Search results for: rehabilitation team

Authors: Sultana Razia

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The number of children whose social, communication and behavior pattern is affected due to mental and developmental conditions is on the rise. Most of these conditions develop to uncontrollable levels because of ignorance and unaware about their child’s condition. The many myths surrounding mental or developmental conditions are a major cause of families of affected children to develop bitterness and to shy off from seeking appropriate help in time. Several early intervention programs have been put in place, and the number of beneficiaries of these programs is increasing by the day. This research seeks to look into early intervention programs and their effectiveness. The purpose of this study was to investigate the effect of early therapeutic intervention for the children with autism spectrum disorder. Participants were 140 children with autism spectrum disorder from Autism Corner in a selected rehabilitation center of Bangladesh. This study included children who are at age of 18-month to 36-month and who were taking occupational therapy and speech and language therapy from the autism center. They were primarily screened using M-CHAT; however, children with other physical disability or medical conditions excluded. 3-months interventions of 6 sessions per week are a minimum of 45-minutes long per session, one to one interaction followed by parent-led structured home-based therapy were provided. The results indicated that early intensive therapeutic intervention improve understanding, social skills and sensory skills. It can be concluded that therapeutic early intervention a positive effect on diminishing symptoms of Autism Spectrum Disorder.

Keywords: M-CHAT, ASD, sensory cheeklist, OT

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Authors: Lormaine Anne Branzuela, Elysa Largo, Julie Marisol Pagalilauan, Neil Concibido, Monet Concepcion Detras

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Energy is a necessity both for the people and the country. The demand for energy is continually increasing, but the supply is not doing the same. The reopening of the Bataan Nuclear Power Plant (BNPP) in the Philippines has been circulating in the media for the current time. The general public has been hesitant in accepting the inclusion of nuclear energy in the Philippine energy mix due to perceived unsafe conditions of the plant. This study evaluated the possible operations of a nuclear power plant, which is of the same type as the BNPP, considering the safety of the workers, the public, and the environment using a Process Hazard Analysis (PHA) method. What-If Technique was utilized to identify the hazards and consequences on the operations of the plant, together with the level of risk it entails. Through the brainstorming sessions of the PHA team, it was found that the most critical system on the plant is the primary system. Possible leakages on pipes and equipment due to weakened seals and welds and blockages on coolant path due to fouling were the most common scenarios identified, which further caused the most critical scenario – radioactive leak through sump contamination, nuclear meltdown, and equipment damage and explosion which could result to multiple injuries and fatalities, and environmental impacts.

Keywords: process safety management, process hazard analysis, what-If technique, nuclear power plant

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Authors: Harry Burton, Alexios Dimitrios Iliadis, Neil Jones, Aaron Saini, Nicola Bystrzonowski, Alexandros Vris, Georgios Pafitanis

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This article portrays the authors’ experience with a complex lower limb bone and soft tissue defect, following chronic osteomyelitis and pathological fracture, which was managed by the multidisciplinary orthoplastic team. The decision for functional amputation versus limb salvage was deemed necessary, enhanced by the principles of “spares parts” in reconstructive microsurgery. This case describes a successful use of the osteocutaneous distal tibia turn-over fillet flap that allowed ‘lowering the level of the amputation’ from a through knee to the conventional level of a below-knee amputation to preserve the knee joint function. This case demonstrates the value of ‘spare-parts’ surgery principles and how these concepts refine complex orthoplastic approaches when limb salvage is not possible to enhance function. The osteocutaneous distal tibia turn-over fillet flap is a robust technique for modified BKA reconstructions that provides sufficient bone length to achieve a tough, sensate stump and functional knee joint.

Keywords: osteocutaneous flap, fillet flap, spare-parts surgery, Below knee amputation

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Authors: Saeed Alshahri

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Introduction: Our study aims to estimate the characteristics & causes of TSCI at King Fahad Medical City (KFMC) in Riyadh city in order to hypothesize strategy for primary prevention of traumatic spinal cord injury. Method: Cross-sectional, retrospective study was conducted on all TSCI patients who aged 14 and above and who were admitted to rehabilitation center of King Fahad Medical City from January 2012 to December 2015. Furthermore, a descriptive analysis was conducted while considering factors including age, gender, marital status, educational level and causes of injury and characteristics of injury. Results: Total of 216 patients were admitted during this period, mean age was 28.94, majority of patients were male (86.5%), 71.7% of total patients were high school level of education or less, 68% were single, RTA was the main cause with 90.7% and the main result of TSCI was complete paraplegia 37%. Furthermore, statistically, we found that males are at a low risk of having incomplete paraplegia compared to female (p = 0.035, RRR=0.35). Conclusion: The rate of TSCI related to RTA has increased in Saudi Arabia in previous years despite the government’s efforts to decrease RTA. It’s clear that we need TSCI registry data developed on the basis of international data standards to have a clear idea about the exact etiology of TSCI in Saudi Arabia. This will assist in planning for primary prevention.

