Search results for: Joon Hong Park

Authors: Park Eri, Sklad Marcin, Tsirogianni Stavroula

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In a world where there is increasing exchange and movement of populations groups, and interconnectedness, there are plenty of opportunities for mutual cultural enrichment. However, in everyday life, relations among different cultural groups do not go that smoothly often resulting in discrimination, inequalities and violence. The increasing differentiation of roles, values and worldviews raise a lot of tensions and dilemmas for the state and people -especially in western liberal societies- about issues of acceptance, fairness, justice, autonomy, plurality, freedom, equality and cohesion. Cultural diversity requires a deeper understanding of the roots, meaning and consequences of group differences. We argue, that a psychology from the standpoint of the subject needs to be developed further according to new societal needs. This means within a globalised society, issues regarding the construction of the other as another have become of utmost importance. In constructing the other human beings construct their ideal and possible worlds and meanings about their lives and their significance by drawing on a set of cultural norms, beliefs and values embedded in the different contexts whereby they find themselves in. In this article, we are describing a series of exercises developed in collaboration with University students in the Netherlands that have been piloted with undergraduate 2nd year University Psychology students. These exercises aimed at making tangible and obvious how students apply different moral principles and norms to regulate relationships, which are linked to hegemonic ideological forces. The exercises were in the form of thought experiments that included 8 moral dilemmas, inspired by the moral foundations theory, that touched on different moral principles. The moral dilemmas were built onto each other in incremental steps: from a very tangible/hands-on level to more challenging and demanding ones which require to step into pre-existing networks on knowledge and discourses. After the execution of every dilemma, a discussion followed, which is focused on building links between the ‘theme of the exercise’ and participants’ own lives experiences. In this paper, we provide an evaluation of the methodology used through a discursive analysis of the discussion between the students and the teacher.

Keywords: citizenship, moral dilemmas, social justice, education

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Authors: Sena Park

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Background: The concurrent presentation with colorectal cancer in the inguinal hernia has been extremely rare. Due to its rarity, its presentation may lead to diagnostic and therapeutic dilemmas. We aim to review all the reported cases on colorectal cancer incarcerated in the inguinal hernia in the last 20 years, and discuss the operative approaches. Methods: We identified all case reports on colorectal cancer within inguinal hernia using PUBMED (2002-2022) and MEDLINE (2002-2022). The search strategy included the following keywords: colorectal cancer (title/abstract) AND inguinal hernia (title/abstract) OR incarceration (title/abstract). The search did not include letters, book chapters, systemic reviews, meta-analysis and editorials. Results: In the last 20 years, a total of 19 cases on colorectal cancer within the inguinal hernia were identified. The age of the patients ranged between 48 and 89. Majority of the patients were male (95%). Most commonly involved part of the large intestine was sigmoid colon (79%). Of all the cases, 79 percent of patients received open procedure and 21 percent had laparoscopic procedure. Discussion: Inguinal hernias are common with an incidence of approximately 1.7 percent. Colorectal cancer is the one of the leading causes of cancer-related mortality worldwide. However, their concurrent presentation has been extremely rare. In the last 20 years, 19 cases on concurrent presentation of colorectal cancer and inguinal hernia have been reported. Most patients who had open procedures had two incisions of groin incision and a midline laparotomy. There were 4 cases where the oncological resection was performed laparoscopically. The advantages of laparoscopic resection include reduced blood lost, reduced post-operative pain, reduced length of hospital stay and similar number of lymph nodes taken. From the review of the cases in the last 20 years, both open and laparoscopic approaches seemed to be safe and achieve adequate oncological resections. Conclusion: This is a brief overview of reported cases of colorectal cancer presenting with inguinal hernia concurrently. Due to its rarity, there are no current guidelines on operative approach in clinical practice. The experience in the last 20 years supports both open and laparoscopic approach.

Keywords: colorectal cancer, inguinal hernia, incarceration, operative approach

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Authors: Susan Ka Yee Chow

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Effective clinical preceptorship is affecting students’ competence and fostering their growth in applying theoretical knowledge and skills in clinical settings. Any difference between the expected and actual learning experience will reduce nursing students’ interest in clinical practices and having a negative consequence with their clinical performance. This cross-sectional study is an attempt to compare the differences between preferred and actual preceptorship experience of final year nursing students, and to examine the relationship between the actual preceptorship experience and perceived clinical competence of the students in a tertiary institution. Participants of the study were final year bachelor nursing students of a self-financing tertiary institution in Hong Kong. The instruments used to measure the effectiveness of clinical preceptorship was developed by the participating institution. The scale consisted of five items in a 5-point likert scale. The questions including goals development, critical thinking, learning objectives, asking questions and providing feedback to students. The “Clinical Competence Questionnaire” by Liou & Cheng (2014) was used to examine students’ perceived clinical competences. The scale consisted of 47 items categorized into four domains, namely nursing professional behaviours; skill competence: general performance; skill competence: core nursing skills and skill competence: advanced nursing skills. There were 193 questionnaires returned with a response rate of 89%. The paired t-test was used to compare the differences between preferred and actual preceptorship experiences of students. The results showed significant differences (p<0.001) for the five questions. The mean for the preferred scores is higher than the actual scores resulting statistically significance. The maximum mean difference was accepted goal and the highest mean different was giving feedback. The Pearson Correlation Coefficient was used to examine the relationship. The results showed moderate correlations between nursing professional behaviours with asking questions and providing feedback. Providing useful feedback to students is having moderate correlations with all domains of the Clinical Competence Questionnaire (r=0.269 – 0.345). It is concluded that nursing students do not have a positive perception of the clinical preceptorship. Their perceptions are significantly different from their expected preceptorship. If students were given more opportunities to ask questions in a pedagogical atmosphere, their perceived clinical competence and learning outcomes could be improved as a result.

Keywords: clinical preceptor, clinical competence, clinical practicum, nursing students

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Authors: Jae-Yong Park, Yeo-Kyeong Lee, Hee-Sun Kim

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Purpose: This study aims at investigating the mechanical behaviors of mastication, according to various teeth movement. There are three masticatory cases which are general case and 2 cases of teeth movement. General case includes the common arrange of all teeth and 2 cases of teeth movement are that one is the half movement location case of molar teeth in no. 14 tooth seat after extraction of no. 14 tooth and the other is no. 14 tooth seat location case of molar teeth after extraction in the same case before. Materials and Methods: In order to analyze these cases, 3 dimensional finite element (FE) model of the skull were generated based on computed tomography images, 964 dicom files of 38 year old male having normal occlusion status. An FE model in general occlusal case was used to develop CAE procedure. This procedure was applied to FE models in other occlusal cases. The displacement controls according to loading condition were applied effectively to simulate occlusal behaviors in all cases. From the FE analyses, von Mises stress distribution of skull and teeth was observed. The von Mises stress, effective stress, had been widely used to determine the absolute stress value, regardless of stress direction and yield characteristics of materials. Results: High stress was distributed over the periodontal area of mandible under molar teeth when the mandible was transmitted to the coronal-apical direction in the general occlusal case. According to the stress propagation from teeth to cranium, stress distribution decreased as the distribution propagated from molar teeth to infratemporal crest of the greater wing of the sphenoid bone and lateral pterygoid plate in general case. In 2 cases of teeth movement, there were observed that high stresses were distributed over the periodontal area of mandible under teeth where they are located under the moved molar teeth in cranium. Conclusion: The predictions of the mechanical behaviors of general case and 2 cases of teeth movement during the masticatory process were investigated including qualitative validation. The displacement controls as the loading condition were applied effectively to simulate occlusal behaviors in 2 cases of teeth movement of molar teeth.

