Search results for: integrated clinical environment

Authors: Adedayo Jeremiah Adeyekun, Samuel Oluwagbemiga Ishola

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This paper aimed to identify the significance of sustainability in the built environment, the economic and environmental importance to building and construction projects. Sustainability in the built environment has been a key objective of research over the past several decades. Sustainability in the built environment requires reconciliation between economic, environmental and social impacts of design and planning decisions made during the life cycle of a project from inception to termination. Planning for sustainability in the built environment needs us to go beyond our individual disciplines to consider the variety of economic, social and environmental impacts of our decisions in the long term. A decision to build a green residential development in an isolated location may pass some of the test of sustainability through its reduction in stormwater runoff, energy efficiency, and ecological sustainability in the building, but it may fail to be sustainable from a transportation perspective. Sustainability is important to the planning, design, construction, and preservation of the built environment; because it helps these activities reflect multiple values and considerations. In fact, the arts and sciences of the built environment have traditionally integrated values and fostered creative expression, capabilities that can and should lead the sustainability movement as society seeks ways to live in dynamic balance with its own diverse needs and the natural world. This research aimed to capture the state-of-the-art in the development of innovative sustainable design and planning strategies for building and construction projects. Therefore, there is a need for a holistic selection and implication approach for identifying potential sustainable strategies applicable to a particular project and evaluating the overall life cycle impact of each alternative by accounting for different applicable impacts and making the final selection among various viable alternatives.

Keywords: sustainability, built environment, planning, design, construction

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Authors: Safaa Mahmoud Issa

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Architecture, as an art and science of designing, has always been the medium to create environments that fulfill their users’ needs. It could create an inclusive environment that would not isolate any individual regardless of his /her disabilities. It could help, hopefully, in setting the strategies that provide a supportive, educational environment that would allow the inclusion of students with autism. Architects could help in the battle against this neuro-developmental disorder by providing the accommodating environment, at home and at school, in order to prevent institutionalizing these children. Through a theoretical approach and a review of literature, this study will explore and analyze best practices in autism-friendly, supportive, teaching environments. Additionally, it would provide the range of measures, and set the strategies to deal with the students with autism sensory peculiarities, and that, in order to allow them to concentrate in the school environment, and be able to succeed, and to be integrated as an important addition to society and the social mainstream. Architects should take into consideration the general guidelines for an autism-friendly built environment, and apply them to specific buildings systems. And that, as certain design elements have great effect on children’s behavior, by appropriating architecture to provide inclusive accommodating environments, the basis for equalization of opportunities is set allowing these individuals a better, normal, non-institutional life, as the discussion presented in this study would reveal.

Keywords: architecture, inclusion, students with autism, society mainstream

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Authors: Mamdouh Milad Adly Morkos

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Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health

Keywords: electromagnetic solar system, nano-material, nano pharmacology, pharmacovigilance, quantum theoryclinical simulation, education, pharmacology, simulation, virtual learning low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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Authors: Shilpa Murthy, Hazlina Binti Abu Bakar, Juliet Mathew, Chandrashekhar Thummala Hlly Sreerama Reddy, Pathiyil Ravi Shankar

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Simulation is defined as a technique that replaces or expands real experiences with guided experiences that interactively imitate real-world processes or systems. Simulation enables learners to train in a safe and non-threatening environment. For decades, simulation has been considered an integral part of clinical teaching and learning strategy in medical education. The several types of simulation used in medical education and the clinical environment can be applied to several models, including full-body mannequins, task trainers, standardized simulated patients, virtual or computer-generated simulation, or Hybrid simulation that can be used to facilitate learning. Simulation allows healthcare practitioners to acquire skills and experience while taking care of patient safety. The recent COVID pandemic has also led to an increase in simulation use, as there were limitations on medical student placements in hospitals and clinics. The learning is tailored according to the educational needs of students to make the learning experience more valuable. Simulation in the pre-clinical years has challenges with resource constraints, effective curricular integration, student engagement and motivation, and evidence of educational impact, to mention a few. As instructors, we may have more reliance on the use of simulation for pre-clinical students while the students’ confidence levels and perceived competence are to be evaluated. Our research question was whether the implementation of simulation-based learning positively influences preclinical medical students' confidence levels and perceived competence. This study was done to align the teaching activities with the student’s learning experience to introduce more low-fidelity simulation-based teaching sessions for pre-clinical years and to obtain students’ input into the curriculum development as part of inclusivity. The study was carried out at International Medical University, involving pre-clinical year (Medical) students who were started with low-fidelity simulation-based medical education from their first semester and were gradually introduced to medium fidelity, too. The Student Satisfaction and Self-Confidence in Learning Scale questionnaire from the National League of Nursing was employed to collect the responses. The internal consistency reliability for the survey items was tested with Cronbach’s alpha using an Excel file. IBM SPSS for Windows version 28.0 was used to analyze the data. Spearman’s rank correlation was used to analyze the correlation between students’ satisfaction and self-confidence in learning. The significance level was set at p value less than 0.05. The results from this study have prompted the researchers to undertake a larger-scale evaluation, which is currently underway. The current results show that 70% of students agreed that the teaching methods used in the simulation were helpful and effective. The sessions are dependent on the learning materials that are provided and how the facilitators engage the students and make the session more enjoyable. The feedback provided inputs on the following areas to focus on while designing simulations for pre-clinical students. There are quality learning materials, an interactive environment, motivating content, skills and knowledge of the facilitator, and effective feedback.

