Search results for: professional path

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

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

Keywords: civil protection, earthquake, preparedness, volunteers

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Authors: Raúl García de la Cruz

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In the state of Hidalgo and to the vicinity to the state of Mexico, there is a network of people who also share a valley bordered by hills with agave landscape of cacti and shared a bond of building traditions inherited from pre-Hispanic times and according to their material resources, habits and needs have been adapted in time. Weather has played an important role in the way buildings and roofs are constructed. Throughout the centuries, the population has developed very sophisticated building techniques like the flat roof, made out of a layer of earth; that is usually identified as belonging to architecture of the desert, but it can also be found in other climates, such as semi-arid and even template climates. It is an example of a constructive logic applied efficiently to various cultures proving its thermal isolation. So far it has done a review and analysis of the use of the roof in different areas, from pre-Hispanic architecture to traditional Moroccan architecture , finding great similarities in the elements of the system to be incorporated into the contemporary architecture. The rescue of a lore that dissolves with the changing environment, depends in principle on the links created towards the use of environmental resources as the anchor of the people to retain and preserve a building tradition which has viability deep league with the possibility of obtaining the raw material from the immediate environment. The objective of the research is the documentation of existing earth flat roofs in the state of Hidalgo and Mexico, as evidence of the importance of constructive system and its historical value in the area, considering its environmental, social aspects, also understanding the process of transformation of public housing at the time replaced the traditional techniques for industrial materials on a path towards urbanization. So far it has done a review and analysis of the use of the roof in different areas, from pre-Hispanic architecture to traditional Moroccan architecture, finding great similarities in the elements of the system to be incorporated into the contemporary architecture. The rescue of a lore that dissolves with the changing environment, depends in principle on the links created towards the use of environmental resources as the anchor of the people to retain and preserve a building tradition which has viability deep league with the possibility of obtaining the raw material from the immediate environment.

Keywords: earth roof, low impact building system, sustainable architecture, vernacular architecture

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Authors: Betsy Hannam

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

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

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Authors: Dilek Dede

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

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

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

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

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

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Authors: Zaka Nisa, Farooq Sher

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

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

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Authors: Timothy E. Frank, Peter J. Amaddio, Elizabeth D. Decko, Alexis M. Tri, Darcy A. Farrell, Cole M. Landes

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Ultra high performance concrete (UHPC) is a class of cementitious composites with a relatively large percentage of cement generating high compressive strength. Additionally, UHPC contains disbursed fibers, which control crack width, carry the tensile load across narrow cracks, and limit spalling. These characteristics lend themselves to a wide range of structural applications when UHPC members are reinforced with longitudinal steel. Efficient use of fibers and longitudinal steel is required to keep lifecycle cost competitive in reinforced UHPC members; this requires full utilization of both the compressive and tensile qualities of the reinforced cementitious composite. The objective of this study is to investigate the shear response of steel-reinforced UHPC beams to guide design decisions that keep initial costs reasonable, limit serviceability crack widths, and ensure a ductile structural response and failure path. Five small-scale, reinforced UHPC beams were experimentally tested. Longitudinal steel, transverse steel, and casting direction were varied. Results indicate that an increase in transverse steel in short-spanned reinforced UHPC beams provided additional shear capacity and increased the peak load achieved. Beams with very large longitudinal steel reinforcement ratios did not achieve yield and fully utilized the tension properties of the longitudinal steel. Casting the UHPC beams from the end or from the middle affected load-carrying capacity and ductility, but image analysis determined the fiber orientation was not significantly different. It is believed the presence of transverse and longitudinal steel reinforcement minimized the effect of different UHPC casting directions. Results support recent recommendations in the literature suggesting a 1% fiber volume fraction is sufficient within UHPC to prevent spalling and provide compressive fracture toughness under extreme loading conditions.

