed as quantitative evaluative research which analyzed the quality and effectiveness of the library adult programs by analyzing the role of each factor based on ServQUAL and the NIPPA's library program assessment guidelines. Data were collected from November 2019 to January 2020 using a questionnaire with a Likert Scale. The data obtained were analyzed in a descriptive quantitative manner. The impact of this research can provide information about the quality and effectiveness of existing programs and can be used as input to develop strategies for developing future adult programs. Overall the result of ServQUAL measurement is in very good quality, but still, areas need improvement and emphasis in each variable: Tangible Variables still need improvement in indicators of the temperature and space of the meeting room. Reliability Variable still needs improvement in the timely delivery of the programs. Responsiveness Variable still needs improvement in terms of the ability of the presenters to convey trust and confidence from participants. Assurance Variables still need improvement in the indicator of knowledge and skills of program presenters. Empathy Variable still needs improvement in terms of the presenters' willingness to provide extra assistance. The result of program outcomes measurement based on NIPPA guidelines is very positive. Over 96% of participants indicated that the programs were informative and fun. They learned new knowledge and new skills and would recommend the programs to their friends and families. They believed that together, the library and participants build stronger and healthier communities.

Keywords: ServQual model, ServQual in public libraries, library program assessment, NIPPA library programs assessment

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Authors: Asif Khaliq, Sayeeda A. Sayed

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

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

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Authors: Madoda Cekiso, Thenjiwe Meyiwa

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Successful postgraduate supervision involves possessing research capabilities, being knowledgeable in specific disciplines, understanding interpersonal relations, exercising mentoring/guidance skills and having appropriate knowledge of own institutional regulatory systems for postgraduate studies. On the other hand, postgraduate students are expected to know what the postgraduate journey entails and the elements and requirements of a postgraduate study. This paper sought to explore and analyse the research experiences of supervisors and postgraduate research students at one South African higher education institution. The study was qualitative in nature and a case study design was followed. The sample was purposively selected and comprised 25 postgraduate students and 20 postgraduate supervisors from one Faculty of the said university. The study findings revealed that there was no clear contract or memorandum of understanding between the postgraduate students and their supervisors. As a result, both supervisors and postgraduate students were not aware of their responsibilities. Both supervisors and postgraduate students complained about the non-availability of postgraduate facilities and resources for postgraduate students. The results further revealed that the allocation of students to supervisors who are not experts in a particular field was a challenge for both postgraduate students and supervisors. The results also revealed that the supervisors were not happy about the commitment of the postgraduate students towards their studies. The supervisors also complained about the postgraduate students who cannot work independently. Based on the findings, the authors recommended that a memorandum of understanding between a postgraduate student and a supervisor might solve some of the challenges. We further recommended a match between the supervisor’s expertise and the student’s focus area.

Keywords: feedback, mentoring, postgraduate, supervisors, student, memorandum of understanding

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Authors: Chiedu C. Ifekandu, Olusegun Sangowawa, Jean E. Njab

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Background: Health care providers (HCPs) in Nigeria receive little or no training of the healthcare needs of men who have sex with men (MSM) limiting the quality and effectiveness of comprehensive HIV prevention and treatment services. Consequently, most MSM disguise themselves to access services which limit the quality of care provided partly due to challenges related to stigma and discrimination, and breach of confidentiality. Objective: To assess the knowledge of healthcare providers on effective intervention for MSM. Methods: We trained 122 HIV focal persons drawn from 60 health facilities from twelve Nigerian states. , the participants were requested to complete a pre-training questionnaire to assess their level of working experience with key populations as a baseline. Participants included male and female doctors, nurses and counselors/testers. A test was administered to measure their knowledge on MSM sexual risk practices, HIV prevention and healthcare needs and also to assess their attitudes (including homophobia) and beliefs and how it affects service uptake by key populations particularly MSM prior and immediately after the training to ascertain the impact of the training. Results: The mean age of the HCP was 38 years +/- SD Of the 122 HCPs (45 % female, 55 % male; 85 % counsellor/testers; 15 % doctors and nurses; 92 % working in government facilities) from 42 health facilities were trained, of which 105 attempted the test questions. At the baseline, few HCPs reported any prior sensitivity training on MSM. Most of the HCPs had limited knowledge of MSM sexual health needs. Over 90% of the HCPs believed that homosexuality is a mental illness. 8 % do not consider MSM, FSW and PWID as key populations for HIV infection. 45 % lacked knowledge on MSM anal sexual practices. The post-test showed that homophobic attitudes had decreased significantly by the end of the training; the health care providers have acquired basic knowledge compared to the pre-test. Conclusions: Scaling up MSM sensitivity training for Nigerian HCPs is likely to be a timely and effective means to improve their understanding of MSM-related health issues, reduce homophobic sentiments and enhance their capacity to provide responsive HIV prevention, treatment and care services in a supportive and non-stigmatizing environment.