Keywords: low-fidelity simulation, pre-clinical simulation, students satisfaction, self-confidence

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Authors: Tuong Thi Van Thuy, Dao Van Toan, Nguyen Duc Phuc

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Mesenchymal stem cells (MSCs) were discovered in the 1970s with their unique properties of differentiation, immunomodulation, multiple secreting, and homing factors to injured organs. MSC-based therapies have emerged as a promising strategy for various diseases such as cancer, tissue regeneration, or immunologic/inflammatory-related diseases. This study evaluated the clinical application of MSCs for cancer therapy in trials registered on Clinical Trial as of July 2022. The results showed 40 clinical trials used MSCs in various cancer conditions. 62% of trials used MSCs for therapeutic purposes to minimize the side effects of cancer treatment. Besides, 38% of trials were focused on using MSCs as a therapeutic agent to treat cancer directly. Most trials (38/40) are ongoing phase I/II, and 2 are entering phase III. 84% of trials used allogeneic MSCs compared with 13% using autologous sources and 3% using both. 25/40 trials showed participants received a single dose of MSCs, while the most times were 12 times in a pancreatic cancer treatment trial. Conclusion: MSC-based therapy for cancer in clinical trials should be applied to (1) minimize the side effects of oncological treatments and (2) directly affect the tumor via selectively delivering anti-cancer payloads to tumor cells. Allogeneic MSCs are a priority selected in clinical cancer therapy.

Keywords: mesenchymal stem cells, MSC-based therapy, cancer condition, cancer treatment, clinical trials

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Authors: Erkan Rehber, Hasan Vural, Sule Turhan

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It is a fact that food is a vital need of human beings. As a consumer, everyone has the right to access adequate and safe food. There are considerable development to establish quality standards and schemes to have safe foods and sustainable agriculture alternatives to protect natural resources and environment to reach this target. Recently, there is also a remarkable development in integration and combination of these efforts. Food Safety and Sustainable Agriculture Forum organized in 2014, Beijing shows that it is a global awareness more than being an individual view. Eventually, quality standards, assurance systems applied to conventional agriculture has to be applied to sustainable agriculture alternatives to have a holistic sustainable food chain from seed to fork. All actors of the whole food system from farmer to ultimate consumers, along with the state, have to work together meeting this big challenge.

Keywords: integrated safe, food safety, sustainable food system, consumer

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Authors: Siti N. I. Mat Kamal, Othman Ibrahim, Mehrbakhsh Nilashi, Jafalizan M. Jali

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The use of digital forensics (DF) is nowadays essential for law enforcement agencies to identify analysis and interpret the digital information derived from digital sources. In Malaysia, the engagement of Malaysian Law Enforcement Agencies (MLEA) with this new technology is not evenly distributed. To investigate the factors influencing the adoption of DF in Malaysia law enforcement agencies’ operational environment, this study proposed the initial theoretical framework based on the integration of technology organization environment (TOE), institutional theory, and human organization technology (HOT) fit model. A questionnaire survey was conducted on selected law enforcement agencies in Malaysia to verify the validity of the initial integrated framework. Relative advantage, compatibility, coercive pressure, normative pressure, vendor support and perceived technical competence of technical staff were found as the influential factors on digital forensics adoption. In addition to the only moderator of this study (agency size), any significant moderating effect on the perceived technical competence and the decision to adopt digital forensics by Malaysian law enforcement agencies was found insignificant. Thus, these results indicated that the developed integrated framework provides an effective prediction of the digital forensics adoption by Malaysian law enforcement agencies.

Keywords: digital forensics, digital forensics adoption, digital information, law enforcement agency

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Authors: Eman Tadros, Natasha Finney

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The following case study involving a high-conflict, Children’s Services Bureau (CSB) referred couple is analyzed and reviewed through an integrated lens of structural family therapy and dialectical behavior therapy. In structural family therapy, normal family development is not characterized by a lack of problems, but instead by families’ having developed a functional structure for dealing with their problems. Whereas, in dialectical behavioral therapy normal family development can be characterized by having a supportive and validating environment, where all family members feel a sense of acceptance and validation for who they are and where they are in life. The clinical case conceptualization highlights the importance of conceptualizing how change occurs within a therapeutic setting. In the current case study, the couple did not only experience high-conflict, but there were also issues of substance use, health issues, and other complicating factors. Clinicians should view their clients holistically and tailor their treatment to fit their unique needs. In this framework, change occurs within the family unit, by accepting each member as they are, while at the same time working together to change maladaptive familial structures.

