Search results for: expert knowledge

Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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Authors: Aneela Sheikh

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Private higher education institutes are challenged for their resilience and competitive edge in the globalized knowledge-based economy in the 21st century. Faculty retention plays an important role as a catalyst for addressing the current mega-developmental phenomenon in higher education institutes faced by developing countries. This study intends to explore the influence of servant leadership practice on faculty retention through the intervening role of job satisfaction towards minimizing the high faculty turnover in private higher education institutes, with the mediating role of job satisfaction. A sample of 341 faculty members from ten private higher education institutes in Lahore city of Pakistan, was selected through a stratified proportionate random sampling technique. A descriptive survey research approach was employed to collect data from 341 faculty members by administering a close-ended questionnaire based on a seven-point Likert scale as a self-administered research instrument. The study was conducted under the domain of the Leader-Member Exchange (LMX) theory. The mediating role of job satisfaction was measured by bootstrapping technique. The results revealed that servant leadership has a statistically significant influence on faculty retention, with a statistically significant mediating role of job satisfaction, in private higher education institutes in Pakistan. Further, up to the best of the authors’ knowledge, this is the first systematic and empirical study on faculty retention conducted against the backdrop of servant leadership in an Eastern context, particularly in Pakistan.

Keywords: servant leadership, faculty retention, job satisfaction, higher education institutes

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Authors: Kamrun Nahar Koly, Saimul Islam

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Overweight and obesity is increasing at an alarming rate and a leading risk factor for morbidity throughout the world. In a country like Bangladesh where under nutrition and overweight both co-exist at the same time, but this issue has been underexplored as expected. The aim of the present study was to assess the knowledge, attitudes and identify the barriers of the physicians regarding overweight and obesity management on an urban hospital of Dhaka city in Bangladesh. A simple cross sectional study was conducted at two selected government and two private hospital to assess the knowledge, attitude and common barriers regarding overweight and obesity management among healthcare professionals. One hundred and fifty five physicians were surveyed. A standard questionnaire was constructed in local language and interview was administrated. Among the 155 physicians, majority 53 (34.20%) were working on SMC, 36 (23.20%) from DMC, 33 (21.30%) were based on SSMC and the rest 33 (21.30%) were from HFRCMH. Mean age of the study physicians were 31.88±5.92. Majority of the physicians 80 (51.60%) were not able to answer the correct prevalence of obesity but also a substantial number of them 75(48.40%) could mark the right answer. Among the physicians 150 (96.77%) reported BMI as a diagnostic index for overweight and obesity, where as 43 (27.74%) waist circumference, 30 (19.35%) waist hip ratio and 26 (16.77%) marked mid-arm circumference. A substantial proportion 71 (46.70%) of the physicians thought that they do not have much to do controlling weight problem in Bangladesh context though it has been opposed by 42 (27.60%) of the physicians and 39(25.70%) was neutral to comment. The majority of them 147 (96.1%) thought that a family based education program would be beneficial followed by 145 (94.8%) physicians mentioned about raising awareness among mothers as she is the primary caregiver. The idea of a school based education program will also help to early intervene referred by 142 (92.8%) of the physicians. Community based education program was also appreciated by 136 (89.5%) of the physicians. About 74 (47.7%) of them think that the patients still lack in motivation to maintain their weight properly at the same time too many patients to deal with can be a barrier as well assumed by 73 (47.1%) of them. Lack of national policy or management guideline can act as an obstacle told by 60 (38.7%) of the physicians. The relationship of practicing as a part of the general examination and chronic disease management was statistically significant (p<0.05) with physician occupational status. As besides, perceived barriers like lack of parents support, lack of a national policy was statistically significant (p<0.05) with physician occupational status. For the young physician, more training programme will be needed to transform their knowledge and attitude into practice. However, several important barriers interface for the physician treatment efforts and need to address.

Keywords: obesity management, physician, awareness, barriers, Bangladesh

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Authors: Francis Zerd, Brian E. Moore, Atuganile E. Malango, Patrick W. Hosokawa, Kevin O. Lillehei, Laurence Lemery Mchome, D. Ryan Ormond

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Introduction: Since neuropathologic diagnosis in the developing world is hampered by limitations in technical infrastructure, trained laboratory personnel, and subspecialty-trained pathologists, the use of telepathology for diagnostic support, second-opinion consultations, and ongoing training holds promise as a means of addressing these challenges. This research aims to assess the utility of static teleneuropathology in improving neuropathologic diagnoses in low- and middle-income countries. Methods: Consecutive neurosurgical biopsy and resection specimens obtained at Muhimbili National Hospital in Tanzania between July 1, 2018, and June 30, 2019, were selected for retrospective, blinded static-image neuropathologic review followed by on-site review by an expert neuropathologist. Results: A total of 75 neuropathologic cases were reviewed. The agreement of static images and on-site glass diagnosis was 71% with strict criteria and 88% with less stringent criteria. This represents an overall improvement in diagnostic accuracy from 36% by general pathologists to 71% by a neuropathologist using static telepathology (or 76% to 88% with less stringent criteria). Conclusions: Telepathology offers a suitable means of providing diagnostic support, second-opinion consultations, and ongoing training to pathologists practicing in resource-limited countries. Moreover, static digital teleneuropathology is an uncomplicated, cost-effective, and reliable way to achieve these goals.