Keywords: healthcare providers, key population, men who have sex with men, HCT

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Authors: Firouz Amani, Adalat Hoseinian, Sajjad Hakimian

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Background: The mortality due to Myocardial Infarction (MI) is often occur during the first hours after onset of symptom. So, for taking the necessary treatment and decreasing the mortality rate, timely visited of the hospital could be effective in this regard. The aim of this study was to investigate the impact of effective factors in mortality of MI patients by using Linear Logistic Regression. Materials and Methods: In this case-control study, all patients with Acute MI who referred to the Ardabil city hospital were studied. All of died patients were considered as the case group (n=27) and we select 27 matched patients without Acute MI as a control group. Data collected for all patients in two groups by a same checklist and then analyzed by SPSS version 24 software using statistical methods. We used the linear logistic regression model to determine the effective factors on mortality of MI patients. Results: The mean age of patients in case group was significantly higher than control group (75.1±11.7 vs. 63.1±11.6, p=0.001).The history of non-cardinal diseases in case group with 44.4% significantly higher than control group with 7.4% (p=0.002).The number of performed PCIs in case group with 40.7% significantly lower than control group with 74.1% (P=0.013). The time distance between hospital admission and performed PCI in case group with 110.9 min was significantly upper than control group with 56 min (P=0.001). The mean of delay time from Onset of symptom to hospital admission (patient delay) and the mean of delay time from hospital admissions to receive treatment (system delay) was similar between two groups. By using logistic regression model we revealed that history of non-cardinal diseases (OR=283) and the number of performed PCIs (OR=24.5) had significant impact on mortality of MI patients in compare to other factors. Conclusion: Results of this study showed that of all studied factors, the number of performed PCIs, history of non-cardinal illness and the interval between onset of symptoms and performed PCI have significant relation with morality of MI patients and other factors were not meaningful. So, doing more studies with a large sample and investigated other involved factors such as smoking, weather and etc. is recommended in future.

Keywords: acute MI, mortality, heart failure, arrhythmia

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Authors: Taki Eddine Seghier, Mohd Hamdan Ahmad, Yaik-Wah Lim, Samuel Opeyemi Williams

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The assessment of building sustainability to achieve a specific green benchmark and the preparation of the required documents in order to receive a green building certification, both are considered as major challenging tasks for green building design team. However, this labor and time-consuming process can take advantage of the available Building Information Modeling (BIM) features such as material take-off and scheduling. Furthermore, the workflow can be automated in order to track potentially achievable credit points and provide rating feedback for several design options by using integrated Visual Programing (VP) to handle the stored parameters within the BIM model. Hence, this study proposes a BIM-based tool that uses Green Building Index (GBI) rating system requirements as a unique input case to evaluate the building sustainability in the design stage of the building project life cycle. The tool covers two key models for data extraction, firstly, a model for data extraction, calculation and the classification of achievable credit points in a green template, secondly, a model for the generation of the required documents for green building certification. The tool was validated on a BIM model of residential building and it serves as proof of concept that building sustainability assessment of GBI certification can be automatically evaluated and documented through BIM.