Keywords: traumatic spinal cord injury, road traffic accident, Saudi Arabia, spinal cord injury

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Authors: Yi-Chu Liu, Hsiu-Huei Hung, Li-Hui Yang, Ming-Jyh Chen

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introduction: To promote environmental sustainability, the hospital formed a corporate volunteer team in 2016 to build the Green Experiential Education Center. Our green creation center utilizes attic space to achieve sustainability objectives such as energy efficiency and carbon reduction. Other than executing sustainable plans, the center emphasizes experiential education. We invite our community to actively participate in building a sustainable, economically viable environment. Since 2020, the China Medical University Hospital has provided medical care to the Tgbin community in Taichung City's Heping District. The tribe, primarily composed of Atayal people, the elderly comprise 18% of the total population, and these families' per capita income is relatively low compared to Taiwanese citizens elsewhere. Purpose / Methods: With the experiences at the Green Experiential Education Center, CMUH team identifies the following objectives: Create an aquaponic system to supply vulnerable local households with food. Create a solar renewable energy system to meet the electricity needs of vulnerable local households. Promote the purchase of green electricity certificates to reduce the hospital's carbon emissions and generate additional revenue for the local community. Materials and Methods: In March 2020, we visited the community and installed The aquaponic system in January 2021. CMUH spent 150,000NT (approximately 5000US dollars) in March 2021 to build a 100-square-meter aquaponic system. The production of vegetables and fish caught determines the number of vulnerable families that can be supported. The aquaponics system is a kind of Low energy consumption and environmentally friendly production method, and can simultaneously achieve energy saving, water saving, and fertilizer saving .In September 2023, CMUH will complete a solar renewable energy system. The system will cover an area of 308 square meters and costs approximately NT$240,000 (approximately US$8,000). The installation of electricity meters will enable statistical analysis of power generation. And complete the Taiwan National Renewable Energy Certificate application process. The green electricity certificate will be obtained based on the monthly power generation from the solar renewable energy system. Results: I Food availability and access are crucial considering the remote location and aging population. By creating a fish and vegetable symbiosis system, the vegetables and catches produced will enable economically disadvantaged families to lower food costs. In 2021 and 2022, the aquaponic system produced 52 kilograms of vegetables and 75 kilograms of catch. The production ensures the daily needs of 8 disadvantaged families. Conclusions: The hospital serves as a fortress for public health and the ideal setting for corporate social responsibility. China Medical University Hospital and the Green Experiential Education Center work to strengthen ties with rural communities and offer top-notch specialty medical care. We are committed to assisting people in escaping poverty and hunger as part of the 2030 Sustainable Development Goals.

Keywords: environmental education, sustainability, energy conservation, carbon emissions, rural area development

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Authors: Akbar Darouie, Mamak Joulaie

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In regard of phonological skills development importance and its influence on other aspects of language, this study has been performed. Determination of some phonological indexes in children with hearing impairment and comparison with hearing children was the objective. A sample of convenience was selected from a rehabilitation center and a kindergarten in Karaj, Iran. Participants consisted of 12 hearing impaired and 12 hearing children (age range: 5 years and 6 months to 6 years and 6 months old). Hearing impaired children suffered from severe to profound hearing loss while three of them were cochlear implanted and the others were wearing hearing aids. Conversational speech of these children was recorded and 50 first utterances were selected to analyze. Percentage of consonant correct (PCC) and vowel correct (PVC), initial and final consonant omission error, cluster consonant omission error and syllabic structure variety were compared in two groups. Data were analyzed with t test (version 16th SPSS). Comparison between PCC and PVC averages in two groups showed a significant difference (P< 0/01). There was a significant difference about final consonant emission error (P<0/001) and initial consonant emission error (P<0/01) too. Also, the differences between two groups on cluster consonant omission were significant (P<0/001). Therefore, some changes were seen in syllabic structures in children with hearing impairment compared to typical group. This study demonstrates some phonological differences in Farsi language between two groups of children. Therefore, it seems, in clinical practices we must notice this issue.

Keywords: hearing impairment, phonology, vowel, consonant

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Authors: Redha M. Elhuni

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This paper presents an analysis of the essential characteristics of the TQM philosophy by comparing the work of five notable authors in the field. A framework is produced which gather the identified TQM enablers under the well-known operations management dimensions of process, business and people. These enablers are linked with sustainable development via balance scorecard type economic and non-economic measures. In order to capture a picture of Libyan Company’s efforts to implement the TQM, a questionnaire survey is designed and implemented. Results of the survey are presented showing the main differentiating factors between the sample companies, and a way of assessing the difference between the theoretical underpinning and the practitioners’ undertakings. Survey results indicate that companies are experiencing much difficulty in translating TQM theory into practice. Only a few companies have successfully adopted a holistic approach to TQM philosophy, and most of these put relatively high emphasis on hard elements compared with soft issues of TQM. However, where companies can realize the economic outputs, non- economic benefits such as workflow management, skills development and team learning are not realized. In addition, overall, non-economic measures have secured low weightings compared with the economic measures. We believe that the framework presented in this paper can help a company to concentrate its TQM implementation efforts in terms of process, system and people management dimensions.

Keywords: TQM, balance scorecard, EFQM excellence model, oil sector, Libya

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Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale

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Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.

