Search results for: dietary practice

Authors: Sugam Kale, Arif Uzair Bin Mohammed Roslan, Cindy Lee, Syed Beevee Mohammed Ismail

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Preemptive analgesia is an established concept in the modern practice of anaesthesia. To be most effective, it is best instituted earlier than the surgical stimulus and should last beyond the offset of surgically induced pain till healing is complete. Whereas the start of afferent pain blockade with regional anaesthesia is common, its effect often falls short to cover the entire period of pain impulses making their way to CNS in the post-operative period. We tried to use a combination of two regional anaesthetic techniques used sequentially to overcome this handicap. Madam S., a 56 year old lady, was scheduled for elective surgery for pancreatic cancer. She underwent laparotomy and distal pancreatectomy, splenectomy, bilateral salpingo oophorectomy, and sigmoid colectomy. Surgery was expected to be extensive, and it was presumed that the standard pain relief with PCA with opiates and oral analgesics would not be adequate. After counselling the patient pre-operative about the technique of regional anaesthesia techniques, including epidural catheterization and rectus sheath catheter placement, their benefits, and potential complications, informed consent was obtained. Epidural catheter was placed awake, and general anaesthesia was then induced. Epidural infusion of local anaesthetics was started prior to surgical incision and was continued till 60 hours into the postoperative period. Before skin closure, the surgeons inserted commercially available rectus sheath catheters bilaterally along the midline incision used for laparotomy. After 46 hours post-op, local anaesthetic infusion via these was started as bridging while the epidural infusion rate was tapered off. The epidural catheter was removed at 75 hours. Elastomeric pumps were used to provide local anaesthetic infusion with the ability to vary infusion rates. Acute pain service followed up the patient’s vital signs and effectiveness of pain relief twice daily or more frequently as required. Rectus sheath catheters were removed 137 hours post-op. The patient had good post-op analgesia with the minimal additional analgesic requirement. For the most part, the visual analog score (VAS) for pain remained at 1-3 on a scale of 1 to 10. Haemodynamics remained stable, and surgical recovery was as expected. Minimal opiate requirement after an extensive laparotomy also translates to the early return of intestinal motility. Our experience was encouraging, and we are hoping to extend this combination of two regional anaesthetic techniques to patients undergoing similar surgeries. Epidural analgesia is denser and offers excellent pain relief for both visceral and somatic pain in the first few days after surgery. As the pain intensity grows weaker, rectus sheath block and oral analgesics provide almost the same degree of pain relief after the epidural catheter is removed. We discovered that the background infusion of local anaesthetic down the rectus sheath catherter largely reduced the requirement for other classes of analgesics. We aim to study this further with a larger patient cohort and hope that it may become an established clinical practice that benefits patients everywhere.

Keywords: rectus sheath, epidural infusion, post operative analgesia, elastomeric

Procedia PDF Downloads 135

Authors: Shin-Shin Kao

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This paper reviews the crucial situation in higher education in Taiwan due to the rapid decline of the birth rate in the past three decades, and how the government and local colleges/universities work to face the challenge. Recruiting international students is one of the possible ways to resolve the problem, but offering enough courses in English is one of the main obstacles when the majority of learners are still Taiwanese students. In the academic year of 2012, Chung Yuan Christian University determined to make its campus international and began to enforce two required courses for freshmen taught in English. It failed in the beginning, but succeeded in the following academic year of 2013. Using the teaching evaluations accumulated in the past three years, this paper aims to clarify the myths which had been bothering most faculties. It also offers some suggestions for college/university teachers interested in giving lectures in English to English as Second Language (ESL) learners. A conclusion is presented at the end of the paper, in which the author explained why Taiwanese students could learn their profession in English.

Keywords: calculus, English, teaching evaluation, teaching strategy, vocabulary

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Authors: George Lin

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This study examines a practice in which Chinese municipal governments actively pursue momentary and spectacular urbanism through the hosting of mega-events as an instrument to reproduce urban space for the enhancement of place competitiveness and advancement of political career. Practicing event-driven spectacular urbanism is found to have a short-term impact upon the economy and an effect upon the career advancement of the party secretary more than the mayor. Hosting mega-events has been used as a means to create “a harmonious society” and unified social space whereby grievance and discontents are grossed over, ignored, excluded and marginalized. Geographically, a new urban space has been created for the central city to reassert/consolidate its leading competitive position in the regional and national economy at the expense of the disadvantaged and marginalized. Findings of this research call for a critical re-evaluation of the sophisticated state-space inter-relations in the ongoing processes of planetary urbanization and global urban revolution in which China has taken an important part.

Keywords: Chinese cities, mega events, urbanism, urbanization

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Authors: Ziwei Chen, Yujiang Gao

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The rapid urbanization has caused the massive physical space in Chinese cities to be in a state of duplication and dislocation through the rapid development, forming many daily spaces that cannot be standardized, typed, and identified, such as illegal construction. This phenomenon is known as urban spatial redundancy and is often excluded from mainstream architectural discussions because of its 'remaining' and 'excessive' derogatory label. In recent years, some practice architects have begun to pay attention to this phenomenon and tried to tap the value behind it. In this context, the author takes the redundancy phenomenon of resident space as the research object and explores the inspiration to the urban architectural renewal and the innovative residential area model, based on the urban survey of redundant living space in Hongkou District of Shanghai. On this basis, it shows that the changes accumulated in the long-term use of the building can be re-applied to the goals before the design, which is an important link and significance of the existence of an architecture.

Keywords: rapid urbanization, living space redundancy, architectural renewal, residential area model

Procedia PDF Downloads 135

Authors: Shyam Mehraaj, Samanthi E. R. Siriwardana, Shehara A. K. G. H., Wanigasinghe N. T., Wandana R. A. K., Wedage C. V.