Keywords: green building rating system, GBRS, building information modeling, BIM, visual programming, VP, sustainability assessment

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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: Thaiurie Govender, Shannon Verne

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The Fourth Industrial Revolution has ushered in an era where technology significantly impacts various aspects of life, including higher education. Blended learning, which combines synchronous and asynchronous learning, has gained popularity as a pedagogical approach. However, its effective implementation is a challenge, particularly in the context of the COVID-19 pandemic and technological obstacles faced in South Africa. This study focused on lecturers' teaching and learning practices to implement blended learning, aiming to understand the teaching and learning strategies used with the integration of digital tools to facilitate the blended learning approach within a private higher educational institution in South Africa. Using heutagogy and constructivism theoretical frameworks, the study aimed to uncover insights into the lecturer’s teaching and learning practices to overcome challenges in designing and facilitating blended learning modules. Through a qualitative analysis, the themes of student engagement, teaching and learning strategies, digital tools, and feedback emerged, highlighting the complexities and opportunities in a blended learning classroom. The findings emphasize the importance of tailoring methods to students' needs and subject matter, aligning with constructivist principles. Recommendations include promoting professional development opportunities, addressing infrastructure issues, and fostering a supportive learning environment.

Keywords: blended learning, digital tools, higher education, teaching strategies

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Authors: Kamarul Fairuz Hassim, Sharifah Fatimah Syed-Ahmad

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New managerialism has become the current trend in managing public sector which emphasizes on efficiency, effectiveness, and accountability. Public universities are not exempted from experiencing this new system. This study tries to explore the direct impact of new managerialism towards work performance of the employees in a public university in Malaysia and the indirect impact through a mediating factor – Organizational Commitment. Feedback were gathered from 204 respondents comprises of academics and non-academics managers in the University of Malaya using a 39 items, self-administered questionnaire. Respondents’ views were asked in the aspects of managerialism level of the university, their organizational commitment, and self-rated work performance level. The findings exhibit that there is a direct impact of new managerialism towards employees’ work performance in a positive way. This is contradicting to the established Hypotheses of this study. Furthermore, there is no significant finding on the role of all three components of organizational commitment – affective, normative, and continuance as the mediating factors in new managerialism approach that gave impact towards work performance. Consequently these insignificant found failed to corroborate the remaining six hypotheses in this study. On another note, findings gathered from this study show some contradiction to the original research conducted earlier by Smeenk et al. in 2009. Therefore, results obtained from this study do contribute to the existing pool of knowledge as previous studies on this topic are scarce especially in the Malaysia’s context.

Keywords: new managerialism, Malaysia public universities, organizational commitment, work performance

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Authors: Seulki Lee, Seoung Bum Kim

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Statistical process control (SPC) is a practical and effective method for quality control. The most important and widely used technique in SPC is a control chart. The main goal of a control chart is to detect any assignable changes that affect the quality output. Most conventional control charts, such as Hotelling’s T2 charts, are commonly based on the assumption that the quality characteristics follow a multivariate normal distribution. However, in modern complicated manufacturing systems, appropriate control chart techniques that can efficiently handle the nonnormal processes are required. To overcome the shortcomings of conventional control charts for nonnormal processes, several methods have been proposed to combine statistical learning algorithms and multivariate control charts. Statistical learning-based control charts, such as support vector data description (SVDD)-based charts, k-nearest neighbors-based charts, have proven their improved performance in nonnormal situations compared to that of the T2 chart. Beside the nonnormal property, time-varying operations are also quite common in real manufacturing fields because of various factors such as product and set-point changes, seasonal variations, catalyst degradation, and sensor drifting. However, traditional control charts cannot accommodate future condition changes of the process because they are formulated based on the data information recorded in the early stage of the process. In the present paper, we propose a SVDD algorithm-based control chart, which is capable of adaptively monitoring time-varying and nonnormal processes. We reformulated the SVDD algorithm into a time-adaptive SVDD algorithm by adding a weighting factor that reflects time-varying situations. Moreover, we defined the updating region for the efficient model-updating structure of the control chart. The proposed control chart simultaneously allows efficient model updates and timely detection of out-of-control signals. The effectiveness and applicability of the proposed chart were demonstrated through experiments with the simulated data and the real data from the metal frame process in mobile device manufacturing.