Keywords: COPD, pulmonary hypertension, chronic lung disease, India

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Authors: Emma Garcia-Meca, Jennifer Martinez-Ferrero, Camino Ramon Llorens

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This paper provides insights into how narcissistic Chief Executive Officers (CEOs) influence the presence of women in top management teams (TMT). We also study whether a CEO's power and gender and the gender diversity of the firm's board moderate the relationship between CEO narcissism and TMT gender diversity. Our results reveal that narcissistic CEOs are less likely to support women in TMTs, confirming that CEO personality traits influence team structure. Further results suggest that this aversion increases as the CEO's power grows when female representation on boards decreases and when the CEO is a woman. This paper integrates theories that use the social psychology and upper echelon theories, offering a greater understanding of how CEO personality traits influence the structure of firms. We also contribute to the knowledge about how different governance characteristics can moderate the influence of narcissistic CEOs on women in TMTs, highlighting the relevance of governance traits that increase the effect of narcissism. The results demonstrate different female behavior toward promoting TMT gender equality depending on the specific position of women in the firm's hierarchy and their psychological attributes. We find that women directors support social identity values, and narcissistic female CEOs act like queen bees.

Keywords: gender diversity, board, corporate governance, female CEO, management

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Authors: S. Bagur, S. Verger, B. Mut

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Early childhood intervention (ECI) is understood as the set of interventions aimed at the child population with developmental disorders or disabilities from 0 to 6 years of age, the family, and the environment. Under the principles of family-centred practices, the members of the family nucleus are direct agents of intervention. Thus, the multidisciplinary team of professionals should work to improve family empowerment and the level of parenting skills. The aim of the present study is to analyse descriptively and differentially the level of parenting skills and family empowerment of parents using ECI services during the foster care phase. There were 135 families participating in the study. Three questionnaires were completed. The results show that the employment situation, the age of the child receiving an intervention, and the number of children in the family nucleus or the professional carrying out the intervention are variables that have a differential impact on different items of empowerment and parenting skills. The results are discussed and future lines of research are proposed, with the understanding that the initial analysis of the variables of empowerment and parenting skills may be predictors for the improvement of child development and family well-being. In addition, it is proposed to identify and analyse professional training in order to be able to adapt early care practices without depending on the discipline of the professional of reference.

Keywords: developmental disabilities, early childhood intervention, family empowerment, parenting skills

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Authors: Abdelaadim Bidaoui

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As one of the most important linguistic inquiries, the topic of the intertwined relationship between language, the mind, and the world has attracted many scholars. In the fifties, Sapir and Whorf advocated the hypothesis that language shapes our cultural realities as an early attempt to provide answers to this linguistic inquiry. Later, discursive psychology views the linguistic behavior as “a dynamic form of social practice which constructs the social world, individual selves and identity.” (Jorgensen & Phillips 2002, 118). Discursive psychology also considers discourse as a trigger of social action and change. Building on discursive psychology and motivation theory, this paper examines the impact of linguistic behavior of the Moroccan coach Walid Reggragui on the Moroccan team’s exceptional performance in Qatar 2022 Soccer World Cup. The data used in the research is based on interviews conducted by the Moroccan coach prior and during the World Cup. Using a discourse analysis of the linguistic behavior of Reggragui, this paper shows how the linguistic behavior of Reggragui provided support for the three psychological needs: sense of belonging, competence, and autonomy. As any CDA research, this paper uses a triangulated theoretical framework that includes language, cognition and society.

Keywords: critical discourse analysis, motivation theory, discursive psychology, linguistic behavior

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Authors: A. Elbaz, K. Spang

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Infrastructure projects are often subjected to delays and cost overruns and mistakenly described as unsuccessful projects. These projects have many peculiarities such as public attention, impact on the environment, subjected to special regulations, etc. They also deal with several stakeholders with different motivations and face unique risks. With this in mind we need to reconsider our approach to manage them, define their success factors and implement these success factors. Infrastructure projects are not only lacking a unified meaning of project success or a definition of success factors, but also a clear method to implement these factors. This paper investigates this gap and introduces a concept to implement success factors in an efficient way, taking into consideration the specific characteristics of infrastructure projects. This concept consists of six enablers such as project organization, project team, project management workflow, contract management, communication and knowledge transfer and project documentations. These enablers allow other success factors to be efficiently implemented in projects. In conclusion, this paper provides project managers as well as company managers with a tool to define and implement success factors efficiently in their projects, along with upgrading their assets for the coming projects. This tool consists of processes and validated checklists to ensure the best use of company resources and knowledge. Due to the special features of infrastructure projects this tool will be tested in the German infrastructure market. However, it is meant to be adaptable to other markets and industries.