Keywords: neuropathology, resource-limited settings, static image, Tanzania, teleneuropathology

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Authors: Ekpeti Bukola Grace, Mahmoudi Sabar Esmail, Chaer Issa

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Global energy consumption has been increasing steadily over the last half - century, and this trend is projected to continue. As energy demand rises in many countries throughout the world due to population growth, natural ventilation in buildings has been identified as a viable option for lowering these demands, saving costs, and also lowering CO2 emissions. However, natural ventilation is driven by forces that are generally unpredictable in nature thus, it is important to manage the resulting airflow in order to maintain pleasant indoor conditions, making it a complex system that necessitates specific control approaches. The effective application of fuzzy logic technique amidst other intelligent systems is one of the best ways to bridge this gap, as its control dynamics relates more to human reasoning and linguistic descriptions. This article reviewed existing literature and presented practical solutions by applying fuzzy logic control with optimized techniques, selected input parameters, and expert rules to design a more effective control system. The control monitors used indoor temperature, outdoor temperature, carbon-dioxide levels, wind velocity, and rain as input variables to the system, while the output variable remains the control of window opening. This is achieved through the use of fuzzy logic control tool box in MATLAB and running simulations on SIMULINK to validate the effectiveness of the proposed system. Comparison analysis model via simulation is carried out, and with the data obtained, an improvement in control actions and energy savings was recorded.

Keywords: fuzzy logic, intelligent control systems, natural ventilation, optimization

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Authors: Habes Moh’d Khalifeh Hatamleh, Shukri Refai Ibrahim Marashdh

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The study came with the aim of identifying the most prominent quantitative, qualitative, and technological challenges facing the higher education system in Jordan as a dilemma in light of the technological revolution that had a radical contribution to changing the face of science and knowledge in various fields of higher education in Jordan. Human societies that require the adoption of scientific research and its basics as a clear entrance aimed at serving the community and upgrading it civilly. The number of private and public universities has increased, and many students have been accepted for all levels of study in the bachelor’s, higher diploma, master’s and doctoral programs, and the quantitative growth has been accompanied by many negatives, which requires renewal and development in the field of higher education, which led to the emergence of many challenges, and the qualitative challenge in terms of relevance, quality and goodness constitutes an important requirement for the improvement of teaching, scientific research and services in light of the social demand for higher education, in order to reach the quality. The real challenge facing our country is to enter the civilization of advanced technology, which has become the main factor and the starting point for preparing staff capable of accomplishing this transformation and creating an appropriate educational environment for the student to help him to use the sources of knowledge. This study can provide a set of recommendations and proposals that may contribute to addressing challenges and contributing to improving educational outcomes in light of the requirements of the labor market and the needs of society.

Keywords: quantitative, qualitative, technological, challenges, higher education

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Authors: Habes Moh’d Khalifeh Hatamleh, Shukri Refai Ibrahim Marashdh

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The study came with the aim of identifying the most prominent quantitative, qualitative, and technological challenges facing the higher education system in Jordan as a dilemma in light of the technological revolution that had a radical contribution to changing the face of science and knowledge in various fields of higher education in Jordan. Human societies that require the adoption of scientific research and its basics as a clear entrance aimed at serving the community and upgrading it civilly. The number of private and public universities has increased, and many students have been accepted for all levels of study in the bachelor’s, higher diploma, master’s and doctoral programs, and the quantitative growth has been accompanied by many negatives, which requires renewal and development in the field of higher education, which led to the emergence of many challenges, and the qualitative challenge in terms of relevance, quality and goodness constitutes an important requirement for the improvement of teaching, scientific research and services in light of the social demand for higher education, in order to reach the quality. The real challenge facing our country is to enter the civilization of advanced technology, which has become the main factor and the starting point for preparing staff capable of accomplishing this transformation and creating an appropriate educational environment for the student to help him to use the sources of knowledge. This study can provide a set of recommendations and proposals that may contribute to addressing challenges and contributing to improving educational outcomes in light of the requirements of the labor market and the needs of society.

Keywords: quantitative, qualitative, technological, challenges, higher education

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Authors: Ayomi Indika Irugalbandara

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Reproductive Health (RE) education among Sri Lankan Adolescents (comprising one fifth inner population) remains unsatisfactory despite 91.8% of them completing primary education & 56.2 % receiving post secondary level education. The main reason for this large population not receiving satisfactory RH education is traditional values and longstanding taboos surrounding sexuality. The current study was undertaken with there objectives. The relevance of achieving them being to formulate RH educational policies and programs that address a sizable and sensitive chunk of the population thereby achieving the goal of mental and social well being and not merely the absence of reproductive disease or infirmity. This research was a descriptive study, using random sampling technique, sample of the study consisting of 160 adolescent in the age group of 16-19, studying in government schools in Sri Lanka. Questionnaire was the main instrument of data collection, qualitative and quantitative techniques were used in data analysis. According to the data it was revealed that a majority has some idea about RH education. While this awareness had been provided by the school, the source of information had been Health and Physical Education. The entire sample mentioned that more RH information, than was provided, should be given and everybody wanted further knowledge regarding sexuality, and in depth information on it was essential. About 96 adolescents were of the opinion that their behavior was respectful to elders and 64 felt embarrassed while communicating with elders regarding RH issues. About their preferred sources of information, both genders named health providers as their first choice, followed by family members and friends. The internet was cited by a few boys; less than 5 percent cited religious figures. More than 50% of respondents had no knowledge about abortion and they were unaware of dangerous abortion. The practice of abortion was reported among zero percent. Although every member of the sample did not possess knowledge of the scientific process involved in abortion, all of them totally rejected the idea of destroying a foetus. Adolescence is a critical period in the life of girls and boys and sexuality education empowers young people to protect their health and well-being. Schools have the proper staff, and environment for learning. It might be stated that the greater segment of individuals entering adolescents and going through their adolescence are still in the school. This becomes the reason why it is mandatory that the school should be geared to handle this critical stage of the students. Adolescents or those approaching adolescence are best educated by the relevant parents, but this being quite a sensitive issue in the socio cultural context, it is somewhat doubtful whether all parents are prepared to handle this candidly, due either to lack of knowledge or absence of the appropriate state of mind. As such it is best that seminars/workshops be conducted to enlighten parents on handling HR issues related to their adolescent children. Apart from the awareness on HR provided through the school curriculum a greater impact can be brought about through street dramas, exhibitions etc. specific to HR. Finally the researcher would like to suggest that Sunday schools be harnessed for the provision of HR education linked with cultural values, ethics, and social well-being.

