Search results for: software project management

Authors: Meltem Karatepe Kaya

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The concept of corporate governance is not new but, due to the recent international financial crisis, it has become prominent in contemporary business, accounting and legal debates. There is a wealth of anecdotal evidence which shows that protection of minority shareholders is an important issue in the corporate governance literature. Minority shareholders typically hold low amounts of stocks, so the benefits gained from their participation in shareholder meetings are very asymmetric to the cost. Therefore, the presence of a good corporate governance structure is the proper protection of and respect for the rights and interests of shareholders, particularly those of minority shareholders. The research will attempt to find answers to the following questions: Why minority shareholders’ rights should be protected? How minority shareholders’ rights could be improved? Does the legal framework in the United Kingdom provide adequate protection for minority shareholders? This study will assess regulations about the legal protections of minority shareholders and try to find answer this question: ’Why is it inevitable for company law to treat in a successful way the problems arising from minority shareholders' conflict with other shareholders of a company?’The protection of minority shareholders is not only a corporate governance objective in its own right but also has added importance particularly in developing countries. In the United Kingdom(UK) and the United States of America(USA), there are diffused ownership structures so that any shareholders do not influence the management of the company. This is in stark contrast to companies in developing countries such as Turkey where controlling shareholders and related insiders are a well-known feature of ownership structures, and where companies are often governed and managed by controlling shareholders such as family firms and associated companies through cross-shareholdings and pyramiding ownership structures. In Turkey, the agency problem is not between shareholders and management. Rather it gives rise to another dimension of the agency problem – a conflict of interest between majority shareholders (controlling) and minority shareholders. This research will make a particularly useful contribution to knowledge-based information and understanding of company law in the UK, particularly minority shareholders' remedies. It will not only give information about law and regulations of minority shareholders' remedies but also it will provide some knowledge about doctrinal discussions and relevant cases. The major contribution to study will be in the knowledge of law and regulation in the legal protections of minority shareholders in the United Kingdom and Turkey. In this study, the recommendations will be given for the development of the legal framework and practices of protections for minority shareholders and small investors.

Keywords: controlling shareholders, corporate governance, derivative actions, minority shareholders

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Authors: Vincent Murray

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The chromatin structure at the transcription start sites (TSSs) of genes is very important in the control of gene expression. In order for gene expression to occur, the chromatin structure at the TSS has to be altered so that the transcriptional machinery can be assembled and RNA transcripts can be produced. In particular, the nucleosome structure and positioning around the TSS has to be changed. Bleomycin is utilized as an anti-tumor agent to treat Hodgkin's lymphoma, squamous cell carcinoma, and testicular cancer. Bleomycin produces DNA damage in human cells and DNA strand breaks, especially double-strand breaks, are thought to be responsible for the cancer chemotherapeutic activity of bleomycin. Bleomycin is a large glycopeptide with molecular weight of approximately 1500 Daltons and hence its DNA strand cleavage activity can be utilized as a probe of chromatin structure. In this project, Illumina next-generation DNA sequencing technology was used to determine the position of DNA double-strand breaks at the TSSs of genes in intact cells. In this genome-wide study, it was found that bleomycin cleavage preferentially occurred at the TSSs of actively transcribed human genes in comparison with non-transcribed genes. There was a correlation between the level of enhanced bleomycin cleavage at TSSs and the degree of transcriptional activity. In addition, bleomycin was able to determine the position of nucleosomes at the TSSs of human genes. Bleomycin analogues were also utilized as probes of chromatin structure at the TSSs of human genes. In a similar manner to bleomycin, the bleomycin analogues 6′-deoxy-BLM Z and zorbamycin preferentially cleaved at the TSSs of human genes. Interestingly this degree of enhanced TSS cleavage inversely correlated with the cytotoxicity (IC50 values) of BLM analogues. This indicated that the degree of cleavage by bleomycin analogues at the TSSs of human genes was very important in the cytotoxicity of bleomycin and analogues. It also provided a deeper insight into the mechanism of action of this cancer chemotherapeutic agent since actively transcribed genes were preferentially targeted.

Keywords: anti-cancer activity, chromatin structure, cytotoxicity, gene expression, next-generation DNA sequencing

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Authors: Mitra Saberi, Saeideh Fakhari, Amir Karam, Ali Ahmadabadi

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Geomorphology is the scientific study of the characteristics of form and shape of the Earth's surface. The existence of types of landforms and their variation is mainly controlled by changes in the shape and position of land and topography. In fact, the interest and application of fractal issues in geomorphology is due to the fact that many geomorphic landforms have fractal structures and their formation and transformation can be explained by mathematical relations. The purpose of this study is to identify and analyze the fractal behavior of landforms of macro geomorphologic regions of Iran, as well as studying and analyzing topographic and landform characteristics based on fractal relationships. In this study, using the Iranian digital elevation model in the form of slopes, coefficients of deposition and alluvial fan, the fractal dimensions of the curves were calculated through the box counting method. The morphometric characteristics of the landforms and their fractal dimension were then calculated for 4criteria (height, slope, profile curvature and planimetric curvature) and indices (maximum, Average, standard deviation) using ArcMap software separately. After investigating their correlation with fractal dimension, two-way regression analysis was performed and the relationship between fractal dimension and morphometric characteristics of landforms was investigated. The results show that the fractal dimension in different pixels size of 30, 90 and 200m, topographic curves of different landform units of Iran including mountain, hill, plateau, plain of Iran, from1.06in alluvial fans to1.17in The mountains are different. Generally, for all pixels of different sizes, the fractal dimension is reduced from mountain to plain. The fractal dimension with the slope criterion and the standard deviation index has the highest correlation coefficient, with the curvature of the profile and the mean index has the lowest correlation coefficient, and as the pixels become larger, the correlation coefficient between the indices and the fractal dimension decreases.

Keywords: box counting method, fractal dimension, geomorphology, Iran, landform

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Authors: Y. Zhang, J. Perez, S. Marnier

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To date, no study on goaltending butterfly motion has been completed in real conditions, during an ice hockey game or training practice, to the author's best knowledge. This motion, performed to save score, is unnatural, intense, and repeated. The target of this research activity is to identify representative biomechanical criteria for this goaltender-specific movement pattern. Determining specific physical parameters may allow to will identify the risk of hip and groin injuries sustained by goaltenders. Four professional or academic goalies were instrumented during ice hockey training practices with five inertial measurement units. These devices were inserted in dedicated pockets located on each thigh and shank, and the fifth on the lumbar spine. A camera was also installed close to the ice to observe and record the goaltenders' activities, especially the butterfly motions, in order to synchronize the captured data and the behavior of the goaltender. Each data recorded began with a calibration of the inertial units and a calibration of the fully equipped goaltender on the ice. Three butterfly motions were recorded out of the training practice to define referential individual butterfly motions. Then, a data processing algorithm based on the Madgwick filter computed hip and knee joints joint range of motion as well as angular specific angular velocities. The developed algorithm software automatically identified and analyzed all the butterfly motions executed by the four different goaltenders. To date, it is still too early to show that the analyzed criteria are representative of the trauma generated by the butterfly motion as the research is only at its beginning. However, this descriptive research activity is promising in its ecological assessment, and once the criteria are found, the tools and protocols defined will allow the prevention of as many injuries as possible. It will thus be possible to build a specific training program for each goalie.

