Search results for: retrospective cohort study

Authors: Kiran Datta, Daniella Holland-Hart, Anthony Byrne

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Introduction: Oesophago-gastric (OG) cancers are the fifth commonest in the UK, accounting for over 12,000 deaths each year. Most patients will present at later stages of the disease, with only 21% of patients with stage 4 disease surviving longer than a year. As a result, many patients are unsuitable for curative surgery and instead receive palliative treatment to improve prognosis and symptom burden. However, palliative chemotherapy can result in significant toxicity: almost half of the patients are unable to complete their chemotherapy regimen, with this proportion rising significantly in older and frailer patients. In addition, clinical trials often exclude older and frailer patients due to strict inclusion criteria, meaning there is limited evidence to guide which patients are most likely to benefit from palliative chemotherapy. Inappropriate chemotherapy administration is at odds with the goals of palliative treatment and care, which are to improve quality of life, and this also represents a significant resource expenditure. This literature review aimed to examine and appraise evidence regarding treatment resilience in order to guide clinicians in identifying the most suitable candidates for palliative chemotherapy. Factors influencing treatment resilience were assessed, as measured by completion rates, dose reductions, and toxicities. Methods: This literature review was conducted using rapid review methodology, utilising modified systematic methods. A literature search was performed across the MEDLINE, EMBASE, and Cochrane Library databases, with results limited to papers within the last 15 years and available in English. Key inclusion criteria included: 1) participants with either oesophageal, gastro-oesophageal junction, or gastric cancers; 2) patients treated with palliative chemotherapy; 3) available data evaluating the association between baseline participant characteristics and treatment resilience. Results: Of the 2326 papers returned, 11 reports of 10 studies were included in this review after excluding duplicates and irrelevant papers. Treatment resilience factors that were assessed included: age, performance status, frailty, inflammatory markers, and sarcopenia. Age was generally a poor predictor for how well patients would tolerate chemotherapy, while poor performance status was a better indicator of the need for dose reduction and treatment non-completion. Frailty was assessed across one cohort using multiple screening tools and was an effective marker of the risk of toxicity and the requirement for dose reduction. Inflammatory markers included lymphopenia and the Glasgow Prognostic Score, which assessed inflammation and hypoalbuminaemia. Although quick to obtain and interpret, these findings appeared less reliable due to the inclusion of patients treated with palliative radiotherapy. Sarcopenia and body composition were often associated with chemotherapy toxicity but not the rate of regimen completion. Conclusion: This review demonstrates that there are numerous measures that can estimate the ability of patients with oesophago-gastric cancer to tolerate palliative chemotherapy, and these should be incorporated into clinical assessments to promote personalised decision-making around treatment. Age should not be a barrier to receiving chemotherapy and older and frailer patients should be included in future clinical trials to better represent typical patients with oesophago-gastric cancers. Decisions regarding palliative treatment should be guided by these factors identified as well as patient preference.

Keywords: frailty, oesophago-gastric cancer, palliative chemotherapy, treatment resilience

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Authors: Jan C. Droste, Justine Burns, Nithin Narayan

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Introduction: Life-threatening detrimental effects of inappropriate adrenaline (epinephrine) administration, e.g., by giving the wrong dose, in the context of anaphylaxis management is well documented in the medical literature. Half of the fatal anaphylactic reactions in the UK are iatrogenic, and the median time to a cardio-respiratory arrest can be as short as 5 minutes. It is therefore imperative that hospital doctors of all grades have active and accurate knowledge of the correct route, site, and dosage of administration of adrenaline. Given this time constraint and the potential fatal outcome with inappropriate management of anaphylaxis, it is alarming that surveys over the last 15 years have repeatedly shown only a minority of doctors to have accurate knowledge of adrenaline administration as recommended by the UK Resuscitation Council guidelines (2008 updated 2012). This comparison of survey results of the medical workforce over several years in a small NHS District General Hospital was conducted in order to establish the effect of the employment of multiple educational methods regarding adrenaline administration in anaphylaxis in adults. Methods: Between 2010 and 2017, several education methods and tools were used to repeatedly inform the medical workforce (doctors and advanced clinical practitioners) in a single district general hospital regarding the treatment of anaphylaxis in adults. Whilst the senior staff remained largely the same cohort, junior staff had changed fully in every survey. Examples included: (i) Formal teaching -in Grand Rounds; during the junior doctors’ induction process; advanced life support courses (ii) In-situ simulation training performed by the clinical skills simulation team –several ad hoc sessions and one 3-day event in 2017 visiting 16 separate clinical areas performing an acute anaphylaxis scenario using actors- around 100 individuals from multi-disciplinary teams were involved (iii) Hospital-wide distribution of the simulation event via the Trust’s Simulation Newsletter (iv) Laminated algorithms were attached to the 'crash trolleys' (v) A short email 'alert' was sent to all medical staff 3 weeks prior to the survey detailing the emergency treatment of anaphylaxis (vi) In addition, the performance of the surveys themselves represented a teaching opportunity when gaps in knowledge could be addressed. Face to face surveys were carried out in 2010 ('pre-intervention), 2015, and 2017, in the latter two occasions including advanced clinical practitioners (ACP). All surveys consisted of convenience samples. If verbal consent to conduct the survey was obtained, the medical practitioners' answers were recorded immediately on a data collection sheet. Results: There was a sustained improvement in the knowledge of the medical workforce from 2010 to 2017: Answers improved regarding correct drug by 11% (84%, 95%, and 95%); the correct route by 20% (76%, 90%, and 96%); correct site by 40% (43%, 83%, and 83%) and the correct dose by 45% (27%, 54%, and 72%). Overall, knowledge of all components -correct drug, route, site, and dose-improved from 13% in 2010 to 62% in 2017. Conclusion: This survey comparison shows knowledge of the medical workforce regarding adrenaline administration for treatment of anaphylaxis in adults can be considerably improved by employing a variety of educational methods.