Keywords: multivariate control chart, nonparametric method, support vector data description, time-varying process

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Authors: Mohamamd Ayish

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This study addresses media diplomacy as an integral component of public diplomacy which emerged in the United States in the post-World War II era and found applications in other countries around the world. The study seeks to evolve a conceptual framework for understanding the practice of public diplomacy through social networks, often referred to as social engagement diplomacy. This form of diplomacy is considered far more ahead of the other two forms associated with both government controlled and independent media. The cases of the Voice of America Arabic Service and the 1977 CBS interviews with the late Egyptian President Anwar Sadat and Israeli Prime Minister Menachem Begin are cited in this study as reflecting the two traditional models. The new social engagement model sees public diplomacy as an act of communication that seeks to effect changes in target audiences through a process of persuasion shaped by discourse orientations and technological features. The proposed conceptual framework for social, diplomatic engagement draws on an open communication environment, an empowered audience, an interactive and symmetrical process of communication, multimedia-based flows of information, direct and credible feedback, distortion and high risk. The writer believes this study would be helpful in providing appropriate knowledge pertaining to our understanding of social diplomacy and furnishing concrete insights into how diplomats could harness virtual space to maximize their goals in the global environment.

Keywords: diplomacy, engagement, social, globalization

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Authors: Tamika Gordon

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As technology continues to progress every second, educational institutions attempt to stay abreast of the latest developments through the acquisition of technological devices. Within schools, soft and hard technologies have assisted with reaching more students and expedient communication. As schools continue to grow, the need for simultaneous communication and efficient feedback has grown, and technology has allowed for these avenues to be explored and incorporated within a variety of daily operations. With the rapid inclusion of technology comes the potential for less face-to-face interactions among stakeholders. Although technology plays an integral role in education, the elements of both soft and hard technological devices must be proportionally utilized and coexist for the overall advancement and longevity of organizations. Over 20 articles were referenced to obtain a multitude of views on technology reflecting effects for students and teachers. Throughout this literature review, the effects of technology in the workplace will be discussed including views of current researchers, pros and cons surrounding technological inclusion, and implications for future research and further consideration. Upon the completion of the literature review, the benefits and necessity of technology remained high, however, low availability of resources, limited exposure to technological devices, and decreasing soft skills remained high as well. Recommendations are made for proportionate balances of technology and face-to-face interactions in order to minimize societal, educational, and organizational gaps.

Keywords: communication, devices, education, organizations, technology

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Authors: David Mafullul, Jiang Lei, Edward Goacher, Jibin Francis

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PURPOSE: Timely decompressive surgery for cauda equina syndrome (CES) is dependent on efficient referral pathways for patients presenting at local primary or secondary centres to tertiary spinal centres in the United Kingdom (UK). Identifying modifiable points of delay within this process is important as minimising time between presentation and surgery may improve patient outcomes. This study aims to analyse whether adequacy of referral impacts on time to surgery in CES. MATERIALS AND METHODS: Data from all cases of confirmed CES referred to a single tertiary UK hospital between August 2017 to December 2019, via a suspected CES e-referral pathway, were obtained retrospectively. Referral adequacy was defined by the inclusion of sufficient information to determine the presence or absence of several NICE ‘red flags’. Correlation between referral adequacy and delay from referral-to-surgery was then analysed. RESULTS: In total, 118 confirmed CES cases were included. Adequate documentation for saddle anaesthesia was associated with reduced delays of more than 48 hours from referral-to-surgery [X2(1, N=116)=7.12, p=.024], an effect partly attributable to these referrals being accepted sooner [U=16.5; n1=27, n2=4, p=.029, r=.39]. Other red flags had poor association with delay. Referral adequacy was better for somatic red flags [bilateral sciatica (97.5%); severe or progressive bilateral neurological deficit of the legs (95.8%); saddle anaesthesia (91.5%)] compared to autonomic red flags [loss of anal tone (80.5%); urinary retention (79.7%); faecal incontinence or lost sensation of rectal fullness (57.6%)]. Although referral adequacy for urinary retention was 79.7%, only 47.5% of referrals documented a post-void residual numerical value. CONCLUSIONS: Adequate documentation of saddle anaesthesia in e-referrals is associated with reduced delay-to-surgery for confirmed CES, partly attributable to these referrals being accepted sooner. Other red flags had poor association with delay to surgery. Referral adequacy for autonomic red flags, including documentation for post-void residuals, has significant room for improvement.