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A presentation is a critical tool for conveying not just spoken information but also a wide spectrum of human emotions. The single most effective thing to make the presentation successful is to practice it beforehand. Preparing for a presentation has been shown to be essential for improving emotional control, intonation and prosody, pronunciation, and vocabulary, as well as the quality of the presentation slides. As a result, practicing has become one of the most critical parts of giving a good presentation. In this research, the main focus is to analyze the audio, video, and slides of the presentation uploaded by the presenters. This proposed solution is based on the Natural Language Processing and Computer Vision techniques to cater to the requirement for the presenter to do a presentation beforehand using a mobile responsive web application. The proposed system will assist in practicing the presentation beforehand by identifying the presenters’ emotions, body language, tonality, prosody, pronunciations and vocabulary, and presentation slides quality. Overall, the system will give a rating and feedback to the presenter about the performance so that the presenters’ can improve their presentation skills.

Keywords: presentation, self-evaluation, natural learning processing, computer vision

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Authors: Yan Zhang

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With the development of commercial movies, more and more instructors are drawn to adapt film pedagogy to teach history and culture. By challenging traditional standards of classroom culture, instruction through film represents an intersection of modernity and adaptability which is no longer optional but essential to maintaining educational accessibility. First, this presentation describes special features of the film that can be used in the classroom and help students acquire intercultural communicative competence (ICC) and achieve the learning goal. Second, the author brings forward the 5 A STAIRCASE model (Acknowledge-Adjust-Acculturate-Act-Assess) to explore how students acquire international communicative competence. Third, this article presents the intersections between new digital environments and classroom practice, such as how films can contribute to combining classical and contemporary Chinese cultures seamlessly and how film pedagogy can be an effective way to get students to engage in deeper critical thinking by exposing them to visuals, music, language, and styling which do not exist in traditional learning formats. Last, the student’s final video project will be exemplified at the end, demonstrating how to engage students in the analysis and experience of history and culture.

Keywords: intercultural education, curriculum, media, history

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Authors: Obidimma Ezezika

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In light of the increasing importance of trust in development programs, the purpose of this study, was to identify how trust functions as an essential key determinant in successful innovation and technology development programs. Using projects in the agricultural sector as case studies, we determined how the concept of trust is understood. Our data collection relied on semi-structured, face-to-face interviews conducted as part of a larger study investigating the role of trust in development programs. Interview transcripts were analyzed to create a narrative on how trust is understood by the study’s participants and how trust functions in fostering innovation. We identified six themes and showed how trust plays an important factor in innovation. These themes included the practice of integrity and honesty; delivery of results in an accountable manner; capability and competency; sharing of the same objectives and interests; transparency about actions and intentions through clear communication; and the targeting of services toward the interests of the public. The results of this study can provide guidance on how to enhance implementation mechanisms and provide impetus for organizations to implement trust building activities in fostering effective innovation.

Keywords: trust, research, innovation, technology

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Authors: C. Treerattanaphan, P. Boonpramuk, P. Singla

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Frequent, continuous speech training has proven to be a necessary part of a successful speech therapy process, but constraints of traveling time and employment dispensation become key obstacles especially for individuals living in remote areas or for dependent children who have working parents. In order to ameliorate speech difficulties with ample guidance from speech therapists, a website has been developed that supports speech therapy and training for people with articulation disorders in the standard Thai language. This web-based program has the ability to record speech training exercises for each speech trainee. The records will be stored in a database for the speech therapist to investigate, evaluate, compare and keep track of all trainees’ progress in detail. Speech trainees can request live discussions via video conference call when needed. Communication through this web-based program facilitates and reduces training time in comparison to walk-in training or appointments. This type of training also allows people with articulation disorders to practice speech lessons whenever or wherever is convenient for them, which can lead to a more regular training processes.

Keywords: web-based remote training program, Thai speech therapy, articulation disorders, speech booster

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Authors: P. Mbecke

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Developmental social welfare implemented through developmental social work is being applauded internationally as an approach that facilitates social development theory and practice. However, twenty-two years into democracy, there are no tangible evidences that the much-desired developmental social welfare approach has assisted the post-apartheid macroeconomic policy frameworks in addressing poverty and inequality, thus, the derailment of the post-apartheid development approach in South Africa. Based on the implementation research theory, and the literature review technique, this paper recognizes social work as a principal role-player in social development. It recommends the redesign and implementation of an effective developmental social welfare approach with specific strategies, programs, activities and sufficient resources aligned to and appropriate in delivering on the promises of the government’s macroeconomic policy frameworks. Such approach should be implemented by skilled and dedicated developmental social workers in order to achieve transformation in South Africa.

Keywords: apartheid, developmental social welfare, developmental social work, inequality, poverty alleviation, social development, South Africa

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Authors: Mariam Zahwy, Waleed El Nemr, A. Samer Ezeldin

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In 2016, the depreciation of the Egyptian pound (EGP) had a substantial impact on Egypt's construction industry. Studies assessing this influence are scarce, though. The impact of devaluation on contractors is measured in this study using empirical data. The difficulties contractors have as a result of rising import material costs, limited financing alternatives, and inflationary pressures are also determined by analyzing survey responses from contractors and industry experts. The approaches contractors utilize to lessen the impact of devaluation are also examined in the research. The survey results show how currency depreciation directly affects contractors in the Egyptian construction industry in terms of financial consequences. Inflationary pressures, fewer financing alternatives, and rising expenses have all affected contractors. To minimize losses, contractors have, nonetheless, put a number of tactics into practice. These findings highlight the importance of understanding and managing the impact of devaluation on the construction industry to ensure its resilience and development.

