Search results for: professional autonomy

Authors: Danilo Di Donato

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The continuous new releases of free and open source software (FOSS) and the high costs of proprietary software -whose monopoly is characterized by closed codes and the low level of implementation and customization of software by end-users- impose a reflection on possible tools that can be chosen and adopted for the design and the representation of new steel constructions. The paper aims to show experimentation carried out to verify the actual potential and the effective applicability of FOSS supports to the BIM modeling of steel structures, particularly considering the goal of a possible workflow in order to achieve high level of development (LOD); allow effective interchange methods between different software. To this end, the examined software packages are those with open source or freeware licenses, in order to evaluate their use in architectural praxis. The test has primarily involved the experimentation of Freecad -the only Open Source software that allows a complete and integrated BIM workflow- and then the results have been compared with those of two proprietary software, Sketchup and TeklaBim Sight, which are released with a free version, but not usable for commercial purposes. The experiments carried out on Open Source, and freeware software was then compared with the outcomes that are obtained by two proprietary software, Sketchup Pro and Tekla Structure which has special modules particularly addressed to the design of steel structures. This evaluation has concerned different comparative criteria, that have been defined on the basis of categories related to the reliability, the efficiency, the potentiality, achievable LOD and user-friendliness of the analyzed software packages. In order to verify the actual outcomes of FOSS BIM for the steel structure projects, these results have been compared with a simulation related to a real case study and carried out with a proprietary software BIM modeling. Therefore, the same design theme, the project of a shelter of public space, has been developed using different software. Therefore the purpose of the contribution is to assess what are the developments and potentialities inherent in FOSS BIM, in order to estimate their effective applicability to professional practice, their limits and new fields of research they propose.

Keywords: BIM, steel buildings, FOSS, LOD

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Authors: Bartelsen-Raemy Annabelle, Gerber Andrea

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Objectives: The adoption of the UN Convention on the Rights of Persons with Disabilities has the effect that higher education institutions in Switzerland are called upon to promote inclusive university education. In this context, our School of Social Work aims to provide fair participation and the removal of barriers in our study programmes at bachelor’s and master’s levels. In 2015 we developed a concept of reasonable adjustments for students with disabilities and chronic illness as an instrument to provide equal opportunities for those students. We reviewed the implementation of this concept as part of our quality management process. Using a qualitative research design, we explored how affected students and lecturers experience the processes and measures taken and which barriers they still perceive. Methods: We captured subjective perspectives and experience of measures by conducting 15 problem-centred interviews with affected students and three experimental focus groups with lecturers. The data was processed using structured qualitative content analysis and summarised as key categories. Results: All respondents evaluated the concept of reasonable adjustment very positively and emphasised its importance for equal opportunities. Our analysis revealed differences in the usage and perception of both groups and showed that the students interviewed were a heterogeneous group with different needs. Overall, the students described the adjustments, in particular in relation to examinations and other assignments, as a great relief. The lecturers expressed high standards for their own teaching and supervision of students and, at the same time, wished for more support from the university. However, despite the positive evaluation by the lecturers, the limits of reasonable adjustment became evident. It is necessary to consider the limits of reasonable adjustments in terms of professional skills. Conclusion: Reasonable adjustments should, therefore, be seen as an element of an inclusive university culture that must be complemented by further measures. Taking this into account, we have planned further research as a basis for the development of a diversity and inclusion policy.

Keywords: opportunities and limits, reasonable adjustment, social work education, students with disabilities

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Authors: Almagul Nurgaliyeva

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The phenomenon of novice teacher attrition is an urgent issue. The effective mechanisms to increase the retention rate of novice teachers relate to the nature and level of support provided at an employing site. This study considered novice teacher retention as a motivation-based process, which is based on a variety of support activities employed to satisfy novice teachers’ needs at an early career stage. The purpose of the study was to examine novice teachers’ perceptions of the effectiveness of the induction program and other support structure(s) at a secondary school in Nur-Sultan. The study was guided by Abraham Maslow’s (1943) theory of motivation. Maslow’s hierarchy of needs was used as a theoretical framework to identify the novice teachers’ primary needs and the extent to which the induction programs and other support mechanisms provided by the school administrators fulfill those needs. One school supervisor and eight novice teachers (four current and four former novice teachers) with a maximum of four years of teaching experience took part in the study. To investigate the perspectives and experiences of the participants, an online semi-structured interview was utilized. The responses were collected and analyzed. The study revealed four major challenges: educational, personal-psychological, sociological, and structural which are seen as the main constraints during the adaptation period. Four induction activities, as emerged from the data, are being carried out by the school to address novice teachers’ challenges: socialization activities, mentoring programs, professional development, and administrative support. These activities meet novice teachers’ needs and confront the challenges they face. Sufficient and adequate support structures provided to novice teachers during their first years of working experience is essential, as they may influence their decision to remain in the teaching profession, thereby reducing the attrition rate. The study provides recommendations for policymakers and school administrators about the structure and the content of induction program activities.

Keywords: beginning teacher induction, induction programme, orientation programmes, adaptation challenges, novice teacher retention

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Authors: Amizawati Mohd Amir, Ruhanita Maelah, Zaidi Mohd Noor

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As part of the Malaysia Higher Institutions' Strategic Plan in promoting high-quality research and education, the Ministry of Higher Education has introduced various instrument to assess the universities performance. The aims are that university will produce more commercially-oriented research and continue to contribute in producing professional workforce for domestic and foreign needs. Yet the spirit of the success lies in the commitment of university particularly the academic staff to translate the vision into reality. For that reason, the element of fairness and justice in assessing individual academic staff performance is crucial to promote directly linked between university and individual work goals. Focusing on public research universities (RUs) in Malaysia, this study observes at the issue through the practice of university contemporary performance measurement system. Accordingly management control theory has conceptualized that contemporary performance measurement consisting of three dimension namely strategic, comprehensive and dynamic building upon equity theory, the relationships between contemporary performance measurement system and organizational justice and in turn the effect on academic staff work performance are tested based on online survey data administered on 365 academic staff from public RUs, which were analyzed using statistics analysis SPSS and Equation Structure Modeling. The findings validated the presence of strategic, comprehensive and dynamic in the contemporary performance measurement system. The empirical evidence also indicated that contemporary performance measure and procedural justice are significantly associated with work performance but not for distributive justice. Furthermore, procedural justice does mediate the relationship between contemporary performance measurement and academic staff work performance. Evidently, this study provides evidence on the importance of perceptions of justice towards influencing academic staff work performance. This finding may be a fruitful input in the setting up academic staff performance assessment policy.