Keywords: couples, dialectical behavior therapy, high-conflict, structural family therapy

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Authors: Zhuang Hou, Xiaolei Cao

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The general public and medical professionals recognized the importance of accurately measuring and storing blood oxygen levels and heart rate during the COVID-19 pandemic. The demand for accurate contactless devices was motivated by the need for cross-infection reduction and the shortage of conventional oximeters, partially due to the global supply chain issue. This paper evaluated a contactless mini program HealthyPai’s heart rate (HR) and oxygen saturation (SpO2) measurements compared with other wearable devices. In the HR study of 185 samples (81 in the laboratory environment, 104 in the real-life environment), the mean absolute error (MAE) ± standard deviation was 1.4827 ± 1.7452 in the lab, 6.9231 ± 5.6426 in the real-life setting. In the SpO2 study of 24 samples, the MAE ± standard deviation of the measurement was 1.0375 ± 0.7745. Our results validated that HealthyPai utilizing the Integrated Image Deep Learning Solution (IIDLS) framework, can accurately measure HR and SpO2, providing the test quality at least comparable to other FDA-approved wearable devices in the market and surpassing the consumer-grade and research-grade wearable standards.

Keywords: remote photoplethysmography, heart rate, oxygen saturation, contactless measurement, mini program

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Authors: Nasrin Mohammadhasani, Rosa Angela Fabio

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The attention to relevance information is the key element for learning. Otherwise, Attention Deficit Hyperactivity Disorder (ADHD) students have a fuzzy visual pattern that prevents them to attention and remember learning subject. The present study aimed to test the hypothesis that the presence of a pedagogical agent can effectively support ADHD learner's attention and learning outcomes in a multimedia learning environment. The learning environment was integrated with a pedagogical agent, named Koosha as a social peer. This study employed a pretest and posttest experimental design with control group. The statistical population was 30 boys students, age 10-11 with ADHD that randomly assigned to learn with/without an agent in well designed environment for mathematic. The results suggested that experimental and control groups show a significant difference in time when they participated and mathematics achievement. According to this research, using the pedagogical agent can enhance learning of ADHD students by gaining and guiding their attention to relevance information part on display, so it can be considered as asocial cue that provides theme cognitive supports.

Keywords: attention, computer assisted instruction, multimedia learning environment, pedagogical agent

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Authors: Tomohiko Utsuki

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Currently, brain resuscitation becomes increasingly important due to revising various clinical guidelines pertinent to emergency care. In brain resuscitation, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) is required for stabilizing physiological state of brain, and is described as the essential treatment points in many guidelines of disorder and/or disease such as brain injury, stroke, and encephalopathy. Thus, an integrated control system of BT, ICP, and CBF will greatly contribute to alleviating the burden on medical staff and improving treatment effect in brain resuscitation. In order to develop such a control system, models related to BT, ICP, and CBF are required for control simulation, because trial and error experiments using patients are not ethically allowed. A static model of cerebral blood circulation from intracranial arteries and vertebral artery to jugular veins has already constructed and verified. However, it is impossible to represent the pooling of blood in blood vessels, which is one cause of cerebral hypertension in this model. And, it is also impossible to represent the pulsing motion of blood vessels caused by blood pressure change which can have an affect on the change of cerebral tissue pressure. Thus, a dynamic model of cerebral blood circulation is constructed in consideration of the elasticity of the blood vessel and the inertia of the blood vessel wall. The constructed dynamic model was numerically analyzed using the normal data, in which each arterial blood flow in cerebral blood circulation, the distribution of blood pressure in the Circle of Willis, and the change of blood pressure along blood flow were calculated for verifying against physiological knowledge. As the result, because each calculated numerical value falling within the generally known normal range, this model has no problem in representing at least the normal physiological state of the brain. It is the next task to verify the accuracy of the present model in the case of disease or disorder. Currently, the construction of a migration model of extracellular fluid and a model of heat transfer in cerebral tissue are in progress for making them parts of an integrated model of brain physiological state, which is necessary for developing an future integrated control system of BT, ICP and CBF. The present model is applicable to constructing the integrated model representing at least the normal condition of brain physiological state by uniting with such models.

Keywords: dynamic model, cerebral blood circulation, brain resuscitation, automatic control

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Authors: Abiola Falilat Ibraheem, Akinyimika Sowunmi, Valerie Otti