Keywords: cranium, finite element analysis, mandible, masticatory action, occlusal force

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Authors: A. Berraf-Tebbal, Z. Bouznad, , A.J.L. Phillips

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Phaeomoniella is a fungus genus in the mitosporic ascomycota which includes Phaeomoniella chlamydospora specie associated with two declining diseases on grapevine (Vitis vinifera) namely Petri disease and esca. Recent studies have shown that several Phaeomoniella species also cause disease on many other woody crops, such as forest trees and woody ornamentals. Two new species, Phaeomoniella zymoides and Phaeomoniella pinifoliorum H.B. Lee, J.Y. Park, R.C. Summerbell et H.S. Jung, were isolated from the needle surface of Pinus densiflora Sieb. et Zucc. in Korea. The identification of species in Phaeomoniella genus can be a difficult task if based solely on morphological and cultural characters. In this respect, the application of molecular methods, particularly PCR-based techniques, may provide an important contribution. MSP-PCR (microsatellite primed-PCR) fingerprinting has proven useful in the molecular typing of fungal strains. The high discriminatory potential of this method is particularly useful when dealing with closely related or cryptic species. In the present study, the application of PCR fingerprinting was performed using the micro satellite primer M13 for the purpose of species identification and strain typing of 84 Phaeomoniella -like isolates collected from grapevines with typical symptoms of dieback. The bands produced by MSP-PCR profiles divided the strains into 3 clusters and 5 singletons with a reproducibility level of 80%. Representative isolates from each group and, when possible, isolates from Eutypa dieback and esca symptoms were selected for sequencing of the ITS region. The ITS sequences for the 16 isolates selected from the MSP-PCR profiles were combined and aligned with sequences of 18 isolates retrieved from GenBank, representing a selection of all known Phaeomoniella species. DNA sequences were compared with those available in GenBank using Neighbor-joining (NJ) and Maximum-parsimony (MP) analyses. The phylogenetic trees of the ITS region revealed that the Phaeomoniella isolates clustered with Phaeomoniella chlamydospora reference sequences with a bootstrap support of 100 %. The complexity of the pathosystems vine-trunk diseases shows clearly the need to identify unambiguously the fungal component in order to allow a better understanding of the etiology of these diseases and justify the establishment of control strategies against these fungal agents.

Keywords: Genotyping, MSP-PCR, ITS, phylogeny, trunk diseases

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Authors: Libing Zhu, Waichung Chen, Kwaicing Lo, Lei Li

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Background: Tian Jiu Therapy (a medicinal vesiculation therapy according to traditional Chinese medicine theory) in San Fu Days (the three hottest days in a year is calculated by the Chinese ancient calendar) is widely used by patients with chronic asthma in China although from modern medicine perspective there is insufficient evidence of its effectiveness and safety issues. We investigated the efficacy and safety of Tian Jiu Therapy compared with placebo in patients with chronic asthma. Methods: Patients with chronic asthma were randomly assigned to Tian Jiu treatment group (n=165), placebo control group (n=158). Registered Chinese Medicine practitioners, in Orthopedics-Traumatology, Acupuncture, and Tui-na Clinical Centre for Teaching and Research, School of Chinese Medicine, The University of Hong Kong, administered Tian Jiu Therapy and placebo treatment in 3 times over 2 months. Patients completed questionnaires and lung function test before treatment and after treatment, 3, 6, 9, and 11 months, respectively. The primary outcome was the no of asthma-related sub-healthy symptoms and the percentage of patients with twenty-three symptoms. Results: 451 patients were recruited totally, 111 patients refused or did not participate according the appointment time and 17 did not meet the inclusion criteria. Consequently, 323 of eligible patients were enrolled. There was nothing difference between Tian Jiu Therapy group and placebo control group at the end of all treatments neither primary nor secondary outcomes. While Tian Jiu Therapy as compared with placebo significantly reduced the percentage of participants who are susceptible waken up by asthma symptoms from 27% to 14% at 2nd follow-up (P < 0.05). Similarly, Tian Jiu Therapy significantly reduced the proportion of participants who had the symptom of running nose and sneezing before onset from 18% to 8% at 2nd follow-up (P < 0.05). Additionally, Tian Jiu Therapy significantly reduced the level of asthma, the proportion of participants who don’t need to processed during asthma attack increased from 6% to 15% at 1st follow-up and 0% to 7% at 3rd follow-up (P < 0.05). Improvements also occurred with Tian Jiu Therapy group, it reduced the proportion of participants who were spontaneously sweating at 3rd follow up and diarrhea after intake of oily food at 4th follow-up (P < 0.05). Conclusion: When added to a regimen of foundational therapy for chronic asthma participants, Tian Jiu Therapy further reduced the need for medications to control asthma, improved the quality of participants’ life, and significantly reduced the level of asthma. What is more, this benefit seems to have an accumulative effect over time was in accordance with the TCM theory of 'winter disease is being cured in summer'.

Keywords: asthma, Tian Jiu Therapy, San Fu Days, triaditional Chinese medicine, clinical trial

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Authors: Chan Yan Nok

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The present study is a qualitative study based on the coping experiences of six Hong Kong Chinese mothers who had childhood trauma from their first-person perspective. Expanding the perspective beyond the dominant discourse of “inter-generation transmission of trauma”, this study explores the experiences and meanings of child trauma embedded in their narratives through the process of thematic analysis and narrative analysis. The interviewees painted a nuanced picture of their process of coping and trauma resolution. First, acknowledgement; second, feel safe and start to tell the story of trauma; third, feel the feelings and expression of emotions; fourth, clarifying and coping with the impacts of trauma; fifth, integration and transformation; and sixth, using their new understanding of experience to have a better life. It was seen that there was no “end” within the process of trauma resolution. Instead, this is an ongoing process with positive healing trajectory. Analysis of the stories of the mothers revealed recurrent themes around continuous self-reflective awareness in the process of trauma coping. Rather than being necessarily negative and detrimental, childhood trauma could highlight the meanings of being a mother and reveal opportunities for continuous personal growth and self-enhancement. Utilizing the sense of inadequacy as a core driver in the trauma recovery process while developing a heightened awareness of the unfinished business embedded in their “automatic pattern” of behaviors, emotions, and thoughts can help these mothers become more flexible to formulate new methods in facing future predicaments. Future social work and parent education practices should help mothers deal with unresolved trauma, make sense of their impacts of childhood trauma and discover the growth embedded in the past traumatic experience. They should be facilitated in “acknowledging the reality of the trauma”, including understanding their complicated emotions arising from the traumatic experiences and voicing their struggles. In addition, helping these mothers to be aware of short-term and long-term trauma impacts (i.e., secondary responses to the trauma) and explore their effective coping strategies in “overcoming secondary responses to the trauma” are crucial for their future positive adjustment and transformation. Through affirming their coping abilities and lessons learnt from past experiences, mothers can reduce feelings of shame and powerlessness and enhance their parental capacity.