Keywords: adrenaline, anaphylaxis, epinephrine, medical education, patient safety

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Authors: Paul Licina, Emma M. Johnston, David Lisle, Mark Young, Chris Brady

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Background: Lumbar pars pathology is a common cause of pain in the growing spine. It can be seen in young athletes participating in at-risk sports and can affect sporting performance and long-term health due to its resistance to traditional management. There is a current lack of consensus of classification and treatment for pars injuries. Previous systems used CT to stage pars defects but could not assess early stress reactions. A modified classification is proposed that considers findings on MRI, significantly improving early treatment guidance. The treatment protocol is designed for patients aged 5 to 19 years. Method: Clinical screening identifies patients with a low, medium, or high index of suspicion for lumbar pars injury using patient age, sport participation and pain characteristics. MRI of the at-risk cohort enables augmentation of existing CT-based classification while avoiding ionising radiation. Patients are classified into five categories based on MRI findings. A type 0 lesion (stress reaction) is present when CT is normal and MRI shows high signal change (HSC) in the pars/pedicle on T2 images. A type 1 lesion represents the ‘early defect’ CT classification. The group previously referred to as a 'progressive stage' defect on CT can be split into 2A and 2B categories. 2As have HSC on MRI, whereas 2Bs do not. This distinction is important with regard to healing potential. Type 3 lesions are terminal stage defects on CT, characterised by pseudarthrosis. MRI shows no HSC. Results: Stress reactions (type 0) and acute fractures (1 and 2a) can heal and are treated in a custom-made hard brace for 12 weeks. It is initially worn 23 hours per day. At three weeks, patients commence basic core rehabilitation. At six weeks, in the absence of pain, the brace is removed for sleeping. Exercises are progressed to positions of daily living. Patients with continued pain remain braced 23 hours per day without exercise progression until becoming symptom-free. At nine weeks, patients commence supervised exercises out of the brace for 30 minutes each day. This allows them to re-learn muscular control without rigid support of the brace. At 12 weeks, bracing ceases and MRI is repeated. For patients with near or complete resolution of bony oedema and healing of any cortical defect, rehabilitation is focused on strength and conditioning and sport-specific exercise for the full return to activity. The length of this final stage is approximately nine weeks but depends on factors such as development and level of sports participation. If significant HSC remains on MRI, CT scan is considered to definitively assess cortical defect healing. For these patients, return to high-risk sports is delayed for up to three months. Chronic defects (2b and 3) cannot heal and are not braced, and rehabilitation follows traditional protocols. Conclusion: Appropriate clinical screening and imaging with MRI can identify pars pathology early. In those with potential for healing, we propose hard bracing and appropriate rehabilitation as part of a multidisciplinary management protocol. The validity of this protocol will be tested in future studies.

Keywords: adolescents, MRI classification, pars interticularis, treatment protocol

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Authors: Gokulan Vethanayakam, Daniel Aston

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Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.

Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation

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Authors: Mona Isazad Mashinchi, Davood Roshan Sangachin, Francis J. Sullivan, Dietrich Rebholz-Schuhmann