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Background: Introduction of innovative cancer clinical trials to Nigeria is a critical step in addressing global inequities of cancer burden. Low health and clinical trial literacy among Nigerian patients have been sighted as a significant barrier to ensuring that patients enrolled in clinical trials are truly informed. Video intervention has been shown to be the most proactive method to improving patient’s clinical trial knowledge. In the US, video interventions have been successful at improving education about cancer clinical trials among minority patients. Thus, this study aimed to apply and adapt video interventions addressing attitudinal barriers peculiar to Nigerian patients. Methods: A hospital-based representative mixed-method study was conducted at the Lagos State University Teaching Hospital (LASUTH) from July to December 2020, comprising of cancer patients aged 18 and above. Patients were randomly selected during every clinic day, of which 63 patients volunteered to participate in this study. We first administered a cancer literacy survey to determine patients’ knowledge about clinical trials. For patients who had prior knowledge, a pre-intervention test was administered, after which a 15-minute video (attitudes and intention to enroll in therapeutic clinical trials (AIET)) to improve patients’ knowledge, perception, and attitudes towards clinical trials was played, and then ended by administering a post-intervention test to the patients. For patients who had no prior knowledge, the AIET video was played for them, followed by the post-intervention test. Results: Out of 63 patients sampled, 43 (68.3%) had breast cancer. On average, patients agreed to understand their cancer diagnosis and treatment very well. 84.1% of patients had never heard about cancer clinical trials, and 85.7% did not know what cancer clinical trials were. There was a strong positive relationship (r=0.916) between the pretest and posttest, which means that the intervention improved patients’ knowledge, perception, and attitudes about cancer clinical trials. In the focus groups, patients recommended adapting the video in Nigerian settings and representing all religions in order to address trust in local clinical trialists. Conclusion: Due to the small size of patients, change in clinical trial knowledge was not statistically significant. However, there is a trend suggesting that culturally adapted video interventions can be used to improve knowledge and perception about cancer clinical trials.

Keywords: clinical trials, culturally targeted intervention, patient education, video intervention

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Authors: Yichen Lin, Hsiao-Han Chen, Chi-Chen Jan

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Since 1990, the research area of Integrated Marketing Communications (IMC) has been presented from a different perspective. With advances in information technology and the rise of consumer consciousness, businesses are in a competitive environment. There is an urgent need to adopt more profitable and effective integrated marketing strategies to increase core competitiveness. The goal of the company's sustainable management is to increase consumers' willingness to purchase and to maximize profits. This research uses six aspects of IMC, which includes awareness integration, unified image, database integration, customer-based integration, stakeholders-based integration, and evaluation integration to examine the role of marketing strategies in the strengths and weaknesses of the six components of integrated marketing communications, their effectiveness, the most important components and the most important components that need improvement. At the same time, social media such as FaceBook, Instagram, Youtube, Line, or even TikTok have become marketing tools which firms adopt them more and more frequently in the marketing strategy. In the end of 2019, the outbreak of COVID-19 did really affect the global industries. Lockdown policies also accelerated closure of brick-mentor stores worldwide. Online purchases rose dramatically. Hence, the effectiveness of online marketing will be essential to maintain the business. This study uses multiple-case studies to extend the effects of social media and IMC. Moreover, the study would also explore the differences of social media and IMC during COVID-19. Through literature review and multiple-case studies, it is found that using social media combined with IMC did really help companies expand their business and make good connections with stakeholders. One of previous studies also used system theory to explore the interrelationship among Integrated Marketing Communication, collaborative marketing, and global brand building. Even during pandemic, firms could still maintain the operation and connect with their customers more tightly.

Keywords: integration marketing communications, multiple-case studies, social media, system theory

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Authors: Innocent Pangapanga, Eric Mungatana

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Fall armyworm (FAW) (Spodoptera frugiperda), an invasive lepidopteran pest, has caused substantial yield loss since its first detection in September 2016, thereby threatening the farm productivity food security and poverty reduction initiatives in Malawi. Several stakeholders, including households, have adopted chemical pesticides to control FAW without accounting for its costs on welfare, health and the environment. Thus, this study has used panel data endogenous switching regression model to investigate the impact of FAW and the integrated pest management (IPM) –related practices on-farm productivity and food security. The study finds that FAW substantively reduces farm productivity by seven (7) percent and influences the adoption of IPM –related practices, namely, intercropping, mulching, and agroforestry, by 6 percent, ceteris paribus. Interestingly, multiple adoptions of the IPM -related practices noticeably increase farm productivity by 21 percent. After accounting for potential endogeneity through the endogenous switching regression model, the IPM practices further demonstrate tenfold more improvement on food security, implying the role of the IPM –related practices in containing the effect of FAW at the household level.

Keywords: hunger, invasive fall army worms, integrated pest management practices, farm productivity, endogenous switching regression

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Authors: Petra Dilling

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This study examines the market reaction to the publication of integrated reports for a sample of 316 global companies for the reporting year 2018. Applying event study methodology, we find significant cumulative average abnormal returns (CAARs) after the publication date. To ensure robust estimation resultsthe three-factor model, according to Fama and French, is used as well as a market-adjusted model, a CAPM and a Frama-French model taking GARCH effects into account. We find a significant positive CAAR after the publication day of the integrated report. Our results suggest that investors react to information provided in the integrated report and that they react differently to the annual financial report. Furthermore, our cross-sectional analysis confirms that companies with a significant positive cumulative average abnormal show certain characteristic. It was found that European companies have a higher likelihood to experience a stronger significant positive market reaction to their integrated report publication.