Keywords: childhood trauma, coping, mothers, self-awareness, self-reflection, trauma resolution

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Authors: Young Ah Kim, Hyunsoo Kim, Eun-Jeong Yoon, Young Hee Seo, Kyungwon Lee

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Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli from food animals are considered as a reservoir for transmission of ESBL genes to human. The aim of this study is to assess the prevalence and molecular epidemiology of ESBL-producing E. coli colonization in pigs, farm workers, and farm environments to elucidate the transmission of multidrug-resistant clones from animal to human. Nineteen pig farms were enrolled across the country in Korea from August to December 2017. ESBL-producing E. coli isolates were detected in 190 pigs, 38 farm workers, and 112 sites of farm environments using ChromID ESBL (bioMerieux, Marcy l'Etoile, France), directly (stool or perirectal swab) or after enrichment (sewage). Antimicrobial susceptibility tests were done with disk diffusion methods and blaTEM, blaSHV, and blaCTX-M were detected with PCR and sequencing. The genomes of the four CTX-M-55-producing E. coli isolates from various sources in one farm were entirely sequenced to assess the relatedness of the strains. Whole genome sequencing (WGS) was performed with PacBio RS II system (Pacific Biosciences, Menlo Park, CA, USA). ESBL genotypes were 85 CTX-M-1 group (one CTX-M-3, 23 CTX-M-15, one CTX-M-28, 59 CTX-M-55, one CTX-M-69) and 60 CTX-M-9 group (41 CTX-M-14, one CTX-M-17, one CTX-M-27, 13 CTX-M-65, 4 CTX-M-102) in total 145 isolates. The rectal colonization rates were 53.2% (101/190) in pigs and 39.5% (15/38) in farm workers. In WGS, sequence types (STs) were determined as ST69 (E. coli PJFH115 isolate from a human carrier), ST457 (two E. coli isolates PJFE101 recovered from a fence and PJFA1104 from a pig) and ST5899 (E. coli PJFA173 isolate from the other pig). The four plasmids encoding CTX-M-55 (88,456 to 149, 674 base pair), whether it belonged to IncFIB or IncFIC-IncFIB type, shared IncF backbone furnishing the conjugal elements, suggesting of genes originated from same ancestor. In conclusion, the prevalence of ESBL-producing E. coli in swine farms was surprisingly high, and many of them shared common ESBL genotypes of clinical isolates such as CTX-M-14, 15, and 55 in Korea. It could spread by horizontal transfer between isolates from different reservoirs (human-animal-environment).

Keywords: Escherichia coli, extended-spectrum β-lactamase, prevalence, whole genome sequencing

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Authors: W. L. Tsang, H. Y. Li, S. L. Wong, T. Y. Kwok, S. C. Yuen, S. S. Kwok, P. S. Ko, S. Y. Lau

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Introduction: Palliative care is no doubt necessary in surgery. When one looks at studies of what patients with life-threatening illness want and compares to what they experience in surgical units, the gap is huge. Surgical nurses, being patient advocates, should engage with patients and families sooner rather than later in their illness trajectories to consider how to manage the illness, not just their capacity to survive. Objective: This clinical practice guide aims to fill the service gap of palliative care in surgery by producing a quality-driven, evidence-based yet straightforward clinical practice guide based on a focus strategy. Methodology: In line with Guide to Good Nursing Practice: End-of-Life Care recommended by Nursing Council of Hong Kong and the strategic goal of improving quality of palliative care proposed in HA Strategic Plan 2017-2022, multiple phases of work were undertaken from July 2015 to December 2017. A pragmatic clinical practice guide for surgical patients facing life-threatening conditions was developed based on assessments on knowledge of and attitudes towards end-of-life care of surgical nurses. Key domains, including preparation for bereavement, nursing care for imminently dying patients and at the dying scene were crystallized according to the results of the assessments and the palliative care checklist formulated by UCH Palliative Care Team. After a year of rollout, its content was refined through analyses of implementation in routine practice and consensus opinions from frontline nurses. Results and Outcomes: This clinical practice guide inspires surgical nurses with the art of care to provide for patients’ comfort, function, and longevity. It provides practical directions and assists nurses to master the skills on advance care planning and learn how to be clear with patients, families and themselves about the realities of the disease pictures. Through the implementation, patients and families are included in the decision process, and their wishes are honored. The delivery of explicit and high-quality palliative care maintains good nurse-to-patient relations and enhances satisfaction of hospital care of patients and families. Conclusion: Surgical nursing has always been up to the unique challenges of the era. This clinical practice guide has become an island of credibility for our nurses as they traverse the often stormy waters of life-limiting illness.

Keywords: palliative care delivery, palliative care in surgery, hospice care, end-of-life care

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Authors: Jae-Hyun Choi, Sung-Soo Bae, Sangyoung Yoon, Hong-Ku Yun, Jiyoung Kwahk

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This study was conducted to investigate the effect of ocular dominance on recognition performance using a single-lens smart display designed for cycling. A total of 36 bicycle riders who have been cycling consistently were recruited and participated in the experiment. The participants were asked to perform tasks riding a bicycle on a stationary stand for safety reasons. Independent variables of interest include ocular dominance, bike usage, age group, and information layout. Recognition time (i.e., the time required to identify specific information measured with an eye-tracker), error rate (i.e. false answer or failure to identify the information in 5 seconds), and user preference scores were measured and statistical tests were conducted to identify significant results. Recognition time and error ratio showed significant difference by ocular dominance factor, while the preference score did not. Recognition time was faster when the single-lens see-through display on the dominant eye (average 1.12sec) than on the non-dominant eye (average 1.38sec). Error ratio of the information recognition task was significantly lower when the see-through display was worn on the dominant eye (average 4.86%) than on the non-dominant eye (average 14.04%). The interaction effect of ocular dominance and age group was significant with respect to recognition time and error ratio. The recognition time of the users in their 40s was significantly longer than the other age groups when the display was placed on the non-dominant eye, while no difference was observed on the dominant eye. Error ratio also showed the same pattern. Although no difference was observed for the main effect of ocular dominance and bike usage, the interaction effect between the two variables was significant with respect to preference score. Preference score of daily bike users was higher when the display was placed on the dominant eye, whereas participants who use bikes for leisure purposes showed the opposite preference patterns. It was found more effective and efficient to wear a see-through display on the dominant eye than on the non-dominant eye, although user preference was not affected by ocular dominance. It is recommended to wear a see-through display on the dominant eye since it is safer by helping the user recognize the presented information faster and more accurately, even if the user may not notice the difference.

Keywords: eye tracking, information recognition, ocular dominance, smart headware, wearable device

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Authors: Minhyuk Heo, Jihwan Yun, Seonghun Park

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It has been reported that intervertebral fusion surgery, which removes most of the ligaments and muscles of the spine, increases the degenerative disease in adjacent spinal segments. Therefore, it is required to develop a lumbar interspinous process fixation device that minimizes the risks and side effects from the surgery. The objective of the current study is to design an interspinous process fixation device with simple structures in order to minimize soft tissue removal and operation time during intervertebral fusion surgery. For the design concepts of a lumbar fixation device, the principle of the ratchet was first applied on the joining parts of the device in order to shorten the operation time. The coil spring structure was selected for connecting parts between the spinous processes so that a normal range of motion in spinal segments is preserved and degenerative spinal diseases are not developed in the adjacent spinal segments. The stiffness of the spring was determined not to interrupt the motion of a lumbar spine. The designed value of the spring stiffness allows the upper part of the spring to move ~10° which is higher than the range of flexion and extension for normal lumbar spine (6°-8°), when a moment of 10Nm is applied on the upper face of L1. A finite element (FE) model composed of L1 to L5 lumbar spines was generated to verify the mechanical integrity and the dynamic stability of the designed lumbar fixation device and to further optimize the lumbar fixation device. The FE model generated above produced the same pressure value on intervertebral disc and dynamic behavior as the normal intact model reported in the literature. The consistent results from this comparison validates the accuracy in the modeling of the current FE model. Currently, we are trying to generate an abnormal model with defects in one or more components of the normal FE model above. Then, the mechanical integrity and the dynamic stability of the designed lumbar fixation device will be analyzed after being installed in the abnormal model and then the lumbar fixation device will be further optimized.