Keywords: comprehensive, dynamic, distributive justice, contemporary performance measurement system, strategic, procedure justice, work performance

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Authors: Mustafa Tevfik Hebebci, Ismail Sahin, Sirin Kucuk, Ismail Celik, Ahmet Oguz Akturk

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ADDIE is an instructional design model which has the five core elements: analyze, design, develop, implement, and evaluate. The ADDIE approach provides a systematic process for the analysis of instructional needs, the design and development of instructional programs and materials, implementation of a program, and the evaluation of the effectiveness of an instruction. The case-based study is an instructional design model that is a variant of project-oriented learning. Collecting and analyzing stories can be used in two primary ways -perform task analysis and as a learning support during instruction- by instructional designers. Besides, teachers use technology to develop students’ thinking, enriching the learning environment and providing permanent learning. The purpose of this paper is to introduce an interactive online case-study library website developed in a national project. The design goal of the website is to provide interactive, enhanced, case-based and online educational resource for educators through the purpose and within the scope of a national project. The ADDIE instructional design model was used in the development of the website for the interactive case-based library. This web-based library contains the navigation menus as the follows: “Homepage”, "Registration", "Branches", "Aim of The Research", "About TPACK", "National Project", "Contact Us", etc. This library is developed on a web-based platform, which is important in terms of manageability, accessibility, and updateability of data. Users are able to sort the displayed case-studies by their titles, dates, ratings, view counts, etc. In addition, they encouraged to rate and comment on the case-studies. The usability test is used and the expert opinion is taken for the evaluation of the website. This website is a tool to integrate technology in education. It is believed that this website will be beneficial for pre-service and in-service teachers in terms of their professional developments.

Keywords: design, ADDIE, case based library, technology integration

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Authors: Maria Ghorbanian, Mohammad Ghahramani, Mahmood Abolghasemi

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Universities and institutions of higher education in Iran, like other higher education institutions in the world, have a heavy mission and task to educate students based on the needs of the country. Taking on such a serious responsibility requires having a good governance system for planning, formulating executive plans, evaluating, and finally modifying them in accordance with the current conditions and challenges ahead. In this regard, the present study was conducted with the aim of identifying the components of good governance in the Iranian higher education system by survey method and with a quantitative approach. In order to collect data, a researcher-made questionnaire was used, which includes two parts: personal and professional characteristics (5 questions) and the three components of good governance in the Iranian higher education system, including good management and leadership (8 items), continuous evaluation and effective (university performance, finance, and university appointments) (8 items) and civic responsibility and sustainable development (7 items). These variables were measured and coded in the form of a five-level Likert scale from "Very Low = 1" to "Very High = 5". First, the validity and reliability of the research model were examined. In order to calculate the reliability of the questionnaire, two methods of Cronbach's alpha and combined reliability were used. Fornell-Larker interaction and criterion were also used to determine the degree of diagnostic validity. The statistical population of this study included all faculty members of public universities in Tehran (N = 4429). The sample size was estimated to be 340 using the Cochran's formula. These numbers were studied using a randomized method with a proportional assignment. The data were analyzed by the structural equation method with the least-squares approach. The results showed that the component of civil responsibility and sustainable development with a factor load of 0.827 is the most important element of good governance.

Keywords: good governance, higher education, sustainable, development

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Authors: A. Kourou, A. Ioakeimidou, E. Bafa, C. Fassoulas, M. Panoutsopoulou

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The role of volunteers in disaster management is of decisive importance and the need of their involvement is well recognized, both for prevention measures and for disaster management. During major catastrophes, whereas professional personnel are outsourced, the role of volunteers is crucial. In Greece experience has shown that various groups operating in the civil protection mechanism like local administration staff or volunteers, in many cases do not have the necessary knowledge and information on best practices to act against natural disasters. One of the major problems is the lack of volunteers’ education and training. In the above given framework, this paper presents the results of a survey aimed to identify the level of education and preparedness of civil protection volunteers in Greece. Furthermore, the implementation of earthquake protection measures at individual, family and working level, are explored. More specifically, the survey questionnaire investigates issues regarding pre-earthquake protection actions, appropriate attitudes and behaviors during an earthquake and existence of contingency plans in the workplace. The questionnaires were administered to citizens from different regions of the country and who attend the civil protection training program: “Protect Myself and Others”. A closed-form questionnaire was developed for the survey, which contained questions regarding the following: a) knowledge of self-protective actions; b) existence of emergency planning at home; c) existence of emergency planning at workplace (hazard mitigation actions, evacuation plan, and performance of drills); and, d) respondents` perception about their level of earthquake preparedness. The results revealed a serious lack of knowledge and preparedness among respondents. Taking into consideration the aforementioned gap and in order to raise awareness and improve preparedness and effective response of volunteers acting in civil protection, the EVANDE project was submitted and approved by the European Commission (EC). The aim of that project is to educate and train civil protection volunteers on the most serious natural disasters, such as forest fires, floods, and earthquakes, and thus, increase their performance.

Keywords: civil protection, earthquake, preparedness, volunteers

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Authors: Betsy Hannam

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Background: Staff nurses felt overwhelmed to learn new skills or complete competencies during their shift. Med/Surg units need to provide dedicated, uninterrupted time to complete training and mandatory competencies and practice skills. Purpose: To improve nurse satisfaction and competence by creating a Skills Day with uninterrupted time to complete competencies, brush up on skills, and evaluate skills learned through pre- and post-tests. Methods: The USL and CNL interviewed nurses to obtain input regarding skills needing reinforcement and included mandatory competencies relevant to Med/Surg to create the Skills Day agenda. Content experts from multiple disciplines were invited to educate staff to help address knowledge gaps. To increase attendance, multiple class days were offered. Results: 2018 Skills Day was held for an inpatient unit with 95% participation (n=35 out of 37RNs). The average pretest score, comprised of content questions from topics discussed, was 57%, and post test scoresaveraged 80%. 94% of test scores improved or remained the same. RNs were given an evaluation at the end of the day, where100% of staff noted Skills Day as beneficial, and 97% requested to repeat next year. Another Med/Surg unit asked to join Skills Day in 2019. In 2019, with 89% participation (n=57 out 64 RNs), the average pretest score was 68%, and the average post test score was 85%. 97% of scores improved or remained the same. 98% reported the class as beneficial, and 96% requested to repeat next year. Skills Day 2020-2022 on hold due to COVID. Looking forward to Skills Day 2023. Conclusion: Skills Day allows nurses to maintain competencies and improve knowledge in areas of interest without the stress of a patient assignment. Having unit leaders organize Skills Day, with the involvement of content experts from multiple disciplines, showed to be a successful and innovative team approach to support professional development.