Keywords: infrastructure projects, operative success factors, project success, success factors, transportation projects

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Authors: Francis Edum-Fotwe, Tony Thorpe, Charles Afetornu

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Risk perception informs the outcome of how issues are responded to in either solving or overcoming a problem or improving a situation. Risk perception is established to be affected by some key factors reflecting in the varying ways in which work is done as well as the level of efficiency achieved. These factors potentially would influence risk perception to different extents. Such that if these factors are said to determine risk perception, how does a change in any affect risk perception. Since the ability to address risk is influenced by risk perception, establishing and developing awareness of that perception should enable construction professionals to make viable decisions. Any act to improve the construction industry cannot be overemphasised, considering its contribution to national development. A survey questionnaire was conducted in Ghana to elicit data that measures the risk perception and the essential factors as well as the necessary demographics of the respondents, who are construction professionals. This study finds out the sensitivity of the critical factors of risk perception. It uses the Relative Importance Index analysis tool to investigate the differential effect of these essential factors on risk perception, such that a slight change in a factor makes a significant change in risk perception, having established that it is influenced by essential factors. The findings can lead to policy formation for employers on the prioritisation factors to undertake to improve the risk perception of employees. Other areas in which this study can be useful in team formation for sensitive and complex projects where efficient risk management is critical.

Keywords: construction industry, risk, risk management, risk perception

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Authors: Natasha Goh, Sebastian Brown

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Purpose: This case report describes an unusual presentation of uveal melanoma. Method: Case notes, imaging, and histopathological specimen were reviewed for this case report. Result: The patient is a 62-year-old lady of Chinese heritage who had been receiving follow-up at the eye clinic of a tertiary hospital. She had a longstanding history of poor vision in her right eye after sustaining trauma to the eye at age 3. She was found to have a carotid-cavernous sinus fistula in the right eye in 2009 and underwent stenting in China. Unfortunately, this was unsuccessful and resulted in a painful blind eye. She had represented with headaches, worsening eye pain, and ptosis in Sydney in 2016. Her CT angiogram showed a calcified vascular structure in the orbit and globe, and she was offered a digital subtraction angiography by the neurosurgical team, which she ultimately declined. She had since been followed up at the eye clinic for the pthisical eye. Due to chronic ocular pain and recurrent conjunctivitis, the decision was made for an evisceration in 2021. The specimen was sent for routine histopathological examination and returned positive for uveal melanoma. The patient was subsequently referred to a melanoma center for further follow-up, which comprised serial imaging and radiotherapy treatment. Conclusion: Clinicians should bear in mind that uveal melanomas may present in a longstanding phthisical eye and in patients with no or little apparent risk factors.

Keywords: uveal melanoma, pthisical eye, carotid cavernous fistula, uveal melanoma risk factors

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Authors: Debalina Datta, Pratyaypratim Datta, Kunal Kanti Majumdar

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Introduction: In India 8.1% of total population is elderly. The standard of living and meaningfulness of life are indirectly measured by assessing quality of life of elderly. So, it is important to improve quality of life. Quality of life is an individual’s understanding of his/ her life situation with respect to his/ her values and cultural context as well as in relation to his/her goals, expectations and concerns. The present study was planned to assess the quality of life of geriatric people in urban West Bengal, India. Materials and methods: It was a community based cross sectional observational study conducted among people aged 60 years and above in Kolkata and Sonarpur region of West Bengal, India. Data collection was done by house to house visit using Quality of Life- BREF questionnaire (WHOQOL-BERF) developed by WHO. Analysis of quality of life of physical, psychological, social relationship and environmental domain was done using SPSS (version 16.0). Results: Transformed score (0-100 scale) was used for each domain. Mean of physical, psychological, social relationship and environmental domain were found to be 42.25, 40.84, 39.62 and 48.36 respectively. There was no significant difference in score between Kolkata and Sonarpur people in any domain except social relationship domain, where people living at Sonarpur scored significantly better. Conclusion: Rehabilitation of old age people can be done by improving their quality of life. Social interaction with people of all ages, allowing them to take important family decision, engaging them in different social activities can help a lot.

Keywords: quality of life, elderly, Urban West Bengal, India

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Authors: Mitzi S. Brammer

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Given that the cultural make-up of programs of study in institutions of higher learning is becoming increasingly diverse, much has been written about cultural diversity from a university-level perspective. However, there are little data in the way of specific programs and how they address inclusive practices when teaching and working with marginalized populations. This research study aimed to discover baseline knowledge and attitudes of health sciences faculty, instructional staff, and students related to inclusive teaching/learning and interactions. Quantitative data were collected via an anonymous online survey (one designed for students and another designed for faculty/instructional staff) using a web-based program called Qualtrics. Quantitative data were analyzed amongst the faculty/instructional staff and students, respectively, using descriptive and comparative statistics (t-tests). Additionally, some participants voluntarily engaged in a focus group discussion in which qualitative data were collected around these same variables. Collecting qualitative data to triangulate the quantitative data added trustworthiness to the overall data. The research team analyzed collected data and compared identified categories and trends, comparing those data between faculty/staff and students, and reported results as well as implications for future study and professional practice.