Keywords: lumbar interspinous process fixation device, finite element method, lumbar spine, kinematics

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Authors: Seung Chul Lee, Jooyeong Kim, Ki Ok Ahn, Juok Park

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Background: Injuries caused by motorcycle crashes are one of the major public health burdens leading to high mortality, functional disability. The risk of death among motorcyclists is 30 times greater than that among car drivers, with head injuries the leading cause of death. The motorcycle helmet is crucial protective equipment for motorcyclists. Aims: This study aimed to measure the protective effect of motorcycle helmet use on intracranial injury and mortality and to compare the preventive effect in drivers and passengers. Methods: This is a cross-sessional study based on the Emergency Department (ED)–based Injury In-depth Surveillance (EDIIS) database from 23 EDs in Korea. All of the trauma patients injured in motorcycle crashes between January 1, 2013 and December 31, 2016 were eligible, excluding cases with unknown helmet use and outcomes. The primary and secondary outcomes were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs) of helmet use for study outcomes after adjusting for potential confounders. Using interaction models, we compared the protective effect of helmet use on outcomes across driving status (driver and passenger). Results: Among 17,791 eligible patients, 10,668 (60.0%) patients were wearing helmets at the time of the crash, 2,128 (12.0%) patients had intracranial injuries and 331 (1.9%) patients had in-hospital death. 16,381 (92.1%) patients were drivers and 1410 (7.9%) patients were passengers. 62.6% of drivers and 29.1% of passengers were wearing helmets at the time of the crash. Compared to un-helmeted group, the helmeted group was less likely to have an intracranial injury(8.0% vs. 17.9%, AOR: 0.43 (0.39-0.48)) and in-hospital mortality (1.0% vs. 3.2%, AOR: 0.29 (0.22-0.37)).In the interaction model, AORs (95% CIs) of helmet use for intracranial injury were 0.42 (0.38-0.47) in drivers and 0.61(0.41-0.90) in passengers, respectively. There was a significant preventive effect of helmet use on in-hospital mortality in drivers (AOR: 0.26(0.21–0.34)). Discussion and conclusions: Wearing helmets in motorcycle crashes reduced intracranial injuries and in-hospital mortality. The preventive effect of motorcycle helmet use on intracranial injury was stronger in drivers than in passengers. There was a significant preventive effect of helmet use on in-hospital mortality in driver but not in passengers. Public health efforts to increase motorcycle helmet use are needed to reduce health burden from injuries caused by motorcycle crashes.

Keywords: intracranial injury, helmet, mortality, motorcycle crashes

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Authors: Se-Hwa Park, En-Kyung Han, Jae-Young Lim, Hye-Jung Ahn

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Purpose: The objective of this study is to provide basic data for understanding the substance of inpatient life with CRPS (Complex Regional Pain Syndrome) and developing efficient and effective nursing intervention. Methods: From September 2018 to November, we have interviewed 10 CRPS patients about inpatient experiences. To understand the implication of inpatient life experiences with CRPS and intrinsic structure, we have used the question: 'How about the inpatient experiences with CRPS'. For data analysis, the method suggested by Colaizzi was applied as a phenomenological method. Results: According to the analysis, the study participants' inpatient life process was structured in six categories: (a) breakthrough pain experience (b) the limitation of pain treatment, (c) worsen factors of pain during inpatient period, (d) treat method for pain, (e) positive experience for inpatient period, (f) requirements for medical team, family and people in hospital room. Conclusion: Inpatient with CRPS have experienced the breakthrough pain. They had expected immediate treatment for breakthrough pain, but they experienced severe pain because immediate treatment was not implemented. Pain-worsening factors which patients with CRPS are as follows: personal factors from negative emotions such as insomnia, stress, sensitive character, pain part touch or vibration stimulus on the bed, physical factors from high threshold or rapid speed during fast transfer, conflict with other people, climate factors such as humidity or low temperature, noise, smell, lack of space because of many visitors. Patients actively manage the pain committing into another tasks or diversion. And also, patients passively manage the pain, just suppress, give-up. They think positively about rehabilitation treatment. And they require the understanding and sympathy for other people, and emotional support, immediate intervention for medical team. Based on the results of this study, we suppose the guideline of systematic breakthrough pain management for the relaxation of sudden pain, using notice of informing caution for touch or vibration. And we need to develop non-medicine pain management nursing intervention.

Keywords: breakthrough pain, CRPS, complex regional pain syndrome, inpatient life experiences, phenomenological method

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Authors: Sungpil Ha, Ju Yong Kang, Sangbaek Park, Seung-Ju Lee, Soo-Won Chae

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The growing number of obese patients in aging societies has led to an increase in the number of patients with knee medial osteoarthritis (OA). Artificial joint insertion is the most common treatment for knee medial OA. Surgery is effective for patients with serious arthritic symptoms, but it is costly and dangerous. It is also inappropriate way to prevent a disease as an early stage. Therefore Non-operative treatments such as toe-in gait are proposed recently. Toe-in gait is one of non-surgical interventions, which restrain the progression of arthritis and relieves pain by reducing knee adduction moment (KAM) to facilitate lateral distribution of load on to knee medial cartilage. Numerous studies have measured KAM in various foot progression angle (FPA), and KAM data could be obtained by motion analysis. However, variations in stress at knee cartilage could not be directly observed or evaluated by these experiments of measuring KAM. Therefore, this study applied motion analysis to major gait points (1st peak, mid –stance, 2nd peak) with regard to FPA, and to evaluate the effects of FPA on the human lower extremity, the finite element (FE) method was employed. Three types of gait analysis (toe-in, toe-out, baseline gait) were performed with markers placed at the lower extremity. Ground reaction forces (GRF) were obtained by the force plates. The forces associated with the major muscles were computed using GRF and marker trajectory data. MRI data provided by the Visible Human Project were used to develop a human lower extremity FE model. FE analyses for three types of gait simulations were performed based on the calculated muscle force and GRF. We observed the maximum stress point during toe-in gait was lower than the other types, by comparing the results of FE analyses at the 1st peak across gait types. This is the same as the trend exhibited by KAM, measured through motion analysis in other papers. This indicates that the progression of knee medial OA could be suppressed by adopting toe-in gait. This study integrated motion analysis with FE analysis. One advantage of this method is that re-modeling is not required even with changes in posture. Therefore another type of gait simulation or various motions of lower extremity can be easily analyzed using this method.

