Search results for: trauma informed pedagogy

Authors: M. Bilal Ishfaq, Adnan N. Qureshi

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COVID-19 is the most infectious disease these days, it was first reported in Wuhan, the capital city of Hubei in China then it spread rapidly throughout the whole world. Later on 11 March 2020, the World Health Organisation (WHO) declared it a pandemic. Since COVID-19 is highly contagious, it has affected approximately 219M people worldwide and caused 4.55M deaths. It has brought the importance of accurate diagnosis of respiratory diseases such as pneumonia and COVID-19 to the forefront. In this paper, we propose a hybrid approach for the automated detection of COVID-19 using medical imaging. We have presented the hybridization of manually extracted and convolutional features. Our approach combines Haralick texture features and convolutional features extracted from chest X-rays and CT scans. We also employ a minimum redundancy maximum relevance (MRMR) feature selection algorithm to reduce computational complexity and enhance classification performance. The proposed model is evaluated on four publicly available datasets, including Chest X-ray Pneumonia, COVID-19 Pneumonia, COVID-19 CTMaster, and VinBig data. The results demonstrate high accuracy and effectiveness, with 0.9925 on the Chest X-ray pneumonia dataset, 0.9895 on the COVID-19, Pneumonia and Normal Chest X-ray dataset, 0.9806 on the Covid CTMaster dataset, and 0.9398 on the VinBig dataset. We further evaluate the effectiveness of the proposed model using ROC curves, where the AUC for the best-performing model reaches 0.96. Our proposed model provides a promising tool for the early detection and accurate diagnosis of COVID-19, which can assist healthcare professionals in making informed treatment decisions and improving patient outcomes. The results of the proposed model are quite plausible and the system can be deployed in a clinical or research setting to assist in the diagnosis of COVID-19.

Keywords: COVID-19, feature engineering, artificial neural networks, radiology images

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Authors: Muhammad Suhail Ibrahim, Ahmad Mujtaba

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Background: The accuracy of the most frequently used tests for diagnosing Helicobacter pylori is always under consideration in clinical settings. A reliable diagnosis is crucial to confirm the success of therapy. Objective: The aim of this research was to study the isolation frequency of H. pylori from patients compatible with gastritis or gastric ulcer and to compare some feasible non-invasive and invasive methods for the diagnosis of infection. Materials and Methods: Ninety-six gastric biopsy and blood samples were obtained with various gastroduodenal symptoms after obtaining informed consent. The biopsies were analyzed and compared using the culture, microscopic examination, histopathology, Rapid urease RUT), serology, biochemical, antibiotic susceptibility test and molecular method. Results: A number of 40 (41.67%) were considered H. pylori positive in both histopathology and RUT. On the other hand, 46 patients were positive against anti IgA and IgG by ELISA. Eighteen biopsies were positive according to the culture test. This was further confirmed by endoscopic examination, urease, catalase and oxidase tests. A high percentage of resistance to polymyxin B, amoxicillin, and kanamycin was observed (100, 88.89, and 77.78%, respectively). A gene (Cag A) was also detected by using molecular technique which appeared positive in 16 patients. The sensitivity/specificity (%) of diagnostic method was 95/77 for histology, 100/83.5 for rapid urease, 85.7/90 for gram staining, 100/66.6 for IgG serology, 100/79.5 for IgA serology, 100/75.0 for PCR, 100/79.04 for combination of RUT and IgG serology and 100/92.4 for combination of RUT, gram staining and IgG serology. Conclusion: In view of the result obtained, PCR appeared to be the most reliable test. However, higher sensitivity and specificity were also recorded for other tests. So, for more accurate results, it is advisable not to rely solely on a single method for detection.

Keywords: helicobacter pylori, isolation, detection, culture, urease, polymerase chain reaction, antibiotic susceptibility test, dyspeptic patients

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Authors: Zahid Ullah, Atlas Khan

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The rapid growth of data in various domains has created a pressing need for effective methods to transform this data into meaningful knowledge. In this era of big data, mathematical and statistical innovations play a crucial role in unlocking insights and facilitating informed decision-making in data analytics. This abstract aims to explore the transformative potential of these innovations and their impact on converting raw data into actionable knowledge. Drawing upon a comprehensive review of existing literature, this research investigates the cutting-edge mathematical and statistical techniques that enable the conversion of data into knowledge. By evaluating their underlying principles, strengths, and limitations, we aim to identify the most promising innovations in data analytics. To demonstrate the practical applications of these innovations, real-world datasets will be utilized through case studies or simulations. This empirical approach will showcase how mathematical and statistical innovations can extract patterns, trends, and insights from complex data, enabling evidence-based decision-making across diverse domains. Furthermore, a comparative analysis will be conducted to assess the performance, scalability, interpretability, and adaptability of different innovations. By benchmarking against established techniques, we aim to validate the effectiveness and superiority of the proposed mathematical and statistical innovations in data analytics. Ethical considerations surrounding data analytics, such as privacy, security, bias, and fairness, will be addressed throughout the research. Guidelines and best practices will be developed to ensure the responsible and ethical use of mathematical and statistical innovations in data analytics. The expected contributions of this research include advancements in mathematical and statistical sciences, improved data analysis techniques, enhanced decision-making processes, and practical implications for industries and policymakers. The outcomes will guide the adoption and implementation of mathematical and statistical innovations, empowering stakeholders to transform data into actionable knowledge and drive meaningful outcomes.