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Background: Decision-making processes are nowadays driven by data, data analytics and Business Intelligence (BI). BI as a software platform can provide a wide variety of capabilities such as organization memory, information integration, insight creation and presentation capabilities. Visualizing data through dashboards is one of the BI solutions (for a variety of areas) which helps managers in the decision making processes to expose the most informative information at a glance. In the healthcare domain to date, dashboard presentations are more frequently used to track performance related metrics and less frequently used to monitor those quality parameters which relate directly to patient outcomes. Providing effective and timely care for patients and improving the health outcome are highly dependent on presenting and visualizing data and information. Objective: In this research, the focus is on the presentation capabilities of BI to design a dashboard for prostate cancer (PC) data that allows better decision making for the patients, the hospital and the healthcare system related to a cancer dataset. The aim of this research is to customize a retrospective PC dataset in a dashboard interface to give a better understanding of data in the categories (risk factors, treatment approaches, disease control and side effects) which matter most to patients as well as other stakeholders. By presenting the outcome in the dashboard we address one of the major targets of a value-based health care (VBHC) delivery model which is measuring the value and presenting the outcome to different actors in HC industry (such as patients and doctors) for a better decision making. Method: For visualizing the stored data to users, three interactive dashboards based on the PC dataset have been developed (using the Tableau Software) to provide better views to the risk factors, treatment approaches, and side effects. Results: Many benefits derived from interactive graphs and tables in dashboards which helped to easily visualize and see the patients at risk, better understanding the relationship between patient's status after treatment and their initial status before treatment, or to choose better decision about treatments with fewer side effects regarding patient status and etc. Conclusions: Building a well-designed and informative dashboard is related to three important factors including; the users, goals and the data types. Dashboard's hierarchies, drilling, and graphical features can guide doctors to better navigate through information. The features of the interactive PC dashboard not only let doctors ask specific questions and filter the results based on the key performance indicators (KPI) such as: Gleason Grade, Patient's Age and Status, but may also help patients to better understand different treatment outcomes, such as side effects during the time, and have an active role in their treatment decisions. Currently, we are extending the results to the real-time interactive dashboard that users (either patients and doctors) can easily explore the data by choosing preferred attribute and data to make better near real-time decisions.

Keywords: business intelligence, dashboard, decision making, healthcare, prostate cancer, value-based healthcare

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Authors: Oksana G. Cherednichenko, Anastasia L. Pilyugina, Sergey N.Lukashenko, Elena G. Gubitskaya

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The estimation of accumulated radiation doses in people professionally exposed to ionizing radiation was performed using methods of biological (chromosomal aberrations frequency in lymphocytes) and physical (radionuclides analysis in urine, whole-body radiation meter, individual thermoluminescent dosimeters) dosimetry. A group of 84 "A" category employees after their work in the territory of former Semipalatinsk test site (Kazakhstan) was investigated. The dose rate in some funnels exceeds 40 μSv/h. After radionuclides determination in urine using radiochemical and WBC methods, it was shown that the total effective dose of personnel internal exposure did not exceed 0.2 mSv/year, while an acceptable dose limit for staff is 20 mSv/year. The range of external radiation doses measured with individual thermo-luminescent dosimeters was 0.3-1.406 µSv. The cytogenetic examination showed that chromosomal aberrations frequency in staff was 4.27±0.22%, which is significantly higher than at the people from non-polluting settlement Tausugur (0.87±0.1%) (р ≤ 0.01) and citizens of Almaty (1.6±0.12%) (р≤ 0.01). Chromosomal type aberrations accounted for 2.32±0.16%, 0.27±0.06% of which were dicentrics and centric rings. The cytogenetic analysis of different types group radiosensitivity among «professionals» (age, sex, ethnic group, epidemiological data) revealed no significant differences between the compared values. Using various techniques by frequency of dicentrics and centric rings, the average cumulative radiation dose for group was calculated, and that was 0.084-0.143 Gy. To perform comparative individual dosimetry using physical and biological methods of dose assessment, calibration curves (including own ones) and regression equations based on general frequency of chromosomal aberrations obtained after irradiation of blood samples by gamma-radiation with the dose rate of 0,1 Gy/min were used. Herewith, on the assumption of individual variation of chromosomal aberrations frequency (1–10%), the accumulated dose of radiation varied 0-0.3 Gy. The main problem in the interpretation of individual dosimetry results is reduced to different reaction of the objects to irradiation - radiosensitivity, which dictates the need of quantitative definition of this individual reaction and its consideration in the calculation of the received radiation dose. The entire examined contingent was assigned to a group based on the received dose and detected cytogenetic aberrations. Radiosensitive individuals, at the lowest received dose in a year, showed the highest frequency of chromosomal aberrations (5.72%). In opposite, radioresistant individuals showed the lowest frequency of chromosomal aberrations (2.8%). The cohort correlation according to the criterion of radio-sensitivity in our research was distributed as follows: radio-sensitive (26.2%) — medium radio-sensitivity (57.1%), radioresistant (16.7%). Herewith, the dispersion for radioresistant individuals is 2.3; for the group with medium radio-sensitivity — 3.3; and for radio-sensitive group — 9. These data indicate the highest variation of characteristic (reactions to radiation effect) in the group of radio-sensitive individuals. People with medium radio-sensitivity show significant long-term correlation (0.66; n=48, β ≥ 0.999) between the values of doses defined according to the results of cytogenetic analysis and dose of external radiation obtained with the help of thermoluminescent dosimeters. Mathematical models based on the type of violation of the radiation dose according to the professionals radiosensitivity level were offered.

