Search results for: engagement score

Authors: Alok Pal Jain, Santram Lodhi

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Martynia annua Linn. (Martyniaccae) is traditionally used in inflammation and applied locally to tuberculosis glands of camel’s neck. The leaves used topically to bites of venomous insects and wounds of domestic animals. Chemical examination of Martynia annua leaves revealed the presence of glycosides, tannins, proteins, phenols and flavonoids. The present study was aimed to evaluate the anti-arthritic activity of methanolic extract of Martynia annua leaves. Methanolic extract of Martynia annua leaves was tested by using in vivo collagen-induced arthritis mouse model to investigate the anti-rheumatoid arthritis activity. In addition, antioxidant effect of methanolic extract was determined by the estimation of antioxidants level in joint tissues. The severity of arthritis was assessed by arthritis score and edema. Levels of cytokines TNF-α and IL-6, in the joint tissue homogenate were measured using ELISA. A high dose (250 mg/kg) of methanolic extract was significantly reduced the degree of inflammation in mice as compared with reference drug. Antioxidants level and malondialdehyde (MDA) in joint tissue homogenate found significantly (p < 0.05) higher. Methanolic extract at dose of 250 mg/kg modulated the cytokines production and suppressed the oxidative stress in the mice with collagen-induced arthritis. This study suggested that Martynia annua might be alternative herbal medicine for the management of rheumatoid arthritis.

Keywords: Martynia annua, collagen, rheumatoid arthritis, antioxidants

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Authors: Nipawan Tharasak, Sajeewan Darbavasu

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This research aims 1) to study the opinion, problems and obstacles to internal educational quality assurance system for individual and the university levels, 2) to propose an approach to the development of quality assurance system of Suan Sunandha Rajabhat University. A study of problems and obstacles to internal educational quality assurance system of the university conducted with sample group consisting of staff and quality assurance committee members of the year 2010. There were 152 respondents. 5 executives were interviewed. Tool used in the research was document analysis. The structure of the interview questions and questionnaires with 5-rate scale. Reliability was 0.981. Data analysis were percentage, mean and standard deviation with content analysis. Results can be divided into 3 main points: (1) The implementation of the internal quality assurance system of the university. It was found that in overall, input, process and output factors received high scores. Each item is considered, the preparation, planning, monitoring and evaluation. The results of evaluation to improve the reporting and improvement according to an evaluation received high scores. However, the process received an average score. (2) Problems and obstacles. It was found that the personnel responsible for the duty still lack understanding of indicators and criteria of the quality assurance. (3) Development approach: -Staff should be encouraged to develop a better understanding of the quality assurance system. -Database system for quality assurance should be developed. -The results and suggestions should be applied in the next year development planning.

Keywords: development system, internal quality assurance, education, educational quality assurance

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Authors: Sylvanus N. Wosu

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Research shows that factors, such as low motivation, preparation, resources, emotional and social integration, and fears of risk-taking, are the most common barriers to access, matriculation, and retention into science, technology, engineering, and mathematics (STEM) disciplines for underrepresented (URM) students. These factors have been shown to impact students’ attraction and success in STEM fields. Standardized tests such as the SAT and ACT often used as predictor of success, are not always true predictors of success for African and Hispanic American students. Without an adequate academic support environment, even a high SAT score does not guarantee academic success in science and engineering. This paper proposes a model for Academic Coaching for building success and inclusive excellence in STEM education. Academic coaching is framed as a process of motivating students to be independent learners through relational mentorship, facilitating learning supports inside and outside of the classroom or school environment, and developing problem-solving skills and success attitudes that lead to higher performance in the specific subjects. The model is formulated based on best strategies and practices for enriching Academic Performance Impact skills and motivating students’ interests in STEM. A scaled model for measuring the Academic Performance Impact (API) index and STEM is discussed. The study correlates API with state standardized test and shows that the average impact of those skills can be predicted by the Academic Performance Impact (API) index or Academic Preparedness Index.

Keywords: diversity, equity, graduate education, inclusion, inclusive excellence, model

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Authors: Leila Habibi, Hadi Hakimi, Hadi Sadeghian, Maryam Jafari Mehrabadi

Abstract:

Nowadays, the importance of information technology and web-based information in tourism is very obvious. Increasing of sales and promotion of brands, the rise of information about tourist attractions and tourist areas, entrepreneurship and making money, introducing of hotels and side information to tourists via web are some examples of website effects on tourism. The hotels using web-based information can succeed in attracting tourists and improve the quality of services to the tourists. So, the study of hotel websites has become one of the most important issues in tourism. Therefore, this research aims to analyze the status of hotel websites in Yazd County as one of the most tourist visited counties in Iran. The quality of hotel website in a county can be very vital for tourism. Hence, this research compares the status of hotel websites in Yazd County with standard indexes and items that extracted from literature and theoretical framework. Content analysis is used for analyzing hotel websites with indexes and items in methodology. In the other words, all of the items are compared with the content of hotel-websites in Yazd one by one. Finally, every hotel archived final score which represents the position of the hotel among the others. All of scores and status of hotels are displayed in their own figures. The result of this research shows that many hotels do not offer standard web-based services and information. So, the existing situation is not very suitable for the attraction of web users or improving the tourism. The result of this research may help the managers and authorities of tourism to offer and improve the web-based services and information.

Keywords: e-tourism, hotel websites, tourism, web-tourism

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Authors: Ana Luiza Blanco, Juliana Cordeiro Carvalho, Tábatta Renata Pereira Brito, Ariene Angelini dos Santos Orlandi, Ligiana Pires Corona, Daniella Pires Nunes

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Depressive symptoms are recurrent in older adults and affect the quality of life and well-being of individuals. One of the strategies to reduce depression is social support, but studies are still needed to determine which types of social support are most effective in moderating this effect in certain populations. The objective was to identify the relationship between social support and depressive symptoms in participants of a University of the Third Age. This is a cross-sectional study. Participants were 82 individuals (≥ 50 years) who responded to the Geriatric Depression Scale - GDS and the Medical Outcomes Study - MOS. Data collection was carried out from November 2020 to May 2021. The Chi-Square and Mann Whitney tests were used, at a significance level of 5% for data analysis. Among the participants, 83.4% were female, 57.3% were age between 60 to 69 years, 83.1% studied 12 year or more and 48.1% receive from 4 to 10 minimum wages. The prevalence of depressive symptoms was 12.2%. The type of support with the highest median score was affective (100 points) and the lowest, or emotional (87.5 points). The results showed that participants without depressive symptoms had higher median scores for informational support when compared to those with depressive symptoms (p=0.029). The other types of social support were not statistically significant. The findings suggested that informational support is related to depressive symptoms in older adults. Promote informational support and educational actions in Universities of the Third Age may be an important strategy for preventing depressive symptoms and improve the quality of life of this population.

Keywords: aged, depressive symptoms, social support, university of the third age

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Authors: Aparna Radhakrishnan, Jancy Gupta, R. Dileepkumar

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This paper aims at assessing the Socio Economic Vulnerability (SEV) of dairy farmers to Climate Variability and Change (CVC) in 3 states of Western Ghat region in India. For this purpose, a composite SEV index has been developed on the basis of functional relationships amongst sensitivity, exposure and adaptive capacity using 30 indicators related to dairy farming underlying the principles of Intergovernmental Panel on Climate Change and Fussel framework for nomenclature of vulnerable situation. Household level data were collected through Participatory Rural Appraisal and personal interviews of 540 dairy farmers of nine taluks, three each from a district selected from Kerala, Karnataka and Maharashtra, complemented by thirty years of gridded weather data. The data were normalized and then combined into three indices for sensitivity, exposure and adaptive capacity, which were then averaged with weights given using principal component analysis, to obtain the overall SEV index. Results indicated that the taluks of Western Ghats are vulnerable to CVC. The dairy farmers of Pulpally taluka were most vulnerable having the SEV score +1.24 and 42.66% farmers under high-level vulnerability category. Even though the taluks are geographically closer, there is wide variation in SEV components. Policies for incentivizing the ‘climate risk adaptation’ costs for small and marginal farmers and livelihood infrastructure for mitigating risks and promoting grass root level innovations are necessary to sustain dairy farming of the region.

Keywords: climate change, dairy, vulnerability, livelihoods, adaptation strategies

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Authors: Xing Wang, Lin Feng, Xuan Zou, Hongchen liu

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Immediate Implantation after tooth extraction is considered to be the ideal way to retain the alveolar bone, but some scholars believe the aesthetic effect in the Early Implantation case are more reliable. In this study, 89 patients were added to this retrospective study up to 5 years. Assessment indicators was including the survival of the implant (peri-implant infection, implant loosening, shedding, crowns and occlusal), aesthetics (color and fullness gums, papilla height, probing depth, X-ray alveolar crest height, the patient's own aesthetic satisfaction, doctors aesthetics score), repair defects around the implant (peri-implant bone changes in height and thickness, whether the use of autologous bone graft, whether to use absorption/repair manual nonabsorbable material), treatment time, cost and the use of antibiotics.The results demonstrated that there is no significant difference in long-term success rate of immediate implantation, early implantation and delayed implantation (p> 0.05). But the results indicated immediate implantation group could get get better aesthetic results after two years (p< 0.05), but may increase the risk of complications and failures (p< 0.05). High-risk indicators include gingival recession, labial bone wall damage, thin gingival biotypes, planting position and occlusal restoration bad and so on. No matter which type of implanting methods was selected, the extraction methods and bone defect amplification techniques are observed as a significant factors on aesthetic effect (p< 0.05).

Keywords: immediate implantation, long-term effects, aesthetics area, dental implants

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Authors: R. N. Jay A. Ablog, M. N. Dyanne R. Del Carmen, Roma Rose A. Dela Cruz, Joselle Dara M. Estrada, Luke Clifferson M. Gagarin, Florence T. Lang-ay, Ma. Dayanara O. Mariñas, Maria Christina S. Nepa, Jahraine Chyle B. Ocampo, Mark Reynie Renz V. Silva, Jenny Lyn L. Soriano, Loreal Cloe M. Suva, Jackelyn R. Torres

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Background: To date, there is dearth of literature as to the effect of relaxation techniques in lowering the stress level of mothers of children with autism spectrum disorder (ASD). Aim: To investigate the effectiveness of 4-week relaxation techniques in stress level reduction of mothers of children with ASD. Methods: Quasi experimental design. It included 25 mothers (10-experimental, 15-control) who were chosen via purposive sampling. The mothers were recruited in the different SPED centers in Baguio City and La Trinidad and in the community. Statistics used were T-test and Related T-Test. Results: The overall weighted mean score after 4-week training is 2.3, indicating that the relaxation techniques introduced were moderately effective in lowering stress level. Statistical analysis (T-test; CV=4.51>TV=2.26) shown a significant difference in the stress level reduction of mothers in the experimental group pre and post interventions. There is also a significant difference in the stress level reduction in the control and the experimental group (Related T-test; CV=2.08 >TV=2.07). The relaxation techniques introduced were favorable, cost-effective, and easy to perform interventions to decrease stress level.

Keywords: relaxation techniques, mindful eating, progressive muscle relaxation, breathing exercise, autism spectrum disorder

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Authors: Saeed Ullah Jan

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This study has examined the e-readiness in libraries of public sector universities in Khyber Pakhtunkhwa. Efforts were made to evaluate the availability of human resources, electronic infrastructure, and network services and programs in the public sector university libraries. The population of the study was the twenty-seven public sector university libraries of Khyber Pakhtunkhwa. A quantitative approach was adopted, and a questionnaire-based survey was conducted to collect data from the librarian/in charge of public sector university libraries. The collected data were analyzed using Statistical Package for Social Sciences version 22 (SPSS). The mean score of the knowledge component interpreted magnitudes below three which indicates that the respondents are poorly or moderately satisfied regards knowledge of libraries. The satisfaction level of the respondents about the other components, such as electronic infrastructure, network services and programs, and enhancers of the networked world, was rated as average or below. The study suggested that major aspects of existing public-sector university libraries require significant transformation. For this purpose, the government should provide all the required resources and facilities to meet the population's informational and recreational demands. The Information Communication Technology (ICT) infrastructure of public university libraries needs improvement in terms of the availability of computer equipment, databases, network servers, multimedia projectors, digital cameras, uninterruptible power supply, scanners, and backup devices such as hard discs and Digital Video Disc/Compact Disc.

Keywords: ICT-libraries, e-readiness-libraries, e-readiness-university libraries, e-readiness-Pakistan

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Authors: Oanthata Jester Sealetsa, Richie Moalosi

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Musculoskeletal Disorders (MSDs) are reported to be amongst the leading contributing factors of low productivity in many industries across the world, and the most affected being New Emerging Economies (NEC) such as Botswana. This is due to lack of expertise and resources to deal with existing ergonomics challenges. This study was aimed to evaluate occupational postures and the prevalence of musculoskeletal disorders among diamond polishers in a diamond company in Botswana. A case study was conducted with about 106 diamond polishers in Gaborone, Botswana. A case study was chosen because it can investigate and explore an issue thoroughly and deeply, and record behaviour over time so changes in behaviour can be identified. The Corlett and Bishop Body Map was used to determine frequency of MSDs symptoms in different body parts of the workers. This was then followed by the use of the Rapid Entire Body Assessment (REBA) to evaluate the occupational postural risks of MSDs. Descriptive statistics, chi square, and logistic regression were used for data analysis. The results of the study reveal that workers experienced pain in the upper back, lower back, shoulders, neck, and wrists with the most pain reported in the upper back (44.6%) and lower back (44.2%). However, the mean REBA score of 6.07 suggests that sawing, bruiting and polishing were the most dangerous processes in diamond polishing. The study recommends that a redesign of the diamond polishing workstations is necessary to accommodate the anthropometry characteristic of Batswana (people from Botswana) to prevent the development of MSDs.

Keywords: assessment, Botswana, diamond polishing, ergonomics, musculoskeletal disorders, occupational postural risks

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Authors: Daphne Fietz

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This paper builds on a reflection on an autobiographical experience of uncanniness during fieldwork in the white Afrikaner settlement Orania in South Africa. Drawing on Kristeva’s theory of abjection to establish a theory of Whiteness which is based on boundary threats, it is argued that the uncanny experience as the emergence of the abject points to a moment of crisis of the author’s Whiteness. The emanating abject directs the author to her closeness or convergence with Orania's inhabitants, that is a reciprocity based on mutual Whiteness. The experienced confluence appeals to the author’s White complicity to racism. With recourse to Butler’s theory of subjectivation, the abject, White complicity, inhabits both the outside of a discourse on racism, and of the 'self', as 'I' establish myself in relation to discourse. In this view, the qualities of the experienced abject are linked to the abject of discourse on racism, or, in other words, its frames of intelligibility. It then becomes clear, that discourse on (overt) racism functions as a necessary counter-image through which White morality is established instead of questioned, because here, by White reasoning, the abject of complicity to racism is successfully repressed, curbed, as completely impossible in the binary construction. Hence, such discourse endangers a preservation of racism in its pre-discursive and structural forms as long as its critique does not encompass its own location and performance in discourse. Discourse on overt racism is indispensable to White ignorance as it covers underlying racism and pre-empts further critique. This understanding directs us towards a form of critique which does necessitate self-reflection, uncertainty, and vigilance, which will be referred to as a discourse of relationality. Such a discourse diverges from the presumption of a detached author as a point of reference, and instead departs from attachment, dependence, mutuality and embraces the visceral as a resource of knowledge of relationality. A discourse of relationality points to another possibility of White engagement with Whiteness and racism and further promotes a conception of responsibility, which allows for and highlights dispossession and relationality in contrast to single agency and guilt.

Keywords: abjection, discourse, relationality, the visceral, whiteness

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Authors: Chieh-Chung Tsou, Chun-Min Lo, Yeh-Shiu Chu

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Cell’s mechanical forces provide important physical cues in regulation of proper cellular functions, such as cell differentiation, proliferation and migration. It is believed that adhesive forces generated by cell-cell interaction are able to transmit to the interior of cell through filamentous cortical cytoskeleton. Prominent among other membrane receptors, Cadherins are prototypical adhesive molecules able to generate remarkable forces to regulate intercellular adhesion. However, the mechanistic steps of mechano-transduction in Cadherin-mediated adhesion remain very controversial. We are interested in understanding how Cadherin protein complexes enable force generation and transmission at cell-cell contact in the initial stage of intercellular adhesion. For providing a better control of time, space, and substrate stiffness, in this study, a combination of protein micropattern, micropipette manipulation, and traction force microscopy is used. Pair micropattern with different forms confines cell spreading area and the gaps in pairs varied from 2 to 8 microns are applied for monitoring the forces that cell pairs generated, measured by traction force microscopy. Moreover, cell clones obtained from epithelial cells undergone genome editing are used to score the importance for known components of Cadherin complexes in force generation. We believe that our results from this combinatory mechanobiological method will provide deep insights on understanding the biophysical principle governing mechano- transduction of Cadherin-mediated intercellular adhesion.

Keywords: cadherin, intercellular adhesion, protein micropattern, traction force microscopy

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Authors: Sarah Amodeo

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Drawing on the author’s research about the experiences of female immigrant students in academic Adult Education, in Montreal, Quebec, this paper deconstructs the benefits of autoethnography as a methodology for educators in Adult Education. Autoethnography is an advantageous methodology for teachers in Adult Education as it allows for deep engagement, allowing for educators to reflect on student experiences and their day-to-day realities, and in turn, allowing for professional development, improved andragogy, and changes to classroom practices. Autoethnography is a qualitative research methodology that cultivates strategies for improving adult learning. The paper begins by outlining the context that inspired autoethnography for the author’s work, highlighting the emergence of autoethnography as a method, while examining how it is evolving and drawing on foundational work that continues to inspire research. The basic autoethnographic methodologies that are explored in this paper include the use of memory work in episode formation, the use of personal photographs, and textual readings of artworks. Memory work allows for the researcher to use their professional experience and the lived/shared experiences of their students in their research, drawing on episodes from their past. Personal photographs and descriptions of artwork allow researchers to explore images of learning environments/realities in ways that compliment student experiences. Major findings of the text are examined through the analysis of categories of autoethnography. Specific categories include realism, impressionism, and conceptualism which aid in orientating the analysis and emergent themes that develop through self-study. Finally, the text presents a discussion surrounding the limitations of autoethnography, with attention to the trustworthiness and ethical issues. The paper concludes with a consideration of the implications of autoethnography for adult educators in juxtaposition with youth sector work.

Keywords: artwork, autoethnography, conceptualism, episode formation, impressionism, memory work, personal photographs, and realism, realism

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Authors: Shiran Bord, Assaf Oshri, Matthew W. Carlson, Sihong Liu

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Background: Alcohol-impaired driving (AID) and binge drinking are major health concerns among college students. Although the link between binge drinking and AID is well established, knowledge regarding binge drinking patterns, the factors influencing binge drinking, and the associations between consumption patterns and alcohol-related risk behaviors is lacking. Aims: To examine heterogeneous trajectories of binge drinking during college and tests factors that might predict class membership as well as class membership outcomes. Methods: Data were obtained from a sample of 1,265 college students (Mage = 18.5, SD = .66) as part of the Longitudinal Study of Violence Against Women (N = 1,265; 59.3% female; 69.2% white). Analyses were completed in three stages. First, a growth curve analysis was conducted to identify trajectories of binge drinking over time. Second, growth curve mixture modeling analyses were pursued to assess unobserved growth trajectories of binge drinking without predictors. Lastly, parental drinking variables were added to the model as predictors of class membership, and AID and being a passenger of a drunk driver were added to the model as outcomes. Results: Three binge drinking trajectories were identified: high-convex, medium concave and low-increasing. Parental drinking was associated with being in high-convex and medium-concave classes. Compared to the low-increasing class, the high convex and medium concave classes reported more AID and being a passenger of a drunk driver more frequently. Conclusions: Parental drinking may affect children’s later engagement in AID. Efforts should focus on parents' education regarding the consequences of parental modeling of alcohol consumption.

Keywords: alcohol impaired driving, alcohol consumption, binge drinking, college students, parental modeling

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Authors: Leila Habibi, Hadi Hakimi, Maryam Jafari Mehrabadi, Hadi Sadeghian

Abstract:

Nowadays, the importance of information technology and web- based information in tourism is very obvious. Increasing of sales and promotion of brands, the rise of information about tourist attractions and tourist areas, Entrepreneurship and making money, introducing of hotels and side information to tourists via web are some Examples of website effects on tourism. The hotels using web-based information can succeed in attracting tourists and improve the quality of services to the tourists so; the study of hotel websites has become one of the most important issues in tourism. Therefore, this research aims to analyze the status of hotel websites in Yazd City as one of the most tourist visited counties in Iran. The quality of hotel website in a city such as this city can be very vital for tourism. Hence, this research compares the status of hotel websites in Yazd City with standard indexes and items that extracted from Literature and theoretical framework. It is used content analysis for analyzing of hotel websites with indexes and items in methodology. In the other words, all of the items is compared with the content of hotel-websites in Yazd one by one. Finally, every hotel archived final score and it represents the position of the hotel among the others. All of scores and status of hotels is displayed in their own Figures. The result of this research shows that many hotels do not offer standard web -based services and information. So, the existing situation is not very suitable for the attraction of web users or improving the tourism. The result of this research may help the managers and authorities of tourism to offer and improve the web- based services and information.

Keywords: e-tourism, hotel websites, tourism, web-tourism

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Authors: Thampi Rawther, Jack Cecire, Andrew Sutherland

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Introduction: CT facilitates the diagnosis of potentially life-threatening injuries and facilitates early management. There is evidence that reduced CT acquisition time reduces mortality and length of hospital stay. Currently, there are variable recommendations for ideal timing. Indeed, the NHS standard contract for a major trauma service and STAG both recommend immediate access to CT within a maximum time of 60min and appropriate reporting within 60min of the scan. At Coffs Harbour Health Campus (CHHC), a CT radiographer is on site between 8am-11pm. Aim: To investigate the average time to CT at CHHC and assess for any significant relationship between time to CT and injury severity score (ISS) or time of triage. Method: All major trauma calls between Jan 2021-Oct 2021 were audited (N=87). Patients were excluded if they went from ED to the theatre. Time to CT is defined as the time between triage to the timestamp on the first CT image. Median and interquartile range was used as a measure of central tendency as the data was not normally distributed, and Chi-square test was used to determine association. Results: The median time to CT is 51.5min (IQR 40-74). We found no relationship between time to CT and ISS (P=0.18) and time of triage to time to CT (P=0.35). We compared this to other centres such as John Hunter Hospital and Gold Coast Hospital. We found that the median CT acquisition times were 76min (IQR 52-115) and 43min, respectively. Conclusion: This shows an avenue for improvement given 35% of CT’s were >30min. Furthermore, being proactive and aware of time to CT as an important factor to trauma management can be another avenue for improvement. Based on this, we will re-audit in 12-24months to assess if any improvement has been made.

Keywords: imaging, rural surgery, trauma surgery, improvement

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Authors: S. Bagur, S. Verger, B. Mut

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Early childhood intervention (ECI) is the set of actions aimed at children aged 0-6 years with special needs, the family, and the environment that aim to improve child development and family well-being. Socio-educational intervention with children with disabilities and their families should be understood through the principles of family-centered practice (FCP). The multidisciplinary team of professionals carries out the intake, assessment, and intervention, understanding that families may experience mental health problems, parental role incompetence, or feelings of exclusion. This study examines the relationship between caregivers' levels of anxiety and depression and child development during the fostering and assessment phase. The design is quantitative, non-experimental, and cross-sectional. The sample consisted of 135 family members (78.5% female, 21.5% male) users of child development services in the Balearic Islands (Spain). Three questionnaires were completed: Anxiety and Depression Scale, Child Behavior Checklist (CBCL 1½-5), and sociodemographic questionnaire. The main results show that parents of children with special needs score higher on anxiety than on depression. It should be noted that professional discipline is a variable to be taken into account in relation to parents' perception of the improvement of their child's development. In addition, there is an association between the developmental subscales, where the more the child is affected, the more the parents' mental health is affected. In short, we propose a reflection on the application of FCP during the intervention, understanding the lack of professional training as a predictor of quality in early intervention. Likewise, future lines of research are proposed to improve early care practices.

Keywords: anxiety, depression, early childhood intervention, family

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Authors: Asamaporn Puetpaiboon, Sunisa Chatmongkolchart, Nalinee Kovitwanawong, Osaree Akaraborworn

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Traumatic patients with massive bleeding require intensive resuscitation. The actual cost of anesthesia per case has never been clarified, so our study aimed to quantify the direct cost, and cost-to-charge ratio of anesthetic care in traumatic patients with intraoperative massive bleeding. This study was a prospective, observational, cost analysis study, conducted in Prince of Songkla University hospital, Thailand, with traumatic patients, of any mechanisms being recruited. Massive bleeding was defined as estimated blood loss of at least one blood volume in 24 hours, or a half of blood volume in 3 hours. The cost components were identified by the micro-costing method, and valued by the bottom-up approach. The direct cost was divided into 4 categories: the labor cost, the capital cost, the material cost and the cost of drugs. From September 2017 to August 2018, 10 patients with multiple injuries were included. Seven patients had motorcycle accidents, two patients fell from a height and another one was in a minibus accident. Two patients died on the operating table, and another two died within 48 hours. The median Sequential Organ Failure Assessment (SOFA) score was 8. The median intraoperative blood loss was 3,500 ml. The median direct cost, per case, was 250 United States Dollars (2017 exchange rate), and the cost-to-charge ratio was 0.53. In summary, the direct cost was nearly half of the hospital charge, for these traumatic patients with massive bleeding. However, our study did not analyze the indirect cost.

Keywords: cost, cost-to-charge ratio, micro-costing, trauma

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Authors: Suppara Charoenpoom

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This study focuses on 1) a good-quality management procedures of buildings and environment in schools 2) designing the management procedures and 3) creating an operation manual for the procedures. This study is the combination of qualitative and quantitative research method. Populations in the research were 83 deans and directors of primary and secondary schools from the 10th educational district in Samut Songkram. Sample group was selected from the voluntary deans and directors. There were 14 participants in sample group. Research tools in this study were divided into 2 categories. The first one was data-collecting tools, which were in-depth interview and questionnaires. The second one was the designing tools to help creating management procedures: quality business, quality work procedure and key quality indicator of each activity in schools. All data were analyzed by mean and standard deviation. The result from this study has found out 1 effective process of building and environment management for basic education schools which is called Quality Business Process (QBP) and 7 Quality Work Procedures (QWP). In terms of academic feasibility checkup by experts, the research had shown that new design of building and environment management was approved unanimously. It means that new process of building and environment management in schools works very well and can be adapted. After examining the possibility of management process being used in schools by calculating the mean value among sample group (14 school deans and directors), the mean value was between 0.64-1.00. It means that the new design of building and environment management can be operated effectively in schools. For the satisfaction part, deans and school directors gave the satisfaction score in the highest level (Mean = 4.7372, S.D. = 0.4385).

Keywords: buildings, environment, procedures, quality management

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Authors: Vivek Ku, A. K. Janmeja, D. Aggarwal, R. Gupta

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Purpose: Pulmonary rehabilitation plays a key role in management of chronic lung diseases. However, pulmonary rehabilitation is an underused modality in the management of interstitial lung disease (ILD). This is because limited information is available in literature and no data is available from India on this issue so far. The study was carried out to evaluate the role of pulmonary rehabilitation on respiratory parameters in ILD patients. Methods: The present study was a prospective randomized non-blind case control study. Total of 40 ILD patients were randomized into 2 groups of 20 patients each viz ‘pulmonary rehabilitation group’ and ‘control group’. Pulmonary rehabilitation group underwent 8 weeks pulmonary rehabilitation (PR) along with medical management as per guidelines and the control group was advised only medical management. Results: Mean age in case group was 59.15 ± 10.39 years and in control group was 62.10 ± 14.54 years. The case and the control groups were matched for age and sex. Mean MRC grading at the end of 8 weeks showed significant improvement in the case group as compared to control group (p= 0.011 vs p = 0.655). Similarly, mean St. George Respiratory Questionnaire (SGRQ) score also showed significant improvement in pulmonary rehabilitation group at the end of the study (p= 0.001 vs p= 0.492). However, FEV1 and FVC had no significant change in the case and control group. Similarly, blood gases also did not show any significant difference in the group. Conclusion: Pulmonary rehabilitation improves breathlessness and thereby improves quality of life in the patients suffering from ILD. However, the pulmonary function values and blood gases are unaffected by pulmonary rehabilitation. Clinical Implications: Further large scale multicentre study is needed to ascertain the association.

Keywords: ILD, pulmonary rehabilitation, quality of life, pulmonary functions

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Authors: Rana Bilal, Faiz-Ul-Hassan, Moazzam Jameel

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There is a dire need to replace high-cost protein with more economical protein to overcome animal protein shortage in developing nations especially countries like Pakistan. In conjunction with these efforts, the current study was planned to evaluate the effects of various dried distillery yeast sludge (DYS) levels on the immune level, egg quality, and performance of layers by replacing soybean meal. The study was designed with two hundred layers of Hy-Line variety. Distillery yeast sludge was dried and ground for 2 mm mesh size and after this proximate and mineral analysis was determined. Five isocaloric and isonitrogeneous feeds were given containing C (control), 5, 10, 15, 20% distillery yeast sludge by replacing soybean meal. The trial was performed in the completely randomized design with five treatments, 4 replicates and 10 hen per replicate. Results demonstrated that feed intake, egg production, feed conversion ratio decreased (P < 0.05) with the increased dietary DYS. However, statistically significant decrease (P < 0.05) was found in hens having DYS20 diet than control. Layers on Diets C, DYS5 and DYS10 exerted a higher immune level than DYS15 and DYS20 diets. Egg weight, eggshell weight, eggshell thickness, egg albumen height as well as haugh unit score were affected significantly by the increased level of DYS. In general, results of this study demonstrated that inclusion of DYS up to 10% showed no adverse effects on health and performance of layers.

Keywords: egg quality, immunity, layers, performance

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Authors: Deepak Ganjiwale, Karthik Vishwanathan

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Objective: Splinting is a great domain of occupational therapy profession.Making a splint for the patient would depend upon the need or requirement of the problems and deformities. Swan neck deformity is not very common in finger it may occur after any disease. Conservative treatment of the swan neck deformity is available by using different static splints only. There are very few reports of surgical correction of swan-neck deformity in benign hypermobility syndrome. Method: This case report describes the result of surgical intervention and hand splint in a twenty year old lady with past history of cardiovascular stroke with no residual neurological deficit. She presented with correctable swan neck deformity and failed to improve with static ring splints to correct the deformity. She was noted to have hyperlaxity (EhlerDanlos type) as per modified Beighton’s score of 5/9. She underwent volar plate plication of the proximal interphalangeal joint of the left ring finger along with hemitenodesis of ulnar slip of flexor digitorum superficialis (FDS) tendon whereby, the ulnar slip of FDS was passed through a small surgically created rent in A2 pulley and sutured back to itself. Result: Postoperatively, the patient was referred to occupational therapy for splinting with the instruction that the splint would work some time for as static and some time as dynamic for positional and correction of the finger. Conclusion: After occupational therapy intervention and splinting, the patient had a full correction of the swan-neck deformity with near full flexion of the operated finger and is able to work independently.

Keywords: swan neck, finger, deformity, splint, hypermobility

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Authors: Nkrumak Micheal Atta Ofori

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The Vocational System is a decentralized Studies System implemented in Ghana as vocation studies strategy for grassroot that focuses on providing individuals with the specific skills, knowledge, and training necessary for a particular trade, craft, profession, or occupation. This article asks how devolution of vocational studies to local level authorities produces responsive and accountable representation and sustainable vocational learning under the vocational Studies System. It focuses on two case studies: Asokore Mampong and Atwima kwanwoma Municipal. Then, the paper asks how senior high school are developing new material and social practices around the vocational studies System to rebuild their livelihoods and socio-economic wellbeing. Here, the article focusses on Kumasi District, drawing lessons for the two other cases. The article shows how the creation of representative groups under the Vocational Studies System provides the democratic space necessary for effective representation of community aspirations. However, due to elite capture, the interests of privilege few people are promoted. The state vocational training fails to devolve relevant and discretionary resources to local teachers and do not follow the prescribed policy processes of the Vocational Studies System. Hence, local teachers are unable to promote responsive and accountable representation. Rural communities continue to show great interest in the Vocational Studies System, but the interest is bias towards gaining access to vocational training schools for advancing studies. There is no active engagement of the locals in vocational training, and hence, the Vocational Studies System exists only to promote individual interest of communities. This article shows how ‘failed’ interventions can gain popular support for rhetoric and individual gains.

Keywords: vocational studies system, devolution of vocational studies, local-level authorities, senior high schools and vocational learning, community aspirations and representation

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Authors: Saeideh Lotfi Nikoo, Azadeh Ghaheri, Reza Omani Samani

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Context: In most cultures around the globe, infertility is recognized as a crisis and exposed infertile couples are under psychosocial pressure. Indeed, the quality of life (QoL) for infertile women is lower in comparison with fertile control. Objective, The purpose of this study, was to investigate the impact of social support and hope on QoL in women undergoing infertility treatment. Methods: A cross-sectional study. Patient(s): In this cross-sectional study, 350 infertile women were recruited who were referred to an infertility clinic for the first time and had no history of Assisted Reproductive Techniques (ART) failure. Intervention(s): Questionnaires on the Fertility Quality of Life (FertiQoL), Multi-dimensional Scale of Perceived Social Support (family and friends), and Snyder Hope Scale (pathway and agency) were used to collect data. Data analysis was done by univariate and multivariate analysis. P value <0.05 was considered statistically significant. Result(s): Multivariate analysis indicated that infertile women with a higher score of social support (by family & friends) (b= 0.59 (CI 95%: 0.03, 1.15) (P = 0.040), b= 0.61 (CI 95%: 0.17, 1.04) (P = 0.006)) and hope (pathway & agency) (b= 0.94 (CI 95%: 0.29, 1.59) (P = 0.005), b= 1.13 (CI 95%: 0.45, 1.82) (P = 0.001) respectively) have significantly better Core FertiQoL. The result revealed that social support and hope are significantly and positively associated with other subscales of FertiQoL as well. Conclusions: According to the results, lifestyle interventions such as receiving social support, building a sound family with effective communication, and providing appropriate health education are of crucial importance to address psychological distress and improve the fertility QoL of women experiencing fertility problems.

Keywords: inertility, social support, infertile women, hope

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Authors: Adesomoju O. A., E. A. Onemolease, G. O. Igene

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The study analyzed the determinants of food insecurity among smallholder farming households in the Southwestern part of Nigeria with Ondo and Osun States in focus. Multi-stage sampling procedures were employed to gather data from 389 farming households (194 from Ondo State and 195 from Osun State) spread across 4 agricultural zones, 8 local governments, and 24 communities. The data was analyzed using descriptive statistics, Ordinal regression, and Friedman test. Results revealed the average age of the respondents was 47 years with majority being male 63.75% and married 82.26% and having an household size of 6. Most household heads were educated (94.09%), engaged in farming for about 19 years, and do not belong to cooperatives (73.26%). Respondents derived income from both farming and non-farm activities with the average farm income being N216,066.8/annum and non-farm income being about N360,000/annum. Multiple technologies were adopted by respondents such as application of herbicides (77.63%), pesticides (73.26%) and fertilizers (66.58%). Using the FANTA Cornel model, food insecurity was prevalent in the study area with the majority (61.44%) of the households being severely food insecure, and 35.73% being moderately food insecure. In comparison, 1.80% and 1.03% were food-secured and mildly food insecure. The most significant constraints to food security among the farming households were the inability to access credit (mean rank = 8.78), poor storage infrastructure (8.57), inadequate capital (8.56), and high cost of farm chemicals (8.35). Significant factors related to food insecurity among the farming households were age (b = -0.059), education (b = -0.376), family size (b = 0.197), adoption of technology (b = -0.198), farm income (b = -0.335), association membership (b = -0.999), engagement in non-farm activities (b = -1.538), and access to credit (b = -0.853). Linking farmers' groups to credit institutions and input suppliers was proposed.

Keywords: food insecurity, FANTA Cornel, Ondo, Osun, Nigeria, Southwest, Livelihood

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Authors: Haleh Dadgostar, Faramarz Akbari, Hosien Vahid Tari, Masoud Solaymani-Dodaran, Mohammad Razi

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Introduction: There are a number of exercises-protocols have been applied to improve low back pain. We compared the effect of supervised exercise therapy and home-based exercise therapy among patients with nonspecific chronic low back pain. Methods: 70 patients with nonspecific chronic low back pain were randomly (using a random number generator, excel) divided into two groups to compare the effects of two types of exercise therapy. After a common educational session to learn how to live with low back pain as well as to use core training protocols to strengthen the muscles, the subjects were randomly assigned to follow supervised exercise therapy (n = 31) or home-based exercise therapy (n = 34) for 20 weeks. Results: Although both types of exercise programs resulted in reduced pain, this factor decreased more significantly in supervised exercise program. All scores of fitness improved significantly in supervised exercise group. But only knee extensor strength score was increased in the home base exercise group. Conclusion: Comparing between two types of exercise, supervised group exercise showed more effective than the other one. Reduction in low back pain severity and improvement in muscle flexibility and strength can be more achieved by using a 20-week supervised exercise program compared to the home-based exercise program in patients with nonspecific chronic low back pain.

Keywords: low back pain, anthropometric parameters, supervised exercise therapy, home-based exercise therapy

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Authors: B. Gechbaia, K. Goletiani, G. Gabedava, N. Mikeltadze

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At this stage, Georgia is a country which is actively involved in the European integration process, for which the primary priority is effective integration in the European education system. The modern Georgian higher education system is the process of establishing a new sociocultural reality, whose main priorities are determined by the Quality System as a continuous cycle of planning, implementation, checking and acting. Obviously, in this situation, the issue of management of education institutions comes out in the foreground, since the proper planning and implementation of personnel management processes is one of the main determinants of the company's performance. At the same time, one of the most important factors is the psychological comfort of the personnel, ensuring their protection and efficiency of stress management policy. The purpose of this research is to determine how intensely the relationship is between the psychological comfort of the personnel and the efficiency of the quality system in the institution as the quality assurance mechanisms of educational institutions affect the stability of personnel, prevention and management of the stressful situation. The research was carried out within the framework of the Internal Grant Project «The Role of Organizational Culture in the Process of Settlement of Management of Stress and Conflict, Georgian Reality and European Experience » of the Batumi Navigation Teaching University, based on the analysis of the survey results of target groups. The small-scale research conducted by us has revealed that the introduction of quality assurance system and its active implementation increased the quality of management of Georgian educational institutions, increased the level of universal engagement in internal and external processes and as a result, it has improved the quality of education as well as social and psychological comfort indicators of the society.

Keywords: quality assurance, effective management, stability of personnel, psychological comfort, stress management

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Authors: Maria Magdy Danial Riad

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The objective of this study was to investigate the effect of different protein sources with different degradability ratios during late gestation of ewes on colostrum composition and its IgG concentration, body weight change of dams, and birth weight of their lambs. Objectives: 35 multiparous native crossbred ewes (BW= 59±2.5kg) were randomly allocated to five dietary treatments (7 ewes / treatment) for 2 months prior to lambing. Methods: Experimental diets were isonitrogenous (12.27% CP) and isocaloric (2.22 Mcal ME/kg DM). In diet I (the control), solvent extract soybeans (SESM 33% RUP of CP), II feed grade urea (FGU 31% RUP), III slow release urea (SRU 31% RUP). As sources of undegradable protein, extruded expeller SBM-EESM 40 (37% RUP) and extruded expeller SBM-EESM 60 (41% RUP) were used in groups IV and V, respectively. Results showed no significant effect on feed intake, crude protein (CP), metabolizable energy (ME), and body condition score (BCS). Ewes fed the 37% RUP diet gained more (p<0.05) weight compared with ewes fed the 31% RUP diet (5.62 vs. 2.5kg). Ewes in EESM 60 had the highest levels of fat, protein, total solid, solid not fat, and immunoglobulin and the lowest in urea N content (P< 0.05) in colostrum during the first 24hrs after lambing. Conclusions: Protein source and RUP levels in ewes’ diets had no significant effect (P< 0.05) on lambs’ birth weight and ewes' blood biochemical parameters. Increasing the RUP content of diet during late gestation resulted in an increase in colostrum constituents and its IgG level but had no effect on ewes’ performance and their lambs’ outcome.

Keywords: colostrum, ewes, lambs output, pregnancy, undegradable protein

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Authors: Fenni Sim

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Objectives: The purpose of the study is to examine the relationship between family functioning and level of self-efficacy: how family functioning can potentially affect self-efficacy which will eventually lead to better clinical outcomes. The hypothesis was ‘Patients on haemodialysis with perceived higher family functioning are more likely to have higher perceived level of self-efficacy’. Methods: The study was conducted with a mixed methodology of quantitative and qualitative data collection of survey and semi-structured interview respectively. The General Self-Efficacy scale and SCORE-15 were self-administered by participants. The data will be analysed with correlation analysis method using Microsoft Excel. 79 patients were recruited for the study through random sampling. 6 participants whose results did not reflect the hypothesis were then recruited for the qualitative study. Interpretive phemenological analysis was then used to analyse the qualitative data. Findings: The hypothesis was accepted that higher family functioning leads to higher perceived self-efficacy. The correlation coefficient of -0.21 suggested a mild correlation between the two variables. However, only 4.6% of the variation in perceived self-efficacy is accounted by the variation in family functioning. The qualitative study extrapolated three themes that might explain the variations in the outliers: (1) level of physical functioning affects perceived self-efficacy, (2) instrumental support from family influenced perceived level of family functioning, and self-efficacy, (3) acceptance of illness reflects higher level of self-efficacy. Conclusion: While family functioning does have an impact on perceived self-efficacy, there are many intrapersonal and physical factors that may affect self-efficacy. The concepts of family functioning and self-efficacy are more appropriately seen as complementing each other to help a patient in managing his illness. Healthcare social workers can look at how family functioning is supporting the individual needs of patients with different trajectory of ESRD and the support we can provide to improve one’s self-efficacy.

Keywords: chronic kidney disease, coping of illness, family functioning, self efficacy

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Authors: Pawit Tangviroon, Apichit Svang-Ariyaskul

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As the limited availability of petroleum-based fuel has been a major concern, biodiesel is one of the most attractive alternative fuels because it is renewable and it also has advantages over the conventional petroleum-base diesel. At Present, productions of biodiesel generally perform by transesterification of vegetable oils with low molecular weight alcohol, mainly methanol, using chemical catalysts. Methanol is petrochemical product that makes biodiesel producing from methanol to be not pure renewable energy source. Therefore, ethanol as a product produced by fermentation processes. It appears as a potential feed stock that makes biodiesel to be pure renewable alternative fuel. The research is conducted based on two biodiesel production processes by reacting soybean oils with methanol and ethanol. Life cycle assessment was carried out in order to evaluate the environmental impacts and to identify the process alternative. Nine mid-point impact categories are investigated. The results indicate that better performance on Abiotic Depletion Potential (ADP) and Acidification Potential (AP) are observed in biodiesel production from methanol when compared with biodiesel production from ethanol due to less energy consumption during the production processes. Except for ADP and AP, using methanol as feed stock does not show any advantages over biodiesel from ethanol. The single score method is also included in this study in order to identify the best option between two processes of biodiesel production. The global normalization and weighting factor based on eco-taxes are used and it shows that producing biodiesel form ethanol has less environmental load compare to biodiesel from methanol.

Keywords: biodiesel, ethanol, life cycle assessment, methanol, soybean oil

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