Keywords: data analytics, mathematical innovations, knowledge extraction, decision-making

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Authors: Marzia Bilkiss, Muhammad J. A. Shiddiky, Mostafa K. Masud, Prabhakaran Sambasivam, Ido Bar, Jeremy Brownlie, Rebecca Ford

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A greater achievement in the Integrated Disease Management (IDM) to prevent the loss would result from early diagnosis and quantitation of the causal pathogen species for accurate and timely disease control. This could significantly reduce costs to the growers and reduce any flow on impacts to the environment from excessive chemical spraying. Necrotrophic fungal disease botrytis grey mould, caused by Botrytis cinerea and Botrytis fabae, significantly reduce temperate legume yield and grain quality during favourable environmental condition in Australia and worldwide. Several immunogenic and molecular probe-type protocols have been developed for their diagnosis, but these have varying levels of species-specificity, sensitivity, and consequent usefulness within the paddock. To substantially improve speed, accuracy, and sensitivity, advanced nanoparticle-based biosensor approaches have been developed. For this, two sets of primers were designed for both Botrytis cinerea and Botrytis fabae which have shown the species specificity with initial sensitivity of two genomic copies/µl in pure fungal backgrounds using multiplexed quantitative PCR. During further validation, quantitative PCR detected 100 spores on artificially infected legume leaves. Simultaneously an electro-catalytic assay was developed for both target fungal DNA using functionalised magnetic nanoparticles. This was extremely sensitive, able to detect a single spore within a raw total plant nucleic acid extract background. We believe that the translation of this technology to the field will enable quantitative assessment of pathogen load for future accurate decision support of informed botrytis grey mould management.

Keywords: biosensor, botrytis grey mould, sensitive, species specific

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Authors: Fulufhelo Oscar Makananise

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Digital technologies have played a significant role in bridging the information gap between the haves and the have nots in society. In developing countries such as South Africa, historically marginalised groups such as women in rural communities have an opportunity to use digital technologies to network among themselves as well as interact with their government, thereby enhancing prospects for poverty eradication, political participation, community development and democracy. However, the extent to which these goals can be achieved in a developing context through harnessing digital technologies is not quite clear, particularly given the fact that access to these technologies is not evenly distributed and the fact that women’s access to digital technologies is hampered by factors that go beyond the question of infrastructure. Informed by the technological dependency theory, this paper is about how female youth in rural South Africa are deploying digital media tools for socio-economic empowerment. In particular, the study investigated the extent to which female youth in Limpopo province, South Africa access and use digital media platforms and gadgets and the extent to which those technologies are breaking down barriers that stand in the way of female youth empowerment. Data were gathered using a self-administered questionnaire disseminated to selected 100 female youth in Limpopo Province, South Africa. The data were analysed using SPSS version 9, and the results were analysed using descriptive statistics. The paper argues that wider and constant access to digital media by female youth in rural areas is indicative of the great potential for empowering female youth in rural areas through harnessing digital media. The study established that the majority of female youth had access to digital media technologies and used them to share valuable information among themselves. The study further established that female youth are active users of digital media in South Africa, which is the significant driver for socio-economic empowerment.

Keywords: digital technologies, empowerment, female youth, South Africa, survey, technological dependency

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Authors: Mai Hussein

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'Littoral' is an original voice in Québécois theatre, spanning the cultural gaps that can exist between the playwrights’ native Lebanon, North America, Quebec, and Europe. Littoral is a 'crossroad' of cultures and themes, a 'bridge' connecting cultures and languages. It represents a new form of theatrical writing that combines the verbal, the vocal and the pantomimic, calling upon the stage to question the real, to engage characters in a quest, in a journey of mourning, of reconstructing identity and a collective memory despite ruins and wars. A theatre of witness, a theatre denouncing irrationality of racism and war, a theatre 'performing' the symptoms of the stress disorders of characters passing from resistance and anger to reconciliation and giving voice to the silenced victims, these are some of the pillars that this play has to offer. In this corrida between life and death, the identity seems like a work-in-progress that is shaped in the presence of the Self and the Other. This trajectory will lead to re-open widely the door to questions, interrogations, and reflections to show how this play is at the nexus of contemporary preoccupations of the 21st century: the importance of memory, the search for meaning, the pursuit of the infinite. It also shows how a play can create bridges between languages, cultures, societies, and movements. To what extent does it mediate between the words and the silence, and how does it burn the bridges or the gaps between the textual and the performative while investigating the power of intermediality to confront racism and segregation. It also underlines the centrality of confrontation between cultures, languages, writing and representation techniques to challenge the characters in their quest to restructure their shattered, but yet intertwined identities. The goal of this theatre would then be to invite everyone involved in the process of a journey of self-discovery away from their comfort zone. Everyone will have to explore the liminal space, to read in between the lines of the written text as well as in between the text and the performance to explore the gaps and the tensions that exist between what is said, and what is played, between the 'parole' and the performative body.

Keywords: identity, memory, performance, testimony, trauma

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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Authors: Safieh Javadinejad

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In order to make well-informed decisions respecting long-term system planning, resource managers and policy creators necessitate to comprehend the interconnections among energy and water utilization and manufacture—and also the energy-water nexus. Planning and assessment issues contain the enhancement of strategies for declining the water and energy system’s vulnerabilities to climate alteration with also emissions of decreasing greenhouse gas. In order to deliver beneficial decision support for climate adjustment policy and planning, understanding the regionally-specific features of the energy-water nexus, and the history-future of the water and energy source systems serving is essential. It will be helpful for decision makers understand the nature of current water-energy system conditions and capacity for adaptation plans for future. This research shows an integrated hydrology/energy modeling platform which is able to extend water-energy examines based on a detailed illustration of local circumstances. The modeling links the Water Evaluation and Planning (WEAP) and the Long Range Energy Alternatives Planning (LEAP) system to create full picture of water-energy processes. This will allow water managers and policy-decision makers to simply understand links between energy system improvements and hydrological processing and realize how future climate change will effect on water-energy systems. The Zayandeh Rud river basin in Iran is selected as a case study to show the results and application of the analysis. This region is known as an area with large integration of both the electric power and water sectors. The linkages between water, energy and climate change and possible adaptation strategies are described along with early insights from applications of the integration modeling system.