Keywords: education, competency, skills day, medical/surgical

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Authors: Dilek Dede

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This study aims at scrutinized the dilemma between education place and working place with professional socialization dimension over the beginning teachers in Turkey is to be found the solution for the dilemma in Turkey. The research question is that how can be explained the gap between education place and working place for beginning teachers in Turkey. That expected to contribute to literature with the solutions for shorting the gap between working area and education area of the teaching profession in Turkey case. The study is constructed in two section. Firstly, socialization of the teaching profession and teaching modules have been discussed through the profession, education, working place indicators. In the second section, Secondly, two educational specialists from Turkey has been interviewed about their observation on trainee teachers compelling to participate the class for candidate teachers after university grade. Then, the dilemma between education area and working area of the teaching profession has been detected by of semi-structured and in-depth interviews, the literature on the relationality of institutions and regulation is discussed. The following outcomes have been accessed in accordance with the data set and literature linkage axis: Firstly, teachers coming from the distinctive programmes as an educational background. Hence, teachers who pertain to distinctive cultures work in the same environment. That cause cultural conflicts and complication of socialization of profession. Secondly, the insufficient partnership between schools and universities besides, the education classes lead to a struggle of culture among these two institutions. Thirdly, the education classes are designed as bureaucratic form instead of coalescence between head teachers and trainee teachers around a common culture. That become deep the dilemma. In conclusion, on condition that applied-oriented education that advocates in-service learning is promoted and this programme is supported with well-structured the in-service training through the partnership of universities and schools, the gap between the working-area and education-area might be shortened.

Keywords: beginning teachers, construction of a common, social mobilization in the teaching profession, teacher training institution, the relationality of the regulations and institutions

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Authors: Mahmoud F. Mohamadin, Ahmed Abdel Malek, Wessam Said

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Achieving energy efficient architecture in general, and in emerging countries in particular, is a challenging process that requires the contribution of various governmental, institutional, and individual entities. The rule of architectural design is essential in this process as it is considered as one of the earliest steps on the road to sustainability. Architectural firms have a moral and professional responsibility to respond to these challenges and deliver buildings that consume less energy. This study aims to evaluate the design processes and tools in practice of Egyptian architectural firms based on a limited survey to investigate if their processes and methods can lead to projects that meet the Egyptian Code of Energy Efficiency Improvement. A case study of twenty architectural firms in Cairo was selected and categorized according to their scale; large-scale, medium-scale, and small-scale. A questionnaire was designed and distributed to the firms, and personal meetings with the firms’ representatives took place. The questionnaire answered three main points; the design processes adopted, the usage of performance-based simulation tools, and the usage of BIM tools for energy efficiency purposes. The results of the study revealed that only little percentage of the large-scale firms have clear strategies for building energy efficiency in their building design, however the application is limited to certain project types, or according to the client request. On the other hand, the percentage of medium-scale firms is much less, and it is almost absent in the small-scale ones. This demonstrates the urgent need of enhancing the awareness of the Egyptian architectural design community of the great importance of implementing these methods starting from the early stages of the building design. Finally, the study proposed recommendations for such firms to be able to create a healthy built environment and improve the quality of life in emerging countries.

Keywords: architectural firms, emerging countries, energy efficiency, performance-based simulation tools

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Authors: Zaka Nisa, Farooq Sher

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Adverse drug reactions (ADRs) underreporting is a great challenge to Pharmacovigilance. Health care professionals have to consider ADR reporting as their professional obligation, an effective system of ADR reporting is important to improve patient health care and safety. The present study is designed to assess the knowledge, attitude, practice and factors associated with ADR reporting by health care professionals (physicians and pharmacists) in public and private hospitals of Pakistan. A pretested questionnaire was administered to 384 physicians and pharmacists in public and private hospitals. Respondents were evaluated for their knowledge, attitude, and practice related to ADR reporting. The data was analyzed using the SPSS statistical software, the factors which encourage and discourage respondents in reporting ADRs were determined. Most of the respondents have shown a positive attitude towards ADR reporting. The response rate was 95.32%. Of the 367 questionnaires, including 333 (86.5%) physicians and 34 (8.8%) pharmacists with the mean age 28.34 (SD= 6.69), most of the respondents showed poor ADR reporting knowledge (83.1%). The majority of respondents (78.2%) showed positive attitude towards ADR reporting and only (12.3%) hospitals have good ADR reporting practice. Knowledge of respondents in public hospitals (8.6%) was less as compare to those in the private hospitals (29.7%) (P < 0.001). Attitude of respondents in private hospitals was more positive (92.4%) than those in public hospitals (68.8%) (P < 0.001). No significant difference was observed in practicing of ADR reporting in public (11.8%) and private hospitals (13.1%) (P value 0.89). Seriousness of ADR, unusualness of reaction, new drug involvement and confidence in diagnosis of ADR were the factors which encourage respondents to report ADR, however, lack of knowledge regarding where and how to report ADR, lack of access to ADR reporting form, managing patients was more important than reporting ADR, legal liability issues were the factors which discourage respondents to report ADR. The study reveals poor knowledge and practice regarding ADR reporting. However positive attitude was seen regarding ADR reporting. There is a need of educational training for health care professionals as well as genuine and continuous efforts are required by Government and health authorities to ensure the proper implementation of ADR reporting system in all of the hospitals.

Keywords: adverse drugs reactions (ADR), pharmacovigilance, spontaneous ADR reporting, knowledge of ADR, attitude of health care profesionals, practice of ADR reporting

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Authors: Ahmedou Moulaye Idriss, Yahya Tfeil