Keywords: biodosimetry, chromosomal aberrations, ionizing radiation, radiosensitivity

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Authors: M. Mueller, M. Kuehn, M. Voelker

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In small and medium-sized enterprises (SMEs), the challenge is to create a well-grounded and reliable basis for process analysis, optimization and planning due to a lack of data. SMEs have limited access to methods with which they can effectively and efficiently analyse processes and identify cause-and-effect relationships in order to generate the necessary database and derive optimization potential from it. The implementation of digitalization within the framework of Industry 4.0 thus becomes a particular necessity for SMEs. For these reasons, the abstract presents an analysis methodology that is subject to the objective of developing an SME-appropriate methodology for efficient, temporarily feasible data collection and evaluation in flexible production and logistics systems as a basis for process analysis and optimization. The overall methodology focuses on retrospective, event-based tracing and analysis of material flow objects. The technological basis consists of Bluetooth low energy (BLE)-based transmitters, so-called beacons, and smart mobile devices (SMD), e.g. smartphones as receivers, between which distance data can be measured and derived motion profiles. The distance is determined using the Received Signal Strength Indicator (RSSI), which is a measure of signal field strength between transmitter and receiver. The focus is the development of a software-based methodology for interpretation of relative movements of transmitters and receivers based on distance data. The main research is on selection and implementation of pattern recognition methods for automatic process recognition as well as methods for the visualization of relative distance data. Due to an existing categorization of the database regarding process types, classification methods (e.g. Support Vector Machine) from the field of supervised learning are used. The necessary data quality requires selection of suitable methods as well as filters for smoothing occurring signal variations of the RSSI, the integration of methods for determination of correction factors depending on possible signal interference sources (columns, pallets) as well as the configuration of the used technology. The parameter settings on which respective algorithms are based have a further significant influence on result quality of the classification methods, correction models and methods for visualizing the position profiles used. The accuracy of classification algorithms can be improved up to 30% by selected parameter variation; this has already been proven in studies. Similar potentials can be observed with parameter variation of methods and filters for signal smoothing. Thus, there is increased interest in obtaining detailed results on the influence of parameter and factor combinations on data quality in this area. The overall methodology is realized with a modular software architecture consisting of independently modules for data acquisition, data preparation and data storage. The demonstrator for initialization and data acquisition is available as mobile Java-based application. The data preparation, including methods for signal smoothing, are Python-based with the possibility to vary parameter settings and to store them in the database (SQLite). The evaluation is divided into two separate software modules with database connection: the achievement of an automated assignment of defined process classes to distance data using selected classification algorithms and the visualization as well as reporting in terms of a graphical user interface (GUI).

Keywords: event-based tracing, machine learning, process classification, parameter settings, RSSI, signal smoothing

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Authors: A. Chandra, M. Arthur, L. Mize, A. Pomeroy-Stevens

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Background: Lower and middle-income countries (LMICs) in Asia face rapid urbanization resulting in both economic opportunities (the urban advantage) and emerging health challenges. Urban health risks are magnified in informal settlements and include infectious disease outbreaks, inadequate access to health services, and poor air quality. Over the coming years, urban spaces in Asia will face accelerating public health risks related to migration, climate change, and environmental health. These challenges are complex and require multi-sectoral and multi-stakeholder solutions. The Building Health Cities (BHC) program is funded by the United States Agency for International Development (USAID) to work with smart city initiatives in the Asia region. BHC approaches urban health challenges by addressing policies, planning, and services through a health equity lens, with a particular focus on informal settlements and migrant communities. The program works to develop data-driven decision-making, build inclusivity through stakeholder engagement, and facilitate the uptake of appropriate technology. Methodology: The BHC program has partnered with the smart city initiatives of Indore in India, Makassar in Indonesia, and Da Nang in Vietnam. Implementing partners support municipalities to improve health delivery and equity using two key approaches: political economy analysis and participatory systems mapping. Political economy analyses evaluate barriers to collective action, including corruption, security, accountability, and incentives. Systems mapping evaluates community health challenges using a cross-sectoral approach, analyzing the impact of economic, environmental, transport, security, health system, and built environment factors. The mapping exercise draws on the experience and expertise of a diverse cohort of stakeholders, including government officials, municipal service providers, and civil society organizations. Results: Systems mapping and political economy analyses identified significant barriers for health care in migrant populations. In Makassar, migrants are unable to obtain the necessary card that entitles them to subsidized health services. This finding is being used to engage with municipal governments to mitigate the barriers that limit migrant enrollment in the public social health insurance scheme. In Indore, the project identified poor drainage of storm and wastewater in migrant settlements as a cause of poor health. Unsafe and inadequate infrastructure placed residents of these settlements at risk for both waterborne diseases and injuries. The program also evaluated the capacity of urban primary health centers serving migrant communities, identifying challenges related to their hours of service and shortages of health workers. In Da Nang, the systems mapping process has only recently begun, with the formal partnership launched in December 2019. Conclusion: This paper explores lessons learned from BHC’s systems mapping, political economy analyses, and stakeholder engagement approaches. The paper shares progress related to the health of migrants in informal settlements. Case studies feature barriers identified and mitigating steps, including governance actions, taken by local stakeholders in partner cities. The paper includes an update on ongoing progress from Indore and Makassar and experience from the first six months of program implementation from Da Nang.