Keywords: biomechanics, butterfly motion, human motion analysis, ice hockey, inertial measurement unit

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Authors: Strahinja Kovacevic, Milica Karadzic Banjac, Jasmina Vitas, Stefan Vukmanovic, Radomir Malbasa, Lidija Jevric, Sanja Podunavac-Kuzmanovic

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The present study deals with chemometric regression analysis of quality parameters and the radical scavenging ability of kombucha fermented kefir-like products obtained with winter savory (WS), peppermint (P), stinging nettle (SN) and wild thyme tea (WT) kombucha inoculums. Each analyzed sample was described by milk fat content (MF, %), total unsaturated fatty acids content (TUFA, %), monounsaturated fatty acids content (MUFA, %), polyunsaturated fatty acids content (PUFA, %), the ability of free radicals scavenging (RSA Dₚₚₕ, % and RSA.ₒₕ, %) and pH values measured after each hour from the start until the end of fermentation. The aim of the conducted regression analysis was to establish chemometric models which can predict the radical scavenging ability (RSA Dₚₚₕ, % and RSA.ₒₕ, %) of the samples by correlating it with the MF, TUFA, MUFA, PUFA and the pH value at the beginning, in the middle and at the end of fermentation process which lasted between 11 and 17 hours, until pH value of 4.5 was reached. The analysis was carried out applying univariate linear (ULR) and multiple linear regression (MLR) methods on the raw data and the data standardized by the min-max normalization method. The obtained models were characterized by very limited prediction power (poor cross-validation parameters) and weak statistical characteristics. Based on the conducted analysis it can be concluded that the resulting radical scavenging ability cannot be precisely predicted only on the basis of MF, TUFA, MUFA, PUFA content, and pH values, however, other quality parameters should be considered and included in the further modeling. This study is based upon work from project: Kombucha beverages production using alternative substrates from the territory of the Autonomous Province of Vojvodina, 142-451-2400/2019-03, supported by Provincial Secretariat for Higher Education and Scientific Research of AP Vojvodina.

Keywords: chemometrics, regression analysis, kombucha, quality control

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Authors: Shazia Anwer Bukhari, Madiha Javeed Ghani, Muhammad Ibrahim Rajoka

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Objective: Biochemical, environmental, physical and genetic factors have a strong effect on the development of coronary disease (CAD). Plasma homocysteine (Hcy) level and DNA damage play a pivotal role in its development and progression. The aim of this study was to investigate the predictive strength of an oxidative stress, clinical biomarkers and total antioxidant status (TAS) in CAD patients to find the correlation of homocysteine, TOS and oxidative DNA damage with other clinical parameters. Methods: Sixty confirmed patients with CAD and 60 healthy individuals as control were included in this study. Different clinical and laboratory parameters were studied in blood samples obtained from patients and control subjects using commercially available biochemical kits and statistical software Results: As compared to healthy individuals, CAD patients had significantly higher concentrations of indices of oxidative stress: homocysteine (P=0.0001), total oxidative stress (TOS) (P=0.0001), serum cholesterol (P=0.04), low density lipoprotein cholesterol (LDL) (P=0.01), high density lipoprotein-cholesterol (HDL) (P=0.0001), and malondialdehyde (MDA) (P=0.001) than those of healthy individuals. Plasma homocysteine level and oxidative DNA damage were positively correlated with cholesterol, triglycerides, systolic blood pressure, urea, total protein and albumin (P values= 0.05). Both Hcy and oxidative DNA damage were negatively correlated with TAS and proteins. Conclusion: Coronary artery disease patients had a significant increase in homocysteine level and DNA damage due to increased oxidative stress. In conclusion, our study shows a significantly increase in lipid peroxidation, TOS, homocysteine and DNA damage in the erythrocytes of patients with CAD. A significant decrease level of HDL-C and TAS was observed only in CAD patients. Therefore these biomarkers may be useful diagnosis of patients with CAD and play an important role in the pathogenesis of CAD.

Keywords: antioxidants, coronary artery disease, DNA damage, homocysteine, oxidative stress, malondialdehyde, 8-Hydroxy-2’deoxyguanosine

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Authors: Viridiana Edith Ardura Perea, José Luis Bermúdez Alcocer

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The purpose of this paper is to establish the influence of shading on a Building Integrated Photovoltaic (BIPV) system´s performance in an urban context. The PV systems of the Science Center of Complexity (Centro de Ciencias de la Complejidad) Building based in the Main Campus of the National and Autonomous University of Mexico (UNAM) in Mexico City was taken as case study.  The PV systems are placed on the rooftop and on the south façade of the building.  The south-façade PV system, operating as sunshades, consists of two strings:  one at the ground floor and the other one at the first floor.  According to the building’s facility manager, the south-façade PV system generates 42% less electricity per kilowatt peak (kWp) installed than the one on the roof.  The methods applied in this study were Solar Radiation Analysis (SRA) simulations performed with the Insight 360 Plug-in from Revit 2018^® and an on-site measurement using specialized tools.  The results of the SRA simulations showed that the shading casted by the PV system placed on the first floor on top of the PV system of the ground floor decreases its solar incident radiation over 50%.  The simulation outcome was compared and validated to the measured data obtained from the on-site measurement.  In conclusion, the loss factor achieved from the shading of the PVs is due to the surroundings and the PV system´s own design.  The south-façade BIPV system’s deficient design generates critical losses on its performance and decreases its profitability.

Keywords: building integrated photovoltaics design, energy analysis software, shading losses, solar radiation analysis

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Authors: Elsa Marta Soares, Ana Rita Valente, Cristiana Rodrigues, Filipa Gonçalves

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Background: The assessment of feelings and attitudes of preschool children in relation to stuttering is crucial. Negative experiences can lead to anxiety, worry or frustration. To avoid the worsening of attitudes and feelings related to stuttering, it is important the early detection in order to intervene as soon as possible through an individualized intervention plan. Then it is important to have Portuguese instruments that allow this assessment. Aims: The aim of the present study is to realize the translation and adaptation of the Communication Attitude Test for Children in Preschool Age and Kindergarten (KiddyCat) for EP. Methodology: For the translation and adaptation process, a methodological study was carried out with the following steps: translation, back translation, assessment by a committee of experts and pre-test. This abstract describes the results of the first two phases of this process. The translation was accomplished by two bilingual individuals without experience in health and any knowledge about the instrument. One of them was an English teacher and the other one a Translator. The back-translation was conducted by two Senior Class Teachers that live in United Kingdom without any knowledge in health and about the instrument. Results and Discussion: In translation there were differences in semantic equivalences of various expressions and concepts. A discussion between the two translators, mediated by the researchers, allowed to achieve the consensus version of the translated instrument. Taking into account the original version of KiddyCAT the results demonstrated that back-translation versions were similar to the original version of this assessment instrument. Although the back-translators used different words, they were synonymous, maintaining semantic and idiomatic equivalences of the instrument’s items. Conclusion: This project contributes with an important resource that can be used in the assessment of feelings and attitudes of preschool children who stutter. This was the first phase of the research; expert panel and pretest are being developed. Therefore, it is expected that this instrument contributes to an holistic therapeutic intervention, taking into account the individual characteristics of each child.