Keywords: reproductive health, awareness, perception, school curriculum

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Authors: Pranav Ajmera, Amit Kharat, Tanveer Gupte, Richa Pant, Viraj Kulkarni, Vinay Duddalwar, Purnachandra Lamghare

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The cardiothoracic ratio (CTR) is the ratio of the diameter of the heart to the diameter of the thorax. An abnormal CTR, that is, a value greater than 0.55, is often an indicator of an underlying pathological condition. The accurate prediction of an abnormal CTR from chest X-rays (CXRs) aids in the early diagnosis of clinical conditions. We propose a deep learning-based model for automatic CTR calculation that can assist the radiologist with the diagnosis of cardiomegaly and optimize the radiology flow. The study population included 1012 posteroanterior (PA) CXRs from a single institution. The Attention U-Net deep learning (DL) architecture was used for the automatic calculation of CTR. A CTR of 0.55 was used as a cut-off to categorize the condition as cardiomegaly present or absent. An observer performance test was conducted to assess the radiologist's performance in diagnosing cardiomegaly with and without artificial intelligence (AI) assistance. The Attention U-Net model was highly specific in calculating the CTR. The model exhibited a sensitivity of 0.80 [95% CI: 0.75, 0.85], precision of 0.99 [95% CI: 0.98, 1], and a F1 score of 0.88 [95% CI: 0.85, 0.91]. During the analysis, we observed that 51 out of 1012 samples were misclassified by the model when compared to annotations made by the expert radiologist. We further observed that the sensitivity of the reviewing radiologist in identifying cardiomegaly increased from 40.50% to 88.4% when aided by the AI-generated CTR. Our segmentation-based AI model demonstrated high specificity and sensitivity for CTR calculation. The performance of the radiologist on the observer performance test improved significantly with AI assistance. A DL-based segmentation model for rapid quantification of CTR can therefore have significant potential to be used in clinical workflows.

Keywords: cardiomegaly, deep learning, chest radiograph, artificial intelligence, cardiothoracic ratio

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Authors: Denise F. Brown, Melina McConatha

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African Americans utilizing the art of vocal expressions, particularly for self-expression, has been a historical avenue of advocating for social justice and human rights. Vocal expressions can take many forms, such as singing, poetry, storytelling, and acting. Many well-known artists, politicians, leaders, and teachers used their voices to promote the causes and concerns of the African American community as well as the expression of their own experiences of being 'black' in America. The purpose of this project was to evaluate the perceptions of African American students in utilizing their voices for self-awareness, interview skills, and social change after attending a three-part workshop on vocal advocacy. This research utilized the framework of black feminism to understand empowerment in advocacy and self-expression. Students participated in learning about the power of their voices, and what purpose presence, and passion they discovered through the Immersive Voice workshop. There were three areas covered in the workshop. The first area was the power of the voice, the second area was the application of vocal passion, and the third area was applying the vocal power to express personal interest, interests of advocating for others, and confidence and speaking to others to further careers, i.e., using vocal power for job interviewing skills. The students were instructed to prepare for the workshops by completing a pre-workshop open-ended survey. There were a total of 15 students that participated. After the workshop ended, the students were instructed to complete a post-workshop survey. The surveys were assessed by evaluating both themes and codes from student's written feedback. From the pre-workshop survey, students were given a survey for them to provide feedback regarding the power of voice prior to participating in the workshops. From the student's responses, the theme (advocating for self and others) emerged as it related to student's feedback on what it means to advocate. There were three codes that led to the theme, having knowledge about advocating for self and others, gaining knowledge to advocate for self and others, and using that knowledge to advocate for self and others. After the students completed participation in the workshops, a post workshop- survey was given to the students. Students' feedback was assessed, and the same theme emerged, 'advocating for self and others.' The codes related to the theme, however, were different and included using vocal power (a term students learned during the workshop) to represent self, represent others, and obtain a job/career. In conclusion, the results of the survey showed that students still perceived advocating as speaking up for themselves and other people. After the workshop, students still continued to associate advocacy with helping themselves and helping others but were able to be more specific about how the sound of their voice could help in advocating, and how they could use their voice to represent themselves in getting a job or starting a career.

Keywords: advocacy, command, self-expression, voice

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Authors: Julia Wimmers-Klick

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In the contemporary study of anatomy, medical students utilize a diverse array of resources, including lab handouts, lectures, and, increasingly, digital media such as interactive anatomy apps and digital images. Notably, a significant shift has occurred, with fewer students possessing traditional anatomy atlases or books, reflecting a broader trend towards digital approaches like Virtual Reality, Augmented Reality, and web-based programs. This paper seeks to explore the evolution of anatomy education by contrasting current digital tools with historical resources, such as classical anatomical illustrations and atlases, to assess their relevance and potential benefits in modern medical education. Through a comprehensive literature review, the development of anatomical illustrations is traced from the textual descriptions of Galen to the detailed and artistic representations of Da Vinci, Vesalius, and later anatomists. The examination includes how the printing press facilitated the dissemination of anatomical knowledge, transforming covert dissections into public spectacles and formalized teaching practices. Historical illustrations, often influenced by societal, religious, and aesthetic contexts, not only served educational purposes but also reflected the prevailing medical knowledge and ethical standards of their times. Critical questions are raised about the place of historical illustrations in today's anatomy curriculum. Specifically, their potential to teach critical thinking, highlight the history of medicine, and offer unique insights into past societal conditions are explored. These resources are viewed in their context, including the lack of diversity and the presence of ethical concerns, such as the use of illustrations from unethical sources like Pernkopf’s atlas. In conclusion, while digital tools offer innovative ways to visualize and interact with anatomical structures, historical illustrations provide irreplaceable value in understanding the evolution of medical knowledge and practice. The study advocates for a balanced approach that integrates traditional and modern resources to enrich medical education, promote critical thinking, and provide a comprehensive understanding of anatomy. Future research should investigate the optimal combination of these resources to meet the evolving needs of medical learners and the implications of the digital shift in anatomy education.