Keywords: climate impacts, hydrology, water systems, adaptation planning, electricity, integrated modeling

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Authors: Amro Matyori, Fatimah Sherbeny, Askal Ali, Olayiwola Popoola

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Objectives: The study evaluated the impact of COVID-19 on anxiety levels in the general population in the United States. Methods: The study used an online questionnaire. It adopted the Generalized Anxiety Disorder Assessment (GAD-7) instrument. It is a self-administered scale with seven items used as a screening tool and severity measure for generalized anxiety disorder. The participants rated the frequency of anxiety symptoms in the last two weeks on a Likert scale, which ranges from 0-3. Then the item points are summed to provide the total score. Results: Thirty-two participants completed the questionnaire. Among them, 24 (83%) females and 5 (17%) males. The age range of 18-24-year-old represented the most respondents. Only one of the participants tested positive for the COVID-19, and 39% of them, one of their family members, friends, or colleagues, tested positive for the coronavirus. Moreover, 10% have lost a family member, a close friend, or a colleague because of COVID-19. Among the respondents, there were ten who scored approximately five points on the GAD-7 scale, which indicates mild anxiety. Furthermore, eight participants scored 10 to 14 points, which put them under the category of moderate anxiety, and one individual who was categorized under severe anxiety scored 15 points. Conclusions: It is identified that most of the respondents scored the points that put them under the mild anxiety category during the COVID-19 pandemic. It is also noticed that severe anxiety was the lowest among the participants, and people who tested positive and/or their family members, close friends, and colleagues were more likely to experience anxiety. Additionally, participants who lost friends or family members were also at high risk of anxiety. It is obvious the COVID-19 outcomes and too much thinking about the pandemic put people under stress which led to anxiety. Therefore, continuous assessment and monitoring of psychological outcomes during pandemics will help to establish early well-informed interventions.

Keywords: anxiety and covid-19, covid-19 and mental health outcomes, influence of covid-19 on anxiety, population and covid-19 impact on mental health

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Authors: Yili Liu, Honghao Ren, Mariko Kondo

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In the field of second language (L2) speech learning, it is well-known that that learner’s first language (L1) phonetic and phonological characteristics will be transferred into their L2 production and perception, which lead to foreign accent. For L1 Mandarin learners of Japanese, the confusion of /u/ and /o/ in /CjV/ sequences has been observed in their utterance frequently. L1 transfer is considered to be the cause of this issue, however, other factors which influence the identification of /Cju/ and /Cjo/ sequences still under investigation. This study investigates the perception of Japanese /Cju/ and /Cjo/ units by L1 Mandarin learners of Japanese. It further examined whether learners’ proficiency, syllable position, phonetic features of preceding consonants and background noise affect learners’ performance in perception. Fifty-two Mandarin-speaking learners of Japanese and nine native Japanese speakers were recruited to participate in an identification task. Learners were divided into beginner, intermediate and advanced level according to their Japanese proficiency. The average correct rate was used to evaluate learners’ perceptual performance. Furthermore, the comparison of the correct rate between learners’ groups and the control group was conducted as well to examine learners’ nativelikeness. Results showed that background noise tends to pose an adverse effect on distinguishing /u/ and /o/ in /CjV/ sequences. Secondly, Japanese proficiency has no influence on learners’ perceptual performance in the quiet and in background noise. Then all learners did not reach a native-like level without the distraction of noise. Beginner level learners performed less native-like, although higher level learners appeared to have achieved nativelikeness in the multi-talker babble noise. Finally, syllable position tends to affect distinguishing /Cju/ and /Cjo/ only under the noisy condition. Phonetic features of preceding consonants did not impact learners’ perception in any listening conditions. Findings in this study can give an insight into a further understanding of Japanese vowel acquisition by L1 Mandarin learners of Japanese. In addition, this study indicates that L1 transfer is not the only explanation for the confusion of /u/ and /o/ in /CjV/ sequences, factors such as listening condition and syllable position are also needed to take into consideration in future research. It also suggests the importance of perceiving speech in a noisy environment, which is close to the actual conversation required more attention to pedagogy.

Keywords: background noise, Chinese learners of Japanese, /Cju/ and /Cjo/ sequences, second language perception

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Authors: Scholastic Nangila Adeli, Francisca Mbutitia Ngithi

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Stigma is commonly associated with mental health patients and may act as a barrier to individuals who may seek or engage in treatment services. Stigmatization among university students is common whether they know someone with a mental health problem, or have a good knowledge and experience of mental health issues. The objective of this study was to establish the various barriers that prevent university students who have mental health challenges from seeking treatment and care. The study was a descriptive in nature where 320 respondents helped to establish the barriers to treatment or participation in mental health care among university students. A questionnaire was used to help establish the barriers and attitude towards mental illness among the respondents. Results from this study revealed that mental illnesses are common among university students and they are manifested in different forms like; anxiety and panic attacks, mood and eating disorders, Impulse control leading to gambling, alcohol and drug addictions, anger and depression leading to loneliness. Mental stigma (both social and self) was the major barrier with 62% of the respondents stating that social stigma was worse than self-stigma. This is because of the social discrimination towards the victim of mental challenges. On issues of attitude, 71% of the respondents said that they can never admit that they have a mental issue and would rather secretly seek clinical or psychological help for fear of being discriminated or excluded by peers. This view is informed by the societal belief that people with mental health challenges were dangerous (associating them with criminal behavior) and hard to socialize with or help. From the findings of this study, it is concluded that mental health problems are real among university students in Kenya and it is important for the university environment to minimize or eradicate stigma within the social circles. Stigma can be minimized or eradicated by creating awareness among university students and fostering social inclusion so that the students who have mental health challenges can experience a sense of belonging and acceptance hence build their self-esteem.

Keywords: disorders, impulse control, mental health problems, stigma

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Authors: Usma Iftikhar, Khorshed Alam

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Background: Digital health platforms and digital health interventions are gaining increasing importance with the shift to online health-seeking behaviour, especially post-Covid. Subsequently, the importance of digital health literacy is increasingly being recognized. With the surge in culturally and linguistically diverse populations in First World countries, especially females, the predictors of digital health access in this population remain elusive. Keeping in view the inadequate digital infrastructure in rural and remote Australia, with lack of specialist services, the determinants of digital access gain even more importance. Objectives: The objective of this research are to measure the digital health literacy levels in this population, including the predictors of digital health literacy like sociodemographics and the correlation between the predictors and digital health literacy levels. Methods: A population-based quantitative survey was carried out in Regional Queensland from Jan 2022- Dec 2023 on culturally and linguistically diverse adult females. Sociodemographics like age, literacy levels, socioeconomic status, access to digital devices were recorded after informed consent. Digital health literacy levels were measured by specially designed questionnaires. The relationship between sociodemographics and digital health literacy levels was estimated by Pearson correlation. Results: Mean DHL was 2.66 + 0.35. There was a negative significant relationship (p<0.005) between demographics like age and access to a digital device with digital health literacy levels. Also observed was a positive significant relationship between literacy levels and proficiency in English. Conclusion: Age, literacy levels and English proficiency are some of the highest predictors of digital health access. This is important because remote areas rely on digital health access due to less developed health infrastructure, including specialist services. Guide for Policy makers to focus on the populations most in need.

