Search results for: surgical instruments

Authors: Girma Y. Iyassu Menelik

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The international community has gone through indescribable atrocities resulting from acts of war. These atrocities turned Europe and Africa into a wilderness of bloodshed and crime. In the period 1960- 1970s Africa witnessed unprecedented and well-documented assaults on life and property. This necessitated the adoption, signing and ratification of the International Criminal Court, establishment of the International Court of Justice which is a great achievement for the protection and fulfilling of human rights in the context of international political instability. The ICC came as an important opportunity to advance justice for serious crimes committed in violation of international law. Thus the Rome statute has become a formidable contribution to peace and security. There are concerns that the ICC is targeting African states. However, the ICC cannot preside over cases that are not parties to the Rome statute unless the UN Security council refers the situation or the relevant state asks the court to become involved. The instable international political situation thus deals with criminal prosecutions where amnesty is not permissible or is strongly repudiated. The court has become important justice instruments for states that are unable or unwilling to fulfill their obligation to address legacies of massive human rights violations. The ICJ as a court has a twofold role; to settle legal disputes submitted to it by states, and to give advisory opinions on legal questions referred to it by duly authorized United Nations organs and specialized agencies. All members of the UN are ipso facto parties to the statute of the ICJ. The court gives advisory opinion on any legal question. These courts are the most appropriate fora to pronounce on international crimes and are in a better position to know and apply international law. Cases that have been brought to the courts include Rwanda’s genocide, Liberia’s Charles Taylor etc. The receptiveness and cooperation of the local populations are important to the courts and if the ICC and ICJ can provide appropriate protections for the physical and economic safety of victims then peace and human rights observance can be attained. This paper will look into the effectiveness and impediments of these courts in handling criminal and injustices in international politics as while as what needs to be done to strengthen the capacity of these courts.

Keywords: ICC, international politics, justice, UN security council, violence, protection, fulfilling

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Authors: Ana Lambelho

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Nowadays is very common that an activity may be performed independently or dependently. In Portugal, the Labour Law exclusively protects the dependent labour relations. The independent work is regulated by civil law, where the autonomy of the will is the main principle. For companies is more advantageous to hire people under a service agreement since, in that case, the relation is not submitted to the limits established in Labour law and collective bargaining. This practice has nothing wrong, if the performance of work is, in fact, made autonomously. The problem is the increased frequency of the celebration of service agreements to hide a legal relation of subordination. Aware of this and regarding the huge difficulty to demonstrate the existence of subordinated work (that often runs against the employee), the Portuguese legislator devoted some legislative rules in order to facilitate the evidence of legal subordination and, on the other hand, to avoid the misuse of the provision of service agreements. This study focuses precisely on the analysis of this solution, namely the so-called presumption of ‘laboralidade’ and on the lawsuit to recognize the existence of a labour contract. The presumption of the existence of a labour contract is present in the Portuguese legal system since 2003, and received, with the 2009 Labour Code, a new redaction that, according to the doctrine and the jurisprudence, finally approached it to a legal presumption, with the consequent reversal of the burden of proof and, in consequence, made easier to proof the legal subordination, because the employee will just have to plead and prove the existence of two of the elements described in the law to use this presumption. Another change in the Portuguese legal framework is related with the competencies of the Authority for Working Conditions (AWC): now, if during an inspection, the Authority finds a situation that seems to be an undeclared employment situation, it may access the company and, if it does not regularize voluntarily the situation, AWC has a duty to communicate to the public prosecutor, who will begin the lawsuit for the recognition of the existence of an employment contract. To defend the public interest, the action to recognize the existence of an employment contract will follow its terms, even against the employee will. Although the existence of these mechanisms does not solve by itself the problem of evasion of labour law and false ‘green receipts’, it is undeniable that it is an important step in combating fraud in this field.

Keywords: independent work, labour contract, Portugal, service agreement

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Authors: Musa Alghamdi

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Although Saudi students’ motivation to learn English language as a foreign language in Saudi Arabia have been investigated by a number of studies; these have appeared almost completely as using the quantitative research paradigm. There is a significant lack of research that explores the Saudi students’ motivation using qualitative methods. It was essential, as an investigator, to be immersed in the community to understand the individuals under study via their actions and words, their thoughts, views and beliefs, and how those individuals credited to activities. Thus, the study aims to explore the Saudi students’ motivation to learn English language as a foreign language in Saudi Arabia employing qualitative methodology via applying ethnography. The study will be carried out in Saudi Arabia. Ethnography qualitative approach will be used in the current study by employing formal and informal interview instruments. Gardner’s motivation theory is used as frameworks for this study to aid the understanding of the research findings. The author, an English language lecturer, will undertake participant observations for 4 months. He will work as teaching-assistant (on an unpaid basis) with EFL lecturers in different discipline department at a Saudi university where students study English language as a minor course. The researcher will start with informal ethnographical interview with students during his existence with the informants in their natural context. Then the researcher will utilize the semi-structural interview. The informal interview will be with 14-16 students, then, he will carry out semi-structural interview with the same informants to go deep in their natural context to find out to what extent the Saudi university students are motivated to learn English as a foreign language. As well as, to find out the reasons that played roles in that. The findings of this study will add new knowledge about what factors motivate universities’ Saudi students to learn English language in Saudi Arabia. Very few chances have given to students to express themselves and to speak about their feelings in a more comfortable way in order to gain a clear image of those factors. The working author as an EFL teacher and lecturer will provide him secure access into EFL teaching and learning setting. It will help him attain richer insights into the nature EFL context in universities what will provide him with richer insights into the reasons behind the weakness of EFL level among Saudi students.

Keywords: motivation, ethnography, Saudi, language

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Authors: Kristin Thooft

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— Increasing pressure to manage healthcare costs has resulted in shifting care towards ambulatory settings and is driving a focus on cost transparency. There are few nurse staffing to workload models developed for ambulatory settings, less for multi-specialty clinics. Of the existing models, few have been evaluated against outcomes to understand any impact. This evaluation took place after the AWARD model for nurse staffing to workload was implemented in a multi-specialty clinic at a regional healthcare system in the Midwest. The multi-specialty clinic houses 26 medical and surgical specialty practices. The AWARD model was implemented in two specialty practices in October 2020. Donabedian’s Structure-Process-Outcome (SPO) model was used to evaluate outcomes based on changes to the structure and processes of care provided. The AWARD model defined and quantified the processes, recommended changes in the structure of day-to-day nurse staffing. Cost of care per patient visit, total visits, a total nurse performed visits used as structural and process measures, influencing the outcomes of cost of care and access to care. Independent t-tests were used to compare the difference in variables pre-and post-implementation. The SPO model was useful as an evaluation tool, providing a simple framework that is understood by a diverse care team. No statistically significant changes in the cost of care, total visits, or nurse visits were observed, but there were differences. Cost of care increased and access to care decreased. Two weeks into the post-implementation period, the multi-specialty clinic paused all non-critical patient visits due to a second surge of the COVID-19 pandemic. Clinic nursing staff was re-allocated to support the inpatient areas. This negatively impacted the ability of the Nurse Manager to utilize the AWARD model to plan daily staffing fully. The SPO framework could be used for the ongoing assessment of nurse staffing performance. Additional variables could be measured, giving a complete picture of the impact of nurse staffing. Going forward, there must be a continued focus on the outcomes of care and the value of nursing

Keywords: ambulatory, clinic, evaluation, outcomes, staffing, staffing model, staffing to workload

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Authors: Irfan Anjum Manarvi, Zahid Ali kaimkhani

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Predicting location of the fracture in human bones has been a keen area of research for the past few decades. A variety of tests for hardness, deformation, and strain field measurement have been conducted in the past; but considered insufficient due to various limitations. Researchers, therefore, have proposed further studies due to inaccuracies in measurement methods, testing machines, and experimental errors. Advancement and availability of hardware, measuring instrumentation, and testing machines can now provide remedies to these limitations. The human foot is a critical part of the body exposed to various forces throughout its life. A number of products are developed for using it for protection and care, which many times do not provide sufficient protection and may itself become a source of stress due to non-consideration of the delicacy of bones in the feet. A continuous strain or overloading on feet may occur resulting to discomfort and even fracture. Mechanical properties of Tarsals, Metatarsals, and phalanges are, therefore, the primary area of consideration for all such design applications. Hardness is one of the mechanical properties which are considered very important to establish the mechanical resistance behavior of a material against applied loads. Past researchers have worked in the areas of investigating mechanical properties of these bones. However, their results were based on a limited number of experiments and taking average values of hardness due to either limitation of samples or testing instruments. Therefore, they proposed further studies in this area. The present research has been carried out to develop a hardness map of the human foot by measuring micro hardness at various locations of these bones. Results are compiled in the form of distance from a reference point on a bone and the hardness values for each surface. The number of test results is far more than previous studies and are spread over a typical bone to give a complete hardness map of these bones. These results could also be used to establish other properties such as stress and strain distribution in the bones. Also, industrial engineers could use it for design and development of various accessories for human feet health care and comfort and further research in the same areas.

Keywords: tarsals, metatarsals, phalanges, hardness testing, biomechanics of human foot

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Authors: Helga Mayr

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In our ongoing effort to address urgent global challenges related to sustainability, higher education institutions play a central role in raising a generation of informed and empowered citizens committed to sustainable development. This paper presents the preliminary results of the so far realized evaluation of a compulsory module on education for sustainable development (ESD) offered to students in the bachelor's program in elementary education at the University College of Teacher Education Tyrol (PH Tirol), Austria. The module includes a lecture on sustainability and education as well as a project-based seminar that aims to foster a deep understanding of ESD and its application in pedagogical practice. The study examines various dimensions related to the module's impact on participating students, focusing on prevalent sustainability concepts, intentions, actions, general and sustainability-related self-efficacy, perceived competence related to ESD, and ESD-related self-efficacy. In addition, the research addresses assessment of the learning process. To obtain a comprehensive overview of the effectiveness of the module, a mixed methods approach was/is used in the evaluation. Quantitative data was/is collected through surveys and self-assessment instruments, while qualitative findings were/will be obtained through focus group interviews and reflective analysis. The PH Tirol is collaborating with another University College of Teacher Education (Styria) and a university of applied sciences in Switzerland (UAS of the Grisons) to broaden the scope of the analysis and allow for comparative findings. Preliminary results indicate that students have a relatively rudimentary understanding of sustainability. The extent to which completion of the module influences understanding of sustainability, awareness, intentions, and actions, as well as self-efficacy, is currently under investigation. The results will be available at the time of the conference and will be presented there. In terms of learning, the project-based seminar, which promotes hands-on engagement with ESD, was evaluated for its effectiveness in fostering key sustainability competencies as well as sustainability-related and ESD-related self-efficacy. The research not only provides insights into the effectiveness of the compulsory module ESD at the PH Tirol but also contributes to the broader discourse on integrating ESD into teacher education.

Keywords: education for sustainable development, teacher education, project-based learning, effectiveness measurements

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Authors: Oloruntegbe Kunle Oke, Alake Ese Monica, Odutuyi Olubu Musili

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This research explores the differing effectiveness of cascade and cluster models in professional development programs for educators in Ondo State, Nigeria. The cascade model emphasizes a top-down approach, where training is cascaded from expert trainers to lower levels of teachers. In contrast, the cluster model, a bottom-up approach, fosters collaborative learning among teachers within specific clusters. Through a review of the literature and empirical studies of the implementations of the former in two academic sessions followed by the cluster model in another two, the study examined their effectiveness on teacher development, productivity and students’ achievements. The study also drew a comparative analysis of the strengths and weaknesses associated with each model, considering factors such as scalability, cost-effectiveness, adaptability in various contexts, and sustainability. 2500 teachers from Ondo State Primary Schools participated in the cascade with intensive training in five zones for a week each in two academic sessions. On the other hand, 1,980 and 1,663 teachers in 52 and 34 clusters, respectively, were in the first and the following session. The programs were designed for one week of rigorous training of teachers by facilitators in the former while the latter was made up of four components: sit-in-observation, need-based assessment workshop, pre-cluster and the actual cluster meetings in addition to sensitization, and took place one day a week for ten weeks. Validated Cluster Impact Survey Instruments, CISI and Teacher’s Assessment Questionnaire (TAQ) were administered to ascertain the effectiveness of the models during and after implementation. The findings from the literature detailed specific effectiveness, strengths and limitations of each approach, especially the potential for inconsistencies and resistance to change. Findings from the data collected revealed the superiority of the cluster model. Response to TAQ equally showed content knowledge and skill update in both but were more sustained in the cluster model. Overall, the study contributes to the ongoing discourse on effective strategies for improving teacher training and enhancing student outcomes, offering practical recommendations for the development and implementation of future professional development projects.

Keywords: cascade model, cluster model, teachers’ development, productivity, students’ achievement

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Authors: Lintang Putra Sadewa, Ilham Prasetya Budhi

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Slope monitoring program has now become a mandatory campaign for any open pit mines around the world to operate safely. Utilizing various slope monitoring instruments and strategies, miners are now able to deliver precise decisions in mitigating the risk of slope failures which can be catastrophic. Currently, the most sophisticated slope monitoring technology available is the Slope Stability Radar (SSR), whichcan measure wall deformation in submillimeter accuracy. One of its eminent features is that SSRcan provide a timely warning by automatically raise an alarm when a predetermined rate-of-movement threshold is reached. However, establishing proper alarm thresholds is arguably one of the onerous challenges faced in any slope monitoring program. The difficulty mainly lies in the number of considerations that must be taken when generating a threshold becausean alarm must be effectivethat it should limit the occurrences of false alarms while alsobeing able to capture any real wall deformations. In this sense, experience shows that a site-specific alarm thresholdtendsto produce more reliable results because it considers site distinctive variables. This study will attempt to determinealarming thresholds for safety-critical monitoring based on an empirical model of slope deformation behaviour that is defined statistically fromdeformation data captured by the Slope Stability Radar (SSR). The study area comprises of upright-dipping highwall setting in a coal mining area with intense mining activities, andthe deformation data used for the study were recorded by the SSR throughout the year 2022. The model is site-specific in nature thus, valuable information extracted from the model (e.g., time-to-failure, onset-of-acceleration, and velocity) will be applicable in setting up site-specific alarm thresholds and will give a clear understanding of how deformation trends evolve over the area.

Keywords: safety-critical monitoring, alarming strategy, slope deformation behaviour model, coal mining

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Authors: Pajaree Naramitpanich, Natchanok Jansawang, Panwilai Chomchid

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The aims of this are compared between the students’ logical thinking abilities of their learning for designing the 5-lesson instructional plans of the 2-instructional methods, namely; the STEM Education and the Creative Learning Process (CLP) for developing students’ logical thinking abilities that a sample consisted of 90 students from two chemistry classes of different learning outcomes in Wapi Phathum School with the cluster random sampling technique was used at the 11th grade level. To administer of their learning environments with the 45-experimenl student group by the STEM Education method and the 45-controlling student group by the Creative Learning Process. These learning different groups were obtained using the 5 instruments; the 5-lesson instructional plans of the STEM Education and the Creative Learning Process to enhance the logical thinking tests on Mineral issue were used. The efficiency of the Creative Learning Processes (CLP) Model and the STEM Education’s innovations of these each five instructional lesson plans based on criteria are higher than of 80/80 standard level with the IOC index from the expert educators. The averages mean scores of students’ learning achievement motives were assessed with the Pre and Post Techniques and Logical Thinking Ability Test (LTAT) and dependent t-test analysis were differentiated between the CLP and the STEM, significantly. Students’ perceptions of their chemistry classroom environment inventories with the MCI with the CLP and the STEM methods also were found, differently. Associations between students’ perceptions of their chemistry classroom learning environment inventories on the CLP Model and the STEM Education learning designs toward their logical thinking abilities toward chemistry, the predictive efficiency of R2 values indicate that 68% and 76% of the variances in students’ logical thinking abilities toward chemistry to their controlling and experimental chemistry classroom learning environmental groups with the MCI were correlated at .05 levels, significantly. Implementations of this result are showed the students’ learning by the CLP of the potential thinking life-changing roles in most their logical thinking abilities that it is revealed that the students perceive their abilities to be highly learning achievement in chemistry group are differentiated with the STEM education of students’ outcomes.

Keywords: design, the lesson instructional plans, the stem education, the creative learning process, logical thinking ability, different, learning outcome, student, chemistry class

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Authors: Kristian Bugeja, Upeshala A. Jayawardena, Clarissa Fenech, Mark Zammit Vincenti

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Introduction: Biliary colic, acute cholecystitis, and gallstone pancreatitis are some of the most common surgical presentations at Gozo General Hospital (GGH). National Institute for Health and Care Excellence (NICE) guidelines advise that suitable patients with acute biliary problems should be offered a laparoscopic cholecystectomy within one week of diagnosis. There has traditionally been difficulty in achieving this mainly due to the reluctance of some surgeons to operate in the acute setting, limited, timely access to MRCP and ERCP, and organizational issues. Methodology: A retrospective study was performed involving all biliary pathology-related admissions to GGH during the two-year period of 2019 and 2020. Patients’ files and electronic case summary (ECS) were used for data collection, which included demographic data, primary diagnosis, co-morbidities, management, waiting time to surgery, length of stay, readmissions, and reason for readmissions. NICE clinical guidance 188 – Gallstone disease were used as the standard. Results: 51 patients were included in the study. The mean age was 58 years, and 35 (68.6%) were female. The main diagnoses on admission were biliary colic in 31 (60.8%), acute cholecystitis in 10 (19.6%). Others included gallstone pancreatitis in 3 (5.89%), chronic cholecystitis in 2 (3.92%), gall bladder malignancy in 4 (7.84%), and ascending cholangitis in 1 (1.97%). Management included laparoscopic cholecystectomy in 34 (66.7%); conservative in 8 (15.7%) and ERCP in 6 (11.7%). The mean waiting time for laparoscopic cholecystectomy for patients with acute cholecystitis was 74 days – range being between 3 and 146 days since the date of diagnosis. Only one patient who was diagnosed with acute cholecystitis and managed with laparoscopic cholecystectomy was done so within the 7-day time frame. Hospital re-admissions were reported in 5 patients (9.8%) due to vomiting (1), ascending cholangitis (1), and gallstone pancreatitis (3). Discussion: Guidelines were not met for patients presenting to Gozo General Hospital with acute biliary pathology. This resulted in 5 patients being re-admitted to hospital while waiting for definitive surgery. The local issues resulting in the delay to surgery need to be identified and steps are taken to facilitate the provision of urgent cholecystectomy for suitable patients.

Keywords: biliary colic, acute cholecystits, laparoscopic cholecystectomy, conservative management

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Authors: T. Almutairi, K. Naudi, N. Nairn, X. Ju, B. Eng, J. Whitters, A. Ayoub

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Purpose: At present Cone Beam Computed Tomography (CBCT) imaging does not record dental morphology accurately due to the scattering produced by metallic restorations and the reported magnification. The aim of this pilot study is the development and validation of a new method for the replacement of the distorted dentition of CBCT scans with the dental image captured by the digital intraoral camera. Materials and Method: Six dried skulls with orthodontics brackets on the teeth were used in this study. Three intra-oral markers made of dental stone were constructed which were attached to orthodontics brackets. The skulls were CBCT scanned, and occlusal surface was captured using TRIOS® 3D intraoral scanner. Marker based and surface based registrations were performed to fuse the digital intra-oral scan(IOS) into the CBCT models. This produced a new composite digital model of the skull and dentition. The skulls were scanned again using the commercially accurate Laser Faro® arm to produce the 'gold standard' model for the assessment of the accuracy of the developed method. The accuracy of the method was assessed by measuring the distance between the occlusal surfaces of the new composite model and the 'gold standard' 3D model of the skull and teeth. The procedure was repeated a week apart to measure the reproducibility of the method. Results: The results showed no statistically significant difference between the measurements on the first and second occasions. The absolute mean distance between the new composite model and the laser model ranged between 0.11 mm to 0.20 mm. Conclusion: The dentition of the CBCT can be accurately replaced with the dental image captured by the intra-oral scanner to create a composite model. This method will improve the accuracy of orthognathic surgical prediction planning, with the final goal of the fabrication of a physical occlusal wafer without to guide orthognathic surgery and eliminate the need for dental impression.

Keywords: orthognathic surgery, superimposition, models, cone beam computed tomography

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Authors: Erna Judith Roach, Nalini Bhaskaranand

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Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.

Keywords: childhood asthma, drug administration, mothers of children, inhaler

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Authors: Agata Ferreira

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Rapidly increasing debates and initiatives in the area of Corporate Social Responsibility (“CSR”) have reached the world of international investment law. CSR standards that focus on the operations of multinational companies are increasingly relevant in the context of international investment policy making. In the past, the connection between CSR standards and legal framework for foreign direct investment has been largely non-existent. Recently, however, there is a growing trend of a more balance approach to rights and obligations as between investors and states under investment treaties. CSR principles join other social and environmental measures slowly being included in the investment treaties to enhance their sustainable development dimension. Issues of CSR are present on negotiation tables of new mega regional investment treaties like TTIP for example. To date, only a very few bilateral investment treaties and a handful of other international treaties with investment provisions include CSR clauses. In addition, the existing provisions tend to be of a soft type, where parties merely acknowledge importance of good corporate governance and CSR for sustainable development or generally affirm their aim to encourage enterprises to observe internationally recognised guidelines and principles of CSR. The relevant provisions often leave it up to the states to encourage enterprises operating within their territories to voluntarily incorporate CSR principles. The interaction between general non-binding CSR standards, domestic laws and policies and provisions of international investment treaties have not been tested by investment tribunals yet. The role of investment treaties in raising awareness and promoting CSR is still in its infancy. The use of CSR standards in the international investment protection regime for promotion of CSR standards, and as a tool for disciplining investors into complying with such standards, pose a number of questions and is met with resistance from investors` lobbies. Integration of these two areas, CSR and international investment law, both consisting of multilayered, diverse and often overlapping instruments is by no means an easy task. Whether international investment world is ready to embrace CSR standards or shrug them off is a matter of uncertain future. The subject however has been raised, first introductions have been made and the time will show whether the relationship between legal framework of international investment and CSR will flourish or remain dormant.

Keywords: corporate social responsibility, foreign direct investment, investment treaties, sustainable development

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Authors: Joseph Bentil

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Successful acquisition of 21st-century competencies needed by students to navigate through the ever-changing world requires that they are taught and molded by 21st-century teachers with the needed professional competencies. Accordingly, this study sought to understand the readiness and how efficacious pre-service Social Studies specialism students are towards the implementation of the Common Core Social Studies Curriculum in the Junior High Schools in Ghana. Theory of Experience served as the theoretical lens for the study. Working within the pragmatist paradigm, this study utilized the cross-sectional descriptive survey design with a mixed method approach where, through census sampling technique, all the 120 pre-service Social Studies specialism students were sampled for the study. A structured questionnaire and an interview guide were the instruments employed for data collection. Descriptive statistics (mean, standard deviation and inferential statistics like independent samples t-test, one-way between groups ANOVA and Pearson Product Moment Correlation) were employed in the analysis the research questions and hypotheses with the aid of version 28 of SPSS while the qualitative data was analyzed using thematic analysis. The findings discovered that pre-service Social Studies teachers were highly ready and efficacious towards implementing the Common Core Junior High School Social Studies curriculum. However, male pre-service teachers were highly efficacious and ready than their female counterparts. Besides, it was disclosed that pre-service teachers within the 31-40 years age bracket were found to be highly efficacious and ready than their colleagues with 20-30 and below 20 years age bracket respectively. The findings further revealed that there was a moderate and statistically significant positive relationship between pre-service teachers’ readiness and efficacy in implementing the Common Core Social Studies curriculum. Therefore, the study recommended that interventional programmes aimed at raising the readiness and efficacy beliefs of pre-service teachers should be targeted towards female preservice teachers and those below 20 years age bracket for successful implementation and realization of the competencies enshrined in the common core social Studies curriculum.

Keywords: pre-service, readiness, social studies, teachers

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Authors: Rossana Taravella, Gilberto M. Cellura, Giuseppe Cirrincione, Salvatore Asciutto, Marco Caruso, Massimo Benedetto, Renato Ciofalo, Giuliana Pace, Salvatore Novo

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Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effectiveness endpoint. Background: Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR), with increasing real-world cases of functional MR (FMR). In the EVEREST (Endovascular Valve Edge-to-Edge Repair Study)II trial, the percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of moderate-severe and severe MR or mortality at 4years between surgical mitral repair and percutaneous approach. Methods: We analysed retrospectively collected data from one center experience in Italy enrolled from January 2011 to December 2016. The study included 62 patients [mean age 74±11years, 43 men (69%)] with MR of at least grade3+. Most of the patients had functional MR, were in New York Heart Association (NYHA) functional class III or IV, with a large portion (78%) of mild-to-moderate Tricuspid Regurgitation (TR). One or more clips were implanted in 67 procedures (62 patients). Results and Conclusions: Severity of MR was reduced in all successfully treated patients,54(90%) were discharged with MR≤2+ (primary effectiveness endpoint). Clinical 1-month follow-up data showed an improvement in NYHA functional class (42 patients (70%) in NYHA class I-II). 60 of 62 (97 %) successfully treated patients were free from death and mitral valve surgery at 1-month follow-up. MitraClip therapy reduces functional MR with acute MR reduction to <2+ in the great majority of patients, with a large freedom from death, surgery or recurrent MR in a great portion of patients.

Keywords: MitraClip, mitral regurgitation, heart valves, catheter-based therapy

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Authors: Ishith Seth, Lyndel Hewitt, Takako Yabe, James Wykes, Jonathan Clark, Bruce Ashford

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Background: Vastus lateralis (VL) can be used to reconstruct defects of the head and neck. Whilst the advantages are documented, donor-site morbidity is not well described. This study aimed to assess donor-site morbidity after VL flap harvest. The results will determine future directions for preventative and post-operative care to improve patient health outcomes. Methods: Ten participants (mean age 55 years) were assessed for the presence of donor-site morbidity after VL harvest. Musculoskeletal (pain, muscle strength, muscle length, tactile sensation), quality of life (SF-12), and lower limb function (lower extremity function, gait (function and speed), sit to stand were assessed using validated and standardized procedures. Outcomes were compared to age-matched healthy reference values or the non-operative side. Analyses were conducted using descriptive statistics and non-parametric tests. Results: There was no difference in muscle strength (knee extension), muscle length, ability to sit-to-stand, or gait function (all P > 0.05). Knee flexor muscle strength was significantly less on the operated leg compared to the non-operated leg (P=0.02) and walking speed was slower than age-matched healthy values (P<0.001). Thigh tactile sensation was impaired in 89% of participants. Quality of life was significantly less for the physical health component of the SF-12 (P<0.001). The mental health component of the SF-12 was similar to healthy controls (P=0.26). Conclusion: There was no effect on donor site morbidity with regards to knee extensor strength, pain, walking function, ability to sit-to-stand, and muscle length. VL harvest affected donor-site knee flexion strength, walking speed, tactile sensation, and physical health-related quality of life.

Keywords: vastus lateralis, morbidity, head and neck, surgery, donor-site morbidity

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Authors: Andrea Gion Saluz, Tal Hertig, Axel Heinrich, Stefan Stevanovic

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Higher temperatures, seasonal changes in precipitation, and extreme weather events are increasingly affecting trees. To counteract the increasing challenges of urban trees, strategies are increasingly being sought to preserve existing tree populations on the one hand and to prepare for the coming years on the other. One such strategy lies in strategic climate tree species selection. The search is on for species or varieties that can cope with the new climatic conditions. Many efforts in German-speaking countries deal with this in detail, such as the tree lists of the German Conference of Garden Authorities (GALK), the project Stadtgrün 2021, or the instruments of the Climate Species Matrix by Prof. Dr. Roloff. In this context, different methods for a correct species selection are offered. One possibility is to select certain physiological attributes that indicate the climate resilience of a species. To calculate the dissimilarity of the present climate of different geographic regions in relation to the future climate of any city, a weighted (standardized) Euclidean distance (SED) for seasonal climate values is calculated for each region of the Earth. The calculation was performed in the QGIS geographic information system, using global raster datasets on monthly climate values in the 1981-2010 standard period. Data from a European forest inventory were used to identify tree species growing in the calculated analogue climate regions. The inventory used is the compilation of georeferenced point data at a 1 km grid resolution on the occurrence of tree species in 21 European countries. In this project, the results of the methodological application are shown for the city of Zurich for the year 2060. In the first step, analog climate regions based on projected climate values for the measuring station Kirche Fluntern (ZH) were searched for. In a further step, the methods mentioned above were applied to generate tree species lists for the city of Zurich. These lists were then qualitatively evaluated with respect to the suitability of the different tree species for the Zurich area to generate a cleaned and thus usable list of possible future tree species.

Keywords: climate change, climate region, climate tree, urban tree

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Authors: Ravan Samadov

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Mentally disabled people are the most discriminated against among other disabled people and face much stronger negative attitudes across many cultures. The most complex and severe form of exclusion of these people is deprivation of liberty on the grounds of their disability. This problem was for many years overlooked to a great extent by the core human rights instruments. However, the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD), adopted in 2006, is considered a potential tool to successfully fill the gap. It is especially vital for the developing countries with the vast majority of disabled people of the world and the CRPD is presumed to be able to trigger drastic positive changes. Article 14 of the mentioned human rights treaty has brought into the international forum a new notion, as prohibits deprivation of liberty on the grounds of disability. It is to be understood as an absolute prohibition of deprivation of liberty on the grounds of disability, including mental disability, which manifests in the form of non-consensual psychiatric hospitalisation. The interpretation by the CRPD Committee indicates that this prohibition well embraces all types of non-consensual psychiatric hospitalisation – whether it is based on illness, impairment or disability. This prohibition also extends to such justifications as ‘dangerousness’, ‘need for treatment’ and ‘diminished capacity’. Moreover, providing due substantive and/or procedural safeguards does not render any legitimacy to application of deprivation of liberty on the grounds of mental disability. Logically, this new prohibition form was to be duly considered by different UN human rights bodies, and was subsequently to bring changes to their practices. However, the analyses of post-CRPD work of those bodies allows for asserting the contrary, as they have continued displaying the position which recognises deprivation of liberty on the grounds of disability to be legitimate. While such a position could be justified in the pre-CRPD time as stemming from the silence of human rights documents about it, the continuation of this course after the CRPD entered into force may call the integrity and coherence of the UN human rights treaty system into question. The non-coherent approaches of different UN bodies to this novelty give grounds for misinterpretation thereof, and hinder its due implementation by the States Parties. The paper will discuss the nature of the mentioned new prohibition and the controversial approaches to that notion by different UN human rights bodies.

Keywords: CRPD, deprivation of liberty, mental disability, non-consensual psychiatric hospitalisation, UN bodies

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Authors: Kunyu Yan

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Early childhood music education plays a significant role in an individual’s growth. Music can help children understand themselves and relate to others, and make connections between family, school, and society. In recent years, with the development of early childhood education in China, an increasing number of kindergartens have been established, and many of them pay more attention to music education. This research has two main aims. One is to discover how and why music is used in both public and private kindergartens. The second aim is to make recommendations for widening the use of music in kindergartens. In order to achieve these aims, the research uses two main methods. Firstly, it considers the historical background and cultural context of early childhood education in China; and secondly, it uses an approach that compares public and private kindergartens. In this research, six kindergartens were chosen from Qingdao city in Shandong Province as case studies, including 3 public kindergartens and 3 private kindergartens. This research was based on using three types of data collection methods: observation, semi-structured interviews with teachers, and questionnaires with parents. Participant and non-participant observational methods were used and included in daily routines at the kindergartens in order to experience the situation of music education first-hand. Interviews were associated with teachers’ views of teaching and learning music, the perceptions of the music context, and their strategies of using music. Lastly, the questionnaire was designed to obtain the views of current music education from the children’s parents in the respective kindergartens. The results are shown with three main themes: (1) distinct characteristics of public kindergartens (e.g., similar equipment, low tuition fee, qualified teachers, etc); (2) distinct characteristics of private kindergartens (e.g., various tuition fees, own teaching system, trained teachers, etc); and (3) differences between public and private kindergartens (e.g., funding, requirements for teachers, parents’ demands, etc). According to the results, we can see that the main purpose of using music in China is to develop the musical ability of children, and teachers focus on musical learning, such as singing in tune and playing instruments. However, as revealed in this research, there are many other uses and functions of music in these educational settings, including music used for non-musical learning (e.g., counting, learning language, etc.) or in supporting social routines.

Keywords: differences between private and public school, early childhood education, music education, uses and functions of music

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Authors: Alessandra Turini Bolsoni-Silva, Sonia Regina Loureiro

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It is important to evaluate such variables simultaneously and differentiating types of behavior problems: internalizing, externalizing and with comorbidity of internalizing and externalizing. The objective was to compare, correlate and predict teacher educational practices (educational social skills and negative practices) and children's behaviors (social skills and behavior problems) of children with internalizing, externalizing and combined internalizing and externalizing problems, controlling variables of child (gender and education). A total of 262 children were eligible to compose the participants, considering preschool age from 3 to 5 years old (n = 109) and school age from 6 to 11 (n = 153) years old, and their teachers who were distributed, in designs case-control, non-clinical, with internalizing, externalizing problems and internalizing and externalizing comorbidity, using the Teacher's Report Form (TRF) as a criterion. The instruments were applied with the teachers, after consent from the parents/guardians: a) Teacher’s Report Form (TRF); b) Educational Social Skills Interview Guide for Teachers (RE-HSE-Pr); (c) Socially Skilled Response Questionnaire – Teachers (QRSH-Pr). The data were treated by univariate and multivariate analyses, proceeding with comparisons, correlations and predictions regarding the outcomes of children with and without behavioral problems, considering the types of problems. As main results stand out: (a) group comparison studies: in the Inter group there is emphasis on behavior problems in affection interactions, which does not happen in the other groups; as for positive practices, they discriminate against groups with externalizing and combined problems and not in internalizing ones, positive educational practices – hse are more frequent in the G-Exter and G-Inter+Exter groups; negative practices differed only in the G-Exter and G-Inter+Exter groups; b) correlation studies: it can be seen that the Inter+Exter group presents a greater number of correlations in the relationship between behavioral problems/complaints and negative practices and between children's social skills and positive practices/contexts; c) prediction studies: children's social skills predict internalizing, externalizing and combined problems; it is also verified that the negative practices are in the multivariate model for the externalizing and combined ones. This investigation collaborates in the identification of risk and protective factors for specific problems, helping in interventions for different problems.

Keywords: development, educational practices, social skills, behavior problems, teacher

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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: Ardiana Murtezani, Ilirijana Dallku, Teuta Osmani Vllasolli, Sabit Sllamniku

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Background: The use of foot orthoses are always indicated when there are alterations of the optimal biomechanics' position of the foot. Orthotics are very effective and very suitable for the majority of patients with pain due to overload which can be related to biomechanical disorders. Aim: To assess the frequency of patients requiring foot orthoses, type of orthoses and analysis of their disease leading to the use of foot orthoses. Material and Methods: Our study included 128 patients with various foot pathologies, treated at the outpatient department of the Ortho-Prosthetic Center of Kosovo (OPCK) in Prishtina. Prospective-descriptive clinical method was used during this study. Functional status of patients was examined, and the following parameters are noted: range of motion measurements for the affected joints/lower extremities, manual test for muscular strength below the knee and foot of the affected extremity, perimeter measurements of the lower extremities, measurements of lower extremities, foot length measurement, foot width measurements and size. In order to complete the measurements the following instruments are used: plantogram, pedogram, meter and cork shoe lift appliances. Results: The majority of subjects in this study are male (60.2% vs. 39.8%), and the dominant age group was 0-9 (47.7%), 61 subjects respectively. Most frequent foot disorders were: congenital disease 60.1%, trauma cases 13.3%, consequences from rheumatologic disease 12.5%, neurologic dysfunctions 11.7%, and the less frequented are the infectious cases 1.6%. Congenital anomalies were the most frequent cases, and from this group majority of cases suffered from pes planovalgus (37.5%), eqinovarus (15.6%) and discrepancies between extremities (6.3%). Furthermore, traumatic amputations (2.3%) and arthritis (0.8%). As far as neurologic disease, subjects with cerebral palsy are represented with (3.1%), peroneal nerve palsy (2.3%) and hemiparesis (1.6%). Infectious disease osteomyelitis sequels are represented with (1.6%). Conclusion: Based on our study results, we have concluded that the use of foot orthoses for patients suffering from rheumatoid arthritis and nonspecific arthropaty was effective treatment choice, leading to decrease of pain, less deformities and improves the quality of life.

Keywords: orthoses, epidemiological analysis, rheumatoid arthritis, rehabilitation

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Authors: V. Argyropoulos, M. Nikolaraizi, K. Tanou

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There is little available information concerning the cognitive and communicative abilities of the people who are deaf-blind. This mainly stems from the general inadequacy of existing assessment instruments employed with deafblind individuals. Although considerable variability exists with regard to cognitive capacities of the deaf-blind, careful examination of the literature reveals that the majority of these persons suffer from significant deficits in cognitive and adaptive functioning. The few reports available primarily are case studies, narrative program descriptions, or position papers by workers in the field. Without the objective verification afforded by controlled research, specialists in psychology, education, and other rehabilitation services must rely on personal speculations or biases to guide their decisions in the planning, implementation, and evaluation of services to deaf-blind children and adults. This paper highlights the framework and discusses the results of an action research network. The aim of this study was twofold: a) to describe and analyse the different ways in which a student with deafblindness approached a number of developmental issues such as novel tasks, exploration and manipulation of objects, reactions to social stimuli, motor coordination, and quality of play and b) to map the appropriate functional approach for the specific student that could be used to develop strategies for classroom participation and socialization. The persons involved in this collaborative action research scheme were general teachers, a school counsellor, academic staff and student teachers. Rating scales and checklists were used to gather information in natural activities and settings, and additional data were also obtained through interviews with the educators of the student. The findings of this case study indicated that there is a great need to focus on the development of effective intervention strategies. The results showed that the identification of positive reinforcers for this population might represent an important and challenging aspect of behaviour programmes. Finally, the findings suggest that additional empirical work is needed to increase attention to methodological and social validity issues.

Keywords: action research, cognitive and communicative abilities, deafblindness, effective strategies

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Authors: Catherine Mary Abou-Zaid, Sandra Goodwin

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This study was conducted in a cardiac center in Bahrain. The rise in the amount of obese patients’ both men and women, being admitted for surgical procedures has become an issue to the nurses and doctors as these patients pose a high risk of major complications arising from their problem. The cessation of obesity in the country is very high and obesity-related diseases has been the cause of concern among men and women, also related individual diseases such as cardiovascular, diabetes and chronic respiratory diseases are rising dramatically within Bahrain in the last 10 years. Rationale for the Study: The ontological approach will help to understand and assess the true nature of the social world and how the world looks at obesity. Obesity has to be looked at as being a realistic ongoing issue. The epistemological approach will look at the theory of the origins of the nature of knowledge, set the rule of validating and learning in the social world of what can be done to curb this concept and how this can help prevent otherwise preventable diseases. Design Methodology: The qualitative design methodology took the form of an ontological/epistemological approach using phenomenology as a framework. The study was based on a social research issue, therefore, ontological ‘realism and idealism’ will feature as the nature of the world from a social and natural context. Epistemological positions of the study will be how we as researchers will find the actual social world and the limiting of that knowledge. The one-to-one interviews will be transcribed and the taped verbatim will be coded and charted giving the thematic analytic results. Recommendations: The significance of the research brought many recommendations. These recommendations were taken from the themes and sub-themes and were presented to the centers management and the necessary arrangements for updating knowledge and attitudes towards obesity in cardiac patients was then presented to the in-service education department. Workshops and training sessions on promoting health education were organized and put into the educational calendar for the next academic year. These sessions would look at patient autonomy, the patients’ rights, healthy eating for patients and families and the risks associated with obesity in cardiac disease processes.

Keywords: cardiac patients, diabetes, education & training, obesity cessation, qualitative

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Authors: Duangduen L. Bhanthumnavin, Duchduen E. Bhanthumnavin

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Widening gap between new academic knowledge in all areas and habit of exploring and exploiting this precious information by students causes an alarm and need for urgent prevention. At present, all advanced nations are committed to WHO’s Sustainable Development Goals (SDGs), which require some objective achievements by the year 2030 and further. The responsibility has been enforced on university lecturers, in addition to the higher education learning outcomes (HELO). The two groups of goals (SDGs and HELO) can be realized if most university instructors are capable of inculcating some important psychological characteristics and behavioral change in the new generations. Thus, this study aimed at pinpointing the significant factors for additional teaching skills of instructors regardless of the area of study. University lecturers from various parts of Thailand, with the total of 540 persons, participated in this cross-sectional study. Based on interactionism model of behavior antecedents, it covers psychological situational factors, as well as their interaction. Most measuring instruments were summated rating with 10 or more items, each accompanied by a six-point rating scale. All these measures were constructed with acceptable standards. Most of the respondents were volunteers who gave their written responses in a meeting room or conference hall. By applying Multiple Regression Analysis in the total sample as well as in the subsamples of these university instructors, about 70 to 73 predictive percentages with 4 to 6 significant predictors were found. The major dependent variable was instructor’s teaching behavior for inculcating the psycho-moral strength for academic exploration and knowledge application. By performing ANOVA, the less-active instructors were identified as the ones with lower education (Master’s level or lower), the minimal research producers, and the ones with less in-service trainings. The preventive factors for these three groups of instructors were intention to increase the students’ psychological development as well as moral development in their regular teaching classes. In addition, social support from their supervisors and coworkers was also necessary. Recommendations for further research and training are offered and welcomed.

Keywords: psychological inculcation, at-risk instructors, preventive measures, undergraduate teaching

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Authors: Arman Kishan, Sanjay Kubsad, Steve Li, Mark Haft, Duc Nguyen, Dawn Laporte

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Objective: Carpal tunnel syndrome can be managed surgically with endoscopic or open carpal tunnel release (CTR). Rheumatoid arthritis (RA) is a known risk factor for Carpal Tunnel Syndrome (CTS) and is believed to be related to compression of the median nerve secondary to inflammation. We aimed to analyze national trends, outcomes, and patient-specific comorbidities associated with ECTR and OCTR in patients with RA. Methods: A retrospective cohort study was conducted using the PearlDiver database, identifying 683 RA patients undergoing ECTR and 4234 undergoing OCTR between 2010 and 2014. Demographic data, comorbidities, and complication rates were analyzed. Univariate and multivariable analyses assessed differences between the treatment methods. Results:  Patients with RA undergoing ECTR in comparison to OCTR had no significant differences in medical comorbidities such as hypertension, obesity, chronic kidney disease, hypothyroidism and diabetes mellitus. Patients in the ECTR group reported a risk ratio of 1.44 (95%CI: 1.10-1.89, p=0.01) of requiring repeat procedures within 90 days of the initial procedure. Five-year trends in ECTR and OCTR procedures reported a combined annual growth rate of 5.6% and 13.15, respectively. Conclusion: Endoscopic and open approaches to CTR are important considerations in surgical planning. RA and ECTR have previously been identified as independent risk factors for revision CTR. Our study has identified the 90-day risk of repeat procedures to be elevated in the ECTR group in comparison to the OCTR group. Additionally, the growth of OCTR procedures has outpaced the growth of ECTR procedures in the same period, likely in response to the trend of ECTR leading to higher rates of repeat procedures. The need for revision following ECTR in patients with RA could be related to chronic inflammation leading to transverse carpal ligament thickening and concomitant tenosynovitis. Future directions could include further characterization of repeat procedures performed in this subset of patients. 

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, rheumatoid arthritis, trends analysis, carpal tunnel syndrome

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Authors: Liaqat Ali, Hubert E. Blum, Türkân Sakinc

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Enterococcus faecium is an emerging multidrug-resistant nosocomial pathogen increased dramatically worldwide and causing bacteremia, endocarditis, urinary tract and surgical site infections in immunocomprised patients. The capsular polysaccharides that contribute to pathogenesis through evasion of the host innate immune system are also involved in hindering leukocyte killing of enterococci. The gene cluster (enterococcal polysaccharide antigen) of E. faecalis encoding homologues of many genes involved in polysaccharide biosynthesis. We identified two putative loci with 22 kb and 19 kb which contained 11 genes encoding for glycosyltransferases (GTFs); this was confirmed by using genome comparison of already sequenced strains that has no homology to known capsule genes and the epa-locus. The polysaccharide-conjugate vaccines have rapidly emerged as a suitable strategy to combat different pathogenic bacteria, therefore, we investigated a polysaccharide biosynthesis CapD protein in E. faecium contains 336 amino acids and had putative function for N-linked glycosylation. The deletion/knock-out capD mutant was constructed and complemented by homologues recombination method and confirmed by using PCR and sequencing. For further characterization and functional analysis, in-vitro cell culture and in-vivo a mouse infection models were used. Our ΔcapD mutant shows a strong hydrophobicity and all strains exhibited biofilm production. Subsequently, the opsonic activity was tested in an opsonophagocytic assay which shows increased in mutant compared complemented and wild type strains but more than two fold decreased in colonization and adherence was seen on surface of uroepithelial cells. However, a significant higher bacterial colonialization was observed in capD mutant during animal bacteremia infection. Unlike other polysaccharides biosynthesis proteins, CapD does not seems to be a major virulence factor in enterococci but further experiments and attention is needed to clarify its function, exact mechanism and involvement in pathogenesis of enteroccocal nosocomial infections eventually to develop a vaccine/ or targeted therapy.

Keywords: E. faecium, pathogenesis, polysaccharides, biofilm formation

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Authors: Prem Bahadur Giri, Mathinee Yucharoen

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Community Forest User Groups (CFUGs) have been the core stone of forest management efforts in Nepal. Due to the lack of a smooth transition into the local governance structure in 2017, policy instruments have not been effectively cascaded to the local level, creating ambiguity and inconsistency in forest governance. Descriptive mixed-method research was performed with community users and stakeholders of Tarpakha community forest, Siranchowk Rural Municipality, to understand the role of the political economy in CFUG management. A household survey was conducted among 100 households (who also are existing members of the Tarpakha CFUG) to understand and document their energy consumption preferences and practices. Likewise, ten key informant interviews and five focus group discussions with the municipality and forest management officials were also conducted to have a wider overview of the factors and political, socio-economic, and religious contexts behind the utilization of renewable energy for sustainable development. Findings from our study suggest only 3% of households use biogas as the main source of energy. The rest of the households mention liquid petroleum gas (LPG), electricity and firewood as major sources of energy for domestic purposes. Community members highlighted the difficulty in accessing firewood due to strict regulations from the CFUG, lack of cattle and manpower to rear cattle to produce cow dung (for biogas), lack of technical expertise at the community level for the operation and maintenance of solar energy, among others as challenges of resource. Likewise, key informants have mentioned policy loopholes at both the federal and local levels, especially with regard to the promotion of alternative or renewable energy, as there are no clear mandates and provisions to regulate the renewable energy industry. The study recommends doing an in-depth study on the feasibility of renewable energy sources, especially in the context of CFUGs, where biodiversity conservation aspects need to be equally taken into consideration while thinking of the promotion and expansion of renewable energy sources.

Keywords: community forest, renewable energy, sustainable development, Nepal

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Authors: Maha A. Al-Hsayni

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Title of the Study: The Effect of Using Augmented Reality Technique in a Computer Course Unit on the Academic Achievement and Attitudes of High School Female Students. This study aimed at identifying the effect of using the Augmented Reality technique on the academic achievement of computer course at the cognitive domains (Knowledge, comprehension and analysis) with third high school female students in Holy Makkah. The researcher used: The quasi-experimental approach. The sample of the study was comprised of (55) female students in the third high school level in Holy Makkah in the second semester of the academic year 1434/1435 H. These students were assigned to two groups: The experimental group of (28) students who were taught by using the Augmented Reality technology, and the control group of (27) students, who were taught by using the traditional method. The researcher prepared a set of tools and materials, which are represented in achievement test consisted of (30) clauses, direction instrument consisted of (25) clauses and the design of augmented reality for computer study unit. The study used the following statistical methods for data analysis: Cronbach's alpha coefficient, Pearson correlation coefficient, means, standard deviations, t-test and analysis of covariance test ANCOVA. The study reached the following results: 1- There are statistically significance difference at ( 0.05) among the adjusted means of the experimental and control groups in the posttest at the domains of (Knowledge, comprehension and analysis) of third high school graders after adjusting the pretest 2- There are statistically significance difference at ( 0.05) among the means of pre and post-test for female students of the experimental group in the scale of attitude towards using Augmented Reality Technique. In the light of the study results, the researcher recommends the followings: The necessity of using Augmented Reality Technique in teaching computer courses for high school students. Furthermore, emphasizing the need to provide schools with educational halls equipped with instruments and screens that enable teachers to use the Augmented Reality in teaching the other courses. Also, the researcher suggested conducting more studies in order to improve the process of teaching and learning.

Keywords: augmented reality technique, computer course unit, academic achievement, attitudes, high school female students

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Authors: Jing Jiang, Yuguang Gao, Yang Yu

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Facing increasingly challenging insurance payment pressures, the Chinese healthcare system is undergoing significant transformations, akin to the implementation of DRG payment models by the United States' Medicare. Consequently, there is a pressing need for Chinese hospitals to establish optimizations in departmental operations tailored to the ongoing healthcare payment reforms. This abstract delineates the meticulous construction of a scientifically rigorous and comprehensive index system at the departmental level in China strategically aligned with the evolving landscape of healthcare payment reforms. Methodologically, it integrates key process areas and maturity assessment theories, synthesizing relevant literature and industry standards to construct a robust framework and indicator pool. Employing the Delphi method, consultations with 21 experts were conducted, revealing a collective demonstration of high enthusiasm, authority, and coordination in designing the index system. The resulting model comprises four primary indicators -technical capabilities, cost-effectiveness, operational efficiency, and disciplinary potential- supported by 14 secondary indicators and 23 tertiary indicators with varied coefficient adjustment for department types (platform or surgical). The application of this evaluation system in a Chinese hospital within the northeastern region yielded results aligning seamlessly with the actual operational scenario. In conclusion, the index system comprehensively considers the integrity and effectiveness of structural, process, and outcome indicators and stands as a comprehensive reflection of the collective expertise of the engaged experts, manifesting in a model designed to elevate the operational management of hospital departments. Its strategic alignment with healthcare payment reforms holds practical significance in guiding departmental development positioning, brand cultivation, and talent development.

Keywords: Chinese healthcare system, Delphi method, departmental management, evaluation indicators, hospital operations, weight coefficients

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