Keywords: integrated report, event methodology, cumulative abnormal return, sustainability, CAPM

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Authors: Anabel Fernandez, Leandro Rodriguez-Ortiz, Rosa RodríGuez

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Due to the negative impact of fossil fuels, renewable energies are promising sources to limit global temperature rise and damage to the environment. Also, the development of technology is focused on obtaining energetic products from renewable sources. In this study, a thermodynamic model including Exergy balance and a subsequent Life Cycle Assessment (LCA) were carried out for four subsystems of the integrated gasification-combustion of pinewood. Results of exergy analysis and LCA showed the process feasibility in terms of exergy efficiency and global energy efficiency of the life cycle (GEELC). Moreover, the energy return on investment (EROI) index was calculated. The global exergy efficiency resulted in 67 %. For pretreatment, reaction, cleaning, and electric generation subsystems, the results were 85, 59, 87, and 29 %, respectively. Results of LCA indicated that the emissions from the electric generation caused the most damage to the atmosphere, water, and soil. GEELC resulted in 31.09 % for the global process. This result suggested the environmental feasibility of an integrated gasification-combustion system. EROI resulted in 3.15, which determinates the sustainability of the process.

Keywords: exergy analysis, life cycle assessment (LCA), renewability, sustainability

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Authors: Avishkar Gawade, Omkar Bansode, Ketan Bhambure, Bhargav Deore

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In recent year wide range of business intelligence technology have been applied to different area in order to support decision making process BI enables extraction of knowledge from data store. BI tools usually used in public health field for financial and administrative purposes.BI uses a dashboard in presentation stage to deliver information to information to end users.In this paper,we intend to analyze some open source BI tools on the market and their applicability in the clinical sphere taking into consideration the general characteristics of the clinical environment.A pervasive BI platform was developed using a real case in order to prove the tool viability.Analysis of various BI Tools in done with the help of several parameters such as data security,data integration,data quality reporting and anlaytics,performance,scalability and cost effectivesness.

Keywords: CDSS, EHR, business intelliegence, tools

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Authors: Mella Ismelina Farma Rahayu

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Environmental problems could not be separated from unethical human perspectives and behaviors toward the environment. There is a fundamental error in the philosophy of people’s perspective about human and nature and their relationship with the environment, which in turn will create an inappropriate behavior in relation to the environment. The aim of this study is to investigate and to understand the ethics of the environment in the context of humans interacting with the environment by using the hermeneutic approach. The related theories and concepts collected from literature review are used as data, which were analyzed by using interpretation, critical evaluation, internal coherence, comparisons, and heuristic techniques. As a result of this study, there will be a picture related to the interaction of human and environment in the perspective of environmental ethics, as well as the problems of the value of ecological justice in the interaction of humans and environment. We suggest that the interaction between humans and environment need to be based on environmental ethics, in a spirit of mutual respect between humans and the natural world.

Keywords: environment, environmental ethics, interaction, value

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Authors: Muhammad Afzal, Muhammad Sajjad

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Climate change has become a global environmental challenge and it has affected the world’s economy. Its impact is widespread across all major sectors of the economy i.e. agriculture, industry, and services sectors. This study attempts to measure the long run as well as the short-run dynamic between energy; environment and economic growth by using Autoregressive Distributed Lag (ARDL) bound testing approach at aggregate as well as sectoral level. We measured the causal relationship between electricity consumption, fuel consumption, CO₂ emission, and real Gross Domestic Product (GDP) for the period of 1980 to 2016 for Pakistan. Our co-integration results reveal that all the variables are co-integrated at aggregate as well as at sectoral level. Electricity consumption shows two-way casual relation at for industry, services and aggregate level. The inverted U-Curve hypothesis tested the relationship between greenhouse gas emissions and per capita GDP and results supported the Environment Kuznet Curve (EKC) hypothesis. This study cannot ignore the importance of energy for economic growth but prefers to focus on renewable and green energy to pave on the trajectory of development.

Keywords: climate change, economic growth, energy, environment

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Authors: Suin Seo, Sung-Il Cho

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Background: The use of mobile apps for smoking cessation has grown exponentially in recent years. Yet, there were limited researches which evaluated the quality of smoking cessation apps to our knowledge. In most cases, a clinical practice guideline which is focused on clinical physician was used as an evaluation tool. Objective: The objective of this study was to develop a user-centered measure for quality of mobile smoking cessation apps. Methods: A literature search was conducted to identify articles containing explicit smoking cessation guideline for smoker published until January 2018. WHO’s guide for tobacco users to quit was adopted for evaluation tool which assesses smoker-oriented contents of smoking cessation apps. Compared to the clinical practice guideline, WHO guideline was designed for smokers (non-specialist). On the basis of existing criteria which was developed based on 2008 clinical practice guideline for Treating Tobacco Use and Dependence, evaluation tool was modified and developed by an expert panel. Results: There were five broad categories of criteria that were identified including five objective quality scales: enhancing motivation, assistance with a planning and making quit attempts, preparation for relapse, self-efficacy, connection to smoking. Enhancing motivation and assistance with planning and making quit attempts were similar to contents of clinical practice guideline, but preparation for relapse, self-efficacy and connection to smoking (environment or habit which reminds of smoking) only existed on WHO guideline. WHO guideline had more user-centered elements than clinical guideline. Especially, self-efficacy is the most important determinant of behavior change in accordance with many health behavior change models. With the WHO guideline, it is now possible to analyze the content of the app in the light of a health participant, not a provider. Conclusion: The WHO guideline evaluation tool is a simple, reliable and smoker-centered tool for assessing the quality of mobile smoking cessation apps. It can also be used to provide a checklist for the development of new high-quality smoking cessation apps.

