Search results for: arbitral case law

Authors: Farnaz Nazem

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Iranian architects had creative ways for constructing the buildings in each climate. Some of these architectural elements were made under the ground. Shovadan is one of these underground spaces in hot- humid regions in Dezfoul and Shoushtar city that had special functions and characteristics. In this paper some subjects such as the history of Shovadan, its elements and effective factors in the formation of Shovadan in Dezfool city are discussed.

Keywords: architecture, dezfoul city, Shovadan, south west of Iran

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Authors: Iris Xiaohong Quan, Sharon Qi, Kelly Tianqin Shi

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This study focuses on the critical role of insurance policies in a world grappling with increasing mental health challenges, as they significantly influence the dynamics of healthcare businesses and entrepreneurial ventures. The paper utilizes the mental health sector as a case to examine the impact of insurance policies on healthcare service providers, entrepreneurs, and individuals seeking mental health support. This paper addressed the following research questions: To what extent do changes in insurance reimbursement policies affect the accessibility and affordability of mental health services for patients, and how does this impact the overall demand for such services? What are the barriers and opportunities that mental health entrepreneurs face and what strategies and adaptations do mental health businesses employ when navigating the evolving landscape of insurance reimbursement policies? How do changes in insurance reimbursement policies, specifically related to mental health services, influence the financial viability and sustainability of mental health clinics and private practices? Employing a self-designed survey aimed at autism spectrum disorder (ASD) treatment companies, alongside two in-depth case studies and an analysis of pertinent insurance policies and documents, this research aims to elucidate the multifaceted influence of insurance policies on the mental health industry. The findings from this study reveal how insurance policies shape the landscape of mental health businesses and their operations. A total of 821 autism treatment organizations or offices were contacted by telephone between November 1, 2019, and January 31, 2020. About half of the offices (53.33%) were established in the past five years, and 80% were established in the past 15 years. There is a significant increase in the establishment of ABA service centers in the recent two decades as a result of autism insurance reform, the increasing social awareness of ASD, and the redefinition of autism. In addition, almost half of the ABA service providers we surveyed had a patient size ranging from 20 to 50 in the year when the residence state passed the legislation for autism insurance coverage. On average, an ABA service provider works with 5.3 insurance companies. This research find that insurance is the main source of revenue for most ABA service providers. However, our survey reveals that clients’ out of pocket payment has been the second main revenue sources. Despite the changes of regulations and insurance policies in all states, clients still have to pay a fraction of, if not all, the ABA treatment service fees out of pocket. This research shows that some ABA service providers seek federal and government funds and grants to support their services and businesses. Our further analysis with the in-depth case studies and other secondary data also indicate the rise of entrepreneurial startups in the mental health industry. Overall, this research sheds light on both the challenges and opportunities presented by insurance policies in the mental health sector, offering insights into the new industry landscape.

Keywords: entrepreneurship, healthcare policy, insurance policy, mental health industry

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Authors: Isis Ribeiro Berger

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In view of recent war conflicts between Russia and Ukraine, the government of Paraná State, in Brazil, started a program to host Ukrainian scientists in state universities in 2022. The initiative aimed at integrating these scientists into the Brazilian academic community, strengthening the role of universities in producing science and innovation even in times of war, as well as fostering Higher Education internationalization. Paraná state was a pioneer in this initiative due to the fact it has been home to the largest contingent of immigrants and descendants of Ukrainians in Brazil because of migratory processes that began at the end of the 19th century. One of the universities receiving Ukrainian scientists is in Foz do Iguaçu, a city that borders Argentina and Paraguay. It is a multilingual environment, whose majority languages are Portuguese (the official language of Brazil), Spanish (the official language of both Argentina and Paraguay), as well as Guarani (the co-official indigenous language of Paraguay). It is in such a sociolinguistic environment that two Ukrainian professors began their activities within the scope of an Interdisciplinary Postgraduate Program (master’s and doctorate degree). This case study, whose theme is the management of multilingualism, was developed within the scope of Language Policy. It aimed at identifying the attitudes of both Ukrainian professors and postgraduate students towards multilingualism in this context, given the plural linguistic repertoire of the academic community, as well as identifying the language management strategies for the construction of knowledge implemented by the program and in the classroom by these participants. Therefore, the study was conducted under a qualitative approach, for which surveys and interviews were adopted as part of its methodological procedures. Data revealed the presence of different languages in the classroom (Portuguese, Spanish, English and Ukrainian), which made pedagogical practices challenging for both professors and students, whose levels of knowledge in the different languages varied significantly. The results indicate that multilingualism was the norm as the means of instruction adopted in this context, in which bilingual Portuguese-English-Ukrainian instruction was used by the professors in their lectures. Although English has been privileged for the internationalization of Higher Education in various contexts, it was not used as an exclusive means of instruction in this case, mostly because it is a predominantly Portuguese-Spanish-speaking environment. In addition, the professors counted on the mediation of an interpreter hired by the program since not every student had sufficient knowledge of English as part of their repertoires. The findings also suggest Portuguese is the language that most of the participants of this study prefer, both because it is the mother tongue of majority, and because it is the official language of the host country to the professors, who have sought to integrate to the local culture and community. This research is inserted in the Axis: Multilingualism and Education, of the UNESCO Chair on Language Policies for Multilingualism to which this study is related.

Keywords: attitudes, border region, multilingualism management, Ukrainian professors

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Authors: Azadeh Shahbazi

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This study tries to find out the determinants of capital structure in hotel industry in 7 important hotel chains in USA within the period of 12 years of 2000 to 2012. The study is used a panel pooled regression to realize the relation among different variables. Results show that the variables which could make changes in the capital structure of firms are Non-Debt Tax Shield and Tangibility.

Keywords: capital structure, service industry, hospitality, finance

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Authors: Armando Cartenì, Ilaria Henke

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The perceived public transport quality is an important driver that influences both customer satisfaction and mobility choices. The competition among transport operators needs to improve the quality of the services and identify which attributes are perceived as relevant by passengers. Among the “traditional” public transport quality attributes there are, for example: travel and waiting time, regularity of the services, and ticket price. By contrast, there are some “non-conventional” attributes that could significantly influence customer satisfaction jointly with the “traditional” ones. Among these, the beauty/aesthetics of the transport terminals (e.g. rail station and bus terminal) is probably one of the most impacting on user perception. Starting from these considerations, the point stressed in this paper was if (and how munch) the travel experience of the overall travel (e.g. how long is the travel, how many transport modes must be used) influences the perception of the public transport quality. The aim of this paper was to investigate the weight of the terminal quality (e.g. aesthetic, comfort and service offered) within the overall travel experience. The case study was the extra-urban Italian bus network. The passengers of the major Italian terminal bus were interviewed and the analysis of the results shows that about the 75% of the travelers, are available to pay up to 30% more for the ticket price for having a high quality terminal. A travel experience effect was observed: the average perceived transport quality varies with the characteristic of the overall trip. The passengers that have a “long trip” (travel time greater than 2 hours) perceived as “low” the overall quality of the trip even if they pass through a high quality terminal. The opposite occurs for the “short trip” passengers. This means that if a traveler passes through a high quality station, the overall perception of that terminal could be significantly reduced if he is tired from a long trip. This result is important and if confirmed through other case studies, will allow to conclude that the “travel experience impact" must be considered as an explicit design variable for public transport services and planning.