Keywords: inclusion, higher education, pedagogy, equity, diversity

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Authors: Kanagarajah Ravishankar

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This paper describes a study performed for a project featuring an elevated steel bridge structure supported by various types of foundation systems. This project focused on rehabilitation or redesign of a portion of the bridge substructures founded on caisson foundations. The study that this paper focuses on is the evaluation of foundation and soil stiffnesses and interactions between the existing caissons and proposed foundations. The caisson foundations were founded on top of rock, where the depth to the top of rock varies from approximately 50 to 140 feet below ground surface. Based on a comprehensive investigation of the existing piers and caissons, the presence of ASR was suspected from observed whitish deposits on cracked surfaces as well as internal damages sustained through the entire depth of foundation structures. Reuse of existing piers and caissons was precluded and deemed unsuitable under the earthquake condition because of these defects on the structures. The proposed design of new foundations and substructures which was selected ultimately neglected the contribution from the existing caisson and pier columns. Due to the complicated configuration between the existing caisson and the proposed foundation system, three-dimensional finite element method (FEM) was employed to evaluate soil-structure interaction (SSI), to evaluate the effect of the existing caissons on the proposed foundations, and to compare the results with conventional group analysis. The FEM models include separate models for existing caissons, proposed foundations, and combining both.

Keywords: soil-structure interaction, foundation stiffness, finite element, seismic design

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Authors: Fawaz A. Binsarra, Halim Boussabaine

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The notion of complexity science has been attracting the interest of researchers and professionals due to the need of enhancing the efficiency of understanding complex systems dynamic and structure of interactions. In addition, complexity analysis has been used as an approach to investigate complex systems that contains a large number of components interacts with each other to accomplish specific outcomes and emerges specific behavior. The design process is considered as a complex action that involves large number interacted components, which are ranked as design tasks, design team, and the components of the design process. Those three main aspects of the building design process consist of several components that interact with each other as a dynamic system with complex information flow. In this paper, the goal is to uncover the complex structure of information interactions in building design process. The Investigating of Royal Institute of British Architects Plan Of Work 2013 information interactions as a case study to uncover the structure and building design process complexity using network analysis software to model the information interaction will significantly enhance the efficiency of the building design process outcomes.

Keywords: complexity, process, building desgin, Riba, design complexity, network, network analysis

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Authors: K. Chethana, A. S. Guru Prasad, S. N. Omkar, B. Vadiraj, S. Asokan

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This paper describes an ab-initio design, development and calibration results of an Optical Sensor Ground Reaction Force Measurement Platform (OSGRFP) for gait and geriatric studies. The developed system employs an array of FBG sensors to measure the respective ground reaction forces from all three axes (X, Y and Z), which are perpendicular to each other. The novelty of this work is two folded. One is in its uniqueness to resolve the tri axial resultant forces during the stance in to the respective pure axis loads and the other is the applicability of inherently advantageous FBG sensors which are most suitable for biomechanical instrumentation. To validate the response of the FBG sensors installed in OSGRFP and to measure the cross sensitivity of the force applied in other directions, load sensors with indicators are used. Further in this work, relevant mathematical formulations are presented for extracting respective ground reaction forces from wavelength shifts/strain of FBG sensors on the OSGRFP. The result of this device has implications in understanding the foot function, identifying issues in gait cycle and measuring discrepancies between left and right foot. The device also provides a method to quantify and compare relative postural stability of different subjects under test, which has implications in post surgical rehabilitation, geriatrics and optimizing training protocols for sports personnel.

Keywords: balance and stability, gait analysis, FBG applications, optical sensor ground reaction force platform

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Authors: Zainal Arifin, Avanti Fontana

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Considering that TOE framework is the most useful instrument for studying technology adoption in firm context, this paper will analyze the influence of technological, organizational and environmental (TOE) factors to the Dynamic capabilities (DCs) associated with technology adoption strategy for improving the firm’s performance. Focusing on the determinant factors of technology adoption at the firm level, the study will contribute to the broader study of resource base view (RBV) and dynamic capability (DC). There is no study connecting directly the TOE factors to the DCs, this paper proposes technology adoption as a functional competence/capability which mediates a relationship between technology adoptions with firm’s performance. The study wants to show a conceptual model of the indirect effects of DCs at the firm level, which can be key predictors of firm performance in dynamic business environment. The results of this research is mostly relevant to top corporate executives (BOD) or top management team (TMT) who seek to provide some supporting ‘hardware’ content and condition such as technological factors, organizational factors, environmental factors, and to improve firm's ‘software ‘ ability such as adaptive capability, absorptive capability and innovative capability, in order to achieve a successful technology adoption in organization. There are also mediating factors which are elaborated at this paper; timing and external network. A further research for showing its empirical results is highly recommended.

Keywords: technology adoption, TOE framework, dynamic capability, resources based view

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Authors: Behrang Dadfar, Hossein Bidhendi, Jimmy Susetyo, John Paul Abbatangelo

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Finding structural demand under various conditions that a structure may experience during its service life is an important step towards structural life-cycle analysis. In this paper, structural demand for the precast concrete tunnel lining (PCTL) segments of Toronto’s 60-year-old subway tunnels is investigated. Numerical modelling was conducted using FLAC3D, a finite difference-based software capable of simulating ground-structure interaction and ground material’s flow in three dimensions. The specific structural details of the segmental tunnel lining, such as the convex shape of the PCTL segments at radial joints and the PCTL segment pockets, were considered in the numerical modelling. Also, the model was developed in a way to accommodate the flexibility required for the simulation of various deterioration scenarios, shapes, and patterns that have been observed over more than 20 years. The soil behavior was simulated by using plastic-hardening constitutive model of FLAC3D. The effect of the depth of the tunnel, the coefficient of lateral earth pressure as well as the patterns of deterioration of the segments were studied. The structural capacity under various deterioration patterns and the existing loading conditions was evaluated using axial-flexural interaction curves that were developed for each deterioration pattern. The results were used to provide recommendations for the next phase of tunnel lining rehabilitation program.