Keywords: human anatomy, historical illustrations, historical context, medical education

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Authors: Ummi Sholihah Pertiwi Abidin, Eva Fadhilah

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Social changes are more and more growing and having many different forms as the time passed and thought methods in the society. One of many forms of that social changes is the emancipation of women that is flourishing by the inception of gender equality perception between men and women in all aspects including education. It’s not anymore found the distinction between genders in learning and the education achieving right at this globalized era. But, it is still many perceptions which are against that equality of education achieving right, either come from the women’s selves or many external factors. They assumed that they are going to be a mother in the future, and a wife, someone with responsible for taking care of the household and everything inside, while the husband is the one who has the responsible for looking for the living. So comes from this kind of assumption, the perception against the education equality between genders, which means there is no need for them –women- to achieve the high education because they will still end up as housewives. Except those working or career women that need high education to support their works. These women are not aware that even a mother needs the high and capable education. Because, as the 'mother to be,' they surely need broad knowledge from the education to educate their children in the future. It is such a big fault to say the kind of thing, 'It is no matter that I am not educated, in case I’m just a housewife. The important thing is my children get a great education'. Unfortunately, it is still often found, saying 'A housewife job is not a big deal to do with high education.' This qualitative method paper raises a theme about the importance of education for women, no matter what will they be in the future. Because however, and whatever is the woman’s career outside the house, or even not working outside, she’s still a mother for her children, and 'educational provision' is a great need. And so forth, this educational provision is a big deal to do with future generation’s foredoom, regarding the first source of children’s knowledge and the first school for them is their mother.

Keywords: women education, mother to be, educational provision, first school, future generation’s foredoom

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Authors: Anurag Niranjan, Michael Fitzpatrick, Yin Jin Janin, Jazeel Chukkan, Niall Smyth

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Fillet welds are used in joining longitudinal stiffeners in ship structures. Welding residual stresses in fillet welds are generally distributed in a non-uniform manner, as shown in previous research the residual stress redistribution occurs under the cyclic loading that is experienced by such joints during service, and the combination of the initial residual stress, local constraints, and loading can alter the stress field in ways that are extremely difficult to predict. As the residual stress influences the crack propagation originating from the toe of the fillet welds, full understanding of the residual stress field and how it evolves is very important for structural integrity calculations. Knowledge of the residual stress redistribution in the presence of a flaw is therefore required for better fatigue life prediction. Moreover, defect assessment procedures such as BS7910 offer very limited guidance for flaw acceptance and the associated residual stress redistribution in the assessment of fillet welds. Therefore the objective of this work is to study a surface-breaking flaw at the weld toe region in a fillet weld under cyclic load, in conjunction with residual stress measurement at pre-defined crack depths. This work will provide details of residual stress redistribution under cyclic load in the presence of a crack. The outcome of this project will inform integrity assessment with respect to the treatment of residual stress in fillet welds. Knowledge of the residual stress evolution for this weld geometry will be greatly beneficial for flaw tolerance assessments (BS 7910, API 591).

Keywords: fillet weld, fatigue, residual stress, structure integrity

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Authors: Ragy Raafat Gaber Attaalla

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Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health.

Keywords: low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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Authors: Baker Ssekitto, Ambrose Mbogo

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The study reveals that indeed agriculture employs over 70% of Uganda’s population, of which majority are youth and women. The study further reveals that over 70% of the farmers are smallholder farmers based in rural areas, whose operations are greatly affected by; climate change, weak digital skills, limited access to productivity knowledge along value chains, limited access to quality farm inputs, weak logistics systems, limited access to quality extension services, weak business intelligence, limited access to quality markets among others. It finds that the emerging 4th industrial revolution powered by artificial intelligence, 5G and data science will provide possibilities of addressing some of these challenges. Furthermore, the study finds that despite rapid development of ICT4Agric Innovation, their uptake is constrained by a number of factors including; limited awareness of these innovations, low internet and smart phone penetration especially in rural areas, lack of appropriate digital skills, inappropriate programmes implementation models which are project and donor driven, limited articulation of value addition to various stakeholders among others. Majority of farmers and other value chain actors lacked knowledge and skills to harness the power of ICTs, especially their application of ICTs in monitoring and evaluation on quality of service in the extension system and farm level processes.

Keywords: artificial intelligence, productivity, ICT4agriculture, value chain, logistics

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Authors: Aisha M. Memon, Arabella Bhutto, Zahid A. Memon, Adnan Pitafi

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This study aims to identify the existing and non-existing elements in the entrepreneurial ecosystem which include finance, institutions, laws and regulations, human capital, culture, and markets, to measure the level of effectiveness of existing elements and to develop recommendations for improving the ecosystem to facilitate the women entrepreneurs in Jamshoro, Pakistan. The nature of this study is qualitative. Data were drawn from 25 in-depth, semi-structured interviews and a focus group discussion with women entrepreneurs in rural Jamshoro, Pakistan. The findings show the lack of awareness and knowledge among women entrepreneurs about available financial resources, lack of knowledge about laws, an absence of familial and societal support for women in accessing the entrepreneurial ecosystem, the absence of business and innovation enablers in rural areas, communication gaps, and unskilled human capital. The study found that institutions like non-for-profit organizations are playing an active role in the growth of women entrepreneurs. The existing entrepreneurial ecosystem in Jamshoro can be improved through culturally sensitive coordinated approach, interventions aimed at increasing awareness about the resources, promoting an understanding about the laws and regulations, making business enablers more effective, establishing public-private partnerships, and providing the women entrepreneurs easy access to market and financial resources.