Keywords: cauda equina, cauda equina syndrome, neurosurgery, spinal surgery, decompression, delay, referral, referral adequacy

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Authors: Humphrey Agevi, Harrison Tsingalia, Richard Onwonga, Shem Kuyah

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Most of the world ecosystems have been affected by the effects of climate change. Efforts have been made to mitigate against climate change effects. While most studies have been done in forest ecosystems and pure plant plantations, trees on farms including agroforestry have only received attention recently. Agroforestry systems and tree cover on agricultural lands make an important contribution to climate change mitigation but are not systematically accounted for in the global carbon budgets. This study sought to: (i) determine tree diversity in different agroforestry practices; (ii) determine tree biomass in different agroforestry practices. Study area was determined according to the Land degradation surveillance framework (LSDF). Two study sites were established. At each of the site, a 5km x 10km block was established on a map using Google maps and satellite images. Way points were then uploaded in a GPS helped locate the blocks on the ground. In each of the blocks, Nine (8) sentinel clusters measuring 1km x 1km were randomized. Randomization was done in a common spreadsheet program and later be downloaded to a Global Positioning System (GPS) so that during surveys the researchers were able to navigate to the sampling points. In each of the sentinel cluster, two farm boundaries were randomly identified for convenience and to avoid bias. This led to 16 farms in Kakamega South and 16 farms in Kakamega North totalling to 32 farms in Kakamega Site. Species diversity was determined using Shannon wiener index. Tree biomass was determined using allometric equation. Two agroforestry practices were found; homegarden and hedgerow. Species diversity ranged from 0.25-2.7 with a mean of 1.8 ± 0.10. Species diversity in homegarden ranged from 1-2.7 with a mean of 1.98± 0.14. Hedgerow species diversity ranged from 0.25-2.52 with a mean of 1.74± 0.11. Total Aboveground Biomass (AGB) determined was 13.96±0.37 Mgha-1. Homegarden with the highest abundance of trees had higher above ground biomass (AGB) compared to hedgerow agroforestry. This study is timely as carbon budgets in the agroforestry can be incorporated in the global carbon budgets and improve the accuracy of national reporting of greenhouse gases.

Keywords: agroforestry, allometric equations, biomass, climate change

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Authors: Wenjun Zhang, Thao Thi Le, Dongyup Shin, Jong Min Kim

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Electrochemical hydrogen peroxide (H₂O₂) synthesis holds significant promise for decentralized environmental remediation through the electro-Fenton process. However, challenges persist, such as the absence of robust electrocatalysts for the selective two-electron oxygen reduction reaction (2e⁻ ORR) and the high cost and sluggish kinetics of conventional electro-Fenton systems in treating highly concentrated wastewater. This study introduces an efficient water treatment system for removing substantial quantities of organic pollutants using an advanced electro-Fenton system coupled with a high-valent NiO catalyst. By employing a precipitation method involving crystal facet and cation vacancy engineering, a trivalent Ni (Ni³⁺)-rich NiO catalyst with a (111)-domain-exposed crystal facet, named {111}-NivO, was synthesized. This catalyst exhibited a remarkable 96% selectivity and a high mass activity of 59 A g⁻¹ for H₂O₂ production, outperforming all previously reported Ni-based catalysts. Furthermore, an advanced electro-Fenton system, integrated with a flow cell for electrochemical H₂O₂ production, was utilized to achieve 100% removal of 50 ppm bisphenol A (BPA) in 200 mL of wastewater under heavy-duty conditions, reaching a superior rapid degradation rate (4 min, k = 1.125 min⁻¹), approximately 102 times faster than the conventional electro-Fenton system. The hyper-efficiency is attributed to the continuous and appropriate supply of H₂O₂, the provision of O₂, and the timely recycling of the electrolyte under high current density operation. This catalyst also demonstrated a 93% removal of total organic carbon after 2 hours of operation and can be applied for efficient removal of highly concentrated phenol pollutants from aqueous systems, which opens new avenues for wastewater treatment.