Keywords: precast concrete tunnel lining, ground-structure interaction, numerical modelling, deterioration, tunnels

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Authors: Ziara Carmelli G. Tan, Irene Carmelle S. Tan

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Background: Trichotillomania (TTM) and Major Depressive Disorder (MDD) are two psychiatric conditions that frequently co-occur, presenting a significant challenge for treatment due to their complex interplay. TTM involves repetitive hair-pulling, leading to noticeable hair loss and distress, while MDD is characterized by persistent low mood and loss of interest or pleasure, leading to dysfunctionality. This case report examines the intricate relationship between TTM and MDD in a young adult female, emphasizing the need for a comprehensive, multifaceted therapeutic approach to address both disorders effectively. Case Presentation: The patient is a 21-year-old female college student and youth church leader who presented with chronic hair-pulling and depressive symptoms. Her premorbid personality was marked by low self-esteem and a strong need for external validation. Despite her academic and social responsibilities and achievements, she struggled with managing her emotional distress, which was exacerbated by her family dynamics and her role within her church community. Her hair-pulling and mood symptoms were particularly triggered by self-esteem threats and feelings of inadequacy. She was diagnosed with Trichotillomania, Scalp and Major Depressive Disorder. Intervention/Management: The patient’s treatment plan was comprehensive, incorporating both pharmacological and non-pharmacological interventions. Initial pharmacologic management was Fluoxetine 20mg/day up, titrated to 40mg/day with no improvement; hence, shifted to Escitalopram 20mg/day and started with N-acetylcysteine 600mg/day with noted significant improvement in symptoms. Psychotherapeutic strategies played a crucial role in her treatment. These included supportive-expressive psychodynamic psychotherapy, which helped her explore and understand underlying emotional conflicts. Cognitive-behavioral techniques were employed to modify her maladaptive thoughts and behaviors. Grief processing was integrated to help her cope with significant losses. Family therapy was done to address conflicts and collaborate with the treatment process. Psychoeducation was provided to enhance her understanding of her condition and to empower her in her treatment journey. A suicide safety plan was developed to ensure her safety during critical periods. An interprofessional approach, which involved coordination with the Dermatology service for co-management, was also a key component of her treatment. Outcome: Over the course of 15 therapy sessions, the patient demonstrated significant improvement in both her depressive symptoms and hair-pulling behavior. Her active engagement in therapy, combined with pharmacological support, facilitated better emotional regulation and a more cohesive sense of self. Her adherence to the treatment plan, along with the collaborative efforts of the interprofessional team, contributed to her positive outcomes. Discussion: This case underscores the significance of addressing both TTM and its comorbid conditions to achieve effective treatment outcomes. The intricate interplay between TTM and MDD in the patient’s case highlights the importance of a comprehensive treatment plan that includes both pharmacological and psychotherapeutic approaches. Supportive-expressive psychodynamic psychotherapy, Cognitive-behavioral techniques, and Family therapy were particularly beneficial in addressing the complex emotional and behavioral aspects of her condition. The involvement of an interprofessional team, including dermatology co-management, was crucial in providing holistic care. Future practice should consider the benefits of such a multidisciplinary approach to managing complex cases like this, ensuring that both the psychological and physiological aspects of the disorders are adequately addressed.

Keywords: cognitive-behavioral therapy, interprofessional approach, major depressive disorder, psychodynamic psychotherapy, trichotillomania

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Authors: Evgeniia Surkova, Manal Assaad, Hleb Makeyeu, Juho Makio

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The main objective of STIMEY (Science, Technology, Innovation, Mathematics, Engineering for the Young) project is the delivery of a hybrid learning environment that combines multi-level components such as social media concepts, robotic artefacts, and radio, among others. It is based on a well-researched pedagogical framework to attract European youths to STEM (science, technology, engineering, and mathematics) education and careers. To develop and integrate these various components, STIMEY is executed in iterative research cycles leading to progressive improvements. Scrum was the development methodology of choice in the project, as studies indicated its benefits as an agile methodology in global software development, especially of e-learning and integrated learning projects. This paper describes the project partners’ experience with the Scrum framework, discussing the challenges faced in its implementation and the mitigation practices employed. The authors conclude with exploring user experience tools and principles for future research, as a novel direction in supporting the Scrum development team.