Keywords: assessment, feelings and attitudes, preschool children, stuttering

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Authors: Halkiopoulos Constantinos, Gkintoni Evgenia, Koutsopoulou Ioanna, Antonopoulou Hera

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E-sports and e-gaming have emerged in recent years since the increase in internet use have become universal and e-gamers are the new reality in our homes. The excessive involvement of young adults with e-sports has already been revealed and the adverse consequences have been reported in researches in the past few years, but the issue has not been fully studied yet. The present research is conducted in Greece and studies the psychological profile of video game players and provides information on personality traits, habits and emotional status that affect online gamers’ behaviors in order to help professionals and policy makers address the problem. Three standardized self-report questionnaires were administered to participants who were young male and female adults aged from 19-26 years old. The Profile of Mood States (POMS) scale was used to evaluate people’s perceptions of their everyday life mood; the personality features that can trace back to people’s habits and anticipated reactions were measured by Eysenck Personality Questionnaire (EPQ), and the Trait Emotional Intelligence Questionnaire (TEIQue) was used to measure which cognitive (gamers’ beliefs) and emotional parameters (gamers’ emotional abilities) mainly affected/ predicted gamers’ behaviors and leisure time activities?/ gaming behaviors. Data mining techniques were used to analyze the data, which resulted in machine learning algorithms that were included in the software package R. The research findings attempt to designate the effect of personality traits, emotional status and emotional intelligence influence and correlation with e-sports, gamers’ behaviors and help policy makers and stakeholders take action, shape social policy and prevent the adverse consequences on young adults. The need for further research, prevention and treatment strategies is also addressed.

Keywords: e-sports, e-gamers, personality traits, POMS, emotional intelligence, data mining, R

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Authors: I. Kade Wiratama

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As a result of the significant growth of wind turbines in size, blade load control has become the main challenge for large wind turbines. Many advanced techniques have been investigated aiming at developing control devices to ease blade loading. Amongst them, trailing edge flaps have been proven as effective devices for load alleviation. The present study aims at investigating the potential benefits of flaps in enhancing the energy capture capabilities rather than blade load alleviation. A software tool is especially developed for the aerodynamic simulation of wind turbines utilising blades equipped with flaps. As part of the aerodynamic simulation of these wind turbines, the control system must be also simulated. The simulation of the control system is carried out via solving an optimisation problem which gives the best value for the controlling parameter at each wind turbine run condition. Developing a genetic algorithm optimisation tool which is especially designed for wind turbine blades and integrating it with the aerodynamic performance evaluator, a design optimisation tool for blades equipped with flaps is constructed. The design optimisation tool is employed to carry out design case studies. The results of design case studies on wind turbine AWT 27 reveal that, as expected, the location of flap is a key parameter influencing the amount of improvement in the power extraction. The best location for placing a flap is at about 70% of the blade span from the root of the blade. The size of the flap has also significant effect on the amount of enhancement in the average power. This effect, however, reduces dramatically as the size increases. For constant speed rotors, adding flaps without re-designing the topology of the blade can improve the power extraction capability as high as of about 5%. However, with re-designing the blade pretwist the overall improvement can be reached as high as 12%.

Keywords: flaps, design blade, optimisation, simulation, genetic algorithm, WTAero

Procedia PDF Downloads 324

Authors: Pouriya Darabiyan, Hadis Nazari, Kourosh Zarea, Saeed Ghanbari, Zeinab Raiesifar, Morteza Khafaie, Hanna Tuvesson

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Introduction Since the beginning of mobile phone addiction, alexithymia, depression, anxiety and stress have been stated as risk factors for Internet addiction, so this study was conducted with the aim of investigating the relationship between Alexithymia and Mobile phone addiction along with the mediating role of anxiety, stress and depression. Materials and methods In this descriptive-analytical and cross-sectional study in 2022, 412 students School of Nursing & Midwifery of Ahvaz Jundishapur University of Medical Sciences were included in the study using available sampling method. Data collection tools were: Demographic Information Questionnaire, Toronto Alexithymia Scale (TAS-20), Depression, Anxiety, Stress Scale (DASS-21) and Mobile Phone Addiction Index (MPAI). Frequency, Pearson correlation coefficient test and linear regression were used to describe and analyze the data. Also, structural equation models and path analysis method were used to investigate the direct and indirect effects as well as the total effect of each dimension of Alexithymia on Mobile phone addiction with the mediating role of stress, depression and anxiety. Statistical analysis was done by SPSS version 22 and Amos version 16 software. Results Alexithymia was a predictive factor for mobile phone addiction. Also, Alexithymia had a positive and significant effect on depression, anxiety and stress. Depression, anxiety and stress had a positive and significant effect on mobile phone addiction. Depression, anxiety and stress variables played the role of a relative mediating variable between Alexithymia and mobile phone addiction. Alexithymia through depression, anxiety and stress also has an indirect effect on Internet addiction. Conclusion Alexithymia is a predictive factor for mobile phone addiction; And the variables of depression, anxiety and stress play the role of a relative mediating variable between Alexithymia and mobile phone addiction.