Keywords: transportation planning, sustainable mobility, decision support system, discrete choice model, design problem

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Authors: Farah Syazwani Hilmy Zaki

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Background: Compared to adult cardiopulmonary resuscitation (CPR), high-quality research and evidence on pediatric CPR remain relatively scarce. This knowledge gap hinders the development of optimal guidelines and best practices for resuscitating children. Objectives: To explore pediatric intensive care unit (PICU) CPR current practices in PICU of Institut Jantung Negara (IJN) Malaysia. Method: The research employed a qualitative approach, utilising case study research design. The data collection process involved in-depth interviews and reviewing the Resuscitation Feedback Form. Purposive sampling was used to select two cases consisting of 14 participants. The study participants comprised a cardiologist, one anaesthetist, and twelve nurses. The data collected were transcribed and entered into NVivo software to facilitate theme development. Subsequently, thematic analysis was conducted to analyse the data. Findings: The study yielded key findings regarding the enhancement of PICU CPR practices. These findings are categorised into four themes, namely routine procedures, resuscitation techniques, team dynamics, and individual contributions. Establishment of cohesive team is crucial in facilitating the effectiveness of resuscitation. According to participants, lack of confidence, skills and knowledge presents significant obstacles to effective PICU CPR. Conclusion: The findings of this study indicate that the participants express satisfaction with the current practices of PICU CPR. However, the research also highlights the need for enhancements in various areas, including routine procedures, resuscitation techniques, as well as team and individual factors. Furthermore, it was suggested that additional training be conducted on the resuscitation process to enhance the preparedness of the medical team.

Keywords: cardiopulmonary resuscitation, feedback, nurses, pediatric intensive care unit

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Authors: Goitom Molalign Takele, Tsegalem Hailemariam Ballo, Kiros Belay Gebrekidan, Birhan Gebresilassie Gebregiorgis

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Background: Emergency medical services (EMS) are services that provide out-of-hospital emergency medical care to injured or ill peoples, and transporting to definitive care. EMS is an integral part of the emergency medical system and has been associated with decreased morbidity and mortality related to emergency cases. The aim of this study was to assess the utilization, barriers, and determinants of EMS in Mekelle, Ethiopia. Methods: A community-based cross-sectional study was conducted in selected sub-cities of Mekelle. A multistage sampling method was employed to recruit study participants, and data were collected by trained data collectors using an interviewer-administered questionnaire. Multivariate logistic regression analysis was used to examine the statistical association of the determinants of EMS utilization. Results: Half (50.5%) of the respondents had experienced or witnessed an emergency incident in the past year. The common means of transportations used were Bajaj’s (39.2%) and ambulances (22.7%). Majority (88.1%) of the respondents did not knew the EMS access phone number of an ambulance. As their preferred mode of transportation in case of emergency conditions, 42.2% of the participants reported an ambulance, followed by Bajaj 33.7%. Where participants who had gynecologic emergencies were 9.4 times (AOR=9.4, 95% CI: 1.04, 85, p=0.046), and those who knew any ambulance numbers were 3.6 times (AOR=3.6, 95% CI: 1.22, 10.8, p=0.02) more likely to use ambulance services in case of emergencies. Conclusion: The ambulance utilization level in Mekelle city was low and victims of emergency conditions were being transported mainly using public transports such as Bajaj’s and taxis. Even though the perception of the public towards EMS services is favorable, lack of awareness of EMS access, and lack of integrated EMS system in the city are the barriers that may have contributed to the low utilization. Actions to improve EMS access and integrating the system are warranted to promote the services utilization.

Keywords: emergency medical services, utilization, Mekelle, barriers

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Authors: Hsin Hua He

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The purpose of this study is to strengthen the social cohesion of the local community by injecting the cultural and creative concept into the industrial heritage transformation. The paradigms of industrial heritage research tend to explore from the perspective of space analysis, which concerned less about the cultural regeneration and the development of local culture. The paradigms of cultural quarter research use to from the perspective of creative economy and urban planning, concerned less about the social impacts and the interaction between residents and industrial sites. This research combines these two research areas of industrial heritage and cultural quarter, and focus on the social and cultural aspects. The transformation from the industrial heritage into a cultural park not only enhances the cultural capital and the quality of residents’ lives, but also preserves the unique local values. Internally it shapes the local identity, while externally establishes the image of the city. This paper uses Westergasfabriek Cultural Park in Amsterdam as the case study, through literature analysis, field work, and depth interview to explore how the cultural regeneration transforms industrial heritage. In terms of the planners’ and residents’ point of view adopt the theory of community participation, social capital, and sense of place to analyze the social impact of the industrial heritage transformation. The research finding is through cultural regeneration policies like holding cultural activities, building up public space, social network and public-private partnership, and adopting adaptive reuse to fulfil the people’s need and desire and reach the social cohesion. Finally, the study will examine the transformation of Taiwan's industrial heritage into cultural and creative quarters. The results are expected to use the operating experience of the Amsterdam cases and provide directions for Taiwan’s industrial heritage management to meet the cultural, social, economic symbiosis.

Keywords: cultural regeneration, community participation, social capital, sense of place, industrial heritage transformation

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Authors: Muamar Salameh, Rania Sinno