Keywords: informal settlements, migration, stakeholder engagement mapping, urban health

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Authors: Suphaporn Rattanaphinanchai

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The purpose of this study is to 1) describe and analyze the travel motivations of tourists visiting Phi Phi Islands after the Tsunami in 2004 and 2) to better understand whether there are significant differences in the tourists’ motivations in visiting Phi Phi Island after the Tsunami hit across tourists with different demographic profile. This study used Phi Phi Islands, which was damaged by the 2004 Indian Ocean tsunami as a case study. The instrument used in the present study is a self-administered questionnaire. A survey with 200 questionnaires was collected in May - December, 2015. Descriptive statistics, Independent Sample Mean T-tests, and Analysis of Variances was used to analyze the data. The result of the study showed that beauty of nature, good climate, and relaxing atmosphere motivated tourists in visiting Phi Phi Islands after the tsunami.

Keywords: motivation, Thailand, Thai tourism, Thai beaches

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Authors: J. Hajri, H. Hrizi, N. Sboui, H. Baudrand

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This paper presents a study of SIW circuits (Substrate Integrated Waveguide) with a rigorous and fast original approach based on Iterative process (WCIP). The theoretical suggested study is validated by the simulation of two different examples of SIW circuits. The obtained results are in good agreement with those of measurement and with software HFSS.

Keywords: convergence study, HFSS, modal decomposition, SIW circuits, WCIP method

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Authors: K. Pandey

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The present study is a functional analysis of the relationship between castes which indicates the dynamics of the caste structure in the rural setting. The researcher has tried to show both the cooperation and competition on important ceremonial and social occasions. The real India exists in the villages, so we need to know about their solidarity and also what the village life is and has been shaping into. We need to emphasize a microcosmic study of Indian rural life. Furthermore, caste integration is an acute problem country faces today. To resolve this we are required to know the dynamics of behavior of the people of different castes and for the study of the caste dynamics a study of caste relations are needed. The present study is an attempt in this direction.

Keywords: hierarchial groups, jajmani system, functional dependence, commensalities

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Authors: Saqib Mehmood, Naveed Iqbal Chaudhry, Asif Mehmood

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This study intends to investigate the information asymmetry theories of IPO and under-pricing in Pakistan. The purpose of the study is to validate the information asymmetry about firm value which leads to under-pricing. A total of 55 IPOs listed from 2000-2011 were included in this study. OLS multiple regression was applied to achieve the objectives of this study. The findings of the study confirm the significance of information asymmetry on under-pricing in Pakistan. The findings have implications for issuing firms and prospective investors.

Keywords: information asymmetry, initial public offerings, under-pricing, firm value

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Authors: Aminul Islam

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The issue of aging is now an emerging aspect of all over the world. Both the rural and urban societies of our country are not immune from this problem. This study mainly explored the influence of wealth on the enjoyment of role and status of the elderly in rural Bangladesh. It is based on empirical findings from the four villages of Gopalnagar union of Dhunat upazila of Bogra district. The study depicted that wealth has much influence regarding the enjoyment of role and status. Mixed approach has been given priority in this study. Survey, observation, case study and life history methods and focus group discussion technique have also been used in this study. Data have been collected from both primary and secondary sources. Simple random sampling procedure has also been followed in this study.

Keywords: wealth, role status, elderly

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Authors: Rajesh Kumar G

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A challenging aspect of any clinical trial is to carefully plan the study design to meet the study objective in optimum way and to validate the assumptions made during protocol designing. And when it is a pediatric study, there is the added challenge of stringent guidelines and difficulty in recruiting the necessary subjects. Unlike adult trials, there is not much historical data available for pediatrics, which is required to validate assumptions for planning pediatric trials. Typically, pediatric studies are initiated as soon as approval is obtained for a drug to be marketed for adults, so with the adult study historical information and with the available pediatric pilot study data or simulated pediatric data, the pediatric study can be well planned. Generalizing the historical adult study for new pediatric study is a tedious task; however, it is possible by integrating various statistical techniques and utilizing the advantage of hybrid study design, which will help to achieve the study objective in a smoother way even with the presence of many constraints. This research paper will explain how well the hybrid study design can be planned along with integrated technique (SEV) to plan the pediatric study; In brief the SEV technique (Simulation, Estimation (using borrowed adult data and applying Bayesian methods)) incorporates the use of simulating the planned study data and getting the desired estimates to Validate the assumptions.This method of validation can be used to improve the accuracy of data analysis, ensuring that results are as valid and reliable as possible, which allow us to make informed decisions well ahead of study initiation. With professional precision, this technique based on the collected data allows to gain insight into best practices when using data from historical study and simulated data alike.