Keywords: smoking cessation, evaluation, mobile application, WHO, guideline

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Authors: Chien-Yeh Hsu, Yuan-Ching Chiang, Zi-Jie Chien, Sih-Li Chen

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In this study, a field experiment and performance analysis of air-tunnel heat exchanger integrated with water-filled raft foundation of residential building were performed. In order to obtain better performance, conventional applications of air-tunnel inevitably have high initial cost or issues about insufficient installation space. To improve the feasibility of air tunnel heat exchanger in high-density housing, an integrated system consisting of air pipes immersed in the water-filled raft foundation was presented, taking advantage of immense amount of water and relatively stable temperature in raft foundation of building. The foundation-integrated air tunnel was applied to a residential building located in Yilan, Taiwan, and its thermal performance was measured in the field experiment. The results indicated that the cooling potential of integrated system was close to the potential of soil-based EAHE at 2 m depth or deeper. An analytical model based on thermal resistance method was validated by measurement results, and was used to carry out the dimensioning of foundation-integrated air tunnel. The discrepancies between calculated value and measured data were less than 2.7%. In addition, the return-on-investment with regard to thermal performance and economics of the application was evaluated. Because the installation for air tunnel is scheduled in the building foundation construction, the utilization of integrated system spends less construction cost compare to the conventional earth-air tunnel.

Keywords: air tunnel, ground heat exchanger, raft foundation, residential building

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Authors: Nora Arbaoui, Rachid Tadili, Ilham Ihoume

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To improve the climatic conditions and increase production in the greenhouse during the winter season under the Mediterranean climate, this thesis project proposes a design of an integrated and autonomous solar system for heating, cooling, and conservation of production in an agricultural greenhouse. To study the effectiveness of this system, experiments are conducted in two similar agricultural greenhouses oriented north-south. The first greenhouse is equipped with an active solar system integrated into the double glazing of the greenhouse’s roof, while the second greenhouse has no system, it serves as a controlled greenhouse for comparing thermal and agronomic performance The solar system allowed for an average increase in the indoor temperature of the experimental greenhouse of 6°C compared to the outdoor environment and 4°C compared to the control greenhouse. This improvement in temperature has a favorable effect on the plants' climate and subsequently positively affects their development, quality, and production.

Keywords: solar system, agricultural greenhouse, heating, cooling, storage, drying

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Authors: Ghanem Al-Ghamdi

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African Horse Sickness causes significant challenges to horse practitioners and owners in Africa and possibly in certain locations in the Arab Pensila. The aim of this work was to observe a hot spot of epidemic in Al-Baha, Southwestern of Saudi Arabia that could be AHS. A five year-old horse farm that had eight horses with no history of clinical problems was visited in late October 2014. In August 2014, horses showed clinical signs of severe pain, congestion of mucus membranes, foam oozing of the nose, recumbency, difficult breath and ultimately death. The course of the disease averaged 2 days. The farm had no previous history of this episode. Other animals including camel, sheep reside the same farm sharing feeding and water sources however no obvious similar clinical problems were noticed among the two species. Five horses showed the clinical disease and all horses were lost. Veterinary help was not available for diagnosis or treatment. A follow up visit to the farm after one year indicated that the three remaining horses were healthy but were relocated to a different facility out the Al-Baha Region. The most likely cause of such clinical problem is African Horse Sickness, however clinical exam and sampling of other horses in the region is absolute must as well as examining arthropods.

Keywords: African horse sickness, horses, Al-Baha, Saudi Arabia

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Authors: Lazzat M. Zhamaliyeva, Nurgul A. Abenova, Gauhar S. Dilmagambetova, Ziyash Zh. Tanbetova, Moldir B. Ahmetzhanova, Tatyana P. Ostretcova, Aliya A. Yegemberdiyeva

Abstract:

Introduction: There are many reasons for the weak training of family doctors in Kazakhstan: the unified national educational program is not focused on competencies, the role of a general practitioner (GP) is not clear, poor funding for the health care and education system, outdated teaching and assessment methods, inefficient management. We highlight two issues in particular. Firstly, academic teachers of family medicine (FM) in Kazakhstan do not practice as family doctors; most of them are narrow specialists (pediatricians, therapists, surgeons, etc.); they usually hold one-time consultations; clinical mentors from practical healthcare (non-academic teachers) do not have the teaching competences, and the vast majority of them are also narrow specialists. Secondly, clinical sites (polyclinics) are unprepared for general practice and do not follow the principles of family medicine; residents do not like to be in primary health care (PHC) settings due to the chaos that is happening there, as well as due to the lack of the necessary equipment for mastering and consolidating practical skills. Aim: We present the concept of the family physicians’ training office (FPTO), which is being created as a friendly learning environment for young general practitioners and for the involvement of academic teachers of family medicine in the practical work and innovative development of PHC. Methodology: In developing the conceptual framework and identifying practical activities, we drew on literature and expert input, and interviews. Results: The goal of the FPTO is to create a favorable educational and clinical environment for the development of the FM residents’ competencies, in which the residents with academic teachers and clinical mentors could understand and accept the principles of family medicine, improve clinical knowledge and skills, and gain experience in improving the quality of their practice in scientific basis. Three main areas of office activity are providing primary care to the patients, improving educational services for FM residents and other medical workers, and promoting research in PHC and innovations. The office arranges for residents to see outpatients at least 50% of the time, and teachers of FM departments at least 1/4 of their working time conduct general medical appointments next to residents. Taking into account the educational and scientific workload, the number of attached population for one GP does not exceed 500 persons. The equipment of the office allows FPTO workers to perform invasive and other manipulations without being sent to other clinics. In the office, training for residents is focused on their needs and aimed at achieving the required level of competence. International methodologies and assessment tools are adapted to local conditions and evaluated for their effectiveness and acceptability. Residents and their faculty actively conduct research in the field of family medicine. Conclusions: We propose to change the learning environment in order to create teams of like-minded people, to unite residents and teachers even more for the development of family medicine. The offices will also invest resources in developing and maintaining young doctors' interest in family medicine.

Keywords: educational environment, family medicine residents, family physicians’ training office, primary care research

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Authors: Yutong Wan, John N. Wood

Abstract:

Introduction: SCN9A encoded Nav1.7 is an ideal therapeutic target with minimal side effects for the pharmaceutical industry because SCN9A variants can cause both human gains of function pain-related mutations and loss of function pain-free mutations. This study reviews the clinical effectiveness of existing Nav1.7 inhibitors, which theoretically should be powerful analgesics. Methods: A systematic review is conducted on the effectiveness of current Nav1.7 blockers undergoing clinical trials. Studies were mainly extracted from PubMed, U.S. National Library of Medicine Clinical Trials, World Health Organization International Clinical Trials Registry, ISRCTN registry platform, and Integrated Research Approval System by NHS. Only studies with full text available and those conducted using double-blinded, placebo controlled, and randomised designs and reporting at least one analgesic measurement were included. Results: Overall, 61 trials were screened, and eight studies covering PF 05089771 (Pfizer), TV 45070 (Teva & Xenon), and BIIB074 (Biogen) met the inclusion criteria. Most studies were excluded because results were not published. All three compounds demonstrated insignificant analgesic effects, and the comparison between PF 05089771 and pregabalin/ibuprofen showed that PF 05089771 was a much weaker analgesic. All three drug candidates only have mild side effects, indicating the potentials for further investigation of Nav1.7 antagonists. Discussion: The failure of current Nav1.7 small molecule inhibitors might attribute to ignorance of the key role of endogenous systems in Nav1.7 null mutants, the lack of selectivity and blocking potency, and central impermeability. The synergistic combination of analgesic drugs, a recent UCL patent, combining a small dose of Nav1.7 blockers and opioids or enkephalinase inhibitors dramatically enhanced the analgesic effects. Conclusion: The current clinical testing Nav1.7 blockers are generally disappointing. However, the newer generation of Nav1.7 targeting analgesics has overcome the major constraints of its predecessors.

Keywords: chronic pain, Nav1.7 blockers, SCN9A, systematic review

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Authors: Valerie A. Conrade

Abstract:

Introduction: A large body of literature suggests patients who complete fecal immunochemical testing (FIT) kits are likely to identify colorectal cancer sooner than those who do not complete FIT kits. Background: Patients who do not participate in preventative measures such as the FIT kit are at a higher risk of colorectal cancer growing unnoticed. The objective was to see if the method the principal investigator (PI) uses to educate clinical staff on the importance of FIT kit administration provides an increased amount of FIT kit dissemination to patients post clinical education. Methodologies: Data collection via manual tallies took place before and after the clinical staff was educated on the importance of FIT kits. Results: The results showed an increase in FIT kit dissemination post clinical staff education. Through enhanced instruction to the clinical staff regarding the importance of FIT kits, expanding their knowledge on preventative measures to detect colorectal cancer positively impacted nurses and, in turn, their patients.