Keywords: entrepreneurship, entrepreneurship ecosystem, Pakistan, women entrepreneurs

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Authors: Sadia Suri Kashif, Raheeda Fatima, Maqsood Ahmed Khan

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Purpose of the study: The objective of this research was to determine the perception of Pakistani physicians (whether primary care, specialists or residents) in Karachi, being one of the largest and highly populated cities of Pakistan, regarding clinical approaches towards diet, exercise, and therapy in obese patients. This research determines their understanding of obesity and employability of obesity management in their daily practices. Research methodology: This is a questionnaire-based survey. A minimum of 300 questionnaires (N=300) were distributed and filled by practicing physicians in a random selection of medical setups in Karachi. Randomly 246 physicians responded to the survey. The survey tested their views regarding weight management, importance of general awareness and their strategies to control weight. Results: In the first part of survey the physicians responded to almost 66% regarding the seriousness of obesity management with advising diet modification, physical exercise and decreasing calorie intake; 57% failed to employ Body Mass Index and Waist Hip Ratio as weight measurement tools in their daily practice; 50% disagreed on using pharmacotherapy as an option; 67% were not sure about the proper dosage and indication of anti-obesity medication while almost same disagreed on using surgical options for management of obesity; 83.3% physicians agreed on the increased obesity pandemic in Pakistan. Conclusion: The findings indicate that there is a gap between awareness and knowledge among Pakistani practicing physicians regarding pharmacotherapy for obesity. There is a need to frequently update latest guidelines to help manage this condition, which is becoming more prevalent in our country day by day. Physicians should be obligated to use updated knowledge for managing obesity.

Keywords: obesity, physicians, BMI, weight management, obesity awareness

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Authors: Xvelian Qin

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Urban "organic renewal" based on the development of existing resources in high-density urban areas has become the mainstream of urban development in the new era. As an important stock resource of public space in high-density urban areas, promoting its value remodeling is an effective way to alleviate the shortage of public space resources. However, due to the lack of evaluation links in the process of underpass space renewal, a large number of underpass space resources have been left idle, facing the problems of low space conversion efficiency, lack of accuracy in development decision-making, and low adaptability of functional positioning to citizens' needs. Therefore, it is of great practical significance to construct the evaluation system of under-bridge space renewal potential and explore the renewal mode. In this paper, some of the under-bridge spaces in the main urban area of Chongqing are selected as the research object. Through the questionnaire interviews with the users of the built excellent space under the bridge, three types of six levels and twenty-two potential evaluation indexes of "objective demand factor, construction feasibility factor and construction suitability factor" are selected, including six levels of land resources, infrastructure, accessibility, safety, space quality and ecological environment. The analytical hierarchy process and expert scoring method are used to determine the index weight, construct the potential evaluation system of the space under the bridge in high-density urban areas of Chongqing, and explore the direction of renewal and utilization of its suitability.

Keywords: space under bridge, potential evaluation, high density urban area, updated using

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Authors: Gulhan Sen

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Disasters could result in many deaths and injuries. In these difficult times, accessible resources are limited, demand and supply balance is distorted, and there is a need to make urgent interventions. Disproportionateness between accessible resources and intervention capacity makes triage a necessity in every stage of disaster response. Healthcare professionals, who are in charge of triage, have to evaluate swiftly and make ethical decisions about which patients need priority and urgent intervention given the limited available resources. For such critical times in disaster triage, 'doing the greatest good for the greatest number of casualties' is adopted as a code of practice. But there is no guide for healthcare professionals about ethical decision-making during disasters, and this study is expected to use as a source in the preparation of the guide. This study aimed to examine whether the qualities healthcare professionals in Izmir related to disaster triage were adequate and whether these qualities influence their capacity to make ethical decisions. The researcher used a survey developed for data collection. The survey included two parts. In part one, 14 questions solicited information about socio-demographic characteristics and knowledge levels of the respondents on ethical principles of disaster triage and allocation of scarce resources. Part two included four disaster scenarios adopted from existing literature and respondents were asked to make ethical decisions in triage based on the provided scenarios. The survey was completed by 215 healthcare professional working in Emergency-Medical Stations, National Medical Rescue Teams and Search-Rescue-Health Teams in Izmir. The data was analyzed with SPSS software. Chi-Square Test, Mann-Whitney U Test, Kruskal-Wallis Test and Linear Regression Analysis were utilized. According to results, it was determined that 51.2% of the participants had inadequate knowledge level of ethical principles of disaster triage and allocation of scarce resources. It was also found that participants did not tend to make ethical decisions on four disaster scenarios which included ethical dilemmas. They stayed in ethical dilemmas that perform cardio-pulmonary resuscitation, manage limited resources and make decisions to die. Results also showed that participants who had more experience in disaster triage teams, were more likely to make ethical decisions on disaster triage than those with little or no experience in disaster triage teams(p < 0.01). Moreover, as their knowledge level of ethical principles of disaster triage and allocation of scarce resources increased, their tendency to make ethical decisions also increased(p < 0.001). In conclusion, having inadequate knowledge level of ethical principles and being inexperienced affect their ethical decision-making during disasters. So results of this study suggest that more training on disaster triage should be provided on the areas of the pre-impact phase of disaster. In addition, ethical dimension of disaster triage should be included in the syllabi of the ethics classes in the vocational training for healthcare professionals. Drill, simulations, and board exercises can be used to improve ethical decision making abilities of healthcare professionals. Disaster scenarios where ethical dilemmas are faced should be prepared for such applied training programs.