Keywords: construction, devaluation, contractors, material costs, inflationary pressures, empirical data, quantitative research

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Authors: Wiolene Montanari Nordi, Debora Botequio Moretti, Mariana Caroline Pontin, Jessica Pampolini, Raul Machado-Neto

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Gills are organs responsible for respiration and osmoregulation between the fish internal environment and water. Under stress conditions, oxidative response and gill plasticity to attempt to increase gas exchange area are noteworthy, compromising the physiological processes and therefore fish health. Colostrum is a dietary source of nutrients, immunoglobulin, antioxidant and bioactive molecules, essential for immunological protection and development of the gastrointestinal epithelium. The hypothesis of this work is that antioxidant factors present in the colostrum, unprecedentedly tested in gills, can minimize or reduce the alteration of its epithelium structure of juvenile pacu (Piaractus mesopotamicus) subjected to high stocking density. The histological changes in the gills architecture were characterized by the frequency, incidence and severity of the tissue alteration and ionic status. Juvenile (50 kg fish/m3) were fed with pelleted diets containing 0, 10, 20 or 30% of lyophilized bovine colostrum (LBC) inclusion and at 30 experimental days, gill and blood samples were collected in eight fish per treatment. The study revealed differences in the type, frequency and severity (histological alterations index – HAI) of tissue alterations among the treatments, however, no distinct differences in the incidence of alteration (mean alteration value – MAV) were observed. The main histological changes in gill were elevation of the lamellar epithelium, excessive cell proliferation of the filament and lamellar epithelium causing total or partial melting of the lamella, hyperplasia and hypertrophy of lamellar and filament epithelium, uncontrolled thickening of filament and lamellar tissues, mucous and chloride cells presence in the lamella, aneurysms, vascular congestion and presence of parasites. The MAV obtained per treatment were 2.0, 2.5, 1.8 and 2.5 to fish fed diets containing 0, 10, 20 and 30% of LBC inclusion, respectively, classifying the incidence of gill alterations as slightly to moderate. The severity of alteration of individual fish of treatment 0, 10 and 20% LBC ranged values from 5 to 40 (HAI average of 20.1, 17.5 and 17.6, respectively, P > 0.05), and differs from 30% LBC, that ranged from 6 to 129 (HAI mean of 77.2, P < 0.05). The HAI value in the treatments 0, 10 and 20% LBC reveals gill tissue with injuries classified from slightly to moderate, while in 30% LBC moderate to severe, consequence of the onset of necrosis in the tissue of two fish that compromises the normal functioning of the organ. In relation to frequency of gill alterations, evaluated according to absence of alterations (0) to highly frequent (+++), histological alterations were observed in all evaluated fish, with a trend of higher frequency in 0% LBC. The concentration of Na+, Cl-, K+ and Ca2+ did not changed in all treatments (P > 0.05), indicating similar capacity of ion exchange. The concentrations of bovine colostrum used in diets of present study did not impair the alterations observed in the gills of juvenile pacu.

Keywords: histological alterations of gill tissue, ionic status, lyophilized bovine colostrum, optical microscopy

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Authors: Satya Girish Goparaju, Sushmita Pareek

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This paper examines two sets of pictograms published in Neurath’s books Basic by Isotype and International Pictorial Language in order to investigate the reasons for pictorial language having become an end in itself despite its potential to be relevant, especially in the 21st century digital age of heightened interlingual engagement. ISOTYPE was developed by Otto Neurath to be an ‘international language’ (pictorial) in the late 1920s. It was derived from the philosophy of logical positivism (of the Vienna Circle), which believed that language can be reduced to sets of direct experiences as bare symbols, devoid of the emotive and expressive functions. In his book International Picture Language, Neurath noted that any language is less clear-cut in one or the other way, and hence the pictorial language was justified. However, Isotype, as an ambitious version of logical positivism in practice distanced itself from the semiotic theories of language, and therefore his pictograms were defined as an independent set of signs rather than signs as a part of the language. This paper attempts to investigate intersemiotic translation in the form of Isotypes and trace the effects of logical positivism on Neurath’s concept of isotypes; the ‘international language’.

Keywords: intersemiotic translation, isotype, logical positivism, Otto Neurath, translation studies

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Authors: Eugenia Vomvoridi-Ivanovic