Keywords: finite element analysis, gait analysis, human model, motion capture

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Authors: Mohamed Aljarallah, Mohamed Nurullah, George Saridakis

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This paper aims and objectives are to investigate how the structural change of the financial regulatory bodies affect the financial supervision and how the regulators can design such a structure with taking into account; the Central Bank, the conduct of business and the prudential regulators, it will also consider looking at the structure of the international regulatory bodies and what barriers are found. There will be five questions to be answered; should conduct of business and prudential regulation be separated? Should the financial supervision and financial stability be separated? Should the financial supervision be under the Central Bank? To what extent the politician should intervene in changing the regulatory and supervisory structure? What should be the regulatory and supervisory structure when there is financial conglomerate? Semi structure interview design will be applied. This research sample selection contains a collective of financial regulators and supervisors from the emerged and emerging countries. Moreover, financial regulators and supervisors must be at a senior level at their organisations. Additionally, senior financial regulators and supervisors would come from different authorities and from around the world. For instance, one of the participants comes from the International Bank Settlements, others come from European Central Bank, and an additional one will come from Hong Kong Monetary Authority and others. Such a variety aims to fulfil the aims and objectives of the research and cover the research questions. The analysis process starts with transcription of the interview, using Nvivo software for coding, applying thematic interview to generate the main themes. The major findings of the study are as follow. First, organisational structure changes quite frequently if the mandates are not clear. Second, measuring structural change is difficult, which makes the whole process unclear. Third, effective coordination and communication are what regulators looking for when they change the structure and that requires; openness, trust, and incentive. In addition to that, issues appear during the event of crisis tend to be the reason why the structure change. Also, the development of the market sometime causes a change in the regulatory structure. And, some structural change occurs simply because of the international trend, fashion, or other countries' experiences. Furthermore, when the top management change the structure tends to change. Moreover, the structure change due to the political change, or politicians try to show they are doing something. Finally, fear of being blamed can be a driver of structural change. In conclusion, this research aims to provide an insight from the senior regulators and supervisors from fifty different countries to have a clear understanding of why the regulatory structure keeps changing from time to time through a qualitative approach, namely, semi-structure interview.

Keywords: financial regulation bodies, financial regulatory structure, global financial regulation, financial crisis

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Authors: Yang-Ho Jang, Soon-Ok Jee, Hae-Chul Park, Jeong-Woo Kang, Byung-Jae So, Sung-Shik Shin, Kyu-Sung Ahn, Kwang-Jick Lee

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Introduction: Antibiotics have been used as feed additives for the growth promotion and performance in food-producing animals. However, the possibility of selection of antimicrobial resistance and the concerns of residue in animal products led to ban the use of antibiotics in farm animals at 2011 in Korea. This strategy is also adjusted to anticoccidial drugs soon but these are still allowed for the time being to use in a diet for the treatment and control for the enteric necrosis in poultry. Therefore substantial focus has been given to find alternatives to antimicrobial agents. Several phytogenic materials have been reported to have positive effects on coccidiosis. This study was to evaluate the effects on anti-coccidial effect of oregano oil based herb mixture on Eimeria spp. in poultry. Materials and Methods: A total of one day-old boiler chickens divided into six groups (each group=30 chkckens) were used in this study. The herbal mixture was fed with water freely as follows: two groups, one infected with Eimeria spp. and the other group served as controls without herbal mixture respectively; 0.2ml/L of oregano oil; 0.2ml/L of oregano oil and Sanguisorbae radix; 0.2ml/L of Sanguisorbae radix; last group was fed with dichlazuril diet as positive control. Sporulated Eimeria spp. was infected at 14 day-old. Following infection, survival rate, bloody diarrhea, OPG (oocyst per gram) and feed conversion ratios were determined. The experimental period was lasted for 4 weeks. Results: Herbal mixture feeding groups (Group 3,4,5) showed low feed conversion ratio comparing with negative control. Oregano oil group and positive control group recorded the highest survival rate. The grade of bloody diarrhea was scored 0 to 5. Herbal mixture feeding groups showed 2, 3 and 1 score respectively however, group 2 (infection and no-treatment) showed 4. OPG results in herbal mixture feeding group were 3 to 4 times higher than diclazuril diet feeding group. Conclusions: These results showed that oregano oil and Sanguisorbae radix mixture may have an anti-coccidial effect and also affect chick performance.

Keywords: anticoccidial effects, oregano oil based herb mixture, herbal mixture, antibiotics

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Authors: Minho Lee, Donghyun Back, Jaemoon Jung, Woojin Park

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The current 3-dimensional (3D) posture prediction models commonly provide only a few optimal postures to achieve a specific objective. The problem with such models is that they are incapable of rapidly providing several optimal posture candidates according to various situations. In order to solve this problem, this paper presents a 3D memory-based posture planning (3D MBPP) model, which is a new digital human model that can analyze the feasible postures in 3D space for reaching tasks that have postural constraints and specific reaching space. The 3D MBPP model can be applied to the types of works that are done with constrained working postures and have specific reaching space. The examples of such works include driving an excavator, driving automobiles, painting buildings, working at an office, pitching/batting, and boxing. For these types of works, a limited amount of space is required to store all of the feasible postures, as the hand reaches boundary can be determined prior to perform the task. This prevents computation time from increasing exponentially, which has been one of the major drawbacks of memory-based posture planning model in 3D space. This paper validates the utility of 3D MBPP model using a practical example of analyzing baseball batting posture. In baseball, batters swing with both feet fixed to the ground. This motion is appropriate for use with the 3D MBPP model since the player must try to hit the ball when the ball is located inside the strike zone (a limited area) in a constrained posture. The results from the analysis showed that the stored and the optimal postures vary depending on the ball’s flying path, the hitting location, the batter’s body size, and the batting objective. These results can be used to establish the optimal postural strategies for achieving the batting objective and performing effective hitting. The 3D MBPP model can also be applied to various domains to determine the optimal postural strategies and improve worker comfort.

Keywords: baseball, memory-based, posture prediction, reaching area, 3D digital human models

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Authors: Najia Zulfiqar

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Imparting moral education is the need of time, considering the obvious moral decline in society. Recent research shows the downfall of moral competence among university students. The main objective of the present study was to develop moral development intervention strategies for undergraduate students of Sports and Physical Education. Using an interpretative phenomenological approach, insight into field-specific moral issues was gained through interviews with 7 subject experts and a focus-group discussion session with 8 students. Two research assistants who were trained in qualitative interviewing collected, transcribed and analyzed data into the MAXQDA software using content and discourse analyses. The identified moral issues in Sports and Physical Education were sports gambling and betting, pay-for-play, doping, coach misconduct, tampering, cultural bias, gender equity/nepotism, bullying/discrimination, and harassment. Next, intervention modules were developed for each moral issue based on hypothetical situations, and followed by guided reflection and dilemma discussion questions. The third moral development strategy was community services that included posture screening, diet plan for different age groups, open fitness ground training, exercise camps for physical fitness, balanced diet awareness camp, gymnastic camp, shoe assessment as per health standards, and volunteering for public awareness at the playground, gymnasium, stadium, park, etc. The intervention modules were given to four subject specialists for expert validation who were from different backgrounds within Sport Sciences. Upon refinement and finalization, four students were presented with these intervention modules and questioned about accuracy, relevance, comprehension, and content organization. Iterative changes were made in the content of the intervention modules to tailor them to the moral development needs of undergraduate students. This intervention will strengthen positive moral values and foster mature decision-making about right and wrong acts. As this intervention is easy to apply as a remedial tool, academicians and policymakers can use this to promote students’ moral development.