Keywords: digital health literacy, eHealth literacy, culturally and linguistically diverse, ethnic minorities, regional areas, rural and remote areas

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Authors: Sarita Magu, Deepak Singh

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Study Design: This prospective study was conducted at the department of Radio Diagnosis, at Pt B.D. Sharma PGIMS, Rohtak in 57 patients of spine injury on radiographs or radiographically normal patients with neurological deficits presenting within 72 hours of injury. Aims: Evaluation of the role of Magnetic Resonance Imaging (MRI) in Spinal Trauma Patients and to compare MRI findings with clinical profile and neurological status of the patient and to correlate the MRI findings with neurological recovery of the patient and predict the outcome. Material and Methods: Neurological status of patients was assessed at the time of admission and discharge in all the patients and at long term interval of six months to one year in 27 patients as per American spine injury association classification (ASIA). On MRI cord injury was categorized into cord hemorrhage, cord contusion, cord edema only, and normal cord. Quantitative assessment of injury on MRI was done using mean canal compromise (MCC), mean spinal cord compression (MSCC) and lesion length. Neurological status at admission and neurological recovery at discharge and long term follow up was compared with various qualitative cord findings and quantitative parameters on MRI. Results: Cord edema and normal cord was associated with favorable neurological outcome. Cord contusion show lesser neurological recovery as compared to cord edema. Cord hemorrhage was associated with worst neurological status at admission and poor neurological recovery. Mean MCC, MSCC, and lesion length values were higher in patients presenting with ASIA A grade injury and showed decreasing trends towards ASIA E grade injury. Patients showing neurological recovery over the period of hospital stay and long term follow up had lower mean MCC, MSCC, and lesion length as compared to patients showing no neurological recovery. The data was statistically significant with p value <.05. Conclusion: Cord hemorrhage and higher MCC, MSCC and lesion length has poor prognostic value in spine injury patients.

Keywords: spine injury, cord hemorrhage, cord contusion, MCC, MSCC, lesion length, ASIA grading

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Authors: Sarah Hebbouch

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Two decades ago, research on diasporic women’s participation within Sufi circles would have been inconceivable, not only because of a general lack of recognition of their contribution to Sufism but due to the intimacy of the rituals, often taking place in confined spaces, like zawiyas (Sufi lodges). Recent scholarly attention to female spiritual experience owes to a digital awareness and interest in exploring diasporic community reproduction of those experiences. Within a context where female disciples of a Sufi convent undergo a physical separation from the saint’s sanctuary -because of immigration from the homeland to the host country- technology becomes a social hub accounting for Sufis’ ritual commitment and preservation of cultural capital in the diaspora. This paper elucidates how female Sufi immigrants affiliating with the Boudchichi brotherhood (Morocco-based) maintain ‘a relational network’ and strong social online relationships with their female compatriots in Morocco through the use of online platforms. Sufi communities living in the diaspora find the internet an open interactive space that serves to kindle their distance of spiritual participation and corroborate their transnational belonging. The current paper explores the implications of the use of a digital baseline named “Tariqa Info,” the convent’s digital online platform, and how it mediates everyday ritual performance, the promotion of digital connection, and the communication of ideas and discourses. Such a platform serves the bolstering emotional bonds for transnational female disciples and inclusion within online communities in the homeland. Assisted by an ethnographic lens, this paper discusses the research findings of participatory field observation of Sufi women’s online communities, informed by the need to trace the many ostensible aspects of interconnectedness and divergences.

Keywords: digital connection, Sufi convent, social online relationship, transnational female disciples

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Authors: Ashokkumar Subbiah

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This study investigates the impact of factors that influenced the success of construction planning for a major construction project in Qatar. An approach of participant observation is adopted which is informed by the principles of ethnography: one that reports the participants’ view of their world rather than imposing an artificial theoretical framework upon it. As participant observant, key factors were observed and identified that had an impact on the management and execution of the construction planning. It is found that a ‘shadow culture’ exists between the project participants which, it is argued, is only observable from the perspective of an embedded participant observer. The shadow culture acts to enable the management of the planning process, and its efficacy relates to the ‘quality’ of human inter-relationships amongst immediate stakeholders. Whilst this study uses the concept of shadow culture, it is treated as both a methodological stance and one of the findings of this research in the context of the major construction project in Qatar. The concept of shadow culture is not imposed upon the findings, but instead is used as a research tool: respondents report their own worldview and this is reported from the view of a participant observant in a manner that is understandable and useful to those who are not part of the construction project. The findings of this study identify similar factors influencing the planning process of the Qatar project, but the shadow culture predominantly influences these factors towards the failure of planning process. The research concludes by questioning the assumption that construction planning is a mechanistic process that has to be conducted solely by the planning team. Instead, it is a highly social phenomenon in which the seemingly mechanistic process is made workable by the quality of relationships that exist in the project. Drawing on this the final section provides a series of recommendations that may be helpful in enhancing the efficacy of project planning; these include better training/education at the pre-construction phase; recognition of the importance of shadow processes at management levels, and better appreciation of the impact of contract type and chosen procurement route.