Keywords: disaster triage, medical ethics, ethical principles of disaster triage, ethical decision-making

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Authors: Anush Patric, M. Jadeyegowda, M. N. Ramesh, M. Ravikumar, C. R. Ajay

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Kodagu district which is situated in Central Western Ghats regions falls in one of the hottest of hot spots of biodiversity which is recognised by UNESCO. The district has one of the highest densities of community managed sacred forests in the world with rich floral and faunal diversity. It is a habitat for more than ten different types of Ethnic Indigenous tribal groups commonly called ‘Girijanas’ (Soligas, Yarvas, Jenukuruba, Bettakuruba etc.), who are having the rich knowledge of medicinal value of the plants that are commonly available in the forest. The tribal men of this region are the treasure house of the traditional plant knowledge and health care practices. An ethnobotanical survey was undertaken in tribal areas of the district to collect information about some of the indigenous medicinal plant knowledge of tribal people by semi-structured interviews, ranking exercises and field observations on their native habitat in order to evaluate the potential medicinal uses of local plants. The study revealed that, the ethnobotanical information of 83 plant species belonging to 45 families, of the total 83 species documented, most plants used in the treatment were trees (11 species), shrubs (41 species), herbs (22 species) and rarely climbers (9 species) which are used in the treatment of Hyperacidity, Respiratory disorders, Snake bite Abortifacient, Anthelmintic, Paralysis, Antiseptic, Fever, Chest pain, Stomachic, Jaundice, Piles, Asthma, Malaria, Renal disorders, Malaria and many other diseases. Maximum of 6 plant species each of Acanthaceae, Apiaceae and were used for drug preparation, followed by Asclepiadaceae, Liliaceae, Fabaceae, Verbenaceae, Caesalpinaceae, Bombaceae, Papilonaceae, Solanaceae, Rubiaceae, Myrtaceae, Amaranthaceae, Asteraceae, Ascelepidaceae, Cucurbitaceae, Apocyanaceae, and Solanaceae etc. In our present study, only medicinal plants and their local medicinal uses are recorded and presented. Information was obtained by local informants having the knowledge about medicinal plants. About 23 local tribes were interviewed. For each plant, necessary information like botanical name, family of plant species, local name and uses are given. Recent trend shows a decline in the number of traditional herbal healers in the tribal areas since the younger generation is not interested to continue this tradition. Hence, there is an urgent need to record and preserve all information on plants used by different ethnic/tribal communities for various purposes before it reaches to verge of extinction. In addition, several wild medicinal plants are declining in numbers due to deforestation and forest fires. There is need for phytochemical analysis and conservation measures to be taken for conserving medicinal plant species which is far better than allopathic medicines and these do not cause any side effects as they are the natural disease healers. So, conservation strategies have to be practiced in all levels and sectors by creating awareness about the value of such medicinal plants, and it is necessary to save the disappearing plants to strengthen the document and to conserve them for future generation.

Keywords: diseases, ethnic groups, folk medicine, Kodagu, medicinal plants

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Authors: Basem Elarbe, Ibrahim Elganidi, Norida Ridzuan, Norhyati Abdullah

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Wax deposition in production pipelines and transportation tubing from offshore to onshore is critical in the oil and gas industry due to low-temperature conditions. It may lead to a reduction in production, shut-in, plugging of pipelines and increased fluid viscosity. The most significant popular approach to solve this issue is by injection of a wax inhibitor into the channel. This research aims to determine the amount of wax deposition of Malaysian crude oil by estimating the effective parameters using (Design-Expert version 7.1.6) by response surface methodology (RSM) method. Important parameters affecting wax deposition such as cold finger temperature, inhibitor concentration and experimental duration were investigated. It can be concluded that SA-co-BA copolymer had a higher capability of reducing wax in different conditions where the minimum point of wax reduction was found at 300 rpm, 14℃, 1h, 1200 ppmThe amount of waxes collected for each parameter were 0.12g. RSM approach was applied using rotatable central composite design (CCD) to minimize the wax deposit amount. The regression model’s variance (ANOVA) results revealed that the R2 value of 0.9906, indicating that the model can be clarified 99.06% of the data variation, and just 0.94% of the total variation were not clarified by the model. Therefore, it indicated that the model is extremely significant, confirming a close agreement between the experimental and the predicted values. In addition, the result has shown that the amount of wax deposit decreased significantly with the increase of temperature and the concentration of poly (stearyl acrylate-co-behenyl acrylate) (SABA), which were set at 14°C and 1200 ppm, respectively. The amount of wax deposit was successfully reduced to the minimum value of 0.01 g after the optimization.

Keywords: wax deposition, SABA inhibitor, RSM, operation factors

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Authors: Shih-Heng Sun, Hsiu-Yu Chang

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“Family centered service model” becomes mainstream in early intervention. Family outcome should be evaluated in addition child improvement in terms of outcome evaluation in early intervention. The purpose of this study is to develop a surveys to evaluate family outcomes in early intervention. Method: “Family Outcomes Survey- Revised Taiwan Version” (FOS-RT) was developed through translation, back-translation, and review by the original author. Expert meeting was held to determine the content validity. Two hundred and eighty six parent-child dyads recruited from 10 local Early Intervention Resource Centers (EIRC) participated in the study after they signed inform consent. The results showed both parts of FOS-RT exhibits good internal consistency and test-retest reliability. The result of confirmatory factor analysis indicated moderate fit of 5 factor structure of part A and 3 factor structure of part B of FOS-RT. The correlation between different sessions reached moderate to high level reveals some sessions measure similar latent trait of family outcomes. Correlation between FOS-RT and Parents‘ Perceived Parenting Skills Questionnaire was calculated to determine the convergence validity. The moderate correlation indicates the two assessments measure different parts of early intervention outcome although both assessments have similar sub-scales. The results of this study support FOS-RT is a valid and reliable tool to evaluate family outcome after the family and children with developmental disability receive early intervention services.