Keywords: community service, dilemma discussion, morality, physical education, university students.

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Authors: Marilou Cadatal-Raduban, Minh Hong Pham, Duong Van Pham, Tu Nguyen Xuan, Mui Viet Luong, Kohei Yamanoi, Toshihiko Shimizu, Nobuhiko Sarukura, Hung Dai Nguyen

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There is a great deal of interest in developing all-solid-state tunable ultrashort pulsed lasers emitting in the ultraviolet (UV) region for applications such as micromachining, investigation of charge carrier relaxation in conductors, and probing of ultrafast chemical processes. However, direct short-pulse generation is not as straight forward in solid-state gain media as it is for near-IR tunable solid-state lasers such as Ti:sapphire due to the difficulty of obtaining continuous wave laser operation, which is required for Kerr lens mode-locking schemes utilizing spatial or temporal Kerr type nonlinearity. In this work, the transient cavity method, which was reported to generate ultrashort laser pulses in dye lasers, is extended to a solid-state gain medium. Ce:LiCAF was chosen among the rare-earth-doped fluoride laser crystals emitting in the UV region because of its broad tunability (from 280 to 325 nm) and enough bandwidth to generate 3-fs pulses, sufficiently large effective gain cross section (6.0 x10⁻¹⁸ cm²) favorable for oscillators, and a high saturation fluence (115 mJ/cm²). Numerical simulations are performed to investigate the spectro-temporal evolution of the broadband UV laser emission from Ce:LiCAF, represented as a system of two homogeneous broadened singlet states, by solving the rate equations extended to multiple wavelengths. The goal is to find the appropriate cavity length and Q-factor to achieve the optimal photon cavity decay time and pumping energy for resonator transients that will lead to ps UV laser emission from a Ce:LiCAF crystal pumped by the fourth harmonics (266nm) of a Nd:YAG laser. Results show that a single ps pulse can be generated from a 1-mm, 1 mol% Ce³⁺-doped LiCAF crystal using an output coupler with 10% reflectivity (low-Q) and an oscillator cavity that is 2-mm long (short cavity). This technique can be extended to other fluoride-based solid-state laser gain media.

Keywords: rare-earth-doped fluoride gain medium, transient cavity, ultrashort laser, ultraviolet laser

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Authors: Takashi Yamaguchi, Ichio Asanuma, Jong G. Park, Kenneth J. Mackin, John Mittleman

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In this paper, vessel detection using the artificial neural network is proposed in order to automatically construct the vessel detection model from the satellite imagery of day/night band (DNB) in visible infrared in the products of Imaging Radiometer Suite (VIIRS) on Suomi National Polar-orbiting Partnership (Suomi-NPP).The goal of our research is the establishment of vessel detection method using the satellite imagery of DNB in order to monitor the change of vessel activity over the wide region. The temporal vessel monitoring is very important to detect the events and understand the circumstances within the maritime environment. For the vessel locating and detection techniques, Automatic Identification System (AIS) and remote sensing using Synthetic aperture radar (SAR) imagery have been researched. However, each data has some lack of information due to uncertain operation or limitation of continuous observation. Therefore, the fusion of effective data and methods is important to monitor the maritime environment for the future. DNB is one of the effective data to detect the small vessels such as fishery ships that is difficult to observe in AIS. DNB is the satellite sensor data of VIIRS on Suomi-NPP. In contrast to SAR images, DNB images are moderate resolution and gave influence to the cloud but can observe the same regions in each day. DNB sensor can observe the lights produced from various artifact such as vehicles and buildings in the night and can detect the small vessels from the fishing light on the open water. However, the modeling of vessel detection using DNB is very difficult since complex atmosphere and lunar condition should be considered due to the strong influence of lunar reflection from cloud on DNB. Therefore, artificial neural network was applied to learn the vessel detection model. For the feature of vessel detection, Brightness Temperature at the 3.7 μm (BT3.7) was additionally used because BT3.7 can be used for the parameter of atmospheric conditions.

Keywords: artificial neural network, day/night band, remote sensing, Suomi National Polar-orbiting Partnership, vessel detection, Visible Infrared Imaging Radiometer Suite

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Authors: Jimmy K. C. Lam, Carrie Wong

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One of the key goals on Learning and Teaching as documented in the University strategic plan 2012/13 – 2017/18 is to encourage active learning, the use of innovative teaching approaches and technology, and promoting the adoption of flexible and varied teaching delivery methods. This research reported the recent visited to Prof Eric Mazur at Harvard University on Peer Instruction: Collaborative learning in large class and innovative use of technology to enable new mode of learning. Peer Instruction is a research-based, interactive teaching method developed by Prof. Eric Mazur at Harvard University in the 1990s. It has been adopted across the disciplines, institutional type and throughout the world. One problem with conventional teaching lies in the presentation of the material. Frequently, it comes straight out of textbook/notes, giving students little incentive to attend class. This traditional presentation is always delivered as monologue in front of passive audience. Only exceptional lecturers are capable of holding students’ attention for an entire lecture period. Consequently, lectures simply reinforce students’ feelings that the most important step in mastering the material is memorizing a zoo of unrelated examples. In order to address these misconceptions about learning, Prof Mazur’s Team developed “Peer Instruction”, a method which involves students in their own learning during lectures and focuses their attention on underling concepts. Lectures are interspersed with conceptual questions called Concept Tests, designed to expose common difficulties in understanding the material. The students are given one or two minutes to think about the question and formulate their own answers; they then spend two or three minutes discussing their answers in a group of three or four, attempting to reach consensus on the correct answer. This process forces the students to think through the arguments being developed, and enable them to assess their understanding concepts before they leave the classroom. The findings from Peer Instruction and innovative use of technology on teaching at Harvard University were applied to the first year Textiles and Fashion students in Hong Kong. Survey conducted from 100 students showed that over 80% students enjoyed the flexibility of peer instruction and 70% of them enjoyed the instant feedback from the Clicker system (Student Response System used at Harvard University). Further work will continue to explore the possibility of peer instruction to art and fashion students.

Keywords: peer instruction, education, technology, fashion

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Authors: Yoon-Cheol Park

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This research focuses on examining the information structures in the old Chinese character-Korean translation of the Vajrachedika-prajna-paramita sutra. The background of this research comes from the fact that there were no previous researches which looked into the information structures in the target text of the Vajrachedika-prajna-paramita sutra by now. The existing researches on the Buddhist scripture translation mainly put weight on message conveyance by literal and semantic translation methods. But the message conveyance from one language to another has a necessity to be delivered with equivalent information structure. Thus, this research is intended to investigate on the flow of old and new information in the target text of Buddhist scripture, compared with source text. The Vajrachedika-prajna-paramita sutra unlike other Buddhist scriptures is composed of conversational structures between Buddha and his disciple, Suboli. This implies that the information flow can be changed by utterance context and some propositions. So, this research tries to analyze the flow of old and new information within the source and target text. As a result of analysis, this research can discover the following facts; firstly, there are the differences of the information flow in the message conveyance between the old Chinese character and Korean by language features. The old Chinese character reveals that old-new information flow is developed, while Korean indicates new-old information flow because of word order. Secondly, the source text of the Vajrachedika-prajna-paramita sutra includes abstruse terminologies, jargon and abstract words. These make influence on the target text and cause the change of the information flow. But the repetitive expressions of these words provide the old information in the target text. Lastly, the Vajrachedika-prajna-paramita sutra offers the expository structure from conversations between Buddha and Suboli. It means that the information flow is developed in the way of explaining specific subjects and of paraphrasing unfamiliar phrases and expressions. From the results of analysis above, this research can verify that the information structures in the target text of the Vajrachedika-prajna-paramita sutra are changed by specific subjects and terminologies, developed with the new-old information flow by repetitive expressions or word order and reveal the information structures familiar to target culture. It also implies that the translation of the Vajrachedika-prajna-paramita sutra as a religious book needs the message conveyance to take into account the information structures of two languages.