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Medical imaging technology has become an indispensable tool in many branches of the biomedical, health area, and research and is vitally important for the training of professionals in these fields. It is not only about the tools, technologies, and knowledge provided but also about the community that this training project proposes. In order to be able to raise the level of anatomy teaching in the medical school of Nouakchott in Mauritania, it is necessary and even urgent to facilitate access to modern technology for African countries. The role of technology as a key driver of justifiable development has long been recognized. Anatomy is an essential discipline for the training of medical students; it is a key element for the training of medical specialists. The quality and results of the work of a young surgeon depend on his better knowledge of anatomical structures. The teaching of anatomy is difficult as the discipline is being neglected by medical students in many academic institutions. However, anatomy remains a vital part of any medical education program. When anatomy is presented in various planes medical students approve of difficulties in understanding. They do not increase their ability to visualize and mentally manipulate 3D structures. They are sometimes not able to correctly identify neighbouring or associated structures. This is the case when they have to make the identification of structures related to the caudate lobe when the liver is moved to different positions. In recent decades, some modern educational tools using digital sources tend to replace old methods. One of the main reasons for this change is the lack of cadavers in laboratories with poorly qualified staff. The emergence of increasingly sophisticated mathematical models, image processing, and visualization tools in biomedical imaging research have enabled sophisticated three-dimensional (3D) representations of anatomical structures. In this paper, we report our current experience in the Faculty of Medicine in Nouakchott Mauritania. One of our main aims is to create a local learning community in the fields of anatomy. The main technological platform used in this project is called 3D Slicer. 3D Slicer platform is an open-source application available for free for viewing, analysis, and interaction with biomedical imaging data. Using the 3D Slicer platform, we created from real medical images anatomical atlases of parts of the human body, including head, thorax, abdomen, liver, and pelvis, upper and lower limbs. Data were collected from several local hospitals and also from the website. We used MRI and CT-Scan imaging data from children and adults. Many different anatomy atlases exist, both in print and digital forms. Anatomy Atlas displays three-dimensional anatomical models, image cross-sections of labelled structures and source radiological imaging, and a text-based hierarchy of structures. Open and free online anatomical atlases developed by our anatomy laboratory team will be available to our students. This will allow pedagogical autonomy and remedy the shortcomings by responding more fully to the objectives of sustainable local development of quality education and good health at the national level. To make this work a reality, our team produced several atlases available in our faculty in the form of research projects.

Keywords: anatomy, education, medical imaging, three dimensional

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Authors: Chih-Wen Fan

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Backgrounds/ Research goals : School improvement requires change leadership, which often means discomfort. Principals are the key people that determine the effectiveness of schools. In an era of organization’s pursuit of speed and effectiveness, school administration has to be accountable and innovative. Effective principals work to improve achievement by focusing on the administrative and teaching quality of improvement. However, there is a lack of literature addressing the relevant case studies on school change leadership. This article explores how principals can use change leadership to drive school change. It analyze the driving factors of principal changes in the case school, the beliefs of change leadership, specific methods, and what impact they have. Methods: This study applies the case study research method to the selected primary school located in an urban area for case study, which has achieved excellent performance after reform and innovation. The researchers selected an older primary school located in an urban area that was transformed into a high-performance primary school after changes were enacted by the principal. The selected case was recommended by three supervisors of the Education Department. The case school underwent leadership change by the new principal during his term, and won an award from the Ministry of Education. Total of 8 teachers are interviewed. The data encoding includes interviews and documents. Expected results/ conclusions: The conclusions of the study are, as follows: (1) The influence for Principal Lin's change leadership is from internal and external environmental development and change pressures. (2) The principal's belief in change leadership is to recognize the sense of crisis, and to create a climate of change and demand for change. (3) The principal's specific actions are intended to identify key members, resolve resistance, use innovative thinking, and promote organizational learning. (4) Principal Lin's change leadership can enhance the professional functions of all employees through appropriate authorization. (5) The effectiveness of change leadership lies in teachers' participation in decision-making; the school's reputation has been enhanced through featured courses.

Keywords: change leadership, empowerment, crisis awareness, case study

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Authors: Lara Al-Haddad, Mark Whittington

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This paper aims to examine the impact of two influential internal corporate governance mechanisms, namely board characteristics and ownership structure on the use of real activities-based and accrual-based earnings management by Jordanian public firms. Using panel data from Jordanian public firms after the introduction of the Jordanian Corporate Governance Code (JCGC) in 2009, the study finds both institutional ownership and managerial ownership constrain the use of real and accrual earnings manipulations. On the other side, both independent directors and largest shareholders are found to exaggerate the incidence of using real and accrual earnings management. The study also examines the trade-off between real and accrual earnings management and found that Jordanian firms use a combination of real and accrual-based earnings management to obtain the greatest effect on earnings reporting strategies. For the purpose of this study, three types of real earnings management are considered: sales manipulation, overproduction, and the abnormal reduction of discretionary expenditures. The abnormal discretionary accrual is considered for accruals management. While for the internal corporate governance mechanisms; board characteristics are examined by using board independence, board size, and CEO-duality; and ownership structure is examined by using managerial ownership, institutional ownership, foreign ownership and largest shareholder ownership. To the best knowledge of the researchers, this study is the first to examine the relationship between board characteristics and real earnings management in Jordan. Further, it is the first to examine the relationship between corporate governance mechanisms and discretionary accruals after the introduction of the Jordanian Corporate Governance Code in 2009. Thus, the findings of this study have important policy implications for policymakers, regulators, standard setters, audit professional, and investors in their attempts to constrain the practice of earnings management, whether real or accrual, and to improve the financial reporting quality in Jordan.

Keywords: board characteristics, Jordan, ownership structure, real earnings management

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Authors: Erika Takidah, Salina Kassim

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Digital transformation has accelerated in the new millennium. It is reshaping the financial services industry from a traditional system to financial technology. Moreover, the number of financial inclusion rates in Indonesia is less than 60%. An innovative model needed to elucidate this national problem. On the other hand, the Islamic financial service industry and financial technology grow fast as a new aspire in economic development. An Islamic bank, takaful, Islamic microfinance, Islamic financial technology and Islamic social finance institution could collaborate to intensify the financial inclusion number in Indonesia. The primary motive of this paper is to examine the strategy of collaboration-based Islamic financial services to enhance financial inclusion in Indonesia, particularly facing the digital era. The fundamental findings for the main problems are the foundations and key ecosystems aspect involved in the development of collaboration-based Islamic financial services. By using the Interpretive Structural Model (ISM) approach, the core problems faced in the development of the models have lacked policy instruments guarding the collaboration-based Islamic financial services with fintech work process and availability of human resources for fintech. The core strategies or foundations that are needed in the framework of collaboration-based Islamic financial services are the ability to manage and analyze data in the big data era. For the aspects of the Ecosystem or actors involved in the development of this model, the important actor is government or regulator, educational institutions, and also existing industries (Islamic financial services). The outcome of the study designates that strategy collaboration of Islamic financial services institution supported by robust technology, a legal and regulatory commitment of the regulators and policymakers of the Islamic financial institutions, extensive public awareness of financial inclusion in Indonesia. The study limited itself to realize financial inclusion, particularly in Islamic finance development in Indonesia. The study will have an inference for the concerned professional bodies, regulators, policymakers, stakeholders, and practitioners of Islamic financial service institutions.