Keywords: alexithymia, mobile phone, depression, anxiety, stress

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Authors: Chante Van Tonder, Bart Bossink, Chris Schachtebeck, Cecile Nieuwenhuizen

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Small and Medium-Sized Enterprises (SMEs) play a key role in national economies around the world, being contributors to economic and social well-being. Due to this, the success, growth and competitiveness of SMEs are critical. However, there are many factors that undermine this, such as resource constraints, poor information communication infrastructure (ICT), skills shortages and poor management. The Fourth Industrial Revolution offers new tools and opportunities such as digital transformation and business model innovation (BMI) to the SME sector to enhance its competitiveness. Adopting and leveraging digital technologies such as cloud, mobile technologies, big data and analytics can significantly improve business efficiencies, value proposition and customer experiences. Digital transformation can contribute to the growth and competitiveness of SMEs. However, SMEs are lagging behind in the participation of digital transformation. Extant research lacks conceptual and empirical research on how digital transformation drives BMI and the impact it has on the growth and competitiveness of SMEs. The purpose of the study is, therefore, to close this gap by developing and empirically validating a conceptual model to determine if SMEs are achieving BMI through digital transformation and how this is impacting the growth, competitiveness and overall business performance. An empirical study is being conducted on 300 SMEs, consisting of 150 South-African and 150 Dutch SMEs, to achieve this purpose. Structural equation modeling is used, since it is a multivariate statistical analysis technique that is used to analyse structural relationships and is a suitable research method to test the hypotheses in the model. Empirical research is needed to gather more insight into how and if SMEs are digitally transformed and how BMI can be driven through digital transformation. The findings of this study can be used by SME business owners, managers and employees at all levels. The findings will indicate if digital transformation can indeed impact the growth, competitiveness and overall performance of an SME, reiterating the importance and potential benefits of adopting digital technologies. In addition, the findings will also exhibit how BMI can be achieved in light of digital transformation. This study contributes to the body of knowledge in a highly relevant and important topic in management studies by analysing the impact of digital transformation on BMI on a large number of SMEs that are distinctly different in economic and cultural factors

Keywords: business models, business model innovation, digital transformation, SMEs

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Authors: Efthimios Kokkotos, Kostakis Marios, Beis Alexandros, Angelos Patakas, Antonios Avgeris, Vassilios Triantafyllidis

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H, C, and O stable isotope ratios were measured in different olive oils and table olives originating from different regions of Greece. In particular, the stable isotope ratios of different olive oils produced in the Lakonia region (Peloponesse – South Greece) from different varieties, i.e., cvs ‘Athinolia’ and ‘koroneiki’, were determined. Additionally, stable isotope ratios were also measured in different table olives (cvs ‘koroneiki’ and ‘kalamon’) produced in the same region (Messinia). The aim of this study was to provide sufficient isotope ratio data regarding each variety and region of origin that could be used in discriminative studies of oil olives and table olives produced by different varieties in other regions. In total, 97 samples of olive oil (cv ‘Athinolia’ and ‘koroneiki’) and 67 samples of table olives (cvs ‘kalmon’ and ‘koroneiki’) collected during two consecutive sampling periods (2021-2022 and 2022-2023) were measured. The C, H, and O isotope ratios were measured using Isotope Ratio Mass Spectrometry (IRMS), and the results obtained were analyzed using chemometric techniques. The measurements of the isotope ratio analyses were expressed in permille (‰) using the delta δ notation (δ=Rsample/Rstandard-1, where Rsample and Rstandardis represent the isotope ratio of sample and standard). Results indicate that stable isotope ratios of C, H, and O ranged between -28,5+0,45‰, -142,83+2,82‰, 25,86+0,56‰ and -29,78+0,71‰, -143,62+1,4‰, 26,32+0,55‰ in olive oils produced in Lakonia region from ‘Athinolia’ and ‘koroneiki ‘varieties, respectively. The C, H, and O values from table olives originated from Messinia region were -28,58+0,63‰, -138,09+3,27‰, 25,45+0,62‰ and -29,41+0,59‰,-137,67+1,15‰, 24,37+0,6‰ for ‘Kalamon’ and ‘koroneiki’ olives respectively. Acknowledgments: This research has been co-financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation, under the call RESEARCH—CREATE—INNOVATE (Project code: T2EDK-02637; MIS 5075094, Title: ‘Innovative Methodological Tools for Traceability, Certification and Authenticity Assessment of Olive Oil and Olives’).

Keywords: olive oil, table olives, Isotope ratio, IRMS, geographical origin

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Authors: Mahmoud F. Mohamadin, Ahmed Abdel Malek, Wessam Said

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Achieving energy efficient architecture in general, and in emerging countries in particular, is a challenging process that requires the contribution of various governmental, institutional, and individual entities. The rule of architectural design is essential in this process as it is considered as one of the earliest steps on the road to sustainability. Architectural firms have a moral and professional responsibility to respond to these challenges and deliver buildings that consume less energy. This study aims to evaluate the design processes and tools in practice of Egyptian architectural firms based on a limited survey to investigate if their processes and methods can lead to projects that meet the Egyptian Code of Energy Efficiency Improvement. A case study of twenty architectural firms in Cairo was selected and categorized according to their scale; large-scale, medium-scale, and small-scale. A questionnaire was designed and distributed to the firms, and personal meetings with the firms’ representatives took place. The questionnaire answered three main points; the design processes adopted, the usage of performance-based simulation tools, and the usage of BIM tools for energy efficiency purposes. The results of the study revealed that only little percentage of the large-scale firms have clear strategies for building energy efficiency in their building design, however the application is limited to certain project types, or according to the client request. On the other hand, the percentage of medium-scale firms is much less, and it is almost absent in the small-scale ones. This demonstrates the urgent need of enhancing the awareness of the Egyptian architectural design community of the great importance of implementing these methods starting from the early stages of the building design. Finally, the study proposed recommendations for such firms to be able to create a healthy built environment and improve the quality of life in emerging countries.

Keywords: architectural firms, emerging countries, energy efficiency, performance-based simulation tools

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Authors: Narae Yang, Hyun Kyung Sung, Seon Mi Shin, Hee Jung, Yong Ji Kim, Tae-Yong Park, Ho Yeon Go

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The aim of this study was to build base-line data for the Korean Medicine Doctors` Visiting School Program (KMDVSP) by analyzing a student health survey filled out by the students. Korean medicine doctors assigned to 20 middle and high schools in Seong-nam visited these schools eight times in five months. During each visit, the assigned doctors performed health consultations and Korean medicine treatment, and taught health education classes. 12115 students answered self-reported questionnaires about their own physical condition at the beginning of the program. In a question about pain, 7080(58%) reported having a headache, while 4048(33%) said they had a backache, nuchal pain/shoulder pain was reported by 5993(49%), dyspepsia was present in 2736(23%), rhinitis/sinusitis was reported by 4176(34%), coughing/dyspnea by 7102(59%), itching/skin rash by 2840(23%), and constipation was reported by 1091(9%), while 2264(18%) said they had diarrhea. Increased urinary frequency/feeling of residual urine was reported by 569 students (5%), and 3324(27%) said they had insomnia/fitful sleep/morning fatigue. When asked about menstruation, 4450(83%) of the female students reported irregular menstruation or said they experienced menstrual pain. Understanding the health condition of adolescent students is the starting point to determining national health policy to prevent various diseases in the future. We have developed the pilot project of KMDVSP and collected research about students’ health. Based on this data, further studies should be performed in order to develop a cooperative program between schools and the Korean medical center.