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It is broadly assumed that participation in field experiences will help pre-service teachers (PSTs) bridge theory to practice. However, this is often not the case since PSTs who are placed in classrooms with large numbers of students from diverse linguistic, cultural, racial, and ethnic backgrounds (culturally diverse students (CDS)) usually observe ineffective mathematics teaching practices that are in contrast to those discussed in their teacher preparation program. Over the past decades, the educational research community has paid increasing attention to investigating out-of-school learning contexts and how participation in such contexts can contribute to the achievement of underrepresented groups in Science, Technology, Engineering, and mathematics (STEM) education and their expanded participation in STEM fields. In addition, several research studies have shown that students display different kinds of mathematical behaviors and discourse practices in out-of-school contexts than they do in the typical mathematics classroom since they draw from a variety of linguistic and cultural resources to negotiate meanings and participate in joint problem solving. However, almost no attention has been given to exploring these contexts as field experiences for pre-service mathematics teachers. The purpose of this study was to explore how participation in a community based after-school field experience promotes understanding of the content pedagogy concepts introduced in elementary mathematics methods courses, particularly as they apply to teaching mathematics to CDS. This study draws upon a situated, socio-cultural theory of teacher learning that centers on the concept of learning as situated social practice, which includes discourse, social interaction, and participation structures. Consistent with exploratory case study methodology, qualitative methods were employed to investigate how a cohort of twelve participating pre-service teacher's approach to pedagogy and their conversations around teaching and learning mathematics to CDS evolved through their participation in the after-school field experience, and how they connected the content discussed in their mathematics methods course with their interactions with the CDS in the after-school. Data were collected over a period of one academic year from the following sources: (a) audio recordings of the PSTs' interactions with the students during the after-school sessions, (b) PSTs' after-school field-notes, (c) audio-recordings of weekly methods course meetings, and (d) other document data (e.g., PST and student generated artifacts, PSTs' written course assignments). The findings of this study reveal that the PSTs benefitted greatly through their participation in the after-school field experience. Specifically, after-school participation promoted a deeper understanding of the content pedagogy concepts introduced in the mathematics methods course and gained a greater appreciation for how students learn mathematics with understanding. Further, even though many of PSTs' assumptions about the mathematical abilities of CDS were challenged and PSTs began to view CDSs' cultural and linguistic backgrounds as resources (rather than obstacles) for learning, some PSTs still held negative stereotypes about CDS and teaching and learning mathematics to CDS in particular. Insights gained through this study contribute to a better understanding of how informal mathematics learning contexts may provide a valuable context for pre-service teacher's learning to teach mathematics to CDS.

Keywords: after-school mathematics program, pre-service mathematical education of teachers, qualitative methods, situated socio-cultural theory, teaching culturally diverse students

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Authors: Dingding Chen, Kazuo Arakawa, Masakazu Uchino, Changheng Xu

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Vacuum assisted resin transfer moulding (VARTM) is a promising manufacture process for making large and complex fiber reinforced composite structures. However, the complexity of the flow of the resin in the infusion stage usually leads to nonuniform property distribution of the produced composite part. In order to control the flow of the resin, the situation of flow should be mastered. For the safety of the usage of the produced composite in practice, the understanding of the property distribution is essential. In this paper, we did some trials on monitoring the resin infusion stage and evaluation for the fiber volume fraction distribution of the VARTM produced composite using the digital image correlation methods. The results show that 3D-DIC is valid on monitoring the resin infusion stage and it is possible to use 2D-DIC to estimate the distribution of the fiber volume fraction on a FRP plate.

Keywords: digital image correlation, VARTM, FRP, fiber volume fraction

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Authors: Benedict Ofori, Kwabena Sarpong, Stephen Antwi

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Background: Medicinal plants are utilized all around the world and are becoming increasingly important economically. The WHO notes that ‘inappropriate use of traditional medicines or practices can have negative or dangerous effects and that future research is needed to ascertain the efficacy and safety of such practices and medicinal plants used by traditional medicine systems. The poor around the world have limited access to palliative care or pain relief. Pharmacologists have been focused on developing safe and effective anti-inflammatory drugs. Most of the issues related to their use have been linked to the fact that numerous traditional and herbal treatments are classified in different nations as meals or dietary supplements. As a result, there is no need for evidence of the quality, efficacy, or safety of these herbal formulations before they are marketed. The fact that access to drugs meant for pain relief is limited in low-income countries means advanced studies should be done on home drugs meant for inflammation to close the gap. Methods: The ethanolic extracts of the plant were screened for the presence of 10 phytochemicals. The Pierce BCA Protein Assay Kit was used for the determination of the protein concentration of the egg white. The rats were randomly selected and put in 6 groups. The egg white was sub-plantar injected into the right-hand paws of the rats to induce inflammation. The animals were treated with the three plant extracts obtained from the root bark, stem, and leaves of the plant. The control groups were treated with normal saline, while the standard groups were treated with standard drugs indomethacin and celecoxib. Plethysmometer was used to measure the change in paw volume of the animals over the course of the experiment. Results: The results of the phytochemical screening revealed the presence of reducing sugars and saponins. Alkaloids were present in only R.L.S (1:1:1), and phytosterols were found in R.L(1:1) and R.L.S (1:1:1). The estimated protein concentration was found to be 103.75 mg/ml. The control group had an observable increase in paw volume, which indicated that inflammation was induced during the 5 hours. The increase in paw volume for the control group peaked at the 1st hour and decreased gradually throughout the experiment, with minimal changes in the paw volumes. The 2nd and 3rd groups were treated with 20 mg/kg of indomethacin and celecoxib. The anti-inflammatory activities of indomethacin and celecoxib were calculated to be 21.4% and 4.28%, respectively. The remaining 3 groups were treated with 2 dose levels of 200mg/kg plant extracts. R.L.S, R.L, and S.R.L had anti-inflammatory activities of 22.3%, 8.2%, and 12.07%, respectively. Conclusions: Egg albumin-induced paw model in rats can be used to evaluate the anti-inflammatory activity of herbs that might have potential anti-inflammatory activity. Herbal medications have potential anti-inflammatory activities and can be used to manage various inflammatory conditions if their efficacy and side effects are well studied. The three extracts all possessed anti-inflammatory activity, with R.L.S having the highest anti-inflammatory activity.

Keywords: inflammation, capparis erythrocarpos, anti-inflammatory activity, herbal medicine, paw volume, egg albumin

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Authors: A. Lashkari, H. Khalafi, H. Khazeminejad, S. Khakshourniya

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In this paper, a numerical model is presented. The model is used to analyze a steady state thermo-hydraulic and reactivity insertion transient in TRR reference cores respectively. The model predictions are compared with the experiments and PARET code results. The model uses the piecewise constant and lumped parameter methods for the coupled point kinetics and thermal-hydraulics modules respectively. The advantages of the piecewise constant method are simplicity, efficiency and accuracy. A main criterion on the applicability range of this model is that the exit coolant temperature remains below the saturation temperature, i.e. no bulk boiling occurs in the core. The calculation values of power and coolant temperature, in steady state and positive reactivity insertion scenario, are in good agreement with the experiment values. However, the model is a useful tool for the transient analysis of most research reactor encountered in practice. The main objective of this work is using simple calculation methods and benchmarking them with experimental data. This model can be used for training proposes.