Keywords: e-learning, global software development, scrum, STEM education

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Authors: Hanan H. ALQahtani, Karen Jones

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Catching a ball during sitting is a functional exercise commonly used in rehabilitation to enhance trunk muscle activity. To progress this exercise, physiotherapists incorporate a Swiss ball or change seat height. However, no study has assessed the effect of different seating surfaces on trunk muscle activity while catching a ball. Objective: To investigate the effect of catching a ball during sitting on a Swiss ball, a low seat and a high seat on trunk muscle activity. Method: A repeated-measures, counterbalanced design was used. A total of 26 healthy participants (15 female and 11 male) performed three repetitions of catching a ball on each seating surface. Using surface electromyography (sEMG), the activity of the bilateral transversus abdominis/internal oblique (TrA/IO), rectus abdominis (RA), erector spinae (ES) and lumbar multifidus (MF) was recorded. Trunk muscle activity was normalized using maximum voluntary isometric contraction and analyzed. Statistical significance was set at p ≤ .05. Results: No significant differences were observed in the activity of RA, TrA/IO, ES or MF between a low seat and a Swiss ball. However, the activity of the right and left ES on a low seat was significantly greater than on a high seat (p = .017 and p = .017, respectively). Conversely, the activity of the right and left RA on a high seat was significantly greater than on a low seat (p = .007 and p = .004, respectively). Conclusion: This study suggests that replacing a low seat with a Swiss ball while catching a ball is insufficient to increase trunk muscle activity, whereas changing the seat height could induce different trunk muscle activities. However, research conducted on patients is needed before translating these results into clinical settings.

Keywords: catching, electromyography, seating, trunk

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Authors: Maha Salah, Hanaa Hashem, Mahmoud M. Alsagheir, Mohammed Salah

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Acute respiratory distress syndrome (ARDS) represents a complex clinical syndrome and carries a high risk for mortality. The severity of the clinical course, the uncertainty of the outcome, and the reliance on the full spectrum of critical care resources for treatment mean that the entire health care team is challenged. Researchers and clinicians have investigated the nature of the pathological process and explored treatment options with the goal of improving outcome. Through this application of research to practice, we know that some previous strategies have been ineffective, and innovations in mechanical ventilation, sedation, nutrition, and pharmacological intervention remain important research initiatives. Developed Clinical pathway is multidisciplinary plans of best clinical practice for this specified groups of patients that aid in the coordination and delivery of high quality care. They are a documented sequence of clinical interventions that help a patient to move, progressively through a clinical experience to a desired outcome. Although there is a lot of heterogeneity in patients with ARDS, this suggested developed clinical pathway with alternatives was built depended on a lot of researches and evidence based medicine and nursing practices which may be helping these patients to improve outcomes, quality of life and decrease mortality.

Keywords: acute respiratory distress syndrome (ARDS), clinical pathway, clinical syndrome

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Authors: Tia Morosin, Marie Shella De Robles

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Rectocele may be associated with symptoms of both obstructed defecation and faecal incontinence. Currently, numerous operative techniques exist to treat patients with rectocele; however, no single technique has emerged as the optimal approach in patients with post-partum faecal incontinence. The purpose of this study was to evaluate the clinical outcome in a consecutive series of patients who underwent transperineal repair of rectocele for patients presenting with faecal incontinence as the predominant symptom. Twenty-three consecutive patients from April 2000 to July 2015 with symptomatic rectocele underwent transperineal repair by a single surgeon. All patients had a history of vaginal delivery, with or without evidence of associated anal sphincter injury at the time. The median age of the cohort was 53 years (range 21 to 90 years). The median operating time and length of hospital stay were 2 hours and 7 days, respectively. Two patients developed urinary retention post-operatively, which required temporary bladder catheterization. One patient had wound dehiscence, which was managed by absorbent dressing applied by the patient and her carer. There was no operative mortality. In all patients with rectocele, there was a concomitant anal sphincter disruption. All patients had satisfactory improvement with regard to faecal incontinence on follow-up. This study suggests this method provides excellent anatomic and physiologic results with minimal morbidity. However, because none of the patients gained full continence postoperatively, pelvic floor rehabilitation might be also needed to achieve better sphincter function in patients with incontinence.

Keywords: anal sphincter defect, faecal incontinence, rectocele, transperineal repair

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Authors: Komal Fizza

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All around the world in every field professionals are taking great support from their computers. Computer assisted strategies not only increase the efficiency of the professionals but also in case of healthcare they help in life-saving interventions. The background of this current research is aimed towards two things; first to find out if computer assisted strategies are useful for Pharmacist for not and secondly how much these assist a Pharmacist to do quality interventions. Shifa International Hospital is a 500 bedded hospital, and it is running Antimicrobial Stewardship, during their stewardship rounds pharmacists observed that a lot of wrong doses of antibiotics were coming at times those were being overlooked by the other pharmacist even. So, with the help of MIS team the patients were categorized into adult and peads depending upon their age. Minimum and maximum dose of every single antibiotic present in the pharmacy that could be dispensed to the patient was developed. These were linked to the order entry window. So whenever pharmacist would type any order and the dose would be below or above the therapeutic limit this would give an alert to the pharmacist. Whenever this message pop-up this was recorded at the back end along with the antibiotic name, pharmacist ID, date, and time. From 14th of January 2015 and till 14th of March 2015 the software stopped different users 350 times. Out of this 300 were found to be major errors which if reached to the patient could have harmed them to the greater extent. While 50 were due to typing errors and minor deviations. The pilot study showed that computer assisted strategies can be of great help to the pharmacist. They can improve the efficacy and quality of interventions.