Keywords: korean medicine doctors` visiting school program(kmdvsp), student`s health condition, questionnaires, cohort study

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Authors: Muhammad Shahid Shah, Akram Maqbool, Samina Ashraf

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Since start of this century, world has adopted inclusion as a trend in special education. To meet the challenges of inclusion response, the Punjab government has developed a progressive policy to implement inclusive education. The objectives of this research were to analyze the administration and implementation process by consideration on the management, student’s admission process, screening and assessment, adaptations in curriculum and instruction along with an evaluation, government and nonprofit organizations support. The sample consisted of 50 schools both public and private with a total of 3000 students, 9 percent of which (270) were students with disabilities. Among all the students with disabilities, 63 percent (170) were male and 37 percent (100) were female. The concluded remarks regarding management revealed that a large number of inclusive schools was lacking in terms of developing a certain model for inclusion, including the managerial breakup of staff, the involvement of stakeholders, and conducted frequent meetings. Many of schools are not able to restructure their school organizations due to lack of financial resources, consultations, and backup. As for as student’s admission/identification/assessment was concerned, only 12 percent schools applied a selection process regarding student admission, half of which used different procedures for disable candidates. Approximately 5 percent of inclusive schools had modified their curriculum, including a variety of standards. In terms of instruction, 25 percent of inclusive schools reported that they modified their instructional process. Only a few schools, however, provided special equipment for students with visual impairment, physical impairment, speech and hearing problems, students with mild intellectual disabilities, and autism. In a student evaluation, more than 45 percent reported that test items, administration, time allocations, and students’ reports were modified. For the primary board examination conducted by the Education Department of Government of Punjab, this number decreased dramatically. Finally, government and nonprofit organizations support in the forms of funding, coaching, and facilities were mostly provided by provincial governments and by Ghazali Education Trust.

Keywords: inclusion, identification, assessment, funding, facilities, evaluation

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Authors: Yoftahe Nigussie Worku

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This report unveils a meticulous project focused on the design intricacies of a Fire Tube Boiler tailored for the efficient generation of saturated steam. The overarching objective is to produce 2000kg/h of saturated steam at 12-bar design pressure, achieved through the development of an advanced fire tube boiler. This design is meticulously crafted to harmonize cost-effectiveness and parameter refinement, with a keen emphasis on material selection for component parts, construction materials, and production methods throughout the analytical phases. The analytical process involves iterative calculations, utilizing pertinent formulas to optimize design parameters, including the selection of tube diameters and overall heat transfer coefficients. The boiler configuration incorporates two passes, a strategic choice influenced by tube and shell size considerations. The utilization of heavy oil fuel no. 6, with a higher heating value of 44000kJ/kg and a lower heating value of 41300kJ/kg, results in a fuel consumption of 140.37kg/hr. The boiler achieves an impressive heat output of 1610kW with an efficiency rating of 85.25%. The fluid flow pattern within the boiler adopts a cross-flow arrangement strategically chosen for inherent advantages. Internally, the welding of the tube sheet to the shell, secured by gaskets and welds, ensures structural integrity. The shell design adheres to European Standard code sections for pressure vessels, encompassing considerations for weight, supplementary accessories (lifting lugs, openings, ends, manhole), and detailed assembly drawings. This research represents a significant stride in optimizing fire tube boiler technology, balancing efficiency and safety considerations in the pursuit of enhanced saturated steam production.

Keywords: fire tube, saturated steam, material selection, efficiency

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Authors: Akanksha Gupta, Vishal Dubey

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In the Neoliberal era, there has been a much-talked discourse about urban issues that arise from a narrow approach of the single rationality of market-driven planning in Indian cities. More to this, India's urban planning is already jeopardized by the captious shortage of infrastructure, a cluster of incoherent governing bodies and implementation mechanism, leading cities to lie in the plethora of urban challenges. In this context, Allahabad (now known as Prayagraj) a city in North India is not an exception. Once known as the most planned splendid Colonial city of the British regime in India collapsed phenomenally because of the incompetent approach of planning machinery, straightforward market-driven accession and lack of attention on urban equity and sustainability. Particularly Civil Lines a Colonial neighbourhood, reached to the zenith of the glorified legacy of the Colonial era, transformed into filthy and congested urban form. Contextually this study contemplates and assesses the chronological episodes of major changes in land management reforms and policies under the ad hoc approach of political economy and land use planning which radically degraded the living environment in the present context. This study would empirically showcase the selected sample area detailing some of the major consequences in terms of gradual change in urban morphology, land use, and function. Here the method of study is primarily a qualitative study implying oral history and other historical methods to exhibit the idiom of planning conundrum. This subsequently reflects the repercussions translated into major issues like unclear land titles, encroachment, and unauthorized development and mushrooming of informal and squatter settlements. In nutshell, the study seeks to distinct out the limitations of the land reform and land management policies, which impacted the general degradation to the beautiful setting of Colonial neighbourhood. The Colonial legacy of Civil Lines now exists in the traces of history- memories of people, who once took pride in its serenity have now witnessed the transformation bit by bit till neo-liberal market forces completely swallow it.

Keywords: civil lines, land reforms, policies, urban challenges

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Authors: Azar Sharafianpor, Hossein Rassi, Fahimeh Nemati Mansur

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Cardiovascular diseases (CVD) are the most important cause of death in industrialized and developing countries such as Iran. The most important risk factors for the CVD, genetic factors and chronic infectious agents, such as Helicobacter pylori, can be mentioned. The TNFα gene is one of the most important anti-inflammatory cytokines that can affect the sensitivity, efficacy, and ability of the immune response to chronic infections. Some TNF-α gene polymorphisms, including the replacement of the G nucleotide G with A at position 308 in the promoter region of TNF-α, increase the transcription of cytokines in the target cells and thus predispose a person to chronic infections. This study examines the TNF-α 308 polymorphism and its association with Helicobacter pylori infection in this disease. This study was a case-control study in which 154 patients were examined as cases or patients with symptoms of myocardial infarction or angina and 160 as controls or healthy subjects. All of the subjects at different ages were given venous blood and age, BMI, cholesterol, LDL, and HDL were determined. DNA was extracted from the specimens, and the cagA gene from H. pylori and the TNF-α-308 polymorphism were determined by PCR in patients and healthy subjects. Statistical analysis was performed with Epi Info software. The results showed that the frequency of H. pylori infection in the patients and healthy group were 53.23% (82 out of 154) and 47.5% (76 out of 160). There was no significant difference in H. pylori outbreak between the two groups. The frequencies of TNF-α-308 genotype for GG, GA, and AA in patients were 0.17, 0.49, and 0.34, respectively, whereas for controls 0.47, 0.35, and 0.18 for GG, GA, and AA, respectively. The frequency of genotype analysis of TNF-α-308 polymorphisms in both patients and healthy groups showed that there was a significant difference in the frequency of genotypes and the AA genotype was higher in the affected individuals. Also, there was a significant relationship between the genotype and the contamination with H. pylori and changes in cholesterol, LDL, and HDL levels were observed. The results of the study indicate that H. pylori detection in individuals with AA genotype in people under 50 years of age can play an important role in early diagnosis and treatment of cardiovascular disease.