Keywords: thermal-hydraulic, research reactor, reactivity insertion, numerical modeling

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Authors: Intissar Abbes, Yousra Hallem, Jean-michel Sahut

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The purpose of this research is to explore the legitimacy of a proximity mobile payment (PMP) system by taking into account the social aspects related to its use (social acceptability). We have chosen to focus on the acceptability process of a PMP application (‘Flashplay’) from the first testing to the adoption in a service context. This PMP solution is a pilot program developed as part of a global strategy of disintermediation in various sectors (retail, catering, and entertainment). This case is particularly interesting for two reasons: the context and environment are suitable to the adoption of innovation in payment like other African countries and the possibility to study different stages of the social acceptability process of that PMP system. The neo-institutional theory is mobilized to identify the three pillars of legitimacy: cognitive, normative and regulatory. A longitudinal qualitative study was conducted with 27 customers using the PMP service. Results highlighted the importance of the consumption system and the service provider as institutions. Recommendations are thus proposed to PMP service providers in order to rethink the design and implementation strategies of their PMP system to ensure their adoption and promote the institutionalization of this type of consumption practice.

Keywords: legitimacy, payment, acceptability, mobility

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Authors: Mohammad Moussa Khalaf

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As a significant term in Arab music, ṭarab identifies a particular expression of feelings and emotions, especially in the vocal practice of Arab music. Ṭarab aims to take both the performer and the audience from a normal feeling state to a new state of spiritual feeling through the art of mawwāl. Because of the expertise required for mawwāl, the ability to reach ṭarab has long been considered an indication that a musician has reached a high musical level. Another significant Islamic concept related to feelings and emotions is khushūʿ. It is known that one of the ways to get Khāsheʿ (humble to God) is the artistic reading of the holy Qur’ān. The artistic recitation of the Qur’ān is tajwīd. Like mawwāl, tajwīd requires a high-level rendition to lead the listener to the special emotional state. The research will focus on the relationships between ṭarab, khushūʿ, tajwīd, and mawwāl in Islamic-Arab culture in a way that has not been addressed previously. The relationships between tajwid and mawwāl, ṭarab and khushūʿ would be identified through the examination of musical factors, socio-cultural factors, and emotional factors.

Keywords: Arab music, Ṭarab, Mawwāl, Khushūʿ, Tajwīd, Islam

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Authors: Yael Rieder, Yael Gilboa, S. O. Adva, Efrat Halevi, Ronnie Tepper

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Background: Operation of ultrasound equipment is a core skill for many clinical specialties. As part of the training program at -Simultech- a simulation center for Ob\Gyn at the Meir Medical Center, Israel, teaching how to operate ultrasound equipment requires dealing with misunderstandings of spatial and 3D orientation, failure of the operator to hold a transducer correctly, and limited ability to evaluate the data on the screen. We have developed a platform intended to endow physicians and sonographers with clinical and operational skills of obstetric ultrasound. Simultech's simulations are focused on medical knowledge, risk management, technology operations and physician-patient communication. The simulations encompass extreme work conditions. Setup: Between eight and ten of the eight hundred and fifty physicians and sonographers of the Clalit health services from seven hospitals and eight community centers across Israel, participate in individual Ob/Gyn training sessions each week. These include Ob/Gyn specialists, experts, interns, and sonographers. Innovative teaching and training methodologies: The six-hour training program includes: (1) An educational computer program that challenges trainees to deal with medical questions based upon ultrasound pictures and films. (2) Sophisticated hands-on simulators that challenge the trainees to practice correct grip of the transducer, elucidate pathology, and practice daily tasks such as biometric measurements and analysis of sonographic data. (3) Participation in a video-taped simulation which focuses on physician-patient communications. In the simulation, the physician is required to diagnose the clinical condition of a hired actress based on the data she provides and by evaluating the assigned ultrasound films accordingly. Giving ‘bad news’ to the patient may put the physician in a stressful situation that must be properly managed. (4) Feedback at the end of each phase is provided by a designated trainer, not a physician, who is specially qualified by Ob\Gyn senior specialists. (5) A group exercise in which the trainer presents a medico-legal case in order to encourage the participants to use their own experience and knowledge to conduct a productive ‘brainstorming’ session. Medical cases are presented and analyzed by the participants together with the trainer's feedback. Findings: (1) The training methods and content that Simultech provides allows trainees to review their medical and communications skills. (2) Simultech training sessions expose physicians to both basic and new, up-to-date cases, refreshing and expanding the trainee's knowledge. (3) Practicing on advanced simulators enables trainees to understand the sonographic space and to implement the basic principles of ultrasound. (4) Communications simulations were found to be beneficial for trainees who were unaware of their interpersonal skills. The trainer feedback, supported by the recorded simulation, allows the trainee to draw conclusions about his performance. Conclusion: Simultech was found to contribute to physicians at all levels of clinical expertise who deal with ultrasound. A break in daily routine together with attendance at a neutral educational center can vastly improve performance and outlook.