Keywords: antibiotics, computer assisted strategies, pharmacist, stewardship

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Authors: Rosa Sobreira, Paula Arriscado

Abstract:

Marketers are aware that media relations is an important touch point, which is also cheaper, to bring their products and their brands to the consumer. They recognize the role of journalists as moderators and transformers of public opinion, and they realize their influence on brand image. And also, they know that readers, listeners, viewers and internet users "believe" more what they read, hear and see in the news than in an advertisement. The study is focused on the automotive industry and analyses the news published about three brands that share industrial facilities and components. We wanted to understand the role of the information created by the brand`s media team in the journalists’ work, and the impact on management, activation and differentiation of brands and their products` attributes and benefits. Based on a qualitative methodology, the analysis focused on press news, making comparison between media coverage and their “narratives” about the three cars from different brands. The results point to the fact that journalists easily integrate speech from the marks on their products. In the case of this study, we found that apart from the description of the many similarities between the three cars, the average speech also "struggled" for revealing the attributes that differentiate them. This interpretation of the results helps us to understand the "marriage" between branding and media. We believe also this paper let us to understand how journalists, through news, join the speech of the brands.

Keywords: brand management, media relations, differentiation, positioning

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Authors: Giuliana Murfet, Heidi Behrens

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Chronic disease is Australia’s biggest health concern and obesity the leading risk factor for many. Obesity and chronic disease have a higher representation in rural Tasmania, where levels of socio-disadvantage are also higher. People living outside major cities have less access to health services and poorer health outcomes. To help primary healthcare professionals manage obesity, the Australian NHMRC evidence-based clinical practice guidelines for management of overweight and obesity in adults were developed. They include recommendations for practice and models for obesity management. To our knowledge there has been no research conducted that investigates translation of these guidelines into practice in rural-regional areas; where implementation can be complicated by limited financial and staffing resources. Also, the systematic review that informed the guidelines revealed a lack of evidence for chronic disease models of obesity care. The aim was to establish and evaluate a multidisciplinary model for obesity management in a group of adult people with type 2 diabetes in a dispersed rural population in Australia. Extensive stakeholder engagement was undertaken to both garner support for an obesity clinic and develop a sustainable model of care. A comprehensive nurse practitioner-led outpatient model for obesity care was designed. Multidisciplinary obesity clinics for adults with type 2 diabetes including a dietitian, psychologist, physiotherapist and nurse practitioner were set up in the north-west of Tasmania at two geographically-rural towns. Implementation was underpinned by the NHMRC guidelines and recommendations focused on: assessment approaches; promotion of health benefits of weight loss; identification of relevant programs for individualising care; medication and bariatric surgery options for obesity management; and, the importance of long-term weight management. A clinical pathway for adult weight management is delivered by the multidisciplinary team with recognition of the impact of and adjustments needed for other comorbidities. The model allowed for intensification of intervention such as bariatric surgery according to recommendations, patient desires and suitability. A randomised controlled trial is ongoing, with the aim to evaluate standard care (diabetes-focused management) compared with an obesity-related approach with additional dietetic, physiotherapy, psychology and lifestyle advice. Key barriers and enablers to guideline implementation were identified that fall under the following themes: 1) health care delivery changes and the project framework development; 2) capacity and team-building; 3) stakeholder engagement; and, 4) the research project and partnerships. Engagement of not only local hospital but also state-wide health executives and surgical services committee were paramount to the success of the project. Staff training and collective development of the framework allowed for shared understanding. Staff capacity was increased with most taking on other activities (e.g., surgery coordination). Barriers were often related to differences of opinions in focus of the project; a desire to remain evidenced based (e.g., exercise prescription) without adjusting the model to allow for consideration of comorbidities. While barriers did exist and challenges overcome; the development of critical partnerships did enable the capacity for a potential model of obesity care for rural regional areas. Importantly, the findings contribute to the evidence base for models of diabetes and obesity care that coordinate limited resources.

Keywords: diabetes, interdisciplinary, model of care, obesity, rural regional

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Authors: Leon Pan

Abstract:

The first programming course within post-secondary education has long been recognized as a challenging endeavor for both educators and students alike. Historically, these courses have exhibited high failure rates and a notable number of dropouts. Instructors often lament students' lack of effort in their coursework, and students often express frustration that the teaching methods employed are not effective. Drawing inspiration from the successful principles of Extreme Programming, this study introduces an approach—the Extremes-based teaching model — aimed at enhancing the teaching of introductory programming courses. To empirically determine the effectiveness of the model, a comparison was made between a section taught using the extreme-based model and another utilizing traditional teaching methods. Notably, the extreme-based teaching class required students to work collaboratively on projects while also demanding continuous assessment and performance enhancement within groups. This paper details the application of the extreme-based model within the post-secondary online classroom context and presents the compelling results that emphasize its effectiveness in advancing the teaching and learning experiences. The extreme-based model led to a significant increase of 13.46 points in the weighted total average and a commendable 10% reduction in the failure rate.

Keywords: extreme-based teaching model, innovative pedagogical methods, project-based learning, team-based learning

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