Keywords: Helicobacter pylori, TNFα gene, cardiovascular diseases, TNFα-308 polymorphism

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Authors: Arturo Daag

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The Philippine Institute of Volcanology and Seismology (PHIVOLCS) is enhancing its liquefaction hazard map towards a detailed probabilistic approach using SDS and geophysical data. Target sites for liquefaction assessment are public schools in Metro Manila. Since target sites are in highly urbanized-setting, the objective of the project is to conduct both non-destructive geotechnical studies using Screw Driving Testing (SDFS) combined with geophysical data such as refraction microtremor array (ReMi), 3 component microtremor Horizontal to Vertical Spectral Ratio (HVSR), and ground penetrating RADAR (GPR). Initial test data was conducted in liquefaction impacted areas from the Mw 6.1 earthquake in Central Luzon last April 22, 2019 Province of Pampanga. Numerous accounts of liquefaction events were documented areas underlain by quaternary alluvium and mostly covered by recent lahar deposits. SDS estimated values showed a good correlation to actual SPT values obtained from available borehole data. Thus, confirming that SDS can be an alternative tool for liquefaction assessment and more efficient in terms of cost and time compared to SPT and CPT. Conducting borehole may limit its access in highly urbanized areas. In order to extend or extrapolate the SPT borehole data, non-destructive geophysical equipment was used. A 3-component microtremor obtains a subsurface velocity model in 1-D seismic shear wave velocity of the upper 30 meters of the profile (Vs30). For the ReMi, 12 geophone array with 6 to 8-meter spacing surveys were conducted. Microtremor data were computed through the Factor of Safety, which is the quotient of Cyclic Resistance Ratio (CRR) and Cyclic Stress Ratio (CSR). Complementary GPR was used to study the subsurface structure and used to inferred subsurface structures and groundwater conditions.

Keywords: screw drive testing, microtremor, ground penetrating RADAR, liquefaction

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Authors: Sreto Boljevic

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Heating systems based on geothermal energy sources are becoming increasingly popular among commercial/community buildings as management of these buildings looks for a more efficient and environmentally friendly way to manage the heating system. The thermal energy supply of most European commercial/community buildings at present is provided mainly by energy extracted from natural gas. In order to reduce greenhouse gas emissions and achieve climate change targets set by the EU, restructuring in the area of thermal energy supply is essential. At present, heating and cooling account for approx... 50% of the EU primary energy supply. Due to its physical characteristics, thermal energy cannot be distributed or exchange over long distances, contrary to electricity and gas energy carriers. Compared to electricity and the gas sectors, heating remains a generally black box, with large unknowns to a researcher and policymaker. Ain literature number of documents address policies for promoting renewable energy technology to facilitate heating for residential/community/commercial buildings and assess the balance between heat supply and heat savings. Ground source heat pump (GSHP) technology has been an extremely attractive alternative to traditional electric and fossil fuel space heating equipment used to supply thermal energy for residential/community/commercial buildings. The main purpose of this paper is to create an algorithm using an analytical approach that could enable a feasibility study regarding the implementation of GSHP technology in community building with existing fossil-fueled heating systems. The main results obtained by the algorithm will enable building management and GSHP system designers to define the optimal size of the system regarding technical, environmental, and economic impacts of the system implementation, including payback period time. In addition, an algorithm is created to be utilized for a feasibility study for many different types of buildings. The algorithm is tested on a building that was built in 1930 and is used as a church located in Cork city. The heating of the building is currently provided by a 105kW gas boiler.

Keywords: GSHP, greenhouse gas emission, low-enthalpy, renewable energy

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Authors: Jun Ha Whang

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As New York City weathers a swelling 'affordability crisis' marked by rapid transformation in land development and urban culture, much of the associated scholarly debate has turned to questions of the underlying mechanisms of gentrification. Though classically approached from the point of view of urban planning, increasingly these questions have been addressed with an eye to understanding the role of cultural capital in neighborhood valuation. This paper will examine the construction of an artist-specific affordable housing development in the Spanish Harlem neighborhood of Manhattan in order to identify and discuss several cultural parameters of gentrification. This study’s goal is not to argue that the development in question, named Art space PS 109, straightforwardly increases or decreases the rate of gentrification in Spanish Harlem, but rather to study dynamics present in the construction of Art space PS 109 as a case study considered against the broader landscape of gentrification in New York, particularly with respect to the impact of artist communities on housing supply. In the end, what Art space PS 109 most valuably offers us is a reference point for a comparative analysis of affordable housing strategies currently being pursued within municipal government. Our study of Art space PS 109 has allowed us to examine a microcosm of the city’s response and evaluate its overall strategy accordingly. As a base line, the city must aggressively pursue an affordability strategy specifically suited to the needs of each of its neighborhoods. It must also conduct this in such a way so as not to undermine its own efforts by rendering them susceptible to the exploitative involvement of real estate developers seeking to identify successive waves of trendy neighborhoods. Though Art space PS 109 offers an invaluable resource for the city’s legitimate aim of preserving its artist communities, with such a high inclusion rate of artists from outside of the community the project risks additional displacement, strongly suggesting the need for further study of the implications of sites of cultural capital for neighborhood planning.

Keywords: artist housing, displacement, east Harlem, urban planning

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Authors: Yusuf Hussaini Atulukwu, Daramola Japheth, Tabitit S. Tabiti, Daramola Elizabeth Lara

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In view of the recent limitations faced by the township concerning poorly constructed and in some cases non - existence of drainage facilities that resulted into incessant flooding in some parts of the community poses threat to life,property and the environment. The research seeks to address this issue by showing the spatial distribution of drainage network in Bida Urban using Geographic information System techniques. Relevant features were extracted from existing Bida based Map using un-screen digitization and x, y, z, data of existing drainages were acquired using handheld Global Positioning System (GPS). These data were uploaded into ArcGIS 9.2, software, and stored in the relational database structure that was used to produce the spatial data drainage network of the township. The result revealed that about 40 % of the drainages are blocked with sand and refuse, 35 % water-logged as a result of building across erosion channels and dilapidated bridges as a result of lack of drainage along major roads. The study thus concluded that drainage network systems in Bida community are not in good working condition and urgent measures must be initiated in order to avoid future disasters especially with the raining season setting in. Based on the above findings, the study therefore recommends that people within the locality should avoid dumping municipal waste within the drainage path while sand blocked or weed blocked drains should be clear by the authority concerned. In the same vein the authority should ensured that contract of drainage construction be awarded to professionals and all the natural drainages caused by erosion should be addressed to avoid future disasters.