Keywords: medical training, simulations, ultrasound, Simultech

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Authors: Dina Hadad

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Women empowerment in the Arab world remains a central issue in the context of development and human rights. Akin to many societies around the globe, gender equality is yet to be achieved. This research will provide an introduction into the current legal stand of some Arab countries in terms of gender equality and women rights in the context of family law. It will look specifically into the recent family law in Kuwait and why many women consider it a positive step towards affirming their rights and their needs. Depending on comparative material from the area, the research argues that whilst some countries made efforts to promote women’s empowerment as a concept and practice throughout its policies, others have indeed some unique journeys that reflect organic and from within evolutions. Nonetheless, these efforts are yet to reflect a comprehensive structure that addresses women legal and political empowerment let alone social status. A contradiction in the realities of different Arab states is nothing new since the lack of comprehensive rights-based policy making in Arab countries has contributed to the disconnect between economic growth and development challenges.

Keywords: women empowerment, cultural challenges, gender equality, Islamic law, international standards, family law

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Authors: Tamene Keneni, Tibebu Yohannes

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The prevalence of autism spectrum disorder (ASD) in general and autism in particular is on the rise globally, and the need for evidence-based intervention and care for children with autism has grown, too. However, evidence on autism is scanty in developing countries, including Ethiopia. With the aim to help fill the gap and paucity in research into the issue, the main purpose of this study is to explore, better understand, and document the experiences and perceptions of parents of children with autism. To this end, we used a qualitative survey to collect data from a convenient sample of parents raising a child with autism. The data collected were subjected to qualitative analysis that yielded several themes and subthemes, including late diagnosis, parents’ reactions to diagnosis, sources of information during and after diagnosis, differing reactions to having a child with autism from siblings, extended family members, and the larger community, attribution of autism to several causes by the community, lack of recognition and open discussion of autism and lack of appropriated public educational and health care services for children with autism and their parents. The themes and subthemes identified were discussed in light of existing literature, and implications for practice were drawn.

Keywords: ASD, autism, children with autism, raising children with autism

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Authors: Babak Darvish Rouhani, Mohd Nazri Mahrin, Fatemeh Nikpay, Pourya Nikfard, Maryam Khanian Najafabadi

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Enterprise Architecture (EA) is a strategy that is employed by enterprises in order to align their business and Information Technology (IT). EA is managed, developed, and maintained through Enterprise Architecture Implementation Methodology (EAIM). The effectiveness of EA implementation is the degree in which EA helps to achieve the collective goals of the organization. This paper analyzes the results of a survey that aims to explore the factors that affect the effectiveness of EAIM and specifically the relationship between factors and effectiveness of the output and functionality of EA project. The exploratory factor analysis highlights a specific set of five factors: alignment, adaptiveness, support, binding, and innovation. The regression analysis shows that there is a statistically significant and positive relationship between each of the five factors and the effectiveness of EAIM. Consistent with theory and practice, the most prominent factor for developing an effective EAIM is innovation. The findings contribute to the measuring the effectiveness of EA implementation project by providing an indication of the measurement implementation approaches which is used by the Enterprise Architects, and developing an effective EAIM.

Keywords: enterprise architecture, enterprise architecture implementation methodology, implementation methodology, factors, EA, effectiveness

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Authors: Devina Jain

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The choice between single-use drinking glasses and reusable glasses is of major concern to our lifestyles, and hence, the environment. This study is aimed at comparing three systems - a disposable paper cup, a disposable cup and a reusable stainless steel cup or glass - with respect to their effect on the environment to find out which one is more advantageous for reducing the impact on the environment. Life Cycle Assessment was conducted using modeling software, Umberto NXT Universal (Version 7.1). For the purpose of this study, the cradle to grave approach was considered. Results showed that cleaning is of a very strong influence on the environmental burden by these drinking systems, with a contribution of up to 90 to 100%. Thus, the burden is determined by the way in which the utensils are washed, and how much water is consumed. It maybe seems like a small, insignificant daily practice. In the short term, it would seem that paper and plastic cups are a better idea, since they are easy to acquire and do not need to be stored, but in the long run, we can say that steel cups will have less of an environmental impact. However, if the frequency of use and the number of glasses employed per use are of significance to decide the appropriateness of the usage, it is better to use disposable cups and glasses.

Keywords: disposable glass, life cycle assessment, paper, plastic, reusable glass, stainless steel

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Authors: Manirath Wongsim

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Information Quality (IQ) has become a critical, strategic issue in Accounting Information Systems (AIS) adoption. In order to implement AIS adoption successfully, it is important to consider the quality of information use throughout the adoption process, which seriously impacts the effectiveness of AIS adoption practice and the optimization of AIS adoption decisions. There is a growing need for research to provide insights into issues and solutions related to IQ in AIS adoption. The need for an integrated approach to improve IQ in AIS adoption, as well as the unique characteristics of accounting data, demands an AIS adoption specific IQ framework. This research aims to explore ways of managing information quality and AIS adoption to investigate the relationship between the IQ issues and AIS adoption process. This study has led to the development of a framework for understanding IQ management in AIS adoption. This research was done on 44 respondents as ten organisations from manufacturing firms in Thailand. The findings of the research’s empirical evidence suggest that IQ dimensions in AIS adoption to provide assistance in all process of decision making. This research provides empirical evidence that information quality of AIS adoption affect decision making and suggests that these variables should be considered in adopting AIS in order to improve the effectiveness of AIS.