Keywords: adaptive design, simulation, borrowing data, bayesian model

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Authors: Inbal Peleg Koriat, Rachel Ben-Ari

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The purpose of the present study was to test individual’s conflict management style in romantic relations as a function of their perception of the extent of procedural justice in their partner behavior, and to what extant this relationship is mediated by the quality of the relations. The research procedure included two studies: The first study was a correlative study with 160 participants in a romantic relation. The goal of the first study was to examine the mediation model with self-report questionnaires. The second study was an experimental study with 241 participants. The study was designed to examine the causal connection between perceived procedural justice (PPJ) and conflict management styles. Study 1 indicated a positive connection between PPJ and collaborative conflict management styles (integrating, compromising and obliging). In contrast, a negative connection was not found between PPJ and non-collaborative conflict management styles (avoiding, and dominating). In addition, perceived quality of the romantic relations was found to mediate the connection between PPJ and collaborative conflict management styles. Study 2 validated the finding of Study 1 by showing that PPJ leads the individual to use compromising and integrating conflict management styles. In contrast to Study 1, Study 2 shows that a low PPJ increases the individual’s tendency to use an avoiding conflict management style. The study contributes to the rather scarce research on PPJ role in conflict management in general and in romantic relations in particular. It can provide new insights into cognitive methods of coping with conflict that encourage transformation in the conflict and a way to grow and develop both individually and as a couple.

Keywords: conflict management style, marriage, procedural justice, romantic relations

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Authors: Sajid Ali Khan, Karim Ullah, Usman Ghani

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Community participation is the collaboration of project beneficiaries; voluntarily or because of some incentives or persuasion agree to put effort and work with development projects. Sustainability of projects is the ability to maintain its services, operations, and other benefits during its anticipated time. This study investigated the dynamics of community participation and its contribution to the sustainability of projects. In multiple case-study designs with semi-structured questionnaires and interviews, this study analyzes community participation with the help of individual case analysis followed by cross-case analysis in the RAHA & CDLD developmental project. Finally, the study outcomes are linked with the specified literature in order to comprehend the phenomena. The findings of the study suggest an Analytical framework developed by the current study covering different barriers and enablers to community participation and its implications.

Keywords: community participation, enablers, barriers, project sustainability

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Authors: İsmail Ay

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In this study, it was aimed to determine the relations between need for psychological help and psychological symptoms. The sample of the study consists of 530 university students getting educated in University of Atatürk in 2015-2016 academic years. Need for Psychological Help Scale and Brief Symptom Inventory were used to collect data in the study. In data analysis, correlation analysis and structural equation model with latent variables were used. Normality and homogeneity analyses were used to analyze the basic conditions of parametric tests. The findings obtained from the study show that as the psychological symptoms increase, need for psychological help also increases. The findings obtained through the study were approached according to the literature.

Keywords: psychological symptoms, need for psychological help, structural equation model, correlation

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Authors: Maath M. Musleh

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This research aims to study recent trends in the Palestinian feminist movement through the case study of Tal3at. The study uses social network analysis as its primary method to analyze Twitter data. It attempts to interpret results through the lens of network theories and Parson’s AGIL paradigm. The study reveals major structural weaknesses in the Tal3at network. Our findings suggest that the movement will decline soon as sentiments of alienation amongst Palestinian women increases. These findings were validated by a couple of central actors in the network. This study contributes an SNA approach to the understanding of the understudied Palestinian feminism.

Keywords: feminism, Palestine, social network analysis, Tal3at

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Authors: Collins Ekpiwre Augustine

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Taking into account the impact of teacher training on primary and secondary teachers’ classroom competencies and practices, as revealed by many empirical studies, this study investigated the impact of teacher qualifications on the pedagogical competencies of university teachers in Northwest Nigeria.Four research questions were answered while four hypotheses were tested. Both descriptive statistic of frequencies/arithmetic mean and inferential statistic oft-test were used to analyze the data collected. In order to provide a focus to the study,an observational rating scale titled “University Teachers’ Pedagogical Competency Observation Rating Scale” (UTPCORS) was used to collect data for the study. The population for the study comprised all the university teachers in the three Federal Universities in Northwest Nigeria totaling about 3,401. However, this pilot study was administered on 8 teachers - with 4 participants in each comparison group in Bayero University, Kano.The findings of the study revealed that there was no significant difference in the four hypotheses postulated for the study.