Keywords: drainage network, spatial, digitization, relational database, waste

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Authors: Bojana Ž. Bajić, Damjan G. Vučurović, Siniša N. Dodić, Jovana A. Grahovac, Jelena M. Dodić

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Biosynthesis of xanthan, a microbial polysaccharide produced by Xanthomonas campestris, is characterized by the possibility of using non-specific carbohydrate substrates, which means different waste effluents can be used as a basis for the production media. Potential raw material sources for xanthan production come from industries with large amounts of waste effluents that are rich in compounds necessary for microorganism growth and multiplication. Taking into account the amount of waste effluents generated by the bioethanol industry and the fact that it contains a high inorganic and organic load it is clear that they represent a potential environmental pollutants if not properly treated. For this reason, it is necessary to develop new technologies which use wastes and wastewaters of one industry as raw materials for another industry. The result is not only a new product, but also reduction of pollution and environmental protection. Biotechnological production of xanthan, which consists of using biocatalysts to convert the bioethanol waste effluents into a high-value product, presents a possibility for sustainable development. This research uses scientific software developed for the modeling of biotechnological processes in order to design a xanthan production plant from bioethanol production waste effluents as raw material. The model was developed using SuperPro Designer® by using input data such as the composition of raw materials and products, defining unit operations, utility consumptions, etc., while obtaining capital and operating costs and the revenues from products to create a baseline production plant model. Results from this baseline model can help in the development of novel biopolymer production technologies. Additionally, a detailed economic analysis showed that this process for converting waste effluents into a high value product is economically viable. Therefore, the proposed model represents a useful tool for scaling up the process from the laboratory or pilot plant to a working industrial scale plant.

Keywords: biotechnology, process model, xanthan, waste effluents

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Authors: Ruth Nsibirano

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Online mode of delivery in higher institutions of learning, popularly known in some circles as e-Learning or distance education is a new phenomenon that is steadily taking root in African universities but specifically at Makerere University. For slightly over a decade, the Department of Open and Distance Learning has been offering the first generation mode of distance education. In this, learning and teaching experiences were based on the use of hard copy materials circulated through postal services in a rather correspondence mode. There were more challenges to this including high dropout rates, limited support to the learners and sustainability issues. Fortunately, the Department was supported by the Norwegian Government through a NORHED grant to “leapfrog” to the fifth generation of distance education that makes more use of educational technologies and tools. The capacity of faculty staff was gradually enhanced through a series of training to handle the upgraded structure of fifth generation distance education. The trained staff was then tasked to develop modules befitting an online delivery mode, for use on the program. This paper will present attitudes, experiences of the course writers with a view of sharing the good practices that enabled them leap from e-faculty trainees to distinct online course writers. This perspective will hopefully serve as building blocks to enhance the capacity of other upcoming distance education programs in low capacity universities and also promote the uptake of e-Education on the continent and beyond. Methodologically the findings were collected through individual interviews with the 30 course writers. In addition, semi structured questionnaires were designed to collect data on the profile, challenges and lessons from the writers. Findings show that the attitudes of course writers on project supported activities are so much tagged to the returns from their committed efforts. In conclusion, therefore, it is strategically useful to assess and selectively choose which individual to nominate for involvement at the initial stages.

Keywords: distance education, online course content, staff attitudes, best practices in online learning

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Authors: Ram Chandra Sah

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Few years back, naturally a very beautiful country Nepal was facing a lot of problems related to the practice of open defecation (having no toilet) by almost 98% people of the country. Now, the scenario is changed. Government of Nepal set the target of achieving the situation of basic level sanitation (toilets) facilities by 2017 AD for which the Sanitation and Hygiene Master Plan (SHMP) was brought in 2011 AD with the major beauty as institutional set up formation, local formal authority leadership, locally formulated strategic plan; partnership, harmonized and coordinated approach to working; no subsidy or support at a blanket level, community and local institutions or organizations mobilization approaches. Now, the Open Defecation Free (ODF) movement in the country is at a full swing. The Sanitation and Hygiene Master Plan (SHMP) has clearly defined Total Sanitation which is accepted to be achieved if all the households of the related boundary have achieved the 6 indicators such as the access and regular use of toilet(s), regular use of soap and water at the critical moments, regular practice of use of food hygiene behavior, regular practice of use of water hygiene behavior including household level purification of locally available drinking water, maintenance of regular personal hygiene with household level waste management and the availability of the state of overall clean environment at the concerned level of boundary. Nepal has 3158 Village Development Committees (VDC's) in the rural areas. Amarapuri VDC was selected for the purpose of achieving Total Sanitation. Based on the SHMP; different methodologies such as updating of Village Water Sanitation and Hygiene Coordination Committee (V-WASH-CC), Total Sanitation team formation including one volunteer for each indicator, campaigning through settlement meetings, midterm evaluation which revealed the need of ward level 45 (5 for all 9 wards) additional volunteers, ward wise awareness creation with the help of the volunteers, informative notice boards and hoarding boards with related messages at important locations, management of separate waste disposal rings for decomposable and non-decomposable wastes, related messages dissemination through different types of local cultural programs, public toilets construction and management by community level; mobilization of local schools, offices and health posts; reward and recognition to contributors etc. were adopted for achieving 100 % coverage of each indicator. The VDC was in a very worse situation in 2010 with just 50, 30, 60, 60, 40, 30 percent coverage of the respective indicators and became the first VDC of the country declared with Total Sanitation. The expected result of 100 percent coverage of all the indicators was achieved in 2 years 10 months and 19 days. Experiences of Amarapuri were replicated successfully in different parts of the country and many VDC's have been declared with the achievement of Total Sanitation. Thus, Community Mobilized Total Sanitation Movement in Nepal has supported a lot for achieving a Total Sanitation situation of the country with a minimal cost and it is believed that the approach can be very useful for other developing or under developed countries of the world.

Keywords: community mobilized, open defecation free, sanitation and hygiene master plan, total sanitation

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Authors: Mikiale Gebreslase Gebremariam, Chai Huaqi, Tesfay Gebretsdkan Gebremichael, Dawit Nega Bekele

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In recent years, brownfield redevelopment projects (BRPs) have contributed to the overarching paradigm of the United Nations 2030 agendas. In the present circumstance, most developed nations adopted BRPs, an efficacious urban policy tool. However, in developing and some advanced countries, BRPs are lacking due to limitations of awareness, policy tools, and financial capability for cleaning up brownfield sites. For example, the growth and development of Ethiopian cities were achieved at the cost of poor urban planning, including no community consultations and excessive urbanization for future growth. The demand for land resources is more and more urgent as the result of an intermigration to major cities and towns for socio-economic reasons and population growth. In the past, the development mode of spreading major cities has made horizontal urbanizations stretching outwards. Expansion in search of more land resources, while the outer cities are growing, the inner cities are polluted by environmental pollution. It is noteworthy that the rapid development of cities has not brought about an increase in people's happiness index. Thus, the proposed management framework for managing brownfields in Ethiopia as a lesson to the developing nation facing similar challenges and growth will add immense value in solving the problems and give insights into brownfield land utilization. Under the umbrella of the grey incidence decision-making model and with the consideration of multiple stakeholders and tight environmental and economic constraints, the proposed management framework integrates different criteria from economic, social, environmental, technical, and risk aspects into the grey incidence decision-making model and gives useful guidance to manage brownfields in Ethiopia. Furthermore, it will contribute to the future development of the social economy and the missions of the 2030 UN sustainable development goals.