Keywords: hydrogen peroxide production, nickel oxides, crystal facet and cation vacancy engineering, wastewater treatment, flow cell, electro-Fenton

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Authors: Yaser E. Greish, Emad F. Hindawy, Maryam S. Al Nehayan

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Introductory courses such as General Chemistry I, General Physics I and General Biology need special attention as students taking these courses are usually at their first year of the university. In addition to the language barrier for most of them, they also face other difficulties if these elementary courses are taught in the traditional way. Changing the routine method of teaching of these courses is therefore mandated. In this regard, podcasting of chemistry lectures was used as an add-on to the traditional and non-traditional methods of teaching chemistry to science and non-science students. Podcasts refer to video files that are distributed in a digital format through the Internet using personal computers or mobile devices. Pedagogical strategy is another way of identifying podcasts. Three distinct teaching approaches are evident in the current literature and include receptive viewing, problem-solving, and created video podcasts. The digital format and dispensing of video podcasts have stabilized over the past eight years, the type of podcasts vary considerably according to their purpose, degree of segmentation, pedagogical strategy, and academic focus. In this regard, the whole syllabus of 'General Chemistry I' course was developed as podcasts and were delivered to students throughout the semester. Students used the podcasted files extensively during their studies, especially as part of their preparations for exams. Feedback of students strongly supported the idea of using podcasting as it reflected its effect on the overall understanding of the subject, and a consequent improvement of their grades.

Keywords: podcasting, introductory course, interactivity, flipped classroom

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Authors: Yayra Dzakadzie

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The descriptive cross-sectional survey study assessed dishonest academic intention, mediating academic goals, and attitude relationship with academic dishonesty among university undergraduate students in Ghana. The target population for this study was all the final-year undergraduate students enrolled full-time in Ghanaian public universities. One thousand two hundred (1,200) undergraduate students participated in the study. Multistage sampling was used to select the sample for the study. A structured questionnaire was used to collect the needed data to test hypotheses. Structural Equation Modelling (PLS-SEM) was used for the analyses. The results revealed that academic goals and attitudes had direct and indirect effects on academic dishonesty behaviour. Also, academic intention was statistically a significant mediator in the relationship that academic goals and attitude have with academic dishonesty. It was concluded that when academic goals are high, it compels individual students to try new strategies, and when academic goals are low, the students would like to “cut corners” to meet expectations. It was also concluded that when the attitude towards academic dishonesty is low, students are more unlikely to form an intention to be academically dishonest. It is recommended that lecturers should make their students aware of the goals that need to be attained in their courses and provide them with feedback on goal progress. Students should set their proximal goals and enhance their commitment so that they avoid putting things off. Enforcement of rules and regulations against academic dishonesty must be fully adhered to since students’ positive attitudes can result in high intention, which would lead to academic dishonesty behaviour.