Keywords: construction planning, participant observation, project participants, shadow culture

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Authors: Alexandra Von Guionneau, William Sloper, Charlotte Burford

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The benefits of exercise for the prevention and management of chronic disease are well established and the importance of primary care practitioners in promoting exercise is becoming increasingly recognized. However, those with severe manifestations of the chronic disease are managed in a secondary care setting. Secondary care practitioners, therefore, have a role to play in promoting physical activity. Methods: In order to assess secondary care doctors’ knowledge of the Chief Medical Officer’s guidelines for physical activity, a 12-question survey was administered to staff working in a district general hospital in South England during team and unit meetings. Questions related to knowledge of the current guidelines for both 19 - 64 year olds and older adults (65 years and above), barriers to exercise discussion or prescription and doctors’ own exercise habits. Responses were collected anonymously and analyzed using SPSS Version 24.0. Results: 96 responses were collected. Doctors taking part in the survey ranged from foundation years (26%) to consultants (40%). 17.7% of participants knew the guidelines for moderate intensity activity for 19 - 64 year olds. Only one participant knew all of the guidance for both 19 - 64 year olds and older adults. While 71.6% of doctors felt they were adequately informed about how to exercise, only 45.6% met the minimum recommended guidance for moderate intensity activity. Conclusion: More work is needed to promote the physical activity guidelines and exercise prescription to doctors working within a secondary care setting. In addition, doctors require more support to personally meet the recommended minimum level of physical activity.

Keywords: exercise is medicine, exercise prescription, physical activity guidelines, exercise habits

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Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini, Omid Seyed Esmaeili, Rouzbeh Kezemi, Noushin Mehrbod, Nazanin Vahed, Tahereh Hajiahmad, Noureddin Nakhostin Ansari

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Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of VR beside conventional rehabilitation versus conventional rehabilitation alone on spasticity and motor function in stroke patients. Materials and Methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran, in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were modified Ashworth scale, recovery stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in the combination group (P=0.003). Only wrist extension was varied between groups and was better in the combination group. The variables generally had a statistically significant difference (P < 0.05). Conclusion: Virtual reality plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: stroke, virtual therapy, rehabilitation, treatment

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Authors: Christiane Dumont

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This paper proposes to revisit foreign-language learning as a tool to increase motivation through advocacy and develop effective natural communication skills, which are critical leadership qualities. To this end, collaborative initiatives undertaken by advanced university students of French with local and international community partners will be reviewed. Close attention will be paid to the acquisition of intercultural skills, the reflective process, as well as the challenges and outcomes. Two international development projects conducted in Haiti will be highlighted, i.e., collaboration with a network of providers in the Haitian cultural heritage preservation and tourism sector (2014-15) and development of investigation and teacher training tools for a primary/secondary school in the Port-au-Prince area (current). The choice of community-service learning as a framework to teach French-as-a-second-language stemmed from the need to raise awareness against stereotypes and prejudice, which hinder the development of effective intercultural skills. This type of experiential education also proved very effective in identifying and preventing miscommunication caused by the lack of face-to-face interaction in our increasingly technology-mediated world. Learners experienced first-hand, the challenges and advantages of face-to-face communication, which, in turn, enhanced their motivation for developing effective intercultural skills. Vygotsky's and Kolb's theories, current research on service learning (Dwight, Eyler), action/project-based pedagogy (Beckett), and reflective learning (TSC Farrell), will provide useful background to analyze the benefits and challenges of community-service learning. The ultimate goal of this paper is to find out what makes experiential learning truly unique and transformative for both the learners and the community they wish to serve. It will demonstrate how enhanced motivation, community engagement, and clear, concise, and respectful communication impact and empower learners. The underlying hope is to help students in high-profile, and leading-edge industries become effective global leaders.

Keywords: experiential learning, intercultural communication, reflective learning, effective leadership, learner motivation

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Authors: Lubna Khondker

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Background: Melasma is a common pigmentary dermatosis, manifested by hyperpigmented macules or patches on the face, commonly occurring in females due to an acquired disorder in the melanogenesis process. Although several treatments are currently used, it remains a great challenge due to recurrence and refractory nature. It was recently reported that tranexamic acid (TA-plasmin inhibitor) is an effective treatment for melasma. Objective: This study aims to compare the efficacy and side effects of intralesional injection of Tranexamic acid with oral Tranexamic acid in the treatment of melasma. Methods: A clinical trial was done in the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, for a period of 4 years. A total of 100 patients with melasma who did not respond to topical therapy were included in the study as group A and group B. Group A Patients were administered intralesional injection (10 mg/ml) of Tranexamic acid( TA) weekly for 6 weeks, and group B patients were treated with oral tranexamic acid 250 mg 12 hourly for 12 weeks after taking informed consent. The severity and extent of pigmentation were assessed by the modified melasma area severity index (MASI). The response to treatment was assessed by MASI at 4 weeks, 8 weeks, and 12 weeks after stopping treatment. Results: The study showed the MASI scores at the baseline, 4 weeks, 8 weeks, and 12 weeks in group A were 18.23±1.22, 6.14±3.26, 3.21±2.14 and 2.11±2.01 respectively, and in group B, 17.87±1.12, 11.21±6.25, 6.57±4.26 and 6.41±4.17 respectively. The mean MASI significantly reduced in group A compared to group B in the 4th, 8th, and 12th weeks. The present study showed that among group A patients, 56% rated excellent (>75% reduction) in outcome, 32% good (50-75% reduction), 8% moderate (25-50% reduction) and only 4% (<25% reduction) was unsatisfactory and among group B patients, 14% rated excellent in outcome, 28% good, 36% moderate and 22% was unsatisfactory. Overall improvement in our study in group A was 96% and in group B 78%. Side effects were negligible, and all the patients tolerated the treatment well. Conclusion: Based on our results, intralesional Tranexamic acid (10 mg/ml) is more effective and safer than oral Tranexamic acid in the treatment of melasma.