Keywords: fiber orientation, reinforced ultra high performance concrete beams, shear, transverse steel

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Authors: Yusuf Bulale, Mark Prince, Geoff Tansley, Peter Brett

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Cochlear Implantation (CI) which became a routine procedure for the last decades is an electronic device that provides a sense of sound for patients who are severely and profoundly deaf. Today, cochlear implantation technology uses electrode array (EA) implanted manually into the cochlea. The optimal success of this implantation depends on the electrode technology and deep insertion techniques. However, this manual insertion procedure may cause mechanical trauma which can lead to a severe destruction of the delicate intracochlear structure. Accordingly, future improvement of the cochlear electrode implant insertion needs reduction of the excessive force application during the cochlear implantation which causes tissue damage and trauma. This study is examined tool-tissue interaction of large prototype scale digit embedded with distributive tactile sensor based upon cochlear electrode and large prototype scale cochlea phantom for simulating the human cochlear which could lead to small-scale digit requirements. The digit, distributive tactile sensors embedded with silicon-substrate was inserted into the cochlea phantom to measure any digit/phantom interaction and position of the digit in order to minimize tissue and trauma damage during the electrode cochlear insertion. The digit has provided tactile information from the digit-phantom insertion interaction such as contact status, tip penetration, obstacles, relative shape and location, contact orientation and multiple contacts. The tests demonstrated that even devices of such a relative simple design with low cost have a potential to improve cochlear implant surgery and other lumen mapping applications by providing tactile sensory feedback information and thus controlling the insertion through sensing and control of the tip of the implant during the insertion. In that approach, the surgeon could minimize the tissue damage and potential damage to the delicate structures within the cochlear caused by current manual electrode insertion of the cochlear implantation. This approach also can be applied to other minimally invasive surgery applications as well as diagnosis and path navigation procedures.

Keywords: cochlear electrode insertion, distributive tactile sensory feedback information, flexible digit, minimally invasive surgery, tool/tissue interaction

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Authors: G. T. Ntuli

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This paper critically examines the gender dynamics of a Zulu girl child in her religio-cultural context from the postcolonial feminist perspective. As one of the former colonized ethnic groups in the South African context, the Zulu tribe used to have particular and contextual religio-cultural ways of a girl’s upbringing. This included traditional and cultural norms that any member of the community could not infringe without serious repercussions from the community members. However, the postcolonial social position of a girl child within this community became ambiguous and unpredictable due to colonial changes that enhanced gender dynamics that propelled tribal communities into deeper patriarchal structures. In the empirical study conducted within the Zulu context, which investigated the retrieval of ubuntombi (virginity) as a Zulu cultural heritage, identity and sex education as a path to adulthood, it was found that a Zulu girl child’s social position is geared towards double oppression due to gender dynamics that she experiences in her lifetime. It is these gender dynamics that are examined in this paper from the postcolonial feminist perspective. These gender dynamics are at play from the birth of a girl child, developmental stage to puberty and marriage rituals. These rituals and religio-cultural practices are meant to shape and mold a ‘good woman’ in the Zulu cultural context but social gender inequality that elevates males over females propel women social status into life denying peripheral positions. Consequently, in the place of a ‘good woman’ in the communal view, an oppressed and dehumanized woman becomes the outcome of such gender dynamics, more often treated with contempt, despised and violated in many demeaning ways. These do not only leave women economically and socio-politically impoverished, but also having to face violence of all kinds such as domestic, emotional, sexual and gender-based violence that are increasingly becoming a scourge in some of the sub-Saharan African countries including South Africa. It is for this reason that this paper becomes significant, not only within the Zulu context where the research was conducted, but also in all the countries that practice and promote patriarchal tendencies in the name of religio-cultural practices. There is a need for a different outlook as to what it means to be a ‘good woman’ in the cultural context, because if the goodness of a woman is determined by life denying cultural practices, such practices need to be deconstructed and discarded.

Keywords: feminist, gender dynamics, postcolonial, religio-cultural, Zulu girl child

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Authors: Chih-Wen Fan

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

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

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Authors: Lara Al-Haddad, Mark Whittington

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

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

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Authors: Erika Takidah, Salina Kassim

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

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

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Authors: Angkayarkan Vinayakaselvi

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

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

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Authors: Sitaram Dahal

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

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

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

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

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

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

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

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

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Authors: Fleura Shkëmbi, Sevim Mustafa, Naim Fanaj

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

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

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Authors: Suehyun Cho, Darrell Harrington, Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Alex Kiselyov, Michael Shpigelmacher

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Bionaut Labs, LLC is developing a minimally invasive robotic microdevice designed to treat non-communicating hydrocephalus in both adult and pediatric patients. The device utilizes biocompatible microsurgical particles (Bionaut™) that are specifically designed to safely and reliably perform accurate fenestration(s) in the 3rd ventricle, aqueduct of Sylvius, and/or trapped intraventricular cysts of the brain in order to re-establish normal cerebrospinal fluid flow dynamics and thereby balance and/or normalize intra/intercompartmental pressure. The Bionaut™ is navigated to the target via CSF or brain tissue in a minimally invasive fashion with precise control using real-time imaging. Upon reaching the pre-defined anatomical target, the external driver allows for directing the specific microsurgical action defined to achieve the surgical goal. Notable features of the proposed protocol are i) Bionaut™ access to the intraventricular target follows a clinically validated endoscopy trajectory which may not be feasible via ‘traditional’ rigid endoscopy: ii) the treatment is microsurgical, there are no foreign materials left behind post-procedure; iii) Bionaut™ is an untethered device that is navigated through the subarachnoid and intraventricular compartments of the brain, following pre-designated non-linear trajectories as determined by the safest anatomical and physiological path; iv) Overall protocol involves minimally invasive delivery and post-operational retrieval of the surgical Bionaut™. The approach is expected to be suitable to treat pediatric patients 0-12 months old as well as adult patients with obstructive hydrocephalus who fail traditional shunts or are eligible for endoscopy. Current progress, including platform optimization, Bionaut™ control, and real-time imaging and in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of ovine models, will be discussed.

Keywords: Bionaut™, cerebrospinal fluid, CSF, fenestration, hydrocephalus, micro-robot, microsurgery

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Authors: Upasana G. Singh, Meera Gungea

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

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

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

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

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

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Authors: Galih Imaduddin

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

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

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Authors: Erkingul Soltanaeva, Omyrkhan Abdimanuly, Alua Temirbolat

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

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

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Authors: Noemia Bessa Vilela, Jose Caramelo Gomes

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

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

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Authors: Rehan Ullah

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The primary purpose of the study is to observe the relationship that exists between the organizational information technology (IT) capabilities and the organizational performance in China and Pakistan. Nations like China and Pakistan utilize modern techno-how to enhance their production endeavors. Therefore, making a wide-ranging comparison of the manufacturing services between China and Pakistan was chosen due to numerous reasons. One reason for carrying out this comparison is to determine how IT of the two countries enhances organizational competency on small and medium-sized manufacturing enterprises (SMEs). The study hypothesized that organizational IT capabilities (IT infrastructure, IT competence) have a positive influence on organizational performance and the strategic benefits of IT have a mediating effect on the relationship between IT capability and organizational performance. To investigate the relationship between IT capabilities and organizational performance, surveys were sent to managers of small, medium-sized manufacturing organizations located in the southwestern region, Sichuan province of China, and Pakistani companies, which are located in Islamabad, Lahore, and Karachi. These cities were selected as typical representatives of each country. Organizational performance has been measured in terms of profitability, organizational success, growth, market share, and innovativeness. Out of 400 surveys distributed to different manufacturing organizations, 303 usable and valid responses were received that are analyzed in this research. The data were examined using SPSS and Smart PLS computer software. The results of the study, including the descriptive statistics of each variable, are used. The outer model has been measured with considerations to content validity, discriminant validity, and convergent validity. The path coefficients among the constructs were also computed when analyzing the structural model using the bootstrapping technique. The analysis of data from both China and Pakistan yields an identical but unique result. The results show that IT infrastructure, IT competence, strategic benefits of IT are all correlated to the performance of the organizations. Moreover, strategic benefits of IT have been proved to mediate the relationship between IT capabilities and organization performance. The author, concerning the role of IT on the performance of an organization, highlights the different aspects as well as its benefits in an organization. The overall study concludes several implications for both managers and academicians. It also provides the limitations of the study and offers recommendations for future studies and practice.

Keywords: organizational performance, IT capabilities, IT infrastructure, IT competence, strategic benefits of IT, China, Pakistan

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

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

Keywords: characteristics, hidden curriculum, transformation, informal

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Authors: Ni Zhenyu

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A human settlement is defined as the social activities, social relationships and lifestyles generated within a certain territory, which is also relatively independent territorial living space and domain composed of common people. Along with the advancement of technology and the development of society, the idea, presented in traditional research, that human settlements are deemed as substantial organic integrity with strong autonomy, are more often challenged nowadays. Spatial form of human settlements is one of the most outstanding external expressions with its subjectivity and autonomy, nevertheless, the projections of social, economic activities on certain territories are even more significant. What exactly is the relationship between human beings and the spatial form of the settlements where they live in? a question worth thinking over has been raised, that if a new view, a spatial anthropological one , can be constructed to review and respond to spatial form of human settlements based on research theories and methods of cultural anthropology within the profession of architecture. This article interprets how the typical spatial form of human settlements in the basin area of Bac Giang Province is formed under the collective impacts of local social order, land use condition, topographic features, and social contracts. A particular case of the settlement in Sizhai Village, City of Zhuji, Zhejiang Province is chosen to study for research purpose. Spatial form of human settlements are interpreted as a modeled integrity affected corporately by dominant economy, social patterns, key symbol marks and core values, etc.. Spatial form of human settlements, being a structured existence, is a materialized, behavioral, and social space; it can be considered as a place where human beings realize their behaviors and a path on which the continuity of their behaviors are kept, also for social practice a territory where currant social structure and social relationships are maintained, strengthened and rebuilt. This article aims to break the boundary of understanding that spatial form of human settlements is pure physical space, furthermore, endeavors to highlight the autonomy status of human beings, focusing on their relationships with certain territories, their interpersonal relationships, man-earth relationships and the state of existence of human beings, elaborating the deeper connotation behind spatial form of human settlements.

Keywords: spatial anthropology, human settlement, spatial pattern, spatial structure

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Authors: Yasser Sanad, Thu Trang Dao

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Introduction: Implementing the One Health (OH) approach requires an integrated, interdisciplinary, and cross-sectoral methodology. OH is a key tool for developing and implementing programs and projects and includes developing ambitious policies that consider the common needs and benefits of human, animal, plant, and ecosystem health. OH helps humanity readjust its path to environmentally friendly and impartial sustainability. As co-leader of the Global Health Security Agenda’s Zoonotic Disease Action Package, Vietnam pioneered a strong OH approach to effectively address early waves of the COVID-19 outbreak in-country. Context and Aim: The repeated surges in COVID-19 in Vietnam challenged the capabilities of the national system and disclosed the gaps in multi-sectoral coordination and resilience. To address this, FHI 360 advocated for the standardization of the OH platform by government actors to increase the resiliency of the system during and post COVID-19. Methods: FHI 360 coordinated technical resources to develop and implement evidence-based OH policies, promoting high-level policy dialogue between the Ministries of Health, Agriculture, and the Environment, and policy research to inform developed policies and frameworks. Through discussions, an OH-building Partnership (OHP) was formed, linking climate change, the environment, and human and animal health. Findings: The OHP Framework created a favorable policy environment within and between sectors, as well as between governments and international health security partners. It also promoted strategic dialogue, resource mobilization, policy advocacy, and integration of international systems with National Steering Committees to ensure accountability and emphasize national ownership. Innovative contribution to policy, practice and/or research: OHP was an effective evidence-based research-to-policy platform linking to the National One Health Strategic Plan (2021-2025). Collectively they serve as a national framework for the implementation and monitoring of OH activities. Through the adoption of policies and plans, the risk of zoonotic pathogens, environmental agent spillover, and antimicrobial resistance can be minimized through strengthening multi-sectoral OH collaboration for health security.

Keywords: one health, national policies, health security, COVID-19, Vietnam

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

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

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

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Authors: Salwa Obeisat

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

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

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

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

Keywords: ACLR-coactivation, dynamometry, electromyography, isokinetic

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