Keywords: intention, academic goals, attitude, academic dishonesty, public university

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Authors: Manana Lobzhanidze

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Introduction: The paper will argue that labor migration is the most important problem Georgia faces today. The structure of labor migration by age and gender of Georgia is analyzed. The main driving factors of circular labor migration during the last ten years are identified. While studying migration, it is necessary to discuss the interconnection of economic, social, and demographic features, also taking into consideration the policy of state regulations in terms of education and professional training. Methodology: Different research methods are applied in the presented paper: statistical, such as selection, grouping, observation, trend, and qualitative research methods, namely; analysis, synthesis, induction, deduction, comparison ones. Main Findings: Labour migrants are filling the labor market as a low salary worker. The main positive feedback of migration from developing countries is poverty eradication, but this process is accompanied by problems, such as 'Brain Drain'. The country loses an important part of its intellectual potential, and it is invested by households or state itself. Conclusions: Labor migration is characterized to be temporary, but socio-economic problems of the country often push the labor migration in the direction of longterm and illegal migration. Countries with developed economies try to stricter migration policy and fight illegal migration with different methods; circular migration helps solve this problem. Conclusions and recommendations are included about circular labor migration consequences in Georgia and its influence on the reduction of unemployment level.

Keywords: migration, circular labor migration, labor migration employment, unemployment

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Authors: Kristian Bugeja, Upeshala A. Jayawardena, Clarissa Fenech, Mark Zammit Vincenti

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Introduction: Biliary colic, acute cholecystitis, and gallstone pancreatitis are some of the most common surgical presentations at Gozo General Hospital (GGH). National Institute for Health and Care Excellence (NICE) guidelines advise that suitable patients with acute biliary problems should be offered a laparoscopic cholecystectomy within one week of diagnosis. There has traditionally been difficulty in achieving this mainly due to the reluctance of some surgeons to operate in the acute setting, limited, timely access to MRCP and ERCP, and organizational issues. Methodology: A retrospective study was performed involving all biliary pathology-related admissions to GGH during the two-year period of 2019 and 2020. Patients’ files and electronic case summary (ECS) were used for data collection, which included demographic data, primary diagnosis, co-morbidities, management, waiting time to surgery, length of stay, readmissions, and reason for readmissions. NICE clinical guidance 188 – Gallstone disease were used as the standard. Results: 51 patients were included in the study. The mean age was 58 years, and 35 (68.6%) were female. The main diagnoses on admission were biliary colic in 31 (60.8%), acute cholecystitis in 10 (19.6%). Others included gallstone pancreatitis in 3 (5.89%), chronic cholecystitis in 2 (3.92%), gall bladder malignancy in 4 (7.84%), and ascending cholangitis in 1 (1.97%). Management included laparoscopic cholecystectomy in 34 (66.7%); conservative in 8 (15.7%) and ERCP in 6 (11.7%). The mean waiting time for laparoscopic cholecystectomy for patients with acute cholecystitis was 74 days – range being between 3 and 146 days since the date of diagnosis. Only one patient who was diagnosed with acute cholecystitis and managed with laparoscopic cholecystectomy was done so within the 7-day time frame. Hospital re-admissions were reported in 5 patients (9.8%) due to vomiting (1), ascending cholangitis (1), and gallstone pancreatitis (3). Discussion: Guidelines were not met for patients presenting to Gozo General Hospital with acute biliary pathology. This resulted in 5 patients being re-admitted to hospital while waiting for definitive surgery. The local issues resulting in the delay to surgery need to be identified and steps are taken to facilitate the provision of urgent cholecystectomy for suitable patients.

Keywords: biliary colic, acute cholecystits, laparoscopic cholecystectomy, conservative management