Keywords: intralesional tranexamic acid, melasma, oral tranexamic acid, MASI score

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Authors: Chloe Fauchon

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In Europe, the right to a fair trial is enshrined in the European Convention on Human Rights, signed in 1950, in its famous Article 6, and, in the field of the European Union, in Article 47 of the Charter of Fundamental Rights, binding since 2009. The right to a fair trial is, therefore, a fundamental right protected by all the relevant treaties. The right to a fair trial is an "umbrella right" which encompasses various sub-rights and principles. Although this right applies in all the proceedings, it gets a special relevance in criminal matters and, particularly, regarding the defendant. In criminal proceedings, the parties are not equal: the accusation is represented by a State-organ, with specific prerogatives, and the defense does not benefit from these specific powers and is often inexperienced in criminal law. Equality of arms, and consequently the right to a fair trial, needs some specific mechanisms to be effective in criminal proceedings. For instance, the defendant benefits from some procedural rights, such as the right to a lawyer, the right to be informed of the charges against them, the right to confront witnesses, and so on. These rights aim to give the defendant the tools to dispute the accusation. The role of the defense is, therefore, very important in criminal matters to avoid unjustified convictions. This specificity of criminal matters justifies that the focus will be put on them during this study. Then this paper will also focus on French and Spanish legal orders. Indeed, if the European Court and Convention on Human Rights are the most famous instruments to protect the right to a fair trial, this right is also guaranteed at a constitutional level in European national legal orders in Europe. However, this enshrinement differs from one country to the other: for instance, in Spain, the right to a fair trial is protected explicitly by the 1978 constitutional text, whereas, in France, it is more of a case-law construction. Nevertheless, this difference between both legal orders does not imply huge variations in the substantive aspect of the right to a fair trial. This can be specifically explained by the submission of both States to the European Convention on Human Rights. This work aims to show that, although the French and Spanish legal orders differ in the way they protect the right to a fair trial, this right eventually has the same substantive meaning in both legal orders.

Keywords: right to a fair trial, constitutional law, French law, Spanish law, European Court of Human Rights

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Authors: Ann Dashwood

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Using standard Australian English with confidence is a cultural expectation of parents of primary school aged children who want to engage effectively with their children’s teachers and school administration. That confidence in support of their children’s learning at school is seldom experienced by parents whose first language is not English. Sharing language with competence in an intercultural environment is the common denominator for meaningful communication and engagement to occur in a school community. Experience in relevant interactive sessions is known to enhance engagement and participation. The purpose of this paper is to identify interactional settings for which parents who are isolated from the daily use of functional Australian cultural language learned to engage more effectively in their children’s learning at school. The outcomes measured parents’ intercultural engagement with classroom teachers and attention to the school’s administrative procedures. The study used quantitative and qualitative methods. The principles of communicative task-based language learning combined with intercultural communication principles provided the theoretical base for intensive English task-based learning and engagement. The quantitative analysis examined data samples collected by classroom teachers and administrators and parents’ writing samples. Interviews and observations qualitatively informed the study. Currently significant numbers of projects are active in community centres and schools to enhance English language knowledge of parents from Language Backgrounds Other Than English (LBOTE). The study was significant to explore the effects of conducting intensive English with parents of varied English language backgrounds by targeting language use for social interactions in the community, specific engagement in school activities, cultural interaction with teachers and responsiveness to complying with school procedures.

Keywords: engagement, intercultural communication, LBOTE, school community

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Authors: Diego Alejandro Espíndola-Fernández, Ana María Posada-Cano, Dagnóvar Aristizábal-Ocampo, Jaime Alberto Gallo-Villegas

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Background: With the increase in life expectancy, aging has been subject of frequent research, and therefore multiple strategies have been proposed to quantify the advance of the years based on the known physiology of human senescence. For several decades, attempts have been made to characterize these changes through the concept of biological age, which aims to integrate, in a measure of time, structural or functional variation through biomarkers in comparison with simple chronological age. The objective of this scoping review is to deepen the updated concept of measuring biological age composed of biomarkers in the general population and to summarize recent evidence to identify gaps and priorities for future research. Methods: A scoping review was conducted according to the five-phase methodology developed by Arksey and O'Malley through a search of five bibliographic databases to February 2021. Original articles were included with no time or language limit that described the biological age composed of at least two biomarkers in those over 18 years of age. Results: 674 articles were identified, of which 105 were evaluated for eligibility and 65 were included with information on the measurement of biological age composed of biomarkers. Articles from 1974 of 15 nationalities were found, most observational studies, in which clinical or paraclinical biomarkers were used, and 11 different methods described for the calculation of the composite biological age were informed. The outcomes reported were the relationship with the same measured biomarkers, specified risk factors, comorbidities, physical or cognitive functionality, and mortality. Conclusions: The concept of biological age composed of biomarkers has evolved since the 1970s and multiple methods of its quantification have been described through the combination of different clinical and paraclinical variables from observational studies. Future research should consider the population characteristics, and the choice of biomarkers against the proposed outcomes to improve the understanding of aging variables to direct effective strategies for a proper approach.

Keywords: biological age, biological aging, aging, senescence, biomarker

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Authors: Samah Senbel

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Database Design is a fundamental part of the Computer Science and Information technology curricula in any school, as well as in the study of management, business administration, and data analytics. In this study, we compare the performance of two groups of students studying the same database design and implementation course at Sacred Heart University in the fall of 2018. Both courses used the same textbook and were taught by the same professor, one for seven graduate students and one for 26 undergraduate students (juniors). The undergraduate students were aged around 20 years old with little work experience, while the graduate students averaged 35 years old and all were employed in computer-related or management-related jobs. The textbook used was 'Database Systems, Design, Implementation, and Management' by Coronel and Morris, and the course was designed to follow the textbook roughly a chapter per week. The first 6 weeks covered the design aspect of a database, followed by a paper exam. The next 6 weeks covered the implementation aspect of the database using SQL followed by a lab exam. Since the undergraduate students are on a 16 week semester, we spend the last three weeks of the course covering NoSQL. This part of the course was not included in this study. After the course was over, we analyze the results of the two groups of students. An interesting discrepancy was observed: In the database design part of the course, the average grade of the graduate students was 92%, while that of the undergraduate students was 77% for the same exam. In the implementation part of the course, we observe the opposite: the average grade of the graduate students was 65% while that of the undergraduate students was 73%. The overall grades were quite similar: the graduate average was 78% and that of the undergraduates was 75%. Based on these results, we concluded that having both classes follow the same time schedule was not beneficial, and an adjustment is needed. The graduates could spend less time on design and the undergraduates would benefit from more design time. In the fall of 2019, 30 students registered for the undergraduate course and 15 students registered for the graduate course. To test our conclusion, the undergraduates spend about 67% of time (eight classes) on the design part of the course and 33% (four classes) on the implementation part, using the exact exams as the previous year. This resulted in an improvement in their average grades on the design part from 77% to 83% and also their implementation average grade from 73% to 79%. In conclusion, we recommend using two separate schedules for teaching the database design course. For undergraduate students, it is important to spend more time on the design part rather than the implementation part of the course. While for the older graduate students, we recommend spending more time on the implementation part, as it seems that is the part they struggle with, even though they have a higher understanding of the design component of databases.