Keywords: Brownfields, environmental sustainability, Ethiopia, grey-incidence decision-making, sustainable urban development

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Authors: Daniel Botero, Oscar Rubiano, Pedro P. Barragan, Jaime Baron, Leonardo Rodriguez Perdomo, Jaime Rodriguez

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In the last decade interval training (IT) has gained importance when is compare with strength training (ST). However, there are few studies analyzing the impact of these training over the autonomic nervous system (ANS). This work has aimed to compare the activity of the autonomic nervous system, when is expose to an IT or ST indoor cycling mode. After approval by the ethics committee, a cross-over clinical trial with 22 healthy participants (age 21 ± 3 years) was implemented. The selection of participants for the groups with sequence force-interval (F-I) and interval-force (I-F) was made randomly with assignation of 11 participants for each group. The temporal series of heart rate was obtained before and after each training using the POLAR TEAM® heart monitor. The evaluation of the ANS was performed with spectral analysis of the heart rate variability (HRV) using the fast Fourier transform (Kubios software). A training of 8 weeks in each sequence (4 weeks with each training) with an intermediate period of two weeks of washout was implemented for each group. The power parameter of the HRV in the low frequency band (LF = 0.04-0.15Hz related to the sympathetic nervous system), high frequency (HF = 0.15-0.4Hz, related to the parasympathetic) and LF/HF (with reference to a modulation of parasympathetic over the sympathetic), were calculated. Afterward, the difference between the parameters before and after was realized. Then, to evaluate statistical differences between each training was implemented the method of Wellek (Wellek and Blettner, 2012, Medicine, 109 (15), 276-81). To determine the difference of effect over parasympathetic when FT and IT are used, the T test is implemented obtaining a T value of 0.73 with p-value ≤ 0.1. For the sympathetic was obtained a T of 0.33 with p ≤ 0.1 and for LF/HF the T was 1.44 with a p ≥ 0.1. Then, the carry over effect was evaluated and was not present. Significant changes over autonomic activity with strength or interval training were not observed. However, a modulation of the parasympathetic over the sympathetic can be observed. Probably, these findings should be explained because the sample is little and/or the time of training was insufficient to generate changes.

Keywords: autonomic nervous, force training, indoor cycling, interval training

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Authors: S. MacDougall-Davis, S. Wysling, R. Willmore

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Background: The application of good non-technical skills, also known as crew resource management (CRM), is central to the delivery of safe, effective healthcare. The authors have been running remote trauma courses for over 10 years, primarily focussing on developing participants’ CRM in time-critical, high-stress clinical situations. The course has undergone an iterative process over the past 10 years. We employ a number of experiential learning techniques for improving CRM, including small group workshops, military command tasks, high fidelity simulations with reflective debriefs, and a ‘flipped classroom’, where participants are asked to create their own simulations and assess and debrief their colleagues’ CRM. We created a randomised simulation study to assess the impact of our course on UK medical students’ CRM, both at an individual and a teams level. Methods: Sixteen students took part. Four clinical scenarios were devised, designed to be of similar urgency and complexity. Professional moulage effects and experienced clinical actors were used to increase fidelity and to further simulate high-stress environments. Participants were block randomised into teams of 4; each team was randomly assigned to one pre-course simulation. They then underwent our 5 day remote trauma CRM course. Post-course, students were re-randomised into four new teams; each was randomly assigned to a post-course simulation. All simulations were videoed. The footage was reviewed by two independent CRM-trained assessors, who were blinded to the before/after the status of the simulations. Assessors used the internationally validated team emergency assessment measure (TEAM) to evaluate key areas of team performance, as well as a global outcome rating. Prior to the study, assessors had scored two unrelated scenarios using the same assessment tool, demonstrating 89% concordance. Participants also completed pre- and post-course questionnaires. Likert scales were used to rate individuals’ perceived NTS ability and their confidence to work in a team in time-critical, high-stress situations. Results: Following participation in the course, a significant improvement in CRM was observed in all areas of team performance. Furthermore, the global outcome rating for team performance was markedly improved (40-70%; mean 55%), thus demonstrating an impact at Level 4 of Kirkpatrick’s hierarchy. At an individual level, participants’ self-perceived CRM improved markedly after the course (35-70% absolute improvement; mean 55%), as did their confidence to work in a team in high-stress situations. Conclusion: Our study demonstrates that with a short, cost-effective course, using easily reproducible teaching sessions, it is possible to significantly improve participants’ CRM skills, both at an individual and, perhaps more importantly, at a teams level. The successful functioning of multi-disciplinary teams is vital in a healthcare setting, particularly in high-stress, time-critical situations. Good CRM is of paramount importance in these scenarios. The authors believe that these concepts should be introduced from the earliest stages of medical education, thus promoting a culture of effective CRM and embedding an early appreciation of the importance of these skills in enabling safe and effective healthcare.

Keywords: crew resource management, non-technical skills, training, simulation

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Authors: Farah Syazwani Hilmy Zaki

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Background: Compared to adult cardiopulmonary resuscitation (CPR), high-quality research and evidence on pediatric CPR remain relatively scarce. This knowledge gap hinders the development of optimal guidelines and best practices for resuscitating children. Objectives: To explore pediatric intensive care unit (PICU) CPR current practices in PICU of Institut Jantung Negara (IJN) Malaysia. Method: The research employed a qualitative approach, utilising case study research design. The data collection process involved in-depth interviews and reviewing the Resuscitation Feedback Form. Purposive sampling was used to select two cases consisting of 14 participants. The study participants comprised a cardiologist, one anaesthetist, and twelve nurses. The data collected were transcribed and entered into NVivo software to facilitate theme development. Subsequently, thematic analysis was conducted to analyse the data. Findings: The study yielded key findings regarding the enhancement of PICU CPR practices. These findings are categorised into four themes, namely routine procedures, resuscitation techniques, team dynamics, and individual contributions. Establishment of cohesive team is crucial in facilitating the effectiveness of resuscitation. According to participants, lack of confidence, skills and knowledge presents significant obstacles to effective PICU CPR. Conclusion: The findings of this study indicate that the participants express satisfaction with the current practices of PICU CPR. However, the research also highlights the need for enhancements in various areas, including routine procedures, resuscitation techniques, as well as team and individual factors. Furthermore, it was suggested that additional training be conducted on the resuscitation process to enhance the preparedness of the medical team.

Keywords: cardiopulmonary resuscitation, feedback, nurses, pediatric intensive care unit

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