Keywords: colon cancer, education, fecal immunochemical testing, nursing

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Authors: Kajingulu Malandala, Ranganai Edmore

Abstract:

The asymmetric Laplace distribution (ADL) is commonly used as the likelihood function of the Bayesian quantile regression, and it offers different families of likelihood method for quantile regression. Notwithstanding their popularity and practicality, ADL is not smooth and thus making it difficult to maximize its likelihood. Furthermore, Bayesian inference is time consuming and the selection of likelihood may mislead the inference, as the Bayes theorem does not automatically establish the posterior inference. Furthermore, ADL does not account for greater skewness and Kurtosis. This paper develops a new aspect of quantile regression approach for count data based on inverse of the cumulative density function of the Poisson, binomial and Delaporte distributions using the integrated nested Laplace Approximations. Our result validates the benefit of using the integrated nested Laplace Approximations and support the approach for count data.

Keywords: quantile regression, Delaporte distribution, count data, integrated nested Laplace approximation

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Authors: C. W. F. Che Wan Putra, M. Alshawi, M. S. Al Ahbabi, M. Jabakhanji

Abstract:

Much of the waste that is generated throughout the life-cycle of a building is mainly related to project stakeholders not having access to information that others have created. This results in waste and high costs. Over the past decade, however, the industry reacted to these challenges by adopting effective procurement approaches, such as partnering and design and build, to improve collaboration and communication among projects’ stakeholders. Most recently, there is a focus on creating and reusing digital project information of stakeholders throughout the life-cycle to facilitate the exchange of information among partners. This shift is based around BIM (Building Information Modelling) and collaborative environment (IPD). The power of collaborative BIM goes beyond improving efficiency. Sustainability, perhaps the most important challenge for the design and construction community, is at the intersection of BIM and collaborative project delivery, drawing strength from both. Due to these benefits, a research study has been carried out to investigate the need of BIM and IPD, on a large scale construction project which is procured on a traditional approach, i.e. design-bid-build. A qualitative research work including a semi-structured interview with project partners was conducted on a typical project in the UAE, whereby the selected project suffered from severe delays and cost overrun. This paper aims to bring about clear evidence to what most likely to happen to a typical construction project in spite of employing very good consultants, project manager and contractors and how these problems could have been avoided if BIM and IPD were deployed.

Keywords: building information modelling (BIM), integrated project delivery (IPD), collaborative environment, case study

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Authors: Thanakorn Thanawat, Nomjit Nualnetr

Abstract:

Background and Purpose: In Thailand, rice farmers have the most prevalence of low back pain when compared with other manual workers. Exercises have been suggested to be a principal part of treatment programs for low back pain. However, the programs should be tailored to an individual’s readiness to change categorized by a behavioral approach. This study aimed to evaluate a difference between the responses of rice farmers with chronic low back pain who received an exercise program integrated with the transtheoretical model of behavior change (TTM) and those of the comparison group regarding severity of pain and trunk muscle endurance. Materials and Methods: An 8-week exercise program was conducted to rice farmers with chronic low back pain who were randomized to either the TTM (n=62, 52 woman and 10 men, mean age ± SD 45.0±5.4 years) or non-TTM (n=64, 53 woman and 11 men, mean age ± SD 44.7±5.4 years) groups. All participants were tested for their severity of pain and trunk (abdominal and back) muscle endurance at baseline (week 0) and immediately after termination of the program (week 8). Data were analysed by using descriptive statistics and student’s t-tests. The results revealed that both TTM and non-TTM groups could decrease their severity of pain and improve trunk muscle endurance after participating in the 8-week exercise program. When compared with the non-TTM group, however, the TTM showed a significantly greater increase in abdominal muscle endurance than did the non-TTM (P=0.004, 95% CI -12.4 to -2.3). Conclusions and Clinical Relevance: An exercise program integrated with the TTM could provide benefits to rice farmers with chronic low back pain. Future studies with a longitudinal design and more outcome measures such as physical performance and quality of life are suggested to reveal further benefits of the program.

Keywords: chronic low back pain, transtheoretical model, rice farmers, exercise program

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Authors: Chuanbo Xu, Xinying Li, Gejirifu De, Yunna Wu

Abstract:

Energy Internet (EI) is a new form that deeply integrates the Internet and the entire energy process from production to consumption. The assessment of energy efficient performance is of vital importance for the long-term sustainable development of EI project. Although the newly proposed fuzzy integrated cloud evaluation algorithm considers the randomness of uncertainty, it relies too much on the experience and knowledge of experts. Fortunately, the enrichment of EI data has enabled the utilization of data-driven methods. Therefore, the main purpose of this work is to assess the energy efficient of park-level EI by using a combination of a data-driven method with the fuzzy integrated cloud evaluation algorithm. Firstly, the indicators for the energy efficient are identified through literature review. Secondly, the artificial neural network (ANN)-based data-driven method is employed to cluster the values of indicators. Thirdly, the energy efficient of EI project is calculated through the fuzzy integrated cloud evaluation algorithm. Finally, the applicability of the proposed method is demonstrated by a case study.

Keywords: energy efficient, energy internet, data-driven, fuzzy integrated evaluation, cloud model

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