Keywords: computer science education, database design, graduate and undergraduate students, pedagogy

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Authors: Arash Gharibi

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Mankind has always used models to solve problems. Essentially, models are simplified versions of reality, whose need stems from having to deal with complexity; many processes or phenomena are too complex to be described completely. Thus a fundamental model requirement is that it contains the characteristic features that are essential in the context of the problem to be solved or described. Models are used in virtually every scientific domain to deal with various problems. During the recent decades, the number of models has increased exponentially. Publication of models as part of original research has traditionally been in in scientific periodicals, series, monographs, agency reports, national journals and laboratory reports. This makes it difficult for interested groups and communities to stay informed about the state-of-the-art. During the modeling process, many important decisions are made which impact the final form of the model. Without a record of these considerations, the final model remains ill-defined and open to varying interpretations. Unfortunately, the details of these considerations are often lost or in case there is any existing information about a model, it is likely to be written intuitively in different layouts and in different degrees of detail. In order to overcome these issues, different domains have attempted to implement their own approaches to preserve their models’ information in forms of model documentation. The most frequently cited model documentation approaches show that they are domain specific, not to applicable to the existing models and evolutionary flexibility and intrinsic corrections and improvements are not possible with the current approaches. These issues are all because of a lack of unified standards for model documentation. As a way forward, this research will propose a new standard for capturing and managing models’ information in a unified way so that interoperability and reusability of models become possible. This standard will also be evolutionary, meaning members of modeling realm could contribute to its ongoing developments and improvements. In this paper, the current 3 of the most common metamodels are reviewed and according to pros and cons of each, a new metamodel is proposed.

Keywords: metamodel, modeling, interoperability, reuse

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Authors: Bashar Dahiru Bashar

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Growing research reveals an unprecedented increase in African applicants for PhD positions across European universities. Meanwhile, a very small percentage is accepted as qualified candidates to marginalize, perpetuate stereotypes, and institute racial discrimination. Candidates of color very often encounter barriers and prejudices that not only diminish their sense of belonging but also hinder their academic progress. Although this issue has existed for quite some time, it attracts little attention, even from the academic community in higher education. Moreover, the focus is mostly on the applicants. In this contribution, concern has been raised that the African applicants for PhD positions in European Universities are the victims rather than the perpetrators. The Universities designed a recruitment process that is in all respects exclusive, biased, and European. The recruitment exercise is a hocus-post in order to cover language and racial and ethnic rejection. Just in the same way legacy admission is practiced in the US. The paper further expressed that the logic is to systematically maintain racial hierarchy and social dominance within the education sector. And because those at an advantage are also the ones that have the media and are predominant in academia, issues like this are not receiving deserved attention. Many people were victims of this recruitment process, while others survived severely wounded as a result of mental, social, and economic trauma. It is not the aim of this paper to provide an armchair solution to this issue but only to showcase the process with the hope of providing something that is needed to improve the present day's literacy and situation. The findings contribute to the broader discourse on diversity, equity, and inclusiveness within European Universities, emphasizing, amongst others, the need for cultivating an atmosphere where individuals are valued for their contributions rather than assessed based on race and ethnicity is essential for creating a vibrant and equitable global academic community, forging a path towards a just and harmonious educational landscape where everyone irrespective of race or ethnicity can thrive and contribute to the collective pursuit of knowledge.

Keywords: admission and recruitment for PhD position, globalization of education, systemic rejection, European university

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Authors: T. Nishimura, K. Doi, H. Fujimoto, Y. Hoshikawa, T. Wada

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In Japan, it is expected that reasonable accommodation for persons with disabilities will progress further. In particular, there is an urgent need to enhance information support for visually impaired persons who have difficulty accessing information. Recently, tactile symbols have been attached to various surfaces, such as the content labels of containers and packaging of various everyday products. The advantage of tactile symbols is that they are useful for visually impaired persons who cannot read Braille. The method of displaying tactile symbols is prescribed by the International Organization for Standardization (ISO). However, the quantitative data on the shapes and dimensions of tactile symbols is insufficient. In this study, through an evaluation experiments, we examine the easy-to-distinguish shapes and dimensions of tactile symbols used for various applications, including the content labels on containers and packaging. Visually impaired persons participated in the experiments. They used tactile symbols on a daily basis. The details and processes of the experiments were orally explained to the participants prior to the experiments, and the informed consent of the participants was obtained. They were instructed to touch the test pieces of tactile symbols freely with both hands. These tactile symbols were selected because they were likely to be easily distinguishable symbols on the content labels of top surfaces of containers and packaging based on a hearing survey that involved employees of an organization of visually impaired and a social welfare corporation, as well as academic experts of support technology for visually impaired. The participants then answered questions related to ease of distinguishing of tactile symbols on a scale of 5 (where 1 corresponded to ‘difficult to distinguish’ and 5 corresponded to ‘easy to distinguish’). Hearing surveys were also performed in an oral free answer manner with the participants after the experiments. This study revealed the shapes and dimensions regarding easily distinguishable tactile symbols attached to containers and packaging. We expect that this knowledge contributes to improvement of the quality of life of visually impaired persons.