Keywords: collaboration, financial inclusion, Islamic financial services, Islamic fintech

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Authors: Angkayarkan Vinayakaselvi

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This paper aims at unpacking the questions of subjectivity and their role in altering and redefining the constructed images of self and community as represented in chosen Indian women’s autobiographies. India is a country of plurality and this plurality is further extended by diasporic explorations. As the third world feminism questioned the Euro-American views on homogenizing the socio-cultural condition of women of all over the world, Indian feminism needs to critique the view that all Indian women are one and the same. Similar to the plural nature of nation, the nature and condition of women, too, are plural in India. Indian women are differentiated by caste, class, and region. A critical scrutiny of autobiographies written by Indian women belong to different socio-cultural groups – Northeast Indian, Dalit and Diasporic categories – will assess the impact of education, profession and socio-cultural and economic status on Indian Women. Such a critique would highlight the heterogeneous subjectivity of Indian women. The images/selves of women as represented through these autobiographies are chosen with an aim to unmask and challenge, through ordering and positioning, the capitalist politics of literary representations of Indian women’s formation of 'her-self'. Methodologies and subjects associated with literature are considered essential for understanding and combating women’s oppression and empowerment. The representation of self in personal autobiographical history could be treated as the history of entire nation as personal is always political in feminist writings. The chosen narrators who are well-educated, well-settled, professional women of letters are capable of assessing, critiquing and re/articulating the shifting paradigms of women’s lives. Despite these factors, the textual spaces possess evidences to establish the facts that these women undergo sufferings, and they counter design cultural specific strategies for their empowerment. These metafictional self-conscious synecdoches extend to include the world of entire women. Thus these autobiographical texts could be reinterpreted as a searing critique of Indian society based on woman’s personal life.

Keywords: ethnicity and diversity, gender studies, Indian women’s autobiographies, subjectivity

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Authors: Sitaram Dahal

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Sustainable Development, a universal need for the present generation and the future generation, is an accepted way to assure intra and inter-generational equity. International movements like Rio Earth Summit 1992, Stockholm Conference 1972, Kyoto Protocol, Sustainable Development Goals (SDGs) proclaim the need of sustainable globe. The socio- economic disparity prevailing in the society shows that the indigenous peoples are living life far below poverty line. These indigenous people, aboriginal social groups sharing common cultural values and with a unique identity, are away from development being merely focused on the growth. Though studies suggest that most of the indigenous practices are often environment-friendly, alert about the plunging trend of the practices. This study explores the trend of intergenerational transmission of indigenous profession of pottery making of Kumal community (Meghauli Village Development Committee of Chitwan district) and factors affecting the trend. The SD indicators - contribution of IP to well-being of pottery makers had been query in the study. The study reveals that the pottery making profession can stand sustainable in terms of environment and socio-economic capital compared to modern technologies. However, the number of practitioners has been decreasing and youths hardly show interest to continue their indigenous profession. The new generations are not in a stage of accepting pottery in complete profession, that challenges the social and cultural sustainability of the profession. Indigenous profession demand people investments over modern technology and innovations. The relative investment of human labour is dramatically high with the indigenous profession. In addition, the fashion and innovations of market rule challenge the sustainability of the pottery making profession. The practice is limited to small cluster as a show piece at present. The study illustrates the market driven unsustainability of indigenous profession of Kumal community.

Keywords: professional unsustainability, pottery making, Kumal Community, Indigenous Professoin

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Authors: Thomas Nally, Jane Ireland, Roxanne Khan, Philip Birch

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Intimate Partner Violence (IPV), a significant societal problem, affects individuals worldwide. However, the strategies victims use to keep safe are under-researched. IPV is significantly under-reported, and services often are not able to be accessed by all victims. Thus they are likely to use their own strategies to manage their victimization before being able to seek support. Two studies were completed to understand these strategies. A systematic review of the literature and study completed with professionals who work with victims was undertaken to understand this area. In study one, a systematic review of the literature (n=61 papers), were analyzed using Thematic Analysis. The results indicated that victims use a large array of behaviors to increase their sense of safety and coping with emotions but also experience significant barriers to help-seeking. In study 2, sixty-nine professionals completed a measure exploring the likelihood and effectiveness of various victim strategies regarding increasing their sense of safety. Strategies included in the measure were obtained from those identified in study 1. Findings indicated that professionals perceived victims of IPV to be more likely to employ safety strategies and coping behaviors that may be ineffective but not help-seeking behaviors. Further, the responses were analyzed using Cluster Analysis. Safety strategies resulted in five clusters; perpetrator-directed strategies, prevention strategies, cognitive reappraisal, safety planning and avoidance strategies. Help-Seeking resulted in six clusters; information or practical support, abuse-related support, emotional support, secondary support and informal support. Finally, coping resulted in four clusters; emotional coping, self-directed coping, thought recording/change and cognitive coping. Both studies indicate that victims may use a variety of strategies to manage their safety besides seeking help. Professionals working with victims, using a strength-based approach, should understand what is used and is effective for victims who are unable to leave the relationships or access external support.

Keywords: intimate partner violence, help-seeking, professional support, victims, victim coping, victim safety

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Authors: Ana Mafalda Silva, Rebeca Fontes, Ana Paula Vaz, Carla Carreira, Ana Corte-Real

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Decades of research on the topic of interpersonal violence against minors highlight five main conclusions: 1) it causes harmful effects on children's development and health; 2) it is prevalent; 3) it violates children's rights; 4) it can be prevented and 5) parents are the main aggressors. The child abuse scenario is identified through clinical observation, administrative data and self-reports. The most used instruments are self-reports; however, there are no valid and reliable self-report instruments for minors, which consist of a retrospective interpretation of the situation by the victim already in her adult phase and/or by her parents. Clinical observation and collection of information, namely from the orofacial region, are essential in the early identification of these situations. The management of medical data, such as personal data, must comply with the General Data Protection Regulation (GDPR), in Europe, and with the General Law of Data Protection (LGPD), in Brazil. This review aims to answer the question: In a situation of medical assistance to minors, in the suspicion of interpersonal violence, due to mistreatment, is it necessary for the guardians to provide consent in the registration and sharing of personal data, namely medical ones. A scoping review was carried out based on a search by the Web of Science and Pubmed search engines. Four papers and two documents from the grey literature were selected. As found, the process of identifying and signaling child abuse by the health professional, and the necessary early intervention in defense of the minor as a victim of abuse, comply with the guidelines expressed in the GDPR and LGPD. This way, the notification in maltreatment scenarios by health professionals should be a priority and there shouldn’t be the fear or anxiety of legal repercussions that stands in the way of collecting and treating the data necessary for the signaling procedure that safeguards and promotes the welfare of children living with abuse.