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Non-governmental organizations in Saudi Arabia play a vital role in promoting humanitarian development. Though this paper will emphasize this role and will provide a specific case study on the role of Prince Mohammad Bin Fahd Foundation for Humanitarian Development, yet many organizations do not provide transparent information for the accomplishments of the NGOs. This study will provide answers to the main research question regarding this role that NGOs play in promoting humanitarian development. The recent law regulating associations and foundations in Saudi Arabia was issued in December 2015 and went into effect March 2016. Any new association or foundation will need to follow these regulations. Though the registration, implementation, and workflow of the organizations still need major improvement and development, yet, the currently-registered organizations have several notable achievements. Most of these organizations adopt a centralized administration approach which in many cases still hinders progress and may be an obstacle in achieving and reaching a larger population of beneficiaries. A large portion of the existing organizations are charities, some of which have some sort of government affiliation. The laws and regulations limit registration of new organizations. Any violations to Islamic Sharia, contradictions to public order, breach to national unity, foreign and foreign-affiliation organizations prohibits any organization from registration. The lack of transparency in the operations and inner-working of NGOs in Saudi Arabia is apparent for the public. However, the regulations invoke full transparency with the governing ministry. This transparency should be available to the public and in specific to the target population that are eligible to benefit from the NGOs services. In this study, we will provide an extensive review of all related laws, regulations, policies and procedures related to all NGOs in the Eastern Province of Saudi Arabia. This review will include some examples of current NGOs, services and target population. The study will determine the main accomplishments of reputable NGOs that have impacted positively the Saudi communities. The results will highlight and concentrate on actions, services and accomplishments that achieve sustainable assistance in promoting humanitarian development and advance living conditions of target populations of the Saudi community. In particular, we will concentrate on a case study related to PMFHD; one of the largest foundations in the Eastern Province of Saudi Arabia. The authors have access to the data related to this foundation and have access to the foundation administration to gather, analyze and conclude the findings of this group. The study will also analyze whether the practices, budgets, services and annual accomplishments of the foundation have fulfilled the humanitarian role of the foundation while meeting the governmental requirements, with an analysis in the light of the new laws. The findings of the study show that great accomplishments for advancing and promoting humanitarian development in Saudi community and international communities have been achieved. Several examples will be included from several NGOs, with specific examples from PMFHD.

Keywords: development, foundation, humanitarian, non-governmental organization, Saudi Arabia

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Authors: Sifiso Vilakazi, Lerato Mzenzi

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BACKGROUND :- Human mind is a double-edged sword, it is both arduous and obtuse, vague and explicit. The neuroscience of brain has baffled all and left none. In this labyrinth, a novel neurotransmitter has set its foot. D-Aspartic acid, which has been established in rats and animals’ brain as a neurochemical in controlling behaviour, aggression, fertility, cognition and memory is set to formulate a new benchmark as a marker among suicidal and accidental death victims. Without losing sight of the fact, we have endeavoured to dig out the biochemical relation behind suicide in our research. We in our research have exerted to decipher the puzzle among humans for D-Aspartic acid using HPLC. METHODS:- We have taken 30 samples each of pre-frontal cortex of brain from suicide and road traffic accidents victims for our case-control research to establish brain D-Aspartic acid level using HPLC as a marker for suicide. RESULTS:- By using Independent/Unpaired T-Test Analysis:- The two-tailed P value is less than 0.0044. MEAN (mMOL/mL/G) for D-Aspartic acid in control is 24.2737±7.5958 and for cases is 19.5540±4.2647. By conventional criteria, this difference is considered to be extremely statistically significant. CONCLUSION:- (1) Brain D-Aspartic acid has an effect in the act of suicide and its values show a large drop before the act of suicide is commenced as compared to road traffic accidents which correlates with the study where D-AA was studied as a novel endogenous neurotransmitter in case of mental health disorders in humans, though never studied on suicide victims, likely getting it reference from research occurring on rats where it was discovered that D-AA plays a role in cognition, personality development, thought process, aggression. (2)The other study which was related to humans and signified the role of D-AA in reproduction, where low D-AA leads to infertility and depression and hence providing the much needed proof of role of D-AA in mental health disorders and suicide, and subsequently to the act of suicide.

Keywords: green energy, policy, technology, implementation

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Authors: Angelis P. Barlampas

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Purpose or Learning Objective It is well known that previous examinations play a major role in futural diagnosis, thus avoiding unnecessary new exams that cost in time and money both for the patient and the health system. A case is presented in which past patient’s results, in combination with the least needed new tests, give an easy final diagnosis. Methods or Background A middle aged man visited the emergency department complaining of hard controlled, persisting fever for the last few days. Laboratory tests showed an elevated number of white blood cells with neutrophil shift and abnormal CRP. The patient was admitted to hospital a month ago for continuing lungs symptomatology after a recent covid-19 infection. Results or Findings Computed tomography scanning showed a solid mass with spiculating margins in right lower lobe. After intravenous iodine contrast administration, there was mildly peripheral enhancement and eccentric non enhancing area. A pneumonic cancer was suspected. Comparison with the patient’s latest computed tomography revealed no mass in the area of interest but only signs of recent post covid-19 lung parenchyma abnormalities. Any new mass that appears in a month’s time span can not be a cancer but a benign lesion. It was obvious that an abscess was the most suitable explanation. The patient was admitted to hospital, and antibiotic therapy was given, with very good results. After a few days, the patient was afebrile and in good condition. Conclusion In this case , a PET scan or a biopsy was avoided, thanks to the patient’s medical history and the availability of previous examinations. It is worthy encouraging the patients to keep their medical records and organizing more efficiently the health system with the current technology of archiving the medical examinations, too.

Keywords: covid-19, chest ct, cancer, abscess, fever

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Authors: Eun-Seop Kim, Eun-Ha Jang, Rana R. Kim, Sae-Byul Jang

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Objective: Preterm labor is the most common antecedent of preterm birth(PTB), which is characterized by regular uterine contraction before 37 weeks of pregnancy and cervical change. In acute preterm labor, tocolytics are administered as the first-line medication to suppress uterine contractions but rarely delay pregnancy to 37 weeks of gestation. On the other hand, according to the Korean Traditional Medicine, PTB is caused by the deficiency of Qi and unnecessary energy in the body of the mother. The aim of this study was to demonstrate the benefit of Traditional Korean Medicine as an adjuvant therapy in management of early uterine contractions and the prevention of PTB. Methods: It is a case report of a 38-year-old woman (0-0-6-0) hospitalized for irregular uterine contractions and cervical change at 33+3/7 weeks of gestation. Past history includes chemical pregnancies achieved by Artificial Rroductive Technology(ART), one stillbirth (at 7 weeks) and a laparoscopic surgery for endometriosis. After seven trials of IVF and articificial insemination, she had succeeded in conception via in-vitro fertilization (IVF) with help of Traditional Korean Medicine (TKM) treatments. Due to irregular uterine contractions and cervical changes, 2 TKM were prescribed: Gami-Dangguisan, and Antae-eum, known to nourish blood and clear away heat. 120ml of Gami-Dangguisan was given twice a day monring and evening along with same amount of Antae-eum once a day from 31 August 2013 to 28 November 2013. Tocolytics (Ritodrine) was administered as a first aid for maintenance of pregnancy. Information regarding progress until the delivery was collected during the patient’s visit. Results: On admission, the cervix of 15mm in length and cervical os with 0.5cm-dilated were observed via ultrasonography. 50% cervical effacement was also detected in physical examination. Tocolysis had been temporarily maintained. As a supportive therapy, TKM herbal preparations(gami-dangguisan and Antae-eum) were concomitantly given. As of 34+2/7 weeks of gestation, however intermittent uterine contractions appeared (5-12min) on cardiotocography and vaginal bleeding was also smeared at 34+3/7 weeks. However, enhanced tocolytics and continuous administration of herbal medicine sustained the pregnancy to term. At 37+2/7 weeks, no sign of labor with restored cervical length was confirmed. The woman gave a term birth to a healthy infant via vaginal delivery at 39+3/7 gestational weeks. Conclusions: This is the first successful case report about a preter labor patient administered with conventional tocolytic agents as well as TKM herbal decoctions, delaying delivery to term. This case deserves attention considering it is rare to maintain gestation to term only with tocolytic intervention. Our report implies the potential of herbal medicine as an adjuvant therapy for preterm labor treatment. Further studies are needed to assess the safety and efficacy of TKM herbal medicine as a therapeutic alternative for curing preterm birth.