Keywords: early intervention, family service, outcome evaluation, parenting skills, family centered

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Authors: Eugenio Ferrer Santiago

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The growing complexities of the modern world on high-end gadgets, software applications, scams, identity theft, and Artificial Intelligence (AI) make the “uninformed” the weak and vulnerable to be victims of cybercrimes. Artificial Intelligence is not a new thing in our daily lives; the principles of database management, logical programming, and garbage in and garbage out are all connected to AI. The Philippines had in place legal safeguards against the abuse of cyberspace, but self-regulation of key industry players and self-protection by individuals are primordial to attain the success of these initiatives. Data protection, Data Privacy, and Research Ethics must work hand in hand during the policy process in the course of urban planning practice in different environments. This paper focuses on the interconnection of data protection, data privacy, and research ethics in coming up with clear-cut policies against perpetrators in the urban planning professional practice relevant in sustainable communities and smart cities. This paper shall use expository methodology under qualitative research using secondary data from related literature, interviews/blogs, and the World Wide Web resources. The claims and recommendations of this paper will help policymakers and implementers in the policy cycle. This paper shall contribute to the body of knowledge as a simple treatise and communication channel to the reading community and future researchers to validate the claims and start an intellectual discourse for better knowledge generation for the good of all in the near future.

Keywords: data privacy, data protection, urban planning, research ethics

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Authors: Nabeel Abdulkadhim Athab

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The purpose of this research is to conduct a comparative study according analysis of programmed to some of physical and mechanical variables for joint wrist injury. As it can be through this research to distinguish between the amount of variation in the work of the joint after sample underwent rehabilitation program to improve the effectiveness of the joint and naturally restore its effectiveness. Supposed researcher that there is statistically significant differences between the results of the tests pre and post the members research sample, as a result of submission the sample to the program of rehabilitation, which led to the development of muscle activity that are working on wrist joint and this is what led to note the differences between the results of the tests pre and post. The researcher used the descriptive method. The research sample included (6) of injured players in the wrist joint, as the average age (21.68) and standard deviation (1.13) either length average (178cm) and standard deviation (2.08). And the sample as evidenced homogeneous among themselves. And where the data were collected, introduced in program for statistical processing to get to the most important conclusions and recommendations and that the most important: 1-The commitment of the sample program the qualifying process variables studied in the search for the heterogeneity of study activity and effectiveness of wrist joint for injured players. 2-The analysis programmed a high accuracy in the measurement of the research variables, and which led to the possibility of discrimination into account differences in motor ability camel and injured in the wrist joint. To search recommendations including: 1-The use of computer systems in the scientific research for the possibility of obtaining accurate research results. 2-Programming exercises rehabilitation according to an expert system for possible use by patients without reference to the person processor.

Keywords: analysis of joint wrist injury, physical and mechanical variables, wrist joint, wrist injury

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Authors: Tannistha Dasgupta

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This study explores the aspects of second language (L2) spoken fluency that are related to L2 linguistic knowledge and processing skill. It draws on Levelt’s ‘blueprint’ of the L2 speaker which discusses the cognitive issues underlying the act of speaking. However, L2 speaking assessments have largely neglected the underlying mechanism involved in language production; emphasis is given on the relationship between subjective ratings of L2 speech sample and objectively measured aspects of fluency. Hence, in this study, the relation between L2 linguistic knowledge and processing skill i.e. Cognitive Fluency (CF), and objectively measurable aspects of L2 spoken fluency i.e. Utterance Fluency (UF) is examined. The participants of the study are L2 learners of English, studying at high school level in Hyderabad, India. 50 participants with intermediate level of proficiency in English performed several lexical retrieval tasks and attention-shifting tasks to measure CF, and 8 oral tasks to measure UF. Each aspect of UF (speed, pause, and repair) were measured against the scores of CF to find out those aspects of UF which are reliable indicators of CF. Quantitative analysis of the data shows that among the three aspects of UF; speed is the best predictor of CF, and pause is weakly related to CF. The study suggests that including the speed aspect of UF could make L2 fluency assessment more reliable, valid, and objective. Thus, incorporating the assessment of psycholinguistic mechanisms into L2 spoken fluency testing, could result in fairer evaluation.

Keywords: attention-shifting, cognitive fluency, lexical retrieval, utterance fluency

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Authors: A. Schuchter, M. Promegger

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The outbreak of the COVID-19 pandemic has shown us that online education is so much more than just a cool feature for teachers – it is an essential part of modern teaching. In online math teaching, it is common to use tools to share screens, compute and calculate mathematical examples, while the students can watch the process. On the other hand, flipped classroom models are on the rise, with their focus on how students can gather knowledge by watching videos and on the teacher’s use of technological tools for information transfer. This paper proposes a co-educational teaching approach for coding and engineering subjects with the help of drone-building to spark interest in technology and create a platform for knowledge transfer. The project combines aspects from mathematics (matrices, vectors, shaders, trigonometry), physics (force, pressure and rotation) and coding (computational thinking, block-based programming, JavaScript and Python) and makes use of collaborative-shared 3D Modeling with clara.io, where students create mathematics knowhow. The instructor follows a problem-based learning approach and encourages their students to find solutions in their own time and in their own way, which will help them develop new skills intuitively and boost logically structured thinking. The collaborative aspect of working in groups will help the students develop communication skills as well as structural and computational thinking. Students are not just listeners as in traditional classroom settings, but play an active part in creating content together by compiling a Handbook of Knowledge (called “open book”) with examples and solutions. Before students start calculating, they have to write down all their ideas and working steps in full sentences so other students can easily follow their train of thought. Therefore, students will learn to formulate goals, solve problems, and create a ready-to use product with the help of “reverse engineering”, cross-referencing and creative thinking. The work on drones gives the students the opportunity to create a real-life application with a practical purpose, while going through all stages of product development.