Keywords: child abuse, disease notifications, ethics, healthcare assistance

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Authors: Fleura Shkëmbi, Sevim Mustafa, Naim Fanaj

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Hypnosis, often known as cognitive therapy, is a sort of mind-body psychotherapy. A professional and certified hypnotist or hypnotherapist guides the patient into this extreme level of focus and relaxation during the session by utilizing verbal cues, repetition, and imagery. In recent years, hypnotherapy has gained popularity in the treatment of a variety of disorders, including anxiety and particular phobias. The term "phobia" is commonly used to define fear of a certain trigger. When faced with potentially hazardous situations, the brain naturally experiences dread. While a little dread here and there may keep us safe, phobias can drastically reduce our quality of life. In summary, persons who suffer from anxiety are considered to see particular environmental situations as dangerous, but those who do not suffer from anxiety do not. Hypnosis is essential in the treatment of anxiety disorders. Hypnosis can help patients minimize their anxiety symptoms. This broad concept has aided in the development of models and therapies for anxiety disorders such as generalized anxiety disorder, panic attacks, hypochondria, and obsessional disorders. Hypnosis techniques are supposed to be attentive and mental pictures, which is conceivable; this is why they're associated with improved working memory and visuospatial abilities. In this sense, the purpose of this study is to determine how effectively specific therapeutic methods perform in treating persons with anxiety and phobias. In addition to cognitive-behavioral therapy and other therapies, the approaches emphasized the use of therapeutic hypnosis. This study looks at the use of hypnosis and related psychotherapy procedures in the treatment of anxiety disorders. Following a discussion of the evolution of hypnosis as a therapeutic tool, neurobiological research is used to demonstrate the influence of hypnosis on the change of perception in the brain. The use of hypnosis in the treatment of phobias, stressful situations, and posttraumatic stress disorder is examined, as well as similarities between the hypnotic state and dissociative reactions to trauma. Through an extensive literature evaluation, this study will introduce hypnotherapy procedures that result in more successful anxiety and phobia treatment.

Keywords: anxiety, hypnosis, hypnotherapy, phobia, technique, state

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Authors: Upasana G. Singh, Meera Gungea

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Learning is no more confined to the traditional classroom, teacher, and student interaction. Many universities offer courses through the Open and Distance Learning (ODL) mode, attracting a diversity of learners in terms of age, gender, and profession to name a few. The ODL mode has surfaced as one of the famous sought-after modes of learning, allowing learners to invest in their educational growth without hampering their personal and professional commitments. This mode of learning, however, requires that those who ultimately choose to adopt it must be prepared to undertake studies through such medium. The purpose of this research is to assess whether students who join universities offering courses through the ODL mode are ready to embark and study within such a framework. This study will be helpful to unveil the challenges students face in such an environment and thus contribute to developing a framework to ease adoption and integration into the ODL environment. Prior to the implementation of e-learning, a readiness assessment is essential for any institution that wants to adopt any form of e-learning. Various e-learning readiness assessment models have been developed over the years. However, this study is based on a conceptual model for e-Learning Readiness Assessment which is a ‘hybrid model’. This hybrid model consists of 4 main parameters: 1) Technological readiness, 2) Culture readiness, 3) Content readiness, and 4) Demographics factors, with 4 sub-areas, namely, technology, innovation, people and self-development. The model also includes the attitudes of users towards the adoption of e-learning as an important aspect of assessing e-learning readiness. For this study, some factors and sub-factors of the hybrid model have been considered and adapted, together with the ‘Attitude’ component. A questionnaire was designed based on the models and students where the target population were students enrolled at the Open University of Mauritius, in undergraduate and postgraduate courses. Preliminary findings indicate that most (68%) learners have an average knowledge about ODL form of learning, despite not many (72%) having previous experience with ODL. Despite learning through ODL 74% of learners preferred hard copy learning material and 48% found difficulty in reading learning material on electronic devices.

Keywords: open learning, distance learning, student readiness, a hybrid model

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Authors: M. Baratieri, M. Beccali, S. Corradino, B. Di Pietra, C. La Grassa, F. Monteleone, G. Morosinotto, G. Puglisi

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The energy renovation of existing buildings represents an important opportunity to increase the decarbonization and the sustainability of urban environments. In this context, the work carried out has the objective of demonstrating the technical and economic feasibility of an energy renovate of a public building destined for offices located on the island of Lampedusa in the Mediterranean Sea. By applying the Italian transpositions of European Directives 2010/31/EU and 2009/28/EC, the building has been renovated from the current energy requirements of 111.7 kWh/m² to 16.4 kWh/m². The result achieved classifies the building as nZEB (nearly Zero Energy Building) according to the Italian national definition. The analysis was carried out using in parallel a quasi-stationary software, normally used in the professional field, and a dynamic simulation model often used in the academic world. The proposed interventions cover the components of the building’s envelope, the heating-cooling system and the supply of energy from renewable sources. In these latter points, the analysis has focused more on assessing two aspects that affect the supply of renewable energy. The first concerns the use of advanced logic control systems for air conditioning units in order to increase photovoltaic self-consumption. With these adjustments, a considerable increase in photovoltaic self-consumption and a decrease in the electricity exported to the Island's electricity grid have been obtained. The second point concerned the evaluation of the building's energy classification considering the real efficiency of the heating-cooling plant. Normally the energy plants have lower operational efficiency than the designed one due to multiple reasons; the decrease in the energy classification of the building for this factor has been quantified. This study represents an important example for the evaluation of the best interventions for the energy renovation of buildings in the Mediterranean Climate and a good description of the correct methodology to evaluate the resulting improvements.

Keywords: heat pumps, HVAC systems, nZEB renovation, renewable energy sources

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Authors: Mary T. McKinley

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As socio-economic globalization impacts education and turns knowledge into a commodity, institutions of higher education are becoming more intentional about infusing a global and intercultural perspective into education via the recruitment of international students. Coming from dissimilar cultures, many of these students are evaluated and held accountable to Euro-American values of independence, self-reliance, and autonomy. Not surprisingly, these students often experience culture shock with deleterious effects on their mental health and academic functioning. Thus, it is critical to understand the experiences of international students with the hope that such knowledge will keep the field of psychology from promulgating Eurocentric ideals and values and prevent the training of these students as good-enough White therapists. Using a critical narrative inquiry framework, this study elicits stories about the challenges encountered by international students as they navigate their clinical training in the presence of acculturative stress and potentially different worldviews. With its emphasis on story-telling as meaning making, narrative research design is hinged on the assumption that people are interpretive beings who make meaning of themselves and their world through the language of stories. Also, dominant socially-constructed narratives play a central role in creating and maintaining hegemonic structures that privilege certain individuals and ideologies at the expense of others. On this premise, narrative inquiry begins with an exploration of the experiences of participants in their lived stories. Bounded narrative segments were read, interpreted, and analyzed using a critical events approach. Throughout the process, issues of reliability and researcher bias were addressed by keeping a reflective analytic memo, as well as triangulating the data using peer-reviewers and check-ins with participants. The findings situate culture at the epicenter of international students’ acculturation challenges as well as their resiliency in psychology doctoral programs. It was not uncommon for these international students to experience ethical dilemmas inherent in learning content that conflicted with their cultural beliefs and values. Issues of cultural incongruence appear to be further exacerbated by visible markers for differences like speech accent and clothing attire. These stories also link the acculturative stress reported by international students to the experiences of perceived racial discrimination and lack of support from the faculty, administration, peers, and the society at large. Beyond the impact on the international students themselves, there are implications for internationalization in psychology with the goal of equipping doctoral programs to be better prepared to meet the needs of their international students. More than ever before, programs need to liaise with international students’ services and work in tandem to meet the unique needs of this population of students. Also, there exists a need for multiculturally competent supervisors working with international students with varying degrees of acculturation. In addition to making social justice and advocacy salient in students’ multicultural training, it may be helpful for psychology doctoral programs to be more intentional about infusing cross-cultural theories, indigenous psychotherapies, and/or when practical, the possibility for geographically cross-cultural practicum experiences in the home countries of international students while taking into consideration the ethical issues for virtual supervision.