Keywords: information quality, information quality dimensions, accounting information systems, accounting information system adoption

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Authors: Rosa Amalia Safitri, Ine van der Fels-Klerx, Henk Hogeveen

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Halal is a dietary law observed by people following Islamic faith. It is considered as a type of credence food quality which cannot be easily assured by consumers even upon and after consumption. Therefore, Halal certification takes place as a practical tool for the consumers to make an informed choice particularly in a non-Muslim majority country, including the Netherlands. Discrete choice experiment (DCE) was employed in this study for its ability to assess the importance of attributes attached to Halal beef in the Dutch market and to investigate consumer utilities. Furthermore, willingness to pay (WTP) for the desired Halal certification was estimated. Four most relevant attributes were selected, i.e., the slaughter method, traceability information, place of purchase, and Halal certification. Price was incorporated as an attribute to allow estimation of willingness to pay for Halal certification. There were 242 Muslim respondents who regularly consumed Halal beef completed the survey, from Dutch (53%) and non-Dutch consumers living in the Netherlands (47%). The vast majority of the respondents (95%) were within the age of 18-45 years old, with the largest group being student (43%) followed by employee (30%) and housewife (12%). Majority of the respondents (76%) had disposable monthly income less than € 2,500, while the rest earned more than € 2,500. The respondents assessed themselves of having good knowledge of the studied attributes, except for traceability information with 62% of the respondents considered themselves not knowledgeable. The findings indicated that slaughter method was valued as the most important attribute, followed by Halal certificate, place of purchase, price, and traceability information. This order of importance varied across sociodemographic variables, except for the slaughter method. Both Dutch and non-Dutch subgroups valued Halal certification as the third most important attributes. However, non-Dutch respondents valued it with higher importance (0,20) than their Dutch counterparts (0,16). For non-Dutch, the price was more important than Halal certification. The ideal product preferred by the consumers indicated the product serving the highest utilities for consumers, and characterized by beef obtained without pre-slaughtering stunning, with traceability info, available at Halal store, certified by an official certifier, and sold at 2.75 € per 500 gr. In general, an official Halal certifier was mostly preferred. However, consumers were not willing to pay for premium for any type of Halal certifiers, indicated by negative WTP of -0.73 €, -0.93 €, and -1,03€ for small, official, and international certifiers, respectively. This finding indicated that consumers tend to lose their utility when confronted with price. WTP estimates differ across socio-demographic variables with male and non-Dutch respondents had the lowest WTP. The unfamiliarity to traceability information might cause respondents to perceive it as the least important attribute. In the context of Halal certified meat, adding traceability information into meat packaging can serve two functions, first consumers can justify for themselves whether the processes comply with Halal requirements, for example, the use of pre-slaughtering stunning, and secondly to assure its safety. Therefore, integrating traceability info into meat packaging can help to make informed decision for both Halal status and food safety.

Keywords: consumer utilities, discrete choice experiments, Halal certification, willingness to pay

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Authors: Rajiv Mishra, Mantun Kumar Singh

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The role of educator or teacher in the Indian context is circumscribed by the objective of social transformation as articulated in the Indian National Movement and later enshrined in the Preamble to the Indian Constitution, in the Fundamental Rights and in the Directive Principles of State Policy. Extension, which is the additional dimension of professional practice among teachers at higher education can be used as a revolutionary tool to modify the existing slogan of ‘education for all’ to ‘education for all and for-ever’, thereby making the ‘life-long education’, a reality. This conceptual paper addresses the twin needs of preparing the students for individual growth as also to facilitate them to contribute to social development. It focuses on the inclusion of the measures required to be taken for providing social consciousness and sensitivity, as this happens to be a neglected part of the curriculum. The extra effort so needed to build community based activities presupposes the requirement for professional training to be given to the hospitality and tourism educators as a continuing education initiative.

Keywords: continuing education, extension activities, holistic curriculum, hospitality and tourism educators

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Authors: Manav Sabharwal, Ruda Rai Md, Candace Parker, James Ridley

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Wheat is one of the most commonly consumed grains worldwide, which contains gluten. Nowadays, gluten intake is considered to be a trigger for GRDs, including Celiac disease (CD), a common genetic disease affecting 1% of the US population, non-celiac gluten sensitivity (NCGS) and wheat allergy. NCGS is being recognized as an acquired gluten-sensitive enteropathy that is prevalent across age, ethnic and geographic groups. The cause of this entity is not fully understood, and recent studies suggest that it is more common in participants with irritable bowel syndrome (IBS), with iron deficiency anemia, symptoms of fatigue, and has considerable overlap in symptoms with IBS and Crohn’s disease. However, these studies were lacking in availability of complete serologies, imaging tests and/or pan-endoscopy. We performed a prospective study of 745 adult patients who presented to an outpatient clinic for evaluation of chronic upper gastro-intestinal symptoms and subsequently underwent an upper endoscopic (EGD) examination as standard of care. Evaluation comprised of comprehensive celiac antibody panel, inflammatory bowel disease (IBD) serologic markers, duodenal biopsies and Small Bowel Video Capsule Endoscopy (VCE), when available. At least 6 biopsy specimens were obtained from the duodenum and proximal jejunum during EGD, and CD3+ Intraepithelial lymphocytes (IELs) and villous architecture were evaluated by a single experienced pathologist, and VCE was performed by a single experienced gastroenterologist. Of the 745 patients undergoing EGD, 12% (93/745) patients showed elevated CD3+ IELs in the duodenal biopsies. 52% (387/745) completed a comprehensive CD panel and 7.2% (28/387) were positive for at least 1 CD antibody (Tissue transglutaminase (tTG), being the most common antibody in 65% (18/28)). Of these patients, 18% (5/28) showed increased duodenal CD3+ IELs, but 0% showed villous blunting or distortion to meet criteria for CD. Surprisingly, 43% (12/28) were positive for at 1 IBD serology (ASCA, ANCA or expanded IBD panel (LabCorp)). Of these 28 patients, 29% (8/28) underwent a SB VCE, of which 100 % (8/8) showed significant jejuno-ileal mucosal lesions diagnostic for IBD. Findings of abnormal CD antibodies (7.2%, 28/387) and increased CD3+ IELs on duodenal biopsy (12%, 93/745) were observed frequently in patients with UGI symptoms undergoing EGD in an outpatient clinic. None met criteria for CD, and a high proportion (43%, 12/28) showed evidence of overlap with IBD. This suggests a potential causal link of acquired GRDs to underlying inflammation and gut mucosal barrier disruption. Further studies to investigate a role for abnormal antigen presentation of dietary gluten to gut associated lymphoid tissue as a cause are justified. This may explain a high prevalence of GRDs in the population and correlation with IBS, IBD and other gut inflammatory disorders.