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Authors: Ava Simone Arteaga

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This research explores the portrayal of drug use in U.K. digital news media, a topic of critical importance due to its influence on addiction treatment, recovery efforts, and public perceptions. Substance use disorder (SUD) as one of the most stigmatized health conditions globally, with media representations playing a crucial role in shaping societal attitudes. Despite the impact of media portrayals, there has been no comprehensive analysis of drug-related representations in U.K. digital news media for over thirteen years. This study aims to fill this gap by analyzing contemporary digital news depictions of drug use, focusing on how these portrayals influence public perception and contribute to stigma. This research will examine tabloid, national, and regional East Midlands press sites to understand current trends in drug-related reporting. The study will build on previous research, such as the 2010 UKDPC study, which revealed that drug users were often vilified, and that coverage was predominantly focused on criminal justice rather than recovery. Given the rise in drug-related deaths in the U.K. and the exacerbation of the drug crisis post-Brexit, this analysis is timely and crucial. The findings are expected to reveal how digital media continues to perpetuate stigma and misinformation about drug use. By comparing these findings with U.S. studies, the research will contribute to a better understanding of cross-cultural differences in drug-related media representations and inform policy discussions. The U.K. Government's ten-year plan to combat illegal drugs, which emphasizes reducing stigma, will benefit from this research by highlighting the need for improved media representations. Additionally, the study will engage with recent U.K. and international research on media stigma towards SUD to provide a broader context and comparative perspective. Ultimately, this study aims to drive changes in media reporting and contribute to the development of more effective public policies and interventions. By addressing current gaps in research and providing evidence-based recommendations, this work seeks to support the U.K. Government’s objectives and improve the media’s role in addressing drug-related issues.

Keywords: addiction, UK news media, media representations, depiction of drug use

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Authors: Lintang Putra Sadewa, Ilham Prasetya Budhi

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Slope monitoring program has now become a mandatory campaign for any open pit mines around the world to operate safely. Utilizing various slope monitoring instruments and strategies, miners are now able to deliver precise decisions in mitigating the risk of slope failures which can be catastrophic. Currently, the most sophisticated slope monitoring technology available is the Slope Stability Radar (SSR), whichcan measure wall deformation in submillimeter accuracy. One of its eminent features is that SSRcan provide a timely warning by automatically raise an alarm when a predetermined rate-of-movement threshold is reached. However, establishing proper alarm thresholds is arguably one of the onerous challenges faced in any slope monitoring program. The difficulty mainly lies in the number of considerations that must be taken when generating a threshold becausean alarm must be effectivethat it should limit the occurrences of false alarms while alsobeing able to capture any real wall deformations. In this sense, experience shows that a site-specific alarm thresholdtendsto produce more reliable results because it considers site distinctive variables. This study will attempt to determinealarming thresholds for safety-critical monitoring based on an empirical model of slope deformation behaviour that is defined statistically fromdeformation data captured by the Slope Stability Radar (SSR). The study area comprises of upright-dipping highwall setting in a coal mining area with intense mining activities, andthe deformation data used for the study were recorded by the SSR throughout the year 2022. The model is site-specific in nature thus, valuable information extracted from the model (e.g., time-to-failure, onset-of-acceleration, and velocity) will be applicable in setting up site-specific alarm thresholds and will give a clear understanding of how deformation trends evolve over the area.

Keywords: safety-critical monitoring, alarming strategy, slope deformation behaviour model, coal mining

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Authors: Fatemeh Norouzi

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Today, financial performance has become one of the important issues in accounting and auditing that companies and their managers have paid attention to this issue and for this reason to the variables that are influential in this field. One of the things that can affect financial performance is corporate governance, which is examined in this research, although some things such as issues related to auditing can also moderate this relationship; Therefore, this research has been conducted with the aim of investigating the relationship between corporate governance and financial performance with regard to the moderating role of feedback and internal control weakness. The research is practical in terms of purpose, and in terms of method, it has been done in a post-event descriptive manner, in which the data has been analyzed using stock market data. Data collection has been done by using stock exchange data which has been extracted from the website of the Iraqi Stock Exchange, the statistical population of this research is all the companies admitted to the Iraqi Stock Exchange. . The statistical sample in this research is considered from 2014 to 2021, which includes 34 companies. Four different models have been considered for the research hypotheses, which are eight hypotheses, in this research, the analysis has been done using EXCEL and STATA15 software. In this article, collinearity test, integration test ,determination of fixed effects and correlation matrix results, have been used. The research results showed that the first four hypotheses were rejected and the second four hypotheses were confirmed.

Keywords: size of the board of directors, duality of the CEO, financial performance, internal control weakness

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