Keywords: decolonizing pedagogies, international students, multiculturalism, psychology doctoral programs

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Authors: Galih Imaduddin

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Knowledge has been viewed as one of the most important resources in organizations, including those that operate in the healthcare sector. On that basis, Knowledge Management (KM) is crucial for healthcare organizations to improve their productivity and ensure effective utilization of their resources. Despite the growing interests to understand how KM might work for healthcare organizations, there is only a modest amount of empirical inquiries which have specifically focused on the tools and initiatives to share knowledge. Hence, the main purpose of this paper is to investigate the way healthcare organizations, particularly public sector ones, utilize knowledge sharing tools and initiatives for the benefit of patient-care. Employing a qualitative method, 13 (thirteen) Community Health Centers (CHCs) from a high-performing district health setting in Indonesia were observed. Data collection and analysis involved a repetition of document retrievals and interviews (n=41) with multidisciplinary health professionals who work in these CHCs. A single case study was cultivated reflecting on the means that were used to share knowledge, along with the factors that inhibited the exchange of knowledge among those health professionals. The study discovers that all of the thirteen CHCs exhibited and applied knowledge sharing means which included knowledge documents, virtual communication channels (i.e. emails and chatting applications), and social learning forums such as staff meetings, morning briefings, and communities of practices. However, the intensity of utilization was different among these CHCs, in which organizational culture, leadership, professional boundaries, and employees’ technological aptitude were presumed to be the factors that inhibit knowledge sharing processes. Making a distance with the KM literature of other sectors, this study denounces the primacy of technology-based tools, suggesting that socially-based initiatives could be more reliable for sharing knowledge. This suggestion is largely due to the nature of healthcare work which is still predominantly based on the tacit form of knowledge.

Keywords: knowledge management, knowledge sharing, knowledge sharing tools and initiatives, knowledge sharing inhibitors, primary health care organizations

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Authors: Erkingul Soltanaeva, Omyrkhan Abdimanuly, Alua Temirbolat

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In this article, the public and social functions of literature and art in the Republic of Kazakhstan were analyzed on the basis of formal and informal literary organizations. The external and internal, subjective and objective factors which influenced the modern literary process were determined. The literary forces, their consolidation, types of organization in the art of word were examined. The periods of the literary process as planning, organization, promotion, and evaluation and their leading forces and approaches were analyzed. The right point of view to the language and mentality of the society force will influence to the literary process. The Ministry of Culture, the Writers' Union of RK and various non-governmental organizations are having different events for the promotion of literary process and to glorify literary personalities in the entire territory of Kazakhstan. According to the cultural plan of different state administration, there was a big program in order to publish their literary encyclopedia, to glorify and distribute books of own poets and writers of their region to the country. All of these official measures will increase the reader's interest in the book and will also bring up people to the patriotic education and improve the status of the native language. The professional literary publications such as the newspaper ‘Kazakh literature’, magazine ‘Zhuldyz’, and journal ‘Zhalyn’ materials which were published in the periods 2013-2015 on the basis of statistical analysis of the Kazakh literature topical to the issues and the field of themes are identified and their level of connection with the public situations are defined. The creative freedom, relations between society and the individual, the state of the literature, the problems of advantages and disadvantages were taken into consideration in the same articles. The level of functions was determined through the public role of literature, social feature, personal peculiarities. Now the stages as the literature management planning, organization, motivation, as well as the evaluation are forming and developing in Kazakhstan. But we still need the development of literature management to satisfy the actual requirements of the today’s agenda.

Keywords: literature management, material, literary process, social functions

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Authors: Noemia Bessa Vilela, Jose Caramelo Gomes

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All law student are familiarized, in the first years of their bachelor of laws with the concepts of “public goods” and “ private goods”; often, such legal concept does not exactly match such economic concept, and there are consequences are some sort of confusion being created. The list of goods that follow under each category is not exhaustive, nor are students given proper mechanisms to acknowledge that some legal fields can, on its own, be considered as a “public good”; this is the case of Competition. Legal authors consider that “competition law is used to promote public interest” and, as such, it is a “public good”; in economics theory, Competition is the first public good in a market economy, as the enabler of allocation efficiency. Competition law is the legal tool to support the proper functioning of the market economy and democracy itself. It is fact that Competition Law only applies to economic activities, still, competition is object of private litigation as an integral part of Public Law. Still, regardless of the importance of Competition Law in the economic activity and market regulation, most student complete their studies in law, join the Bar Associations and engage in their professional activities never having been given sufficient tools to deal with the increasing demands of a globalized world. The lack of knowledge of economics, market functioning and the mechanisms at their reach in order to ensure proper realization of their duties as lawyers/ attorneys-at-law would be tackled if Competition Law would be included as part of the curricula of Law Schools. Proper teaching of Competition Law would combine the foundations of Competition Law, doctrine, case solving and Case Law study. Students should to understand and apply the analytical model. Special emphasis should be given to EU Competition Law, namely the TFEU Articles 101 to 106. Damages Directive should also be part of the curriculum. Students must in the first place acquire and master the economic rationale as competition and the world of competition law are the cornerstone of sound and efficient market. The teaching of Competition Law in undergraduate programs in Law would contribute to fulfill the potential of the students who will deal with matters related to consumer protection, economic and commercial law issues both in private practice and as in-house lawyers for companies.