Keywords: visual impairment, accessible design, tactile symbol, containers and packaging

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Authors: Parsa Keyvani, Alistair Phillips, David Warwick

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Background: The current process for gaining patient consent for hand and wrist surgery at University Hospital Southampton (UHS) is paper-based and makes use of generic forms provided by the NHS and no patient information leaflet is available relating to hand and wrist surgery. Aims: To evaluate the process of obtaining clinical consent and suggest ways in which the service can be improved. Methods: A log-book review of four orthopaedic surgeons at UHS was carried out over a three-month period in order to identify the 10 most common types of elective hand and wrist surgeries performed. A literature review was carried out to identify the complications of these surgeries. The surgeries were then divided into 6 types: nerve, bone, ligament, joint, tendon and dupuytren’s surgery. A digitised consent form was created covering the complications of all 6 surgery types. Finally, the surgeons at the orthopaedic department of UHS were asked whether they prefer the old paper-based or the digitised consent form. Results: All of the surgeons felt that the procedure type-based form was easier to read, use and understand. Conclusion: This research highlights a number of problems related to the use of current NHS consent forms. The proposed solution is to use a set of digitised, procedure type-based consent forms. Digital consent forms can be filled in in advance and sent to the patient electronically along with any relevant information leaflets, thus giving them time to absorb the information and come up with any questions before they have their pre-procedure discussion with their doctor. This would allow the doctor to focus the consultation on the patient rather than writing out the consent form and would ultimately be a step forward in making the NHS a global digital leader and fully embrace the opportunity offered by technology.

Keywords: digitised consent form, elective surgery, hand surgery complications, informed consent, procedure type-based consent form

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Authors: Farusil Najeeb Mullaveettil, Rolanas Dauksevicius

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Cellular structures produced by additive manufacturing have earned wide research attention due to their unique specific strength and energy absorption potentiality. The literature review concludes that pattern type and density are vital parameters that affect the mechanical properties of parts formed by additive manufacturing techniques and have an influence on printing time and material consumption. Fused deposition modeling technique (FDM) is used here to produce Polyvinylidene fluoride (PVDF) parts. In this work, patterns are based on triply periodic minimal surfaces (TPMS) produced by PVDF-based filaments using the FDM technique. PVDF homopolymer filament Fluorinar-H™ and PVDF copolymer filament Fluorinar-C™ are printed with three types of TPMS patterns. The patterns printed are Gyroid, Schwartz diamond, and Schwartz primitive. Tensile, flexural, and compression tests under quasi-static loading conditions are performed in compliance with ISO standards. The investigation elucidates the deformation mechanisms and a study that establishes a relationship between the printed and nominal specimens' dimensional accuracy. In comparison to the examined TPMS pattern, Schwartz diamond showed a higher relative elastic modulus and strength than the other patterns in tensile loading, and the Gyroid pattern showed the highest mechanical characteristics in flexural loading. The concluded results could be utilized to produce informed cellular designs for biomedical and mechanical applications.

Keywords: additive manufacturing, FDM, PVDF, gyroid, schwartz primitive, schwartz diamond, TPMS, tensile, flexural

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Authors: Tanka Nath Dahal

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Community-based forestry is seen as a promising instrument for sustainable forest management (SFM) through the purposeful involvement of local communities. Globally, forest area managed by local communities is on the rise. However, transferring management responsibilities to forest users alone cannot guarantee the sustainability of forest management. A monitoring tool, that allows the local communities to track the progress of forest management towards the goal of sustainability, is essential. A case study, including six forest user groups (FUGs), two from each three community-based forestry models—community forestry (CF), buffer zone community forestry (BZCF), and collaborative forest management (CFM) representing three different physiographic regions, was conducted in Nepal. The study explores which community-based forest management model (CF, BZCF or CFM) is doing well in terms of sustainable forest management. The study assesses the overall performance of the three models towards SFM using locally developed criteria (four), indicators (26) and verifiers (60). This paper attempts to quantify the sustainability of the models using sustainability index for individual criteria (SIIC), and overall sustainability index (OSI). In addition, rating to the criteria and scoring of the verifiers by the FUGs were done. Among the four criteria, the FUGs ascribed the highest weightage to institutional framework and governance criterion; followed by economic and social benefits, forest management practices, and extent of forest resources. Similarly, the SIIC was found to be the highest for the institutional framework and governance criterion. The average values of OSI for CFM, CF, and BZCF were 0.48, 0.51 and 0.60 respectively; suggesting that buffer zone community forestry is the more sustainable model among the three. The study also suggested that the SIIC and OSI help local communities to quantify the overall progress of their forestry practices towards sustainability. The indices provided a clear picture of forest management practices to indicate the direction where they are heading in terms of sustainability; and informed the users on issues to pay attention to enhancing the sustainability of their forests.

Keywords: community forestry, collaborative management, overall sustainability, sustainability index for individual criteria

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Authors: Brian Bilich

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A typical global learning program is a two-week project based, culturally immersive and academically relevant experience built around a project with purpose and catered to student and business groups. Global Learning in Continuing Education at Austin Community College promotes global readiness through projects with purpose with special attention given to balancing learning, hospitality and travel. A recent project involved CommunityFirst! Village; a 51-acre planned community which provides affordable, permanent housing for men and women coming out of chronic homelessness. Global Learning students collaborated with residents and staff at the Community First! Village on a project to produce two-dimensional remodeling plans of residents’ tiny homes with a focus on but not limited to design improvements on elements related to accessibility, increased usability of living and storage space and esthetic upgrades to boost psychological and emotional appeal. The goal of project-based learning in the context of global learning in Continuing Educaiton at Austin Community Collegen general is two fold. One, in rapid fashion we develop a project which gives the learner a hands-on opportunity to exercise soft and technical skills, like creativity and communication and analytical thinking. Two, by basing projects on global social conflict issues, the project of purpose promotes the development of empathy for other people and fosters a sense of corporate social responsibility in future generations of business leadership. In the example provide above the project informed the student group on the topic of chronic homelessness and promoted awareness and empathy for this underserved segment of the community. Project-based global learning based on projects with purpose has the potential to cultivate global readiness by developing empathy and strengthening emotional intelligence for future generations.

Keywords: project-based learning, global learning, global readiness, globalization, international exchange, collaboration

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