Keywords: impact, university teachers, teachers' qualifications, competencies

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Authors: Easter Faasoo-Tuilagi

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Study abroad has become a significant aspect of the tertiary system for New Zealand tertiary institutions and has been having a valuable contribution to student achievement and completion rate. The purpose of this doctoral study was to explore the significance and value of study abroad at an individual (learner), institutional (university), and national (government) level, with a focus on Māori and Pasifika learners. Previous research had conducted on the values and benefits of study abroad; however, there is a gap in knowledge on how study abroad can contribute to the educational experience of Māori and Pasifika students in tertiary studies in New Zealand. This study’s main focus aimed to explore the current participation and history of involvement of Māori and Pasifika students with study abroad using the University of Auckland and the University of Otago as case studies. It analysed the experiences of Māori and Pasifika students who were interested in study abroad or have returned from a study abroad. This research also explored how study abroad had become a significant aspect of the tertiary system in New Zealand, focusing on Tertiary Education Strategies. These questions were analysed using a range of methodologies, including a literature review to review how various institutions and nations, in particular New Zealand, were approaching study abroad, semi-structured interviews with Māori and Pasifika students on their experiences expressing interest in study abroad, and case studies of current/ returning Māori and Pasifika students who have had a study abroad experience. The anticipated results from this research will address several gaps in the existing literature and provide ways to better support Māori and Pasifika students who want to have a study abroad experience. This study will also inform education policy at an institutional and national level to boost the achievement of Māori and Pasifika students aligning with the Tertiary Education Strategy priorities.

Keywords: study abroad, Māori and Pasifika learners, international education, tertiary education strategy

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Authors: Vera Jancurova

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People are, in general, exposed to behavioral biases, however, the degree and impact are affected by experience, knowledge, and other characteristics. The purpose of this article is to study two of defined behavioral biases, the overconfidence and self-attribution bias, and its impact on economic and non-economic students at different stage of the study. The research method used for the purpose of this study is a controlled field study that contains questions on perception of own confidence and self-attribution and estimation of limits to analyse actual abilities. The results of the research show that economic students seem to be more overconfident than their non–economic colleagues, which seems to be caused by the fact the questionnaire was asking for predicting economic indexes and own knowledge and abilities in financial environment. Surprisingly, the most overconfidence was detected by the students at the beginning of their study (1st-semester students). However, the estimations of real numbers do not point out, that economic students have better results by the prediction itself. The study confirmed the presence of self-attribution bias at all of the respondents.

Keywords: behavioral finance, overconfidence, self-attribution, heuristics and biases

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Authors: Meenakshi Pappu

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The term, 'urban ecology' has often been misconstrued by the educational practitioners as well as the researchers as a study under a single discipline i.e., the environmental sciences. One who has done research extensively in this study would always argue that urban ecology is not a study under a single discipline, but it is a study across disciplines such as social sciences and other sciences like architecture, engineering, planning, ecology, geography, biology, economics, sociology, anthropology, psychology and health sciences. The aim of this paper is to discuss at length the scope of Urban Ecology as an interdisciplinary study. The paper highlights the nuances of urban ecology as a study across disciplines and the challenges and the implications it holds for future research by conducting a qualitative survey in the particular areas.

Keywords: educational practitioners, interdisciplinary, researchers, urban ecology

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Authors: A. Alshabeb

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Vocabulary is one of the elements that links the four skills of reading, writing, speaking, and listening and is very critical in learning a foreign language. This study aims to determine how Saudi Arabian EFL students learn English vocabulary via Twitter. The study adopts a mixed sequential research design in collecting and analysing data. The results of the study provide several recommendations for vocabulary learning. Moreover, the study can help teachers to consider the possibilities of using Twitter further, and perhaps to develop new approaches to vocabulary teaching and to support students in their use of social media.

Keywords: social media, twitter, vocabulary, web 2

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Authors: M. Rezki, A. Belaidi

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This paper deals with a method of learning to solve a real problem in biomedical engineering from a technical study of muscle fatigue. Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles (viewpoint: anatomical and physiological). EMG is used as a diagnostics tool for identifying neuromuscular diseases, assessing low-back pain and muscle fatigue in general. In order to study the EMG signal for detecting fatigue in a muscle, we have taken a real problem which touches the tramway conductor the handle bar. For the study, we have used a typical autonomous platform in order to get signals at real time. In our case study, we were confronted with complex problem to do our experiments in a tram. This type of problem is recurring among students. To teach our students the method to solve this kind of problem, we built a similar system. Through this study, we realized a lot of objectives such as making the equipment for simulation, the study of detection of muscle fatigue and especially how to manage a study of biomedical looking.

Keywords: EMG, health platform, conductor’s tram, muscle fatigue

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Authors: Mohammad A. Alia, Abdelfatah Aref Tamimi, Omaima N. A. Al-Allaf

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This paper reviews a comparison study on the most common used authentication methods. Some of these methods are actually based on cryptography. In this study, we show the main cryptographic services. Also, this study presents a specific discussion about authentication service, since the authentication service is classified into several categorizes according to their methods. However, this study gives more about the real life example for each of the authentication methods. It talks about the simplest authentication methods as well about the available biometric authentication methods such as voice, iris, fingerprint, and face authentication.