Keywords: preterm labor, traditional Korean medicine, herbal medicine, integrative treatment, complementary and alternative medicine

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Authors: Julian Dario Castro Cifuentes

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In Colombia, the armed conflict has lasted for more than sixty years bringing poverty, internal displacement of people, deaths from both government and insurgent forces and other violence-related problems that has damaged its social fabric. In 2016, the peace process between the Colombian government and the FARC rebels brought the possibility of ending this war and a new set of challenges to Colombian society in order to achieve pacific coexistence and reconciliation. In this scenario, there have been different efforts from diverse social actors in order to build peace and reconciliation mainly within the victims of the armed conflict. In the case of music, there have been multiple programs for social transformation through music and pedagogical experiences. Nevertheless, the need to strengthen this initiative by giving ‘peace building oriented’ pedagogical tools to the musicians that lead this experiences and understanding which aspects make this practices ‘musically meaningful’, has been recognized. For this reason, the purpose of this study is to discuss the convergences and divergences of music, and educational experiences applied to peacebuilding in the context of Colombia’s post-conflict. In this research, the hermeneutic phenomenology paradigm is applied in a case study of a peace building music education experience in the department of Nariño, Colombia articulated with the program ‘Manos a la Paz’. Two particular experiences, one on musical practice and another on music education are taken as a unit of analysis to understand its essence and structure in order to find ways to articulate efforts in peace building actions from music. This study shows how the existent gap between music experience and its subjacent pedagogical knowledge, can be reduced through deconstruction of the music and pedagogical experience. The ‘Manos a la Paz’ program showed how a peace building approach to music education can make major contributions to Pacific Coexistence and Reconciliation in Colombia’s Post-Conflict.

Keywords: music education, music for peace, music pedagogy, peace building, social fabric

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Authors: Yosef Ferede Bogale

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The purpose of this study was to evaluate the degree of customer satisfaction and the variables influencing it in the instance of the Bank of Abyssinia branches in the districts of Arada and Bole in Addis Ababa. The study was carried out utilizing a mixed research approach and a descriptive and explanatory research design in Addis Ababa, the capital city of Ethiopia. Both primary and secondary data were employed in this investigation. The study's target population consisted of 1000 of the bank's most prestigious clients. With a 93% response rate, 265 respondents from both genders in the active age group had higher levels of education and work experience and were in the active age group. Customers of the case bank under consideration comprised the study's target audience. The respondents, who belonged to both gender groups, were in the active age bracket with superior levels of education and work experience. As a result, this investigation discovered that the degree of client satisfaction was assigned a medium rating. Additionally given a middling rating were the company's image practices, employee competency, technology, and service quality. Further, the results also demonstrate that corporate image, employees’ competency, technology, and service quality all positively and significantly affect customer happiness. This study found that, to varying degrees, company image, technology, competence, and high-quality financial services will all improve consumer happiness. According to this report, banks should monitor customer satisfaction and service quality at least twice a year. This is because there is a growing movement among bank service providers for accountability, and measuring these factors is crucial. This study also recommends that banks make every effort to satisfy consumers' expectations to the highest level.

Keywords: customer satisfaction, corporate image, quality service risk, banks

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Authors: Fangfei Li

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Studies on teacher feedback have produced a wide range of findings in aspects of characteristics of good feedback, factors influencing the quality of feedback and teachers’ perspectives on teacher feedback. However, perspectives from students on how they perceive and respond to teacher feedback are still under scrutiny. Especially for Chinese overseas students who come from a feedback-sparse educational context in China, they might have different experiences when engaging with teacher feedback in the UK Higher Education. Therefore, the research aims to investigate and shed some new light on how Chinese students engage with teacher feedback in the UK higher education and how teacher feedback could enhance their learning. Research questions of this study are 1) What are Chinese overseas students’ perceptions of teacher feedback in courses of the UK higher education? 2) How do they respond to the teacher feedback they obtained? 3) What factors might influence their’ engagement with teacher feedback? Qualitative case studies of five Chinese postgraduate students in a UK university have been conducted by employing various types of interviews, such as background interviews, scenario-based interviews, stimulated recall interviews and retrospective interviews to address the research inquiries. Data collection lasted seven months, covering two phases – the pre-sessional language programme and the first semester of the Master’s degree programme. Research findings until now indicate that some factors, such as tutors’ handwriting, implicit instruction and value comments, influence students understanding and internalizing tutor feedback. Except for difficulties in understanding tutor feedback, students’ responses to tutor feedback are also influenced by quantity and quality of tutor-student communication, time constraints and trust to tutor feedback, etc. Findings also reveal that tutor feedback is able to improve students’ learning in aspects of promoting reflection on professional knowledge, promoting students’ communication with peers and tutors, increasing problem awareness and writing with the reader in mind. This paper will mainly introduce the research topic, the methodological procedure and research findings gained until now.

Keywords: Chinese students, students’ perceptions, teacher feedback, the UK higher education

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Authors: Freda Halim

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Endometriosis in bowel is rare condition, about 3-37% of endometriosis cases. Most of bowel endometriosis rising in the rectosigmoid (90% of bowel endometriosis). The incidence of caecal endometriosis is very low ( < 5% of bowel endometriosis) and almost never causing acute small bowel obstruction. The aim of this paper is to show that although bowel obstruction caused by caecal endometriosis is difficult to diagnose as it is rare, and may require laparotomy to make definite diagnosis, but it should be considered in infertile female patient. The case is 37 years old woman infertile woman with intestinal obstruction with pre-operative diagnosis total acute small bowel obstruction caused by right colonic mass, with sepsis as the complication. Before the acute small bowel obstruction, she complained of chronic right lower quadrant pain with chronic constipation alternate with chronic diarrhea, symptoms that happened both in bowel endometriosis and colorectal malignancy. She also complained of chronic pelvic pain and dysmenorrhea. She was married for 10 years with no child. The patient was never diagnosed with endometriosis and never seek medical attention for infertility and the chronic pelvic pain. The patient underwent Abdominal CT Scan, with results: massive small bowel obstruction, and caecal mass that causing acute small bowel obstruction. Diagnosis of acute small bowel obstruction due to right colonic mass was made, and exploratory laparotomy was performed in the patient. During the laparotomy, mass at caecum and ileocaecal that causing massive small bowel obstruction was found and standard right hemicolectomy and temporary ileostomy were performed. The pathology examination showed ectopic endometriosis lesions in caecum and ileocaecal valve. The histopathology also confirmed with the immunohistochemistry, in which positive ER, PR, CD 10 and CD7 was found the ileocaecal and caecal mass. In the second operation, reanastomosis of the ileum was done 3 months after the first operation. The chronic pelvic pain is decreasing dramatically after the first and second operation. In conclusion, although bowel obstruction caused by caecal endometriosis is a rare cause of intestinal obstruction, but it can be considered as a cause in infertile female patient

Keywords: acute, bowel obstruction, caecum, endometriosis

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Authors: Rohit Kothari, Muneer Mohamed, Vivekanandh K., Sunmeet Sandhu, Preema Sinha, Anuj Bhatnagar

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Introduction: Hyper-IgE syndrome is a rare primary immunodeficiency syndrome characterised by triad of severe atopic dermatitis, recurrent pulmonary infections, and recurrent staphylococcal skin infections. The diagnosis requires a high degree of suspicion, typical clinical features, and not mere rise in serum-IgE levels, which may be seen in multiple conditions. Genetic studies are not always possible in a resource poor setting. This study highlights various presentations of Hyper-IgE syndrome in skin of color children. Case-series: Our study had six children of Hyper-IgE syndrome aged twomonths to tenyears. All had onset in first ten months of life except one with a late-onset at two years. All had recurrent eczematoid rash, which responded poorly to conventional treatment, secondary infection, multiple episodes of hospitalisation for pulmonary infection, and raised serum IgE levels. One case had occasional vesicles, bullae, and crusted plaques over both the extremities. Genetic study was possible in only one of them who was found to have pathogenic homozygous deletions of exon-15 to 18 in DOCK8 gene following which he underwent bone marrow transplant (BMT), however, succumbed to lower respiratory tract infection two months after BMT and rest of them received multiple courses of antibiotics, oral/ topical steroids, and cyclosporine intermittently with variable response. Discussion: Our study highlights various characteristics, presentation, and management of this rare syndrome in children. Knowledge of these manifestations in skin of color will facilitate early identification and contribute to optimal care of the patients as representative data on the same is limited in literature.

Keywords: absolute eosinophil count, atopic dermatitis, eczematous rash, hyper-immunoglobulin E syndrome, pulmonary infection, serum IgE, skin of color

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Authors: Made Darmiati, Ni Putu Evi Wijayanti, Ni Ketut Wiwiek Agustina, Putu Gde Arie Yudhistira, Marcel Hardono

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The establishment of tourist village has been the main concern for pro-poor tourism in Indonesia especially in Bali in order to create alternative tourist destination. The case study of this research was Munduk, a tourist village located in Buleleng Regency, Bali Province. Munduk has been unstable in terms of tourist visit in 2012 until 2016. The concept of marketing strategy and its marketing mix are concepts that suitable for application in Munduk as the prime owner of trekking and other rural tour packages to increase the number of visitor in particularly during low season. The research study aims to determine the internal factors (strengths and weaknesses) and external factors (opportunities and threats) impacting the number of tourist visit so that they could formulate appropriate marketing strategy for Munduk Tourist Village. Data has been obtained by observation, interviews with stakeholders, questionnaire to 100 participants and documentation. In addition, this research study uses descriptive qualitative methods and techniques known as SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis by internal factors and external factors impacting the level of tourist visit to Munduk Tourist Village in Buleleng Regency, Bali. The sampling was done by ‘accidental sampling technique’ to obtain the participants to analyse the results of the SWOT analysis. Further assessment of internal and external weights has resulted respectively (1.84 , 1.84) which are in the first quadrant of the diagram in which S-O (Strengths-Opportunities) Strategy. As the prime owner of the trekking and other rural tour packages in the village, Munduk should maximise its strengths and take other opportunities as possible to wrap and design trekking and other rural tour packages and then offer the package to travel agents in Bali.

Keywords: marketing mix, marketing strategy, rural tourism, SWOT matrix

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Authors: Warangkana Juangjandee

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The rapidly increasing number of population in the limited area creates an effect on the idea of the improvement of the area to suit the environment and the needs of people. Faculty of architecture Chiang Mai University is also expanding in both variety fields of study and quality of education. In 2020, the new department will be introduced in the faculty which is Department of Landscape Architecture. With the limitation of the area in the existing building, the faculty plan to renovate some parts of its school for anticipates the number of students who will join the program in the next two years. As a result, the old wooden workshop area is selected to be renovated as student studio space. With such condition, it is necessary to study the restriction and the distinctive environment of the site prior to the improvement in order to find ways to manage the existing space due to the fact that the primary functions that have been practiced in the site, an old wooden workshop space and the new function, studio space, are too different. 72.9% of the annual times in the room are considered to be out of the thermal comfort condition with high relative humidity. This causes non-comfort condition for occupants which could promote mould growth. This study aims to analyze thermal comfort condition in the Landscape Learning Studio Area for finding the solution to improve indoor air quality and respond to local conditions. The research methodology will be in two parts: 1) field gathering data on the case study 2) analysis and finding the solution of improving indoor air quality. The result of the survey indicated that the room needs to solve non-comfort condition problem. This can be divided into two ways which are raising ventilation and indoor temperature, e.g. improving building design and stack driven ventilation, using fan for enhancing more internal ventilation.

Keywords: relative humidity, renovation, temperature, thermal comfort

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Authors: Flex Anim

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The financial system is a decentralized studies system that was put into place in Ghana as a grassroots financial studies approach. Its main goal is to give people the precise knowledge, abilities, and training required for a given trade, business, profession, or occupation. In this essay, the question of how the financial studies system's devolution to local businesses results in responsible and responsive representation as well as long-term company learning is raised. It centers on two case studies, Asekwa Municipal and Oforikrom. The next question posed by the study is how senior high school students are rebuilding their livelihoods and socioeconomic well-being by creating new curriculum and social practices related to the finance and business studies system. The paper here concentrates on Kumasi District and makes inferences for the other two examples. The paper demonstrates how the financial studies system's establishment of representative groups creates the democratic space required for the successful representation of community goals. Nonetheless, the interests of a privileged few are advanced as a result of elite capture. The state's financial and business training programs do not adhere to the financial studies system's established policy procedures and do not transfer pertinent and discretionary resources to local educators. As a result, local educators are unable to encourage representation that is accountable and responsive. The financial studies system continues to pique the interest of rural areas, but this desire is skewed toward getting access to financial or business training institutions for higher education. Since the locals are not actively involved in financial education, the financial studies system serves just to advance the interests of specific populations. This article explains how rhetoric and personal benefits can be supported by the public even in the case of "failed" interventions.

Keywords: financial studies system, financial studies' devolution, local government, senior high schools and financial education, as well as community goals and representation

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Authors: Innocensia John, Henrik Egelyng, Razack Lokina

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As the world`s population is constantly growing, food security has become a thorny trending issue. The impact has particularly been felt more in Africa as most of the people depend on food Agriculture products. Geographical Indications can aid in transforming the Tanzania agriculture-dependent economy through tapping the unique attributes of their quality products like soil, taste color etc. Consumers worldwide demand more uniquer products featuring a ´connect´ with the land use systems producing particular qualities. Tanzania has demonstrated the capacity to tap into the organic world market and has untapped potential for harvesting market value from geographical indications. This paper presents preliminary results from VALOR — a research project investigating conditions under which Tanzanian origin food producers can add value by incorporating territory specific cultural, environmental and social qualities into marketing, production and processing of unique local, niche and specialty products. Cases are investigated of the prospects for Tanzania to leapfrog perhaps into exports of geographical indications products, and certainly into allowing smallholders to create employment and build monetary value, while stewarding local food cultures and natural environments and resources, and increasing the diversity of supply of natural and unique quality products and so contribute to enhanced food security. Rice from Kyela, coffee and Sugar from Kilimanjaro, are some of the product cases investigated and provides for the in-depth case study, as ´landscape´ products incorporating ´taste of place´. Framework conditions for producers creating or capturing market value as stewards of cultural and landscape values and environments and institutional requirements for such creation or capturing to happen, including presence of export opportunities, are discussed.

Keywords: food origins, food security, protected geographical indications, case study analysis

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Authors: Maria Jose Granero Paris, Ana Isabel Jimenez Zarco, Agustin Pablo Alvarez Herranz

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In the industrial sector collaboration with suppliers is key to the development of innovations in the field of processes. Access to resources and expertise that are not available in the business, obtaining a cost advantage, or the reduction of the time needed to carry out innovation are some of the benefits associated with the process. However, the success of this collaborative process is compromised, when from the beginning not clearly rules have been established that govern the relationship. Abundant studies developed in the field of innovation emphasize the strategic importance of the concept of “Goverance”. Despite this, there have been few papers that have analyzed how the governance process of the relationship must be designed and managed to ensure the success of the cooperation process. The lack of literature in this area responds to the wide diversity of contexts where collaborative processes to innovate take place. Thus, in sectors such as the car industry there is a strong collaborative tradition between manufacturers and suppliers being part of the value chain. In this case, it is common to establish mechanisms and procedures that fix formal and clear objectives to regulate the relationship, and establishes the rights and obligations of each of the parties involved. By contrast, in other sectors, collaborative relationships to innovate are not a common way of working, particularly when their aim is the development of process improvements. It is in this case, it is when the lack of mechanisms to establish and regulate the behavior of those involved, can give rise to conflicts, and the failure of the cooperative relationship. Because of this the present paper analyzes the similarities and differences in the processes of governance in collaboration with service providers in engineering R & D in the European aerospace industry. With these ideas in mind, we present research is twofold: - Understand the importance of governance as a key element of the success of the cooperation in the development of process innovations, - Establish the mechanisms and procedures to ensure the proper management of the processes of cooperation. Following the methodology of the case study, we analyze the way in which manufacturers and suppliers cooperate in the development of new processes in two industries with different levels of technological intensity and collaborative tradition: the automotive and aerospace. The identification of those elements playing a key role to establish a successful governance and relationship management and the compression of the mechanisms of regulation and control in place at the automotive sector can be use to propose solutions to some of the conflicts that currently arise in aerospace industry. The paper concludes by analyzing the strategic implications for the aerospace industry entails the adoption of some of the practices traditionally used in other industrial sectors. Finally, it is important to highlight that in this paper are presented the first results of a research project currently in progress describing a model of governance that explains the way to manage outsourced engineering services to suppliers in the European aerospace industry, through the analysis of companies in the sector located in Germany, France and Spain.

Keywords: innovation management, innovation governance, managing collaborative innovation, process innovation

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Authors: Cathrine Scharning Cornwall-Nyquist, David Rafael Vaz Fernandes

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Since its origins, mankind has been dreaming of communicating directly with other animals. Past civilizations interacted on different levels with other species and recognized them in their rituals and daily activities. However, recent scientific developments have limited the ability of humans to consider deeper levels of interaction beyond observation and/or physical behavior. In recent years, animal caretakers and facilities such as sanctuaries or rescue centers have been introducing new techniques based on intuition. Most of those initiatives are related to specific cases, such as the incapacity to understand an animal’s behavior. Respected organizations also include intuitive animal communication (IAC) sessions to follow up on past interventions with their animals. Despite the lack of credibility of this discipline, some animal caring structures have opted to integrate IAC into their daily routines and approaches to animal welfare. At this stage, animal communication will be generally defined as the ability of humans to communicate with animals on an intuitive level. The trend in the field remains to be explored. The lack of theory and previous research urges the scientific community to improve the description of the phenomenon and its consequences. Considering the current scenario, qualitative approaches may become a suitable pathway to explore this topic. The purpose of this case study is to explore the beliefs behind and the consequences of an approach based on intuitive animal communication techniques for Panthera Africa (PA), an ethical sanctuary located in South Africa. Due to their personal experience, the Sanctuary’s founders have developed a philosophy based on IAC while respecting the world's highest standards for big cat welfare. Their dual approach is reflected in their rescues, daily activities, and healing animals’ trauma. The case study's main research questions will be: (i) Why do they choose to apply IAC in their work? (ii) What consequences to their activities do IAC bring? (iii) What effects do IAC techniques bring in their interactions with the outside world? Data collection will be gathered on-site via: (i) Complete participation (field notes); (ii) Semi-structured interviews (audio transcriptions); (iii) Document analysis (internal procedures and policies); (iv) Audio-visual material (communication with third parties). The main researcher shall become an active member of the Sanctuary during a 30-day period and have full access to the site. Access to documents and audio-visual materials will be granted on a request basis. Interviews are expected to be held with PA founders and staff members and with IAC practitioners related to the facility. The information gathered shall enable the researcher to provide an extended description of the phenomenon and explore its internal and external consequences for Panthera Africa.

Keywords: animal welfare, intuitive animal communication, Panthera Africa, rescue

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Authors: Yosef Ferede Bogale

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The purpose of this study was to evaluate the degree of customer satisfaction and the variables influencing it in the instance of the Bank of Abyssinia branches in the districts of Arada and Bole in Addis Ababa. The study was carried out utilizing a mixed research approach and a descriptive and explanatory research design in Addis Ababa, the capital city of Ethiopia. Both primary and secondary data were employed in this investigation. The study's target population consisted of 1000 of the bank's most prestigious clients. With a 93% response rate, 265 respondents from both genders in the active age group had higher levels of education and work experience and were in the active age group. Customers of the case bank under consideration comprised the study's target audience. The respondents, who belonged to both gender groups, were in the active age bracket with superior levels of education and work experience. As a result, this investigation discovered that the degree of client satisfaction was assigned a medium rating. Additionally given a middling rating were the company's image practices, employee competency, technology, and service quality. Further, the results also demonstrate that corporate image, employees’ competency, technology, and service quality all positively and significantly affect customer happiness. This study found that, to varying degrees, company image, technology, competence, and high-quality financial services will all improve consumer happiness. According to this report, banks should monitor customer satisfaction and service quality at least twice a year. This is because there is a growing movement among bank service providers for accountability, and measuring these factors is crucial. This study also recommends that banks make every effort to satisfy consumers' expectations to the highest level.

Keywords: customer satisfaction, corporate image, quality services risk, bank

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Authors: Adinarayana S., Sudhakar I.

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Energy conversion is one of the inevitable parts of any industries. It involves either conversion of mechanical energy in to electrical or vice versa. The later conversion of energy i.e. electrical to mechanical emphasizes the need of motor. Statistics reveals, about 8 % of industries’ annual turnover met on maintenance. Thus substantial numbers of efforts are required to minimize in incurring expenditure met towards break down maintenance. Condition monitoring is one of such techniques based on vibration widely used to recognize premature failures and paves a way to minimize cumbersome involved during breakdown of machinery. The present investigation involves a case study of squirrel cage induction motor (frequently in the electro machines) has been chosen for the conditional monitoring to predict its soundness on the basis of results of FFT analyser. Accelerometer which measures the acceleration converts in to impulses by FFT analyser generates vibration spectrum and time spectrum has been located at various positions on motor under different conditions. Results obtained from the FFT analyser are compared to that of ISO standard vibration severity charts are taken to predict the preventative condition of considered machinery. Initial inspection of motor revealed that stator faults, broken end rings in rotor, eccentricity faults and misalignment between bearings are trouble shootings areas for present investigation. From the results of the shaft frequencies, it can be perceived that there is a misalignment between the bearings at both the ends. The higher order harmonics of FTF shows the presence of cracks on the race of the bearings at both the ends which are in the incipient stage. Replacement of the bearings at both the drive end (6306) and non drive end (6206) and the alignment check between the bearings in the shaft are suggested as the constructive measures towards preventive maintenance of considered squirrel cage induction motor.

Keywords: FFT analyser, condition monitoring, vibration spectrum, time wave form

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Authors: Salimah Hasnah, Namratha Radhakrishnan

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Communities play a vital role in mobilizing people and resources for the benefit of all. Since time immemorial, communities have been spear heading different activities ranging from disaster management, palliative care, local economic development and many more with laudable success. Urban agriculture is one such activity where communities can prove to make a real difference. Farming activities in cities across different developed countries have proved to have favorable outcomes in the form of increased food security, neighborhood revitalization, health benefits and local economic growth. However, urban agriculture in the developing nations have never been prioritized as an important planning tool to cater to the basic needs of the public. Urban agricultural practices are being carried out in a fragmented fashion without a formal backing. The urban dwellers rely heavily on their far-off rural counterparts for daily food requirements. With the onset of the pandemic and the recurring lockdowns, the significance of geographic proximity and its impact on the availability of food to the public are gradually being realized around the globe. This warrants a need for localized food systems by shortening the distance between production and consumption of food. The significance of communities in realizing these urban farming benefits is explored in this paper. A case-study approach is adopted to understand how different communities have overcome barriers to urban farming in cities. The applicability of these practices is validated against the state of Kerala in India wherein different community centered approaches have been successful in the past. The existing barriers are assessed and way forward to achieve a self-sufficient localized food systems is formulated with the key lessons from the case studies. These recommendations will be helpful to successfully establish and sustain farming activities in urban areas by leveraging the power of communities.

Keywords: community-centric, COVID-19, drivers and barriers, local food system, urban agriculture

Procedia PDF Downloads 136

Authors: A. Pensiri, K. Nantaporn, P. Parichut

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Tourism is very important to the economy of many countries due to the large contribution in the areas of employment and income generation. However, the rapid growth of tourism can also be considered as one of the major uses of water user, and therefore also have a significant and detrimental impact on the environment. Guest behavior in water usage can be used to manage water in hotels for sustainable water resources management. This research presents a study of hotel guest water usage behavior at two hotels, namely Hotel A (located in Kathu district) and Hotel B (located in Muang district) in Phuket Province, Thailand, as case studies. Primary and secondary data were collected from the hotel manager through interview and questionnaires. The water flow rate was measured in-situ from each water supply device in the standard room type at each hotel, including hand washing faucets, bathroom faucets, shower and toilet flush. For the interview, the majority of respondents (n = 204 for Hotel A and n = 244 for Hotel B) were aged between 21 years and 30 years (53% for Hotel A and 65% for Hotel B) and the majority were foreign (78% in Hotel A, and 92% in Hotel B) from American, France and Austria for purposes of tourism (63% in Hotel A, and 55% in Hotel B). The data showed that water consumption ranged from 188 litres to 507 liters, and 383 litres to 415 litres per overnight guest in Hotel A and Hotel B (n = 244), respectively. These figures exceed the water efficiency benchmark set for Tropical regions by the International Tourism Partnership (ITP). It is recommended that guest water saving initiatives should be implemented at hotels. Moreover, the results showed that guests have high satisfaction for the hotels, the front office service reveal the top rates of average score of 4.35 in Hotel A and 4.20 in Hotel B, respectively, while the luxury decoration and room cleanliness exhibited the second satisfaction scored by the guests in Hotel A and B, respectively. On the basis of this information, the findings can be very useful to improve customer service satisfaction and pay attention to this particular aspect for better hotel management.

Keywords: hotel, tourism, Phuket, water usage

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Authors: Sumit Roy

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A clear understanding of pedestrian behaviour at road crossing at intersections is needed for providing necessary infrastructure and also for enhancing pedestrian safety at any intersection. Pedestrian road crossing behaviour is studied at Motijheel and Kakrail intersections where Motijheel intersection is a controlled roundabout, and Kakrail intersection is a signalized intersection. Around 60 people at each intersection were interviewed for a questionnaire survey and video recording at different time of a day was done for observation at each intersection. In case of Motijeel intersection, we got pedestrian road crossings were much higher than Kakrail intersection. It is because the number of workplaces here is higher than Kakrail. From questionnaire survey, it is found that 80% of pedestrians crosses at intersection to avail buses and their loading and unloading locations are at intersection, whereas at Kakrail intersection only 25% pedestrian crosses the road for buses as buses do not slow down here. At Motijheel intersection 25 to 40% of pedestrians choose to jump over the barricade for crossing instead of using overbridge for saving time and labour. On the other hand, the pedestrians using overbridge told that they use overbridge for safety. Moreover, pedestrian crosses at the same pace for both red and green interval with vehicle movement in the range of 12.5 to 14.5 km/h and gaps between vehicle were more than 4 m. Here pedestrian crossing speed varies from 3.5 to 7.2 km/h. In Kakrail intersection the road crossing situation can be classified into 4 categories. In case of red time, pedestrians do not wait to cross the road, and crossing speed varies from 3.5 to 7.2 km/h. When vehicle speed varies from 5.4 to 7.4 km/h, and gaps between vehicle vary from 1.5 to 2 m, most of the pedestrians initially choose to wait and try to cross the road in group with crossing speed 2.7 to 3.5 km/h. When vehicle speed varies from 10.8 to 18 km/h, and gaps between vehicles varies from 2 to 3 m most of the people waits and cross the road in group with crossing speed 3.5 to 5.4 km/h. When vehicle speed varies from 25.2 to 32.4 km/h and gaps between vehicles vary from 4 to 6 m most of the pedestrians choose to wait until red time. In Kakrail intersection 87% of people said that they cross the road with risk and 60% of pedestrians told that it is risky to get on and off the bus at this intersection. Planned location of loading and unloading area for buses can improve the pedestrian road crossing behaviour at intersections.

Keywords: crossing speed, pedestrian behaviour, road crossing, use of overbridge

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Authors: Wellemans Isabelle, Remmelink Myriam, Foucart Annick, Rusu Stefan, Compère Christophe

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Primary pulmonary meningioma (PPM) is a very rare tumor, and its occurrence has been reported only sporadically. Multiple PPMs are even more exceptional, and herein, we report, to the best of our knowledge, the fourth case, focusing on the clinicopathological features of the tumor. Moreover, the possible relationship between the use of progesterone–only contraceptives and the development of these neoplasms will be discussed. Case Report: We report a case of a 51-year-old female presenting three solid pulmonary nodules, with the following localizations: right upper lobe, middle lobe, and left lower lobe, described as incidental findings on computed tomography (CT) during a pre-bariatric surgery check-up. The patient revealed no drinking or smoking history. The physical exam was unremarkable except for the obesity. The lesions ranged in size between 6 and 24 mm and presented as solid nodules with lobulated contours. The largest lesion situated in the middle lobe had mild fluorodeoxyglucose (FDG) uptake on F-18 FDG positron emission tomography (PET)/CT, highly suggestive of primary lung neoplasm. For pathological assessment, video-assisted thoracoscopic middle lobectomy and wedge resection of the right upper nodule was performed. Histological examination revealed relatively well-circumscribed solid proliferation of bland meningothelial cells growing in whorls and lobular nests, presenting intranuclear pseudo-inclusions and psammoma bodies. No signs of anaplasia were observed. The meningothelial cells expressed diffusely Vimentin, focally Progesterone receptors and were negative for epithelial (cytokeratin (CK) AE1/AE3, CK7, CK20, Epithelial Membrane Antigen (EMA)), neuroendocrine markers (Synaptophysin, Chromogranin, CD56) and Estrogenic receptors. The proliferation labelling index Ki-67 was low (<5%). Metastatic meningioma was ruled out by brain and spine magnetic resonance imaging (MRI) scans. The third lesion localized in the left lower lobe was followed-up and resected three years later because of its slow but significant growth (14 mm to 16 mm), alongside two new infra centimetric lesions. Those three lesions showed a morphological and immunohistochemical profile similar to previously resected lesions. The patient was disease-free one year post-last surgery. Discussion: Although PPMs are mostly benign and slow-growing tumors with an excellent prognosis, they do not present specific radiological characteristics, and it is difficult to differentiate it from other lung tumors, histopathologic examination being essential. Aggressive behavior is associated with atypical or anaplastic features (WHO grades II–III) The etiology is still uncertain and different mechanisms have been proposed. A causal connection between sexual hormones and meningothelial proliferation has long been suspected and few studies examining progesterone only contraception and meningioma risk have all suggested an association. In line with this, our patient was treated with Levonorgestrel, a progesterone agonist, intra-uterine device (IUD). Conclusions: PPM, defined by the typical histological and immunohistochemical features of meningioma in the lungs and the absence of central nervous system lesions, is an extremely rare neoplasm, mainly solitary and associating, and indolent growth. Because of the unspecific radiologic findings, it should always be considered in the differential diagnosis of lung neoplasms. Regarding multiple PPM, only three cases are reported in the literature, and this is the first described in a woman treated by a progesterone-only IUD to the best of our knowledge.

Keywords: pulmonary meningioma, multiple meningioma, meningioma, pulmonary nodules

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Authors: Fendouli Ines, Zaafrane Nesrine, Mhamdi Hana, Knani Leila, Ghorbel Mohamed

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Introduction: Ocular infiltration of leukemia can involve orbit, uveal tract, retina and optic nerve. It may result from direct ocular infiltration by leukemic cells or indirect ocular involvement resulting from secondary hematologic changes, opportunistic infections and complications of various modalities of therapy. We here in report a case of central venous retinal occlusion associated to optic nerve infiltration as presenting signs of a relapse of acute lymphoblastic leukemia. Case Report: A twelve-year-old male -patient of acute B lymphoblastic leukemia presented with headaches and bilateral blurred vision in the left ee. Ophthalmic examination showed a visual acuity reduced to counting fingers in the right eye and no light perception in the left eye. Funduscopy revealed a voluminous disc edema surrounded by retinal haemorrhages in the right eye, and venous tortusities, papillary edema, and hemorrages suggesting central retinal venous occlusion in the LE. Swept source optical coherence tomography revealed a serous retinal detachment in the RE and .hyperreflective inner layers with macular edema in the left eye. Cerebro-orbital MRI showed bilateral thickened left optic nerve. There were no radiological signs of true papillary edema due to intracranial hypertension secondary to central nervous system involvement. Myelogram and lumbar punction demonstrated blast infiltration and confirmed ocular relapse of the leukemia. Conclusion: Ocular involvement lymphoblastic acute leukemias decreased since the introduction of a systematic prophylactic treatment of central nervous system. Periodic ophthalmic examination is necessary to allow early diagnosis and treatment.

Keywords: acute leukemia, optic nerve, infiltration, relapse

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