Keywords: abstruse terminologies, the information structure, new and old information, old Chinese character-Korean translation

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Authors: Yi Meng, Yun Gao

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Having spent significant periods studying and working in North America and Europe, we, as two Chinese art educators, have been profoundly shaped by both Eastern and Western cultures. Consequently, our ambition is to enrich students' learning experiences by delving into and merging both cultural perspectives for innovative, creative expressions. This exposition draws on our action research study on students' visual literacy practices in a visual literacy course at a prominent Chinese university. The central premise was to explore innovative art forms by cross-utilizing various aspects of diverse cultures. By examining distinct cultural elements, we encouraged students to break away from familiar approaches and forge new paths in their creative endeavors. In implementing our curriculum, we utilized a multimodal pedagogy that deviated from the predominant print-based presentations typically employed in our classroom settings. This pedagogical approach effectively encouraged students to critically analyze the artifact, imbue it with their understanding and perspectives, and then produce an original piece. This approach also motivated students to leverage the semiotic potential of various communicative modes to address diverse cultural issues through their multimodal designs. To demonstrate the potential for cultural amalgamation, we utilized the artwork of Hong Kong-based artist Tik Ka. His works epitomize the fusion of Chinese traditions with Western pop culture, which served as a visual and conceptual reference point for students. Seeing how these distinct cultural elements could coexist and enrich each other in Tik Ka's work was inspiring and motivating for the students. Taken together, these pedagogical strategies helped create a dialogical space where students could actively experience, analyze, and negotiate complex modes of expression. This environment fostered active learning, encouraging students to apply their knowledge, question their assumptions, and reconsider their perspectives. Overall, such a unique approach to visual literacy education has the potential to reshape students' understanding of both cultures. By encouraging them to critically engage with their multimodal designs, we promoted an in-depth, nuanced appreciation of these diverse cultural heritages. The students no longer just interpreted and replicated images—they actively contributed to a dynamic and ongoing conversation between cultures.

Keywords: multimodal pedagogy, creative expressions, visual literacy education, multimodal designs

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Authors: Yongde Dai

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The recent Chinese military action blockbusters, notably known as, Wolf Warrior/Zhan Lang (2015), Operation Mekong/Mei gong he xing dong (2016), Warrior 2/Zhan Lang 2 (2017) and Operation Red Sea/Hong hai xing dong (2018), have achieved phenomenal box-office successes and in particular, Wolf Warrior 2 became China’s highest-grossing film of all time. However, their yearly presence tends to show a paradigmic shift from China’s primacy of wen manliness (soft) to wu masculinity (hard). With the increasing cinematic exposure of a more muscular image manifesting in both the Chinese heroic soldiers and China itself as a rising global power, the backlash of the Chinese public against the proliferation of the feminized masculinity influenced by the ‘pretty-boy’ pop-culture and China’s harder approach to the current Sino-US tensions have correspondingly emerged and continued to brew. Chinese masculinity imagined in these films is one of the key factors that enable a gendered interpretation of the correlation between the Chinese on-screen fantasy and off-screen reality, that is, China’s public and official discourse about the hegemonic masculinity and non-hegemonic masculinity as well as China’s international profile on cinematic appearance and in today’s Sino-US relation. By reading closely at the four megahits as visual-audio texts with Chinese masculinity studies by Kam Louie and Geng Song, this paper attempts to examine the Chinese construction of manliness with historical accounts and argue why and how the recurrent emphasis of hard/military masculinity (wu) on screen are viewed as China’s contemporary rewriting of the ‘sick-man’ history in the film form. Through this investigation, the paper finds that the rewriting of the ‘sick-man’ history in the cinematic world through heroic brawny soldiers comes to resonate a collective anxiety of China in countering the real-life increasing feminized masculinity on the public appearance, particularly on the male celebrities. In addition, the superpower fantasy about China illuminates a hypermasculine imaginary of China as a global rising power and this coincidently echoes China’s current tougher diplomatic strategy tackling the Sino-US trade war, South China sea dispute and Huawei-US lawsuits.

Keywords: Chinese masculinity, Chinese military action film, feminized masculinity, manhood and nationhood, sick man of Asia

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Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

Abstract:

Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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Authors: Yiu K. C. Jacky, Tang S. K. Eric, W. Y. Tsang, C. Y. Li, C. K. Leung

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Objectives : (1) To enhance the competence of nurses on using IPMOE for drug administration; (2) To ensure the transition on implementation of IPMOE in safer and smooth way hospital-wide. Methodology: (1) Well-structured Governance: To make provision for IPMOE implementation, multidisciplinary governance structure at Corporate and Local levels are well established. (2) Staff Engagement: A series of staff engagement events were conducted including Staff Forum, IPMOE Hospital Visit, Kick-off Ceremony and establishment of IPMOE Webpage for familiarizing the forthcoming implementation with frontline staff. (3) Well-organized training program: from Workshop to Workplace Two different IPMOE training programs were tailor-made which aimed at introducing the core features of administration module. Fifty-five identical training classes and six train-the-trainer workshops were organized at 2-3Q 2015. Lending Scheme on IPMOE hardware for hands-on practicing was launched and further extended the training from workshop to workplace. (4) Standard Guidelines and Workflow: the related workflow and guidelines are developed which facilitates users to acquire the competence towards IPMOE and fully familiarize with the standardized contingency plan. (5) Facilities and Equipment: The installations of IPMOE hardware were promptly arranged for rollout. Besides, IPMOE training venue was well-established for staff training. (6) Risk Management Strategy: UCH Medication Safety Forum is organized in December 2015 for sharing “Tricks & Tips” on IPMOE which further disseminate at webpage for arousal of medication safety. Hospital-wide annual audit on drug administration was planned to figure out the compliance and deliberate the rooms for improvement. Results: Through the comprehensive training plan, over 1,000 UCH nurses attended the training program with positive feedback. They agreed that their competence on using IPMOE was enhanced. By the end of November 2015, 28 wards (over 1,000 Inpatient-bed) involving departments of M&G, SUR, O&T and O&G have been successfully rolled out IPMOE in 5-month. A smooth and safe transition of implementation of IPMOE was achieved. Eventually, we all get prepared for embedding IPMOE into daily nursing and work altogether for medication safety at UCH.