Keywords: information security, cryptography, system access control, authentication, network security

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Authors: Saeed Ullah Jan, Muhammad Zahid

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Purpose of study: The main theme of this study is to scrutinize and evaluate the available research on “role of libraries and librarians during COVID-19”. Design/Methodology/Approach: The quantitative research tool Bibliometric was used for the analysis of collected data. All the retrieved articles have been analyzed through MS office, MS Excel. Findings: It was depicted that 48 papers were published in 2021. The researchers from international countries have been published 45 and Pakistani researchers published only3 research papers on the subject cited above. Delimitations of the study: This study is delimited to the research articles published on the role of libraries and librarians during COVID-19. Practical implications: The findings of this study will be guideline for policy makers, higher ups and authorities of various facets of the libraries to revisit their priorities and work for the betterment of effective library culture in the country. Contribution to the knowledge: To the best of author's knowledge, no significant study has been done on this important topic of Library and Information Science research in Pakistan. This study will. add valuable literature the available literary world related to research development on the role of libraries and librarians during COVID-19.

Keywords: role of libraries, COVID-19, libraries, librarians, Pakistan

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Authors: Mutwakel Abdalla Ali Garalzain

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The aim of this study is to develop university EFL students’ communicative competence. The descriptive, analytical method was used in this study. To collect the data, the researcher designed two questionnaires, one for university EFL students and the other for English language teachers. The respondents of the study were eighty-eight; 76 university EFL students, and 12 English language teachers. The data obtained were analyzed by using statistical package for social science (SPSS). The findings of the study have revealed that most of the university EFL students are unable to express their ideas properly, although they have an abundance of vocabulary. The findings of the study have also shown that most of the university EFL students have positive attitudes towards communicative competence. The results of the study also identified the best strategies that can be used to enhance university EFL students’ communicative competence in English language teaching. The study recommends that English language textbooks should be compatible with the requirements of the student-centered approach. It also recommends that English language teachers should adopt the communicative approach’s strategies in the EFL classroom.

Keywords: applied linguistics, communicative competence , English language teaching, university EFL students

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Authors: Hend Al-Ma'seb, Anwar Alkhurinej

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In the field of social work, social workers understand that it is very difficult for individuals to ask for help from therapists. Therefore, it is important to study the variables associated with seeking professional help. A total of 478 undergraduate students from Kuwait University participated voluntarily in the study. The findings for this study showed that the participants of the study have a slightly high degree of public stigma, low self–stigma, and positive attitude toward seeking professional help. In addition, the findings of the study reveal that there are significant relationships between gender, taking social work classes, thinking about receiving counseling and having social problems and participants' attitude towards seeking professional help. Furthermore, the findings of the study showed that there were significant relationships between gender, and thinking about receiving counseling, and self-stigma. The findings of the current study have implications for the field of social work in Kuwait that would help to improve the knowledge in this area.

Keywords: attitude towards help, social work, social workers, stigma

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Authors: Sinem Toraman, Aysun Öztuna Kaplan, Hatice Mertoğlu, Esra Macaroğlu Akgül

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This study aims to examine pre-service teachers’ opinions on disabled people taking into consideration various variables. The participants of the study are composed of 170 pre-service teachers being 1st year students of different branches at Education Department of Yıldız Technical, Yeditepe, Marmara and Sakarya Universities. Data of the research was collected in 2013-2014 fall term. This study was designed as a phenomenological study appropriately qualitative research paradigm. Pre-service teachers’ opinions about disabled people were examined in this study, open ended question form which was prepared by researcher and focus group interview techniques were used as data collection tool. The study presents pre-service teachers’ opinions about disabled people which were mentioned, and suggestions about teacher education.

Keywords: pre-service teachers, disabled people, teacher education, teachers' opinions

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Authors: Azli Bin Ariffin, Noor Amy Afiza Binti Mohd Yusof

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This study aims to identify effect of social network usage on the self-learning method in teaching and learning at Sultan Idris Education University. The study involved 270 respondents consisting of students in the pre-graduate and post-graduate levels from nine fields of study offered. Assessment instrument used is questionnaire which measures respondent’s background includes level of study, years of study and field of study. Also measured the extent to which social pages used for self-learning and effect received when using social network for self-learning in learning process. The results of the study showed that students always visit Facebook more than other social sites. But, it is not for the purpose of self-learning. Analyzed data showed that 45.5% students not sure about using social sites for self-learning. But they realize the positive effect that they will received when use social sites for self-learning to improve teaching and learning process when 72.7% respondent agreed with all the statements provided.

Keywords: facebook, self-learning, social network, teaching, learning

Procedia PDF Downloads 538