Search results for: inclusion programs
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3923

Search results for: inclusion programs

1463 The Urban Expansion Characterization of the Bir El Djir Municipality using Remote Sensing and GIS

Authors: Fatima Achouri, Zakaria Smahi

Abstract:

Bir El Djir is an important coastal township in Oran department, located at 450 Km far away from Algiers on northwest of Algeria. In this coastal area, the urban sprawl is one of the main problems that reduce the limited highly fertile land. So, using the remote sensing and GIS technologies have shown their great capabilities to solve many earth resources issues. The aim of this study is to produce land use and cover map for the studied area at varied periods to monitor possible changes that may occurred, particularly in the urban areas and subsequently predict likely changes. For this, two spatial images SPOT and Landsat satellites from 1987 and 2014 respectively were used to assess the changes of urban expansion and encroachment during this period with photo-interpretation and GIS approach. The results revealed that the town of Bir El Djir has shown a highest growth rate in the period 1987-2014 which is 521.1 hectares in terms of area. These expansions largely concern the new real estate constructions falling within the social and promotional housing programs launched by the government. Indeed, during the last census period (1998 -2008), the population of this town has almost doubled from 73 029 to 152 151 inhabitants with an average annual growth of 5.2%. This also significant population growth is causing an accelerated urban expansion of the periphery which causing its conurbation with the towns of Oran in the West side. The most urban expansion is characterized by the new construction in the form of spontaneous or peripheral precarious habitat, but also unstructured slums settled especially in the southeastern part of town.

Keywords: urban expansion, remote sensing, photo-interpretation, spatial dynamics

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1462 Promotion of a Healthy City by Medical Plants

Authors: Ana M. G. Sperandio, Adriana A. C. Rosa, Jussara C. Guarnieri

Abstract:

This study consists of a research of the Post Occupancy Assessment (POA) of Medicinal Gardens' project of Urban Social Center’s square, in the city of 'Santa Barbara d'Oeste', located in the interior of Sao Paulo, Brazil. In view of the fact that community gardens, as well as medicinal gardens, are based on innumerable functions. The addition to the pedagogical function rescues people from their origins through (re)contact with the land, as a vehicle for social integration. Bearing in mind the project has the potential to fight hunger among the low-income population, to treat some diseases, also works as a strategy of environmental recovery especially of idle land. Such as very often only accumulate weeds and garbage, and therefore, must be considered in the Municipal Master Plan for the activity to be regulated. Objective: Identify on implantation the medicinal plants' value and principles for the promotion of a healthy city. Methodology: Application of the walkthrough, where it is possible to affirm that this instrument has three routes: one officer applied within the urban social center and two complementary ones, one being about 3 miles and the other being almost 5,5 miles. Results: Through a dialogical course, one can observe the benefits that the community medicinal gardens bring to the local population. In addition, it is consistent with the proposal for the community to be enabled to access collective care with home orientations that rescue the local and regional culture making the physical environment. This project aims at promoting more pleasant and inclusive through the actions of the caregiver, local leadership and the co-participation of local government. Although with the aim of increasing the supply value and improving the living conditions of social groups and interrelationship. Conclusion: This type of urban intervention, which articulates social participation, rescue of medicinal cultures and local knowledge, intersectoriality, social inclusion, among other premises connected with health promotion, and the city presents a potential for reverberation of practices in social networks with the objective of meeting the healthy city strategies.

Keywords: healthy city, healthy urban planning, medicinal gardens, social participation

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1461 Parent’s Evaluation of the Services Offered to Their Children with Autism in UAE Centres

Authors: Mohammad Ali Fteiha, Ghanem Al Bustami

Abstract:

The study aimed to identify the assessment of parents of children with Autism for services provided by the Center for special care in the United Arab Emirates, in terms of quality, comprehensive and the impact of some factors related to the diagnosis and place of service provision and efficient working procedures of service and the child age. In order to achieve the objective of the study, researchers used Parent’s Satisfaction Scale, and Parents Evaluation of Services Effectiveness, both the scale and the parents reports provided with accepted level of validity and reliability. Sample includes 300 families of children with Autism receiving educational and rehabilitation services, treatment and support services in both governmental and private centers in United Arab Emirates. ANOVA test was used through SPSS program to analyze the collected data. The results of the study have indicated that there are significant differences in the assessment of services provided by centers due to a place of service, the nature of the diagnosis, child's age at the time of the study, as well as statistically significance differences due to age when first diagnosed. The results also showed positive evaluation for the good level of services as international standard, and the quality of these services provided by autism centers in the United Arab Emirates, especially in governmental centers. At the same time, the results showed the presence of many needs problems faced by the parents do not have appropriate solutions. Based on the results the recommendations were stated.

Keywords: autism, evaluation, diagnosis, parents, autism programs, supportive services, government centers, private centers

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1460 Quantitative, Qualitative, and Technological Challenges for Higher Education in Jordan Critical Analytical Study

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

Abstract:

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

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

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1459 Quantitative, Qualitative, and Technological Challenges for Higher Education in Jordan Critical Analytical Study

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

Abstract:

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

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

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1458 The Higher Education System in Jordan: Philosophy and Premises Preparation

Authors: Ihsan Orsan Oglah Elrabbaei

Abstract:

This research stems from the philosophy of education notion, as it is a fundamental pillar within or component of the philosophy of education. It is the general framework that society takes towards the future in order to build its integrated educational system amid the variables that surround it, in order to prepare its members in all aspects of cognitive, skill, and behavioral life, so that there is a clear concept of the system of productive values, according to the vision of philosophy that defines its future roles, which can be found in the system of productive values. With the resignation, everything changes. As a result, the philosophy of education is anticipated to evolve in response to perceived changes in society in terms of the nature of its human and material resources. The study will answer the following questions: Has the philosophy of education changed to accommodate this change? Alternatively, is the change that occurs because of natural growth without education having a role in directing this change and being aware of it in order to fit with national, regional, and global changes? Were the national educational goals and curricula and their programs viewed through the lenses of interest? On the other hand, do things happen without realizing that the philosophy of education has changed and that it proceeds according to the natural rolling of the invisible impulse? The study concluded that we must reconsider the philosophy of education and redefine who is an educated person. In addition, to recognize all the values of the roles that the individual can play in his society, according to his abilities, and with respect. Moreover, building a new philosophy of education based on what society can look at and what it wants from a flexible future takes the concept of changing life values, their contents, diversity, and the roles of each individual in them.

Keywords: higher education system, jordan, philosophy, premises preparation.

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1457 The Common Location and the Intensity of Surface Electrical Stimulation on the Thorax and Abdomen Areas: A Systematic Review

Authors: Vu Hoang Thu Huong

Abstract:

Background: Surface electrical stimulation (SES) is a popular non-invasive approach that offers a wide range of treatments for many diseases of physical therapy. It involves applying electrical stimulation to the skin via surface electrodes to stimulate nerve fibers. SES was regularly used to treat the back and upper or lower extremities, but it was rarely used to treat the chest and abdomen. SES on the thorax and abdomen should be administered with more attention because crucial organs are under those areas (i.e., heart, lungs, liver, etc.). In these areas, safety precautions are suggested, and some SES applications might even be a contraindication. The fact that physical therapists have less experience with SES in these situations can also be attributed to these. Although a few earlier studies applied it to these settings and discovered hopeful results, none of them highlight the relationship between the intensity of SES and its depth of impact for safety considerations. Objective: To assure feasibility when using SES in these areas, the purpose of this study is to summarize the common location and intensity of those areas that have been conducted in previous studies. Method: A thorough systematic review was conducted to determine the common surface electrode position for the thorax and abdomen areas. The studies with the randomized controlled design were systematically searched using inclusion and exclusion criteria through nine electronic databases, including Pubmed, Scopus, etc., between 1975 and Dec 2021. Results: Thirty-three studies with over 1800 participants and 4 types of SES (TENS, IFC, NMES, and FES) with various categories of department hospitals were found. Following an anterior, lateral, and posterior observation, the particular SES positions found that it concentrated on 6 regions (the thoracic, abdomen, upper lateral, lower lateral, upper back, and lower back regions), and its intensity for each region was also summarized. Conclusion: This systematic review figured out the popular locations of SES in the thorax and abdominal areas as well as a summarized maximum of intensity that was found in previous studies with outstanding outcomes.

Keywords: surface electrical stimulation, electrical stimulation, thoracic, abdomen, abdominal.

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1456 Re-Stating the Origin of Tetrapod Using Measures of Phylogenetic Support for Phylogenomic Data

Authors: Yunfeng Shan, Xiaoliang Wang, Youjun Zhou

Abstract:

Whole-genome data from two lungfish species, along with other species, present a valuable opportunity to re-investigate the longstanding debate regarding the evolutionary relationships among tetrapods, lungfishes, and coelacanths. However, the use of bootstrap support has become outdated for large-scale phylogenomic data. Without robust phylogenetic support, the phylogenetic trees become meaningless. Therefore, it is necessary to re-evaluate the phylogenies of tetrapods, lungfishes, and coelacanths using novel measures of phylogenetic support specifically designed for phylogenomic data, as the previous phylogenies were based on 100% bootstrap support. Our findings consistently provide strong evidence favoring lungfish as the closest living relative of tetrapods. This conclusion is based on high internode certainty, relative gene support, and high gene concordance factor. The evidence stems from five previous datasets derived from lungfish transcriptomes. These results yield fresh insights into the three hypotheses regarding the phylogenies of tetrapods, lungfishes, and coelacanths. Importantly, these hypotheses are not mere conjectures but are substantiated by a significant number of genes. Analyzing real biological data further demonstrates that the inclusion of additional taxa leads to more diverse tree topologies. Consequently, gene trees and species trees may not be identical even when whole-genome sequencing data is utilized. However, it is worth noting that many gene trees can accurately reflect the species tree if an appropriate number of taxa, typically ranging from six to ten, are sampled. Therefore, it is crucial to carefully select the number of taxa and an appropriate outgroup, such as slow-evolving species, while excluding fast-evolving taxa as outgroups to mitigate the adverse effects of long-branch attraction and achieve an accurate reconstruction of the species tree. This is particularly important as more whole-genome sequencing data becomes available.

Keywords: novel measures of phylogenetic support for phylogenomic data, gene concordance factor confidence, relative gene support, internode certainty, origin of tetrapods

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1455 Households’ Willingness to Pay for Watershed Management Practices in Lake Hawassa Watershed, Southern Ethiopia

Authors: Mulugeta Fola, Mengistu Ketema, Kumilachew Alamerie

Abstract:

Watershed provides vast economic benefits within and beyond the management area of interest. But most watersheds in Ethiopia are increasingly facing the threats of degradation due to both natural and man-made causes. To reverse these problems, communities’ participation in sustainable management programs is among the necessary measures. Hence, this study assessed the households’ willingness to pay for watershed management practices through a contingent valuation study approach. Double bounded dichotomous choice with open-ended follow-up format was used to elicit the households’ willingness to pay. Based on data collected from 275 randomly selected households, descriptive statistics results indicated that most households (79.64%) were willing to pay for watershed management practices. A bivariate Probit model was employed to identify determinants of households’ willingness to pay and estimate mean willingness to pay. Its result shows that age, gender, income, livestock size, perception of watershed degradation, social position, and offered bids were important variables affecting willingness to pay for watershed management practices. The study also revealed that the mean willingness to pay for watershed management practices was calculated to be 58.41 Birr and 47.27 Birr per year from the double bounded and open-ended format, respectively. The study revealed that the aggregate welfare gains from watershed management practices were calculated to be 931581.09 Birr and 753909.23 Birr per year from double bounded dichotomous choice and open-ended format, respectively. Therefore, the policymakers should make households to pay for the services of watershed management practices in the study area.

Keywords: bivariate probit model, contingent valuation, watershed management practices, willingness to pay

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1454 The Effectiveness of Using Functional Rehabilitation with Children of Cerebral Palsy

Authors: Bara Yousef

Abstract:

The development of independency and functional participation is an important therapeutic goal for many children with cerebral palsy,They was many therapeutic approach have been used for treatment those children like neurodevelopment treatment, balance training strengthening and stretching exercise. More recently, therapy for children with cerebral palsy has focused on achieving functional goals using task-oriented interventions and summer camping model, which focus on activities that relevant and meaningful to the child, to learn more efficient and effective motor skills. We explore the effectiveness of using functional rehabilitation comparing with regular rehabilitation among 40 Saudi children with cerebral palsy in pediatric unit at Sultan Bin Abdul Aziz Humanitarian City-Ksa ,where 20 children randomly assign in control group who received rehabilitation based on regular therapy approach and other 20 children assign on experiment group who received rehabilitation based on functional therapy approach with an average of 45min OT treatment and 45 min PT treatment- daily within a period of 6 week. Our finding reported that children in experiment group has improved in gross motor function with an average from 49.4 to 57.6 based on GMFM 66 as primary outcome measure and improved in WeeFIM with an average from 52 to 62 while children in control group has improved with an average from 48.4 to 53.7 in GMFM and from 53 to and 58 in WeeFIM. Consequently, there has been growing interest in determining the effects of functional training programs as promising approach for these children.

Keywords: Cerebral Palsy (CP), gross motor function measure (GMFM66), pediatric Functional Independent Measure (WeeFIM), rehabilitation, disability

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1453 On Cold Roll Bonding of Polymeric Films

Authors: Nikhil Padhye

Abstract:

Recently a new phenomenon for bonding of polymeric films in solid-state, at ambient temperatures well below the glass transition temperature of the polymer, has been reported. This is achieved by bulk plastic compression of polymeric films held in contact. Here we analyze the process of cold-rolling of polymeric films via finite element simulations and illustrate a flexible and modular experimental rolling-apparatus that can achieve bonding of polymeric films through cold-rolling. Firstly, the classical theory of rolling a rigid-plastic thin-strip is utilized to estimate various deformation fields such as strain-rates, velocities, loads etc. in rolling the polymeric films at the specified feed-rates and desired levels of thickness-reduction(s). Predicted magnitudes of slow strain-rates, particularly at ambient temperatures during rolling, and moderate levels of plastic deformation (at which Bauschinger effect can be neglected for the particular class of polymeric materials studied here), greatly simplifies the task of material modeling and allows us to deploy a computationally efficient, yet accurate, finite deformation rate-independent elastic-plastic material behavior model (with inclusion of isotropic-hardening) for analyzing the rolling of these polymeric films. The interfacial behavior between the roller and polymer surfaces is modeled using Coulombic friction; consistent with the rate-independent behavior. The finite deformation elastic-plastic material behavior based on (i) the additive decomposition of stretching tensor (D = De + Dp, i.e. a hypoelastic formulation) with incrementally objective time integration and, (ii) multiplicative decomposition of deformation gradient (F = FeFp) into elastic and plastic parts, are programmed and carried out for cold-rolling within ABAQUS Explicit. Predictions from both the formulations, i.e., hypoelastic and multiplicative decomposition, exhibit a close match. We find that no specialized hyperlastic/visco-plastic model is required to describe the behavior of the blend of polymeric films, under the conditions described here, thereby speeding up the computation process .

Keywords: Polymer Plasticity, Bonding, Deformation Induced Mobility, Rolling

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1452 The Impact of Equine-Assisted Therapy on Occupational Engagement for Children with Intellectual and/or Developmental Disabilities: From the Perspectives of the Children and Their Caregivers

Authors: Morgan Dempsey, Sam Lewis, Maggie Pierce, Alex Goodman

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This research investigates the impact of equine-assisted therapy programs on occupational engagement for children with intellectual and developmental disabilities. There is a general lack of evidence for equine-based services for this population, so this research aims to decrease gaps in the current literature. To gain comprehensive insight, data will be collected from both the child and their caregiver. This study takes a qualitative approach utilizing online surveys and in-person guided interviews. The participants are individuals ages 4-17 with a diagnosed intellectual or developmental disability who are currently participating in a PATH int. certified equine-assisted therapy program. Also, caregivers of individuals who meet this criterion are included. This study decreases gaps in the literature by providing comprehensive data regarding the impacts of these services on occupational engagement. The addressed domains are physical, behavioral, emotional, and social functioning, as well as overall activity engagement and impacts in everyday life. With a better understanding of how equine-assisted therapy affects relevant outcomes for children with disabilities, an increased number of occupational therapists can implement these uniquely effective services while adhering to standards of evidence-based practice. Ultimately, this research strives to contribute to generalizable data in occupational therapy by supporting the implementation of equine-assisted services for children with intellectual and/or developmental disabilities and their caregivers/families.

Keywords: occupational therapy, pediatric, rehabilitation, hippotherapy

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1451 Developmental Trajectories and Predictors of Adolescent Depression: A Short Term Study

Authors: Hyang Lim, Sungwon Choi

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Many previous studies in area of adolescents' depression have used a longitudinal design. The previous studies have found that the developmental trajectory of them is only one. But it needs to be examined whether the trajectory is applied to all adolescents. Some factors in their home and/or school have an effect on adolescents' depression and more likely to be specific groups. The present study was a longitudinal study aimed to identify the trajectories and to explore the predictors of adolescents' depression. The study used Korean Children and Youth Panel Survey (KCYPS) data. In this study, 2,351 second and third-year of middle school and first of high school students' data was analyzed by using semi-parametric group modeling (SGM). There were 5 trajectory groups for adolescents; low depressed stables, low depressed risers, moderately depressed decreases, moderately depressed stables, severe depressed decreases. The predictors of adolescents' depression were parental abuse, parental neglect, annual family income, parental academic background, friendship at school, and teacher-student relationship at school. All predictors had the significant difference across trajectory group profile for adolescents. The findings of the present study recommend to promote the socioeconomic status and to train social skill for the interpersonal relationship at the home and school. And the results suggest that the proper prevention programs for each group in the middle adolescents that target selected factors may be helpful in reducing the level of depression.

Keywords: adolescent, depression, KCYPS, school life, semi-parametric group-based modeling

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1450 Translanguaging and Cross-languages Analyses in Writing and Oral Production with Multilinguals: a Systematic Review

Authors: Maryvone Cunha de Morais, Lilian Cristine Hübner

Abstract:

Based on a translanguaging theoretical approach, which considers language not as separate entities but as an entire repertoire available to bilingual individuals, this systematic review aimed at analyzing the methods (aims, samples investigated, type of stimuli, and analyses) adopted by studies on translanguaging practices associated with written and oral tasks (separately or integrated) in bilingual education. The PRISMA criteria for systematic reviews were adopted, with the descriptors "translanguaging", "bilingual education" and/or “written and oral tasks" to search in Pubmed/Medline, Lilacs, Eric, Scopus, PsycINFO, and Web of Science databases for articles published between 2017 and 2021. 280 registers were found, and after following the inclusion/exclusion criteria, 24 articles were considered for this analysis. The results showed that translanguaging practices were investigated on four studies focused on written production analyses, ten focused on oral production analysis, whereas ten studies focused on both written and oral production analyses. The majority of the studies followed a qualitative approach, while five studies have attempted to study translanguaging with quantitative statistical measures. Several types of methods were used to investigate translanguaging practices in written and oral production, with different approaches and tools indicating that the methods are still in development. Moreover, the findings showed that students’ interactions have received significant attention, and studies have been developed not just in language classes in bilingual education, but also including diverse educational and theoretical contexts such as Content and Language Integrated Learning, task repetition, Science classes, collaborative writing, storytelling, peer feedback, Speech Act theory and collective thinking, language ideologies, conversational analysis, and discourse analyses. The studies, whether focused either on writing or oral tasks or in both, have portrayed significant research and pedagogical implications, grounded on the view of integrated languages in bi-and multilinguals.

Keywords: bilingual education, oral production, translanguaging, written production

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1449 Implementing Biogas Technology in Rural Areas of Limpopo: Analysis of Gawula, Mopani District in South Africa

Authors: Thilivhali E. Rasimphi, David Tinarwo

Abstract:

Access to energy is crucial in poverty alleviation, economic growth, education, and agricultural improvement. The best renewable energy source is one which is locally available, affordable, and can easily be used and managed by local communities. The usage of renewable energy technology has the potential to alleviate many of the current problems facing rural areas. To address energy poverty, biogas technology has become an important part of resolving such. This study, therefore, examines the performance of digesters in Gawula village; it also identifies the contributing factors to the adoption and use of the technology. Data was collected using an open-ended questionnaire from biogas users. To evaluate the performance of the digesters, a data envelopment analysis (DEA) non-parametric technique was used, and to identify key factors affecting adoption, a logit model was applied. The reviewed critical barriers to biogas development in the area seem to be a poor institutional framework, poor infrastructure, a lack of technical support, user training on maintenance and operation, and as such, the implemented plants have failed to make the desired impact. Thus most digesters were abandoned. To create awareness amongst rural communities, government involvement is key, and there is a need for national programs. Biogas technology does what few other renewable energy technologies do, which is to integrate waste management and energy. This creates a substantial opportunity for biogas generation and penetration. That is, a promising pathway towards achieving sustainable development through biogas technology.

Keywords: domestic biogas technology, economic, sustainable, social, rural development

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1448 Revealing of the Wave-Like Process in Kinetics of the Structural Steel Radiation Degradation

Authors: E. A. Krasikov

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Dependence of the materials properties on neutron irradiation intensity (flux) is a key problem while usage data of the accelerated materials irradiation in test reactors for forecasting of their capacity for work in realistic (practical) circumstances of operation. Investigations of the reactor pressure vessel steel radiation degradation dependence on fast neutron fluence (embrittlement kinetics) at low flux reveal the instability in the form of the scatter of the experimental data and wave-like sections of embrittlement kinetics appearance. Disclosure of the steel degradation oscillating is a sign of the steel structure cyclic self-recovery transformation as it take place in self-organization processes. This assumption has received support through the discovery of the similar ‘anomalous’ data in scientific publications and by means of own additional experiments. Data obtained stimulate looking-for ways to management of the structural steel radiation stability (for example, by means of nano - structure modification for radiation defects annihilation intensification) for creation of the intelligent self-recovering material. Expected results: - radiation degradation theory and mechanisms development, - more adequate models of the radiation embrittlement elaboration, - surveillance specimen programs improvement, - methods and facility development for usage data of the accelerated materials irradiation for forecasting of their capacity for work in realistic (practical) circumstances of operation, - search of the ways for creating of the radiation stable self-recovery intelligent materials.

Keywords: degradation, radiation, steel, wave-like kinetics

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1447 Effectiveness of Technology Enhanced Learning in Orthodontic Teaching

Authors: Mohammed Shaath

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Aims Technological advancements in teaching and learning have made significant improvements over the past decade and have been incorporated in institutions to aid the learner’s experience. This review aims to assess whether Technology Enhanced Learning (TEL) pedagogy is more effective at improving students’ attitude and knowledge retention in orthodontic training than traditional methods. Methodology The searches comprised Systematic Reviews (SRs) related to the comparison of TEL and traditional teaching methods from the following databases: PubMed, SCOPUS, Medline, and Embase. One researcher performed the screening, data extraction, and analysis and assessed the risk of bias and quality using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2). Kirkpatrick’s 4-level evaluation model was used to evaluate the educational values. Results A sum of 34 SRs was identified after the removal of duplications and irrelevant SRs; 4 fit the inclusion criteria. On Level 1, students showed positivity to TEL methods, although acknowledging that the harder the platforms to use, the less favourable. Nonetheless, the students still showed high levels of acceptability. Level 2 showed there is no significant overall advantage of increased knowledge when it comes to TEL methods. One SR showed that certain aspects of study within orthodontics deliver a statistical improvement with TEL. Level 3 was the least reported on. Results showed that if left without time restrictions, TEL methods may be advantageous. Level 4 shows that both methods are equally as effective, but TEL has the potential to overtake traditional methods in the future as a form of active, student-centered approach. Conclusion TEL has a high level of acceptability and potential to improve learning in orthodontics. Current reviews have potential to be improved, but the biggest aspect that needs to be addressed is the primary study, which shows a lower level of evidence and heterogeneity in their results. As it stands, the replacement of traditional methods with TEL cannot be fully supported in an evidence-based manner. The potential of TEL methods has been recognized and is already starting to show some evidence of the ability to be more effective in some aspects of learning to cater for a more technology savvy generation.

Keywords: TEL, orthodontic, teaching, traditional

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1446 Absolute Lymphocyte Count as Predictor of Pneumocystis Pneumonia in Patients With Unknown HIV Status at a Private Tertiary Hospital

Authors: Marja A. Bernardo, Coreena A. Bueser, Cybele Lara R. Abad, Raul V. Destura

Abstract:

Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection among people with HIV. Early consideration of PCP should be made even in patients whose HIV status is unknown as delay in treatment may be fatal. The use of absolute lymphocyte count (ALC) has been suggested as an alternative predictor of PCP especially in resource limited settings where PCR testing is costly or delayed. Objective: To determine whether the absolute lymphocyte count (ALC) can be used as a screening tool to predict Pneumocystis pneumonia in patients with unknown HIV status admitted at a private tertiary hospital. Methods: A retrospective cross-sectional study was conducted at a private tertiary medical center. Inpatient medical records of patients aged 18 years old and above from January 2012 to May 2014, in whom a clinical diagnosis of Pneumocystis jirovecii pneumonia was made were reviewed for inclusion. Demographic data, clinical features, hospital course, PCP PCR and HIV results were recorded. Independent t-test and chi-square analysis was used to determine any statistical difference between PCP-positive and PCP-negative groups. Mann-Whitney U-test was used for comparison of hospital stay. Results: There were no statistically significant differences in baseline characteristics between PCP positive and negative groups. While both the percent lymphocyte count (0.14 ± 0.13 vs 0.21 ± 0.16) and ALC (1160 ± 528.67 vs 1493.70 ± 988.61) were lower for the PCP-positive group, only the percent lymphocyte count reached a statistically significant difference (p= 0.067 vs p= 0.042). Conclusion: A quick determination of the ALC may be useful as an additional parameter to help screen for and diagnose pneumocystis pneumonia. In our study, the ALC of patients with PCP appear to be lower than in patients without PCP. A low ALC (e.g. below 1200) may help with the decision regarding empiric treatment. However, it should be used in conjunction with the patient’s clinical presentation, as well as other diagnostic tests. Larger, prospective studies incorporating the ALC with other clinical predictors are necessary to optimally predict those who would benefit from empiric or expedited management for potential PCP.

Keywords: Pneumocystis carinii pneumonia, Absolute Lymphocyte Count, infection, PCP

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1445 Bayesian Inference of Physicochemical Quality Elements of Tropical Lagoon Nokoué (Benin)

Authors: Hounyèmè Romuald, Maxime Logez, Mama Daouda, Argillier Christine

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In view of the very strong degradation of aquatic ecosystems, it is urgent to set up monitoring systems that are best able to report on the effects of the stresses they undergo. This is particularly true in developing countries, where specific and relevant quality standards and funding for monitoring programs are lacking. The objective of this study was to make a relevant and objective choice of physicochemical parameters informative of the main stressors occurring on African lakes and to identify their alteration thresholds. Based on statistical analyses of the relationship between several driving forces and the physicochemical parameters of the Nokoué lagoon, relevant Physico-chemical parameters were selected for its monitoring. An innovative method based on Bayesian statistical modeling was used. Eleven Physico-chemical parameters were selected for their response to at least one stressor and their threshold quality standards were also established: Total Phosphorus (<4.5mg/L), Orthophosphates (<0.2mg/L), Nitrates (<0.5 mg/L), TKN (<1.85 mg/L), Dry Organic Matter (<5 mg/L), Dissolved Oxygen (>4 mg/L), BOD (<11.6 mg/L), Salinity (7.6 .), Water Temperature (<28.7 °C), pH (>6.2), and Transparency (>0.9 m). According to the System for the Evaluation of Coastal Water Quality, these thresholds correspond to” good to medium” suitability classes, except for total phosphorus. One of the original features of this study is the use of the bounds of the credibility interval of the fixed-effect coefficients as local weathering standards for the characterization of the Physico-chemical status of this anthropized African ecosystem.

Keywords: driving forces, alteration thresholds, acadjas, monitoring, modeling, human activities

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1444 Effectiveness of Office-Based Occupational Therapy for Office Workers with Low Back Pain: A Public Health Approach

Authors: Dina Jalalvand, Joshua A. Cleland

Abstract:

This double-blind