Keywords: drug administration, inpatient medication order entry system, medication safety, nursing informatics

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Authors: Bonguen Onouck Rolande Carole, Ndongo Barthelemy

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The climate change effects on the Lake Chad, coupled with population growth, have pushed large masses of people of various origins towards the lower part of the lower Logonewatershed in search of the benefits of environmental services, causing pressure on the environment and its resources. Economic services are therefore threatened, and the decrease in resources contributes to the deterioration of the social wellbeing resulting to conflicts among/between local communities, immigrants, displaced people, and foreigners. This paper is an information contribution on ethnical conflicts drivers in the area and the provided local management mechanisms such can help mitigate present or future conflicts in similar areas. It also prints out the necessity to alleviate water access deficit and encourage good practices for the population wellbeing. In order to meet the objective, in 2018, through the interface of the World Bank-Cameroon project-PULCI, data were collected on the field directly by discussing with the population and visiting infrastructures, indirectly by a questionnaire survey. Two administrative divisions were chosen (Logoneet Chari, Mayo-Danay) in which targeted localities were Zina, Mazera, Lahai, Andirni near the Waza Park and Yagoua, Tekele, Pouss, respectively. Due to some sociocultural and religious reasons, some information were acquired through the traditional chiefs. A desk study analysis based on resources access and availability conflicts history, and management mechanism was done. As results, roots drivers of ethnical conflicts are struggles over natural resources access, and the possibility of conflicts increases as the scarcity and vulnerabilities persist, creating more sociocultural gaps and tensions. The mitigation mechanisms though fruitful, are limited. There is poor documentation on the topic, the resources management policies of this basin are unsuitable and ineffective for some. Therefore, the restoration of environmental and ecosystems, the mitigation of climate change effects, and food insecurity are the challenges that must be met to alleviate conflicts in these localities.

Keywords: ethnic, communities, conflicts, mitigation mechanisms, natural resources, logone basin

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Authors: Sang Chul Lee, Gi-Young Park, Dong Rak Kwon

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Objective: The aim of this study was to investigate regenerative effects of ultrasound (US)-guided injection with human umbilical cord blood-derived mesenchymal stem cells (UCB-MSCs) and/or polydeoxyribonucleotide (PDRN) injection in a chronic traumatic full-thickness rotator cuff tendon tear (FTRCTT) in a rabbit model. Material and Methods: Rabbits (n = 32) were allocated into 4 groups. After a 5-mm sized FTRCTT just proximal to the insertion site on the subscapularis tendon was created by excision, the wound was immediately covered by silicone tube to prevent natural healing. After 6 weeks, 4 injections (0.2 mL normal saline, G1; 0.2 mL PDRN, G2; 0.2 mL UCB-MSCs, G3; and 0.2 mL UCB-MSCs with 0.2ml PDRN, G4) were injected into FTRCTT under US guidance. We evaluated gross morphologic changes on all rabbits after sacrifice. Masson’s trichrome, anti-type 1 collagen antibody, bromodeoxyuridine, proliferating cell nuclear antigen, vascular endothelial growth factor and platelet endothelial cell adhesion molecule stain were performed to evaluate histological changes. Motion analysis was also performed. Results: The gross morphologic mean tendon tear size in G3 and 4 was significantly smaller than that of G1 and 2 (p < .05). However, there were no significant differences in tendon tear size between G3 and 4. In G4, newly regenerated collagen type 1 fibers, proliferating cells activity, angiogenesis, walking distance, fast walking time, and mean walking speed were greater than in the other three groups on histological examination and motion analysis. Conclusion: Co-injection of UCB-MSCs and PDRN was more effective than UCB-MSCs injection alone in histological and motion analysis in a rabbit model of chronic traumatic FTRCTT. However, there was no significant difference in gross morphologic change of tendon tear between UCB-MSCs with/without PDRN injection. The results of this study regarding the combination of UCB-MSCs and PDRN are worth additional investigations.

Keywords: mesenchymal stem cell, umbilical cord, polydeoxyribonucleotides, shoulder, rotator cuff, ultrasonography, injections

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Authors: Tas Yong Koh, Steve Rowlinson, Yuzhong Shen

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In construction safety management, safety climate has long been linked to workers' safety behaviors and performance. For this reason, safety climate concept and tools have been used as heuristics to diagnose a range of safety-related issues by some progressive contractors in Hong Kong and elsewhere. However, as a diagnostic tool, safety climate tends to treat the different components of the climate construct in a linear fashion. Safety management in construction projects, in reality, is a multi-faceted and multilevel phenomenon that resembles a complex system. Hence, understanding safety management in construction projects requires not only the understanding of safety climate but also the organizational-systemic nature of the phenomenon. Our involvement, diagnoses, and interpretations of a range of safety climate-related issues which culminated in the project’s sub-optimum safety performance in an infrastructure construction project have brought about such revelation. In this study, a range of data types had been collected from various hierarchies of the project site organization. These include the frontline workers and supervisors from the main and sub-contractors, and the client supervisory personnel. Data collection was performed through the administration of safety climate questionnaire, interviews, observation, and document study. The findings collectively indicate that what had emerged in parallel of the seemingly linear climate-based exploration is the exposition of the organization-systemic nature of the phenomenon. The results indicate the negative impacts of climate perceptions mismatch, insufficient work planning, and risk management, mixed safety leadership, workforce negative attributes, lapsed safety enforcement and resources shortages collectively give rise to the project sub-optimum safety performance. From the dynamic causation and multilevel perspective, the analyses show that the individual, group, and organizational levels issues are interrelated and these interrelationships are linked to negative safety climate. Hence the adoption of both perspectives has enabled a fuller understanding of the phenomenon of safety management that point to the need for an organizational-systemic intervention strategy. The core message points to the fact that intervention at an individual level will only meet with limited success if the risks embedded in the higher levels in group and project organization are not addressed. The findings can be used to guide the effective development of safety infrastructure by linking different levels of systems in a construction project organization.

Keywords: construction safety management, dynamic causation, multilevel analysis, safety climate

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Authors: Neda Orak, Mostafa Zarei

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Environmental assessment is an important session in environment management. Since various methods and techniques have been produces and implemented. Remote sensing (RS) is widely used in many scientific and research fields such as geology, cartography, geography, agriculture, forestry, land use planning, environment, etc. It can show earth surface objects cyclical changes. Also, it can show earth phenomena limits on basis of electromagnetic reflectance changes and deviations records. The research has been done on mangrove forests assessment by RS techniques. Mangrove forests quantitative analysis in Basatin and Bidkhoon estuaries was the aim of this research. It has been done by Landsat satellite images from 1975- 2013 and match to ground control points. This part of mangroves are the last distribution in northern hemisphere. It can provide a good background to improve better management on this important ecosystem. Landsat has provided valuable images to earth changes detection to researchers. This research has used MSS, TM, +ETM, OLI sensors from 1975, 1990, 2000, 2003-2013. Changes had been studied after essential corrections such as fix errors, bands combination, georeferencing on 2012 images as basic image, by maximum likelihood and IPVI Index. It was done by supervised classification. 2004 google earth image and ground points by GPS (2010-2012) was used to compare satellite images obtained changes. Results showed mangrove area in bidkhoon was 1119072 m2 by GPS and 1231200 m2 by maximum likelihood supervised classification and 1317600 m2 by IPVI in 2012. Basatin areas is respectively: 466644 m2, 88200 m2, 63000 m2. Final results show forests have been declined naturally. It is due to human activities in Basatin. The defect was offset by planting in many years. Although the trend has been declining in recent years again. So, it mentioned satellite images have high ability to estimation all environmental processes. This research showed high correlation between images and indexes such as IPVI and NDVI with ground control points.

Keywords: IPVI index, Landsat sensor, maximum likelihood supervised classification, Nayband National Park

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