Keywords: flipped classroom, co-creational education, coding, making, drones, co-education, ARCS-model, problem-based learning

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Authors: Kirsty Biggs, Peter Larsen-Disney

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Background: The UK cervical screening programme significantly reduces cancer mortality through the early detection of abnormal cells. Despite this, over a quarter of eligible women choose not to attend their appointment. Objective: To qualitatively explore patients’ barriers to attending cervical smear appointments and identify key trends of cervical screening behaviour, knowledge, and attitudes in primary and secondary care. Methods: A cross-sectional study was conducted to evaluate smear services in Brighton and Hove using questionnaires in general practice and colposcopy. 226 patients participated in the voluntary questionnaire between 10/11/2017 and 02/02/2018. 118 patients were recruited from general practice surgeries and 108 from the colposcopy department. Women were asked about their smear knowledge, self-perceived risks factors, prior experiences and reasons for non-attendance. Demographic data was also collected. Results: Approximately a third of women did not engage in smear testing services. This was consistent across primary and secondary care groups. Over 90% were aware of the role of the screening process in relation to cervical cancer; however, over two thirds believed the smear was also a tool to screen for other pathologies. The most commonly cited reasons for non-attendance were negative emotions or previous experiences. Inconvenient appointment times were also commonly described. In a comparison of attenders versus non-attenders previous negative experiences (p < 0.01) and number of identified risk factors (p = 0.02) were statistically significant with non-attenders describing more prior negative smears and identifying more risk factors. Smear knowledge, risk perception and perceived importance of screening were not significant. Negative previous experiences were described in relation to poor bedside manner, pain, embarrassment and staff competency. Conclusions: In contrary to the literature, our white Caucasian cohort experienced significant barriers to accessing smear services. Women’s prior negative experiences are overriding their perceived importance to attend the screening programme; therefore, efforts need to focus on improving clinical experiences through auditing tools, training and providing a supportive appointment setting. Positive changes can also be expected by improving appointment availabilities with extended hours and self-booking systems.

Keywords: barriers, cervical, Papanicolaou, screening, smear

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Authors: Tien-Hui Chiang

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The code theory, proposed by Basil Bernstein, indicates that framing can be viewed as the core element in constituting the phenomenon of cultural reproduction because it is able to regulate the transmission of pedagogical information. Strong framing increases the social relation boundary between a teacher and pupils, which obstructs information transmission, so that in order to improve underachieving students’ academic performances, teachers need to reduce to strength of framing. Weak framing enables them to transform academic knowledge into commonsense knowledge in daily life language. This study posits that most teachers would deliver strong framing due to their belief mainly confined within the aspect of instrumental rationality that deprives their critical minds. This situation could make them view the normal distribution bell curve of students’ academic performances as a natural outcome. In order to examine the interplay between framing, instrumental rationality and pedagogical action, questionnaires were completed by over 5,000 primary school teachers in Henan province, China, who were stratified sample. The statistical results show that most teachers employed psychological concepts to measure students’ academic performances and, in turn, educational inequity was legitimatized as a natural outcome in the efficiency-led approach. Such efficiency-led minds made them perform as the agent practicing the mechanism of social control and in turn sustaining the phenomenon of cultural reproduction.

Keywords: code, cultural reproduction, framing, instrumental rationality, social relation and interaction

Procedia PDF Downloads 151

Authors: Achim Kampker, Heiner Hans Heimes, Nemanja Sarovic, Jan-Philip Ganser, Saskia Wessel, Christoph Lienemann

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The electrification of the power train is a fundamental technical transition in the automotive industry and poses a major challenge for established car companies. Providing the traction energy, requiring an ever greater amount of space within the car and having a high share of value-add the lithium-ion battery is a central component of the electric power train and a completely new component to car manufacturers at the same time. Being relatively new to the automotive industry, the current design of the product architecture and production process (including manufacturing and assembling processes) of lithium-ion battery modules do not allow for an easy and cost-efficient disassembly or product design change. Yet these two requirements will increase in importance with rising sales volumes of electric cars in the near future and need to be addressed for the electric car to be competitive with conventional power train systems. This paper focuses on the current product architecture and production process of common automotive battery modules from prismatic lithium-ion battery cells to derive impacts for a remanufacturing concept. The information necessary for this purpose were gathered by literature research, patent inquiries, industry expert interviews and first-hand experiences of the authors. On the basis of these results, the underlying causes for the design´s lack of remanufacturability and flexibility with regards to product design changes are examined. In all, this paper gives an extensive and detailed overview of the state of the art of the product architecture and production process of lithium-ion battery modules from prismatic battery cells, identifies its deficiencies and derives improvement measures.

Keywords: battery module, prismatic lithium-ion battery cell, product architecture, production process, remanufacturing, flexibility

Procedia PDF Downloads 267

Authors: Sandra D. Prewitt

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Introduction—The purpose of the extant study was to explore the relationship between religiosity and suicidal ideation. Through this exploration, further knowledge was sought relevant to gaining a better understanding regarding the higher suicide rate continuing to be experienced by young adults. Endeavoring to discover why the suicide rate continues to increase for the subject population, depression and anxiety emerged as major contributory risk factors. Although religiosity has been shown to be related to the reduced risk of suicidal behavior, the curative value of religion relevant to suicide prevention and treatment has not been sufficiently recognized. Considering the enormity of the current suicide problem, pursuits relevant to discovering effective tools enabling impactful prevention and treatment strategies remain essential to reducing suicide deaths. Methodology—The subject study was conducted utilizing a systematic literature review (SLR) which required the researcher to perform searches of appropriate databases, toward the goal of acquiring advanced knowledge based upon existing studies relevant to the subject matter under consideration. Major Findings—Depression and anxiety have been identified as two potential pathways leading to increased suicidal behavior. On the contrary, religiosity emerged as an important protective factor associated with less depression and therefore, fewer instances of suicidal thoughts. The protective nature of religion has been shown to extend to young adults without regard to the presence of identified potential suicidal behavior pathways.

Keywords: anxiety, depression, religion, suicide

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