Keywords: celiac, gluten sensitive enteropathy, lymphocitic enteritis, IBS, IBD

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Authors: E. Wairimu Mwangi, Daniel Sarpong

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Background: Access to effective antiretroviral therapy in the United States has resulted in the rise in longevity in people living with HIV (PLHIV). Despite the progress, women living with HIV (WLWH) experience increasing rates of cardiometabolic disorders compared with their HIV-negative counterparts. Studies focusing on the predictors of metabolic disorders in this population have largely focused on the composite measure of metabolic syndrome (METs). This study seeks to identify the predictors of composite and individual METs factors in a nationally representative sample of WLWH. In particular, the study also examines the role of food security in predicting METs. Methods: The study comprised 1800 women, a subset of participants from the Women’s Interagency HIV Study (WIHS). The primary exposure variable, food security, was measured using the U.S. 10-item Household Food Security Survey Module. The outcome measures are the five metabolic syndrome indicators (elevated blood pressure [systolic BP > 130 mmHg and diastolic BP ≥ 85 mmHg], elevated fasting glucose [≥ 110 mg/dL], elevated fasting triglyceride [≥ 150 mg/dL], reduced HDL cholesterol [< 50 mg/dL], and waist circumference > 88 cm) and the composite measure - Metabolic Syndrome (METs) Status. Each metabolic syndrome indicator was coded one if yes and 0 otherwise. The values of the five indicators were summed, and participants with a total score of 3 or greater were classified as having metabolic syndrome. Participants classified as having metabolic syndrome were assigned a code of 1 and 0 otherwise for analysis. The covariates accounted for in this study fell into sociodemographic factors and behavioral and health characteristics. Results: The participants' mean (SD) age was 47.1 (9.1) years, with 71.4% Blacks and 10.9% Whites. About a third (33.1%) had less than a high school (HS) diploma, 60.4% were married, 32.8% were employed, and 53.7% were low-income. The prevalence of worst dietary diversity, low, moderate, and high food security were 24.1%, 26.6%, 17.0%, and 56.4%, respectively. The correlate profile of the five individual METs factors plus the composite measure of METs differ significantly, with METs based on HDL having the most correlates (Age, Education, Drinking Status, Low Income, Body Mass Index, and Health Perception). Additionally, metabolic syndrome based on waist circumference was the only metabolic factor where food security was significantly correlated (Food Security, Age, and Body Mass Index). Age was a significant predictor of all five individual METs factors plus the composite METs measure. Except for METs based on Fasting Triglycerides, body mass index (BMI) was a significant correlate of the various measures of metabolic syndrome. Conclusion: High-density Lipoprotein (HDL) cholesterol significantly correlated with most predictors. BMI was a significant predictor of all METs factors except Fasting Triglycerides. Food insecurity, the primary predictor, was only significantly associated with waist circumference.

Keywords: blood pressure, food insecurity, fasting glucose, fasting triglyceride, high-density lipoprotein, metabolic syndrome, waist circumference, women living with HIV

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Authors: Sephora Jose

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Caste slavery was an exploitative human transactional system that prevailed in Kerala, the south-western state of India, till the late nineteenth century. In this particular system, more than ten untouchable/Dalit caste groups had been enslaved and transacted. Mainstream historiographies have subsumed caste slavery under caste servitude covering up the transactional aspect of the practice. However, there are communities in Kerala like Prathyaksha Raksha Daiva Sabha (The Divine Church of Visible Salvation) and Deva Jana Samajam (The Society of God’s People), who claim to be the descendants of the caste slaves. Being spiritual organizations, they engage with the historical reality of slavery through Dalit theology. Their theology is articulated through their oral narratives, including songs, stories, myths, and other cultural productions. This study seeks to understand how the descendants of slave castes in Kerala attempt alternative historiography through Dalit theology articulated in their cultural productions collected over fieldwork.

Keywords: caste slavery, Dalit theology, Dravidians, Deva Jana Samajam, Prathyaksha Raksha Daiva Sabha

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Authors: Luis Miguel Méndez Díaz

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In this article, a mathematics teaching-learning strategy will be presented, specifically differential calculus in one variable, in a fun and competitive space in which the action on the part of the student is manifested and not only the repetition of information on the part of the teacher. Said action refers to motivating, problematizing, summarizing, and coordinating a game of dominoes whose thematic cards are designed around the basic and main contents of differential calculus. The strategies for teaching this area are diverse and precisely the game of dominoes is one of the most used strategies in the practice of mathematics because it stimulates logical reasoning and mental abilities. The objective on this investigation is to identify the way in which the game of dominoes affects the learning and understanding of fundamentals concepts of differential calculus in one variable through experimentation carried out on students of the first semester of the School of Engineering and Sciences of the Technological Institute of Monterrey Campus Querétaro. Finally, the results of this study will be presented and the use of this strategy in other topics around mathematics will be recommended to facilitate logical and meaningful learning in students.

Keywords: collaborative learning, logical-mathematical intelligence, mathematical games, multiple intelligences

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