Keywords: higher education, competition law, legal education, law, market economy, industrial economics

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Authors: Afnan Khoja, Ittisak Subrungruang, Kritchaya Ritruechai, Linda Jones, David Wall

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Background: Some characteristics might be stated as an objective of the curriculum and some might be hidden. The hidden curriculum is the unwritten and unintended lessons and perspectives that students absorb in school. Though, the hidden characteristics are expected that tutors hope students might have in order to become medical educators. We suspected our faculty hoped we would develop skills, know and develop beyond the written outcomes. Our research question aimed to explore the hidden curriculum; as part of our learning; we had to design and report findings. Summary of Work: We undertook semi-structured interviews with a sample of the centre for medical education faculty at Dundee. Participants answered the question , of what are the hidden characteristics that they hope Dundee MMed graduates might have after graduation. Thematic analysis was carried out on the interview scripts. Summary of Results: A thematic analysis was carried out on the interview transcripts. Three main themes were identified from all respondents' comments. These were lifelong learners, being flexible and problem solvers. In addition individual respondents also described sense of humour, collaboration, humility, role model, inquisitiveness, optimism, and ability to express oneself clearly. Discussion: Tutors put great value on three behaviours lifelong learner, flexible, and problem solver, which are part of professional characteristics in leadership. Therefore, leadership characteristics is incorporated as the outcomes of hidden characteristics that tutors would like to see. Conclusion: Tutors in the Master's program of medical education at the University of Dundee hope that medical education students should present the three main hidden characteristics, which are lifelong learner, flexible, and problem solver after graduation. Take-home Messages: These hidden characteristics are considered as informal unless a change has been made to the formal curriculum. Therefore, to reach the tutors’ expectations, further studies might be held to make this personal characteristics transformation more accessible.

Keywords: characteristics, hidden curriculum, transformation, informal

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Authors: Maroua Sbiti, Karim Beddiar, Djaoued Beladjine, Romuald Perrault

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Productivity is decreasing in construction compared to the manufacturing industry. It seems that the sector is suffering from organizational problems and have low maturity regarding technological advances. High international competition due to the growing context of globalization, complex projects, and shorter deadlines increases these challenges. Field employees are more exposed to coordination problems than design officers. Execution collaboration is then a major issue that can threaten the cost, time, and quality completion of a project. Initially, this paper will try to identify field professional requirements as to address building management process weaknesses such as the unreliability of scheduling, the fickleness of monitoring and inspection processes, the inaccuracy of project’s indicators, inconsistency of building documents and the random logistic management. Subsequently, we will focus our attention on providing solutions to improve scheduling, inspection, and hours tracking processes using emerging lean tools and field mobility applications that bring new perspectives in terms of cooperation. They have shown a great ability to connect various field teams and make informations visual and accessible to planify accurately and eliminate at the source the potential defects. In addition to software as a service use, the adoption of the human resource module of the Enterprise Resource Planning system can allow a meticulous time accounting and thus make the faster decision making. The next step is to integrate external data sources received from or destined to design engineers, logisticians, and suppliers in a holistic system. Creating a monolithic system that consolidates planning, quality, procurement, and resources management modules should be our ultimate target to build the construction industry supply chain.

Keywords: lean, last planner system, field mobility applications, construction productivity

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Authors: Salwa Obeisat

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Obesity had become a global issue and a major public health concern, because of its impact on the public health. Obstetric and midwifery evidences reported that maternal obesity an important issue, because of its associated complications like obstructed labors, infections, and hemorrhage. People who are obese are often stigmatized and blamed for their weight. Health care providers are not immune to obesity-related prejudice, and the literature features several examples of their negative attitudes towards obese patients. In Jordan, few studies were conducted to investigate obesity prevalence rate and its associated factors. The purposes of this study were to assess the health care providers' attitudes toward overweight and obese women during the childbirth in the North of Jordan and to investigate the relationships between health care providers' socio-demographic characteristics and their attitudes. A descriptive, cross-sectional design was utilized. A convenient sample was consisted of 95 midwives, 30 nurses and 62 obstetricians, who were working in the labor rooms. A self-administered questionnaire consisted of three sections: demographical data, Arabic version of Fat Phobia Scale (FPS), and Arabic version of Nurses' Attitudes toward Obesity and Obese Patients Scale (NATOOPS). Results: The study findings revealed that the majority of Jordanian health care providers held negative attitudes toward overweight and obese women during childbirth. Midwives held less negative attitudes than did obstetricians and nurses. The majority of participants were perceived the overweight and obese pregnant women during childbirth as overate people, shapeless, slow and unattractive. Age, specialty, education and years of experience were found to be associated with health care providers’ attitudes. The Conclusion: Health care providers negative attitudes toward overweight and obese pregnant women are a cause for concern. Therefore, maternal obesity was needed to be more adequately addressed in basic education courses, and in the continuing professional education classes of practicing health care providers.

Keywords: attitudes, obesity, prevalence rate, nurses, midwives, obstetrician, childbirth

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Authors: Milad Pirali, Sohrab Keyhani, Mohhamad Ali Sanjari, Ali Ashraf Jamshidi

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Purpose: The effect of hamstring antagonist activity on the knee extensors torque of the Anterior Cruciate Ligament reconstruction (ACLR) is not clear and persistent muscle weakness is common after ACLR. Hamstring activation when acting as antagonist is considered very important for knee strengths. Therefore the purpose of this study was to examine hamstring antagonist coactivation during maximal effort of the isokinetic knee extension in ACLR athletes with hamstring autograft. Materials and Methods: We enrolled 20 professional athletes who underwent primary ACLR (hamstring tendon autograft)with 6-24 months postoperative and 20 healthy subjects as control group. Each subjects performed maximal effort isokinetic knee extension and flexion in 60/˚ s and 180/˚ s velocities for the involved and uninvolved limb. Synchronously, surface electromyography (EMG) was recorded of vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF) and biceps femoris (BF). The antagonist integrated EMG (IEMG) values were normalized to the IEMG of the same muscle during maximal isokinetic eccentric effort at the same velocities and ROM. Results: A one-way analysis of variance designs shows significantly greater IEMG coactivation of hamstring and decreased activation of Vm in ACLR when compared to uninvolved and control group leg in 60/˚ s and 180/˚ s velocities. Likewise peak torque to body weight was decreased in ACLR compared to uninvolved and control group during knee extension in both velocities (p < 0.05). Conclusions: Decreased extensors moment caused by decreased quadriceps inhibition and increased hamstring coactivation. In addition, these result indicated to decrease of motor unit recruitment in the VM (as a kinesiologicmonitore of the knee). It is appearing that strengthening of the quadriceps to be an important for rehabilitation program after ACLR for preparation in athletes endeavors. Therefore, we suggest that having more emphasis and focus on quadriceps strength and less emphasis on hamstring following ACLR.

Keywords: ACLR-coactivation, dynamometry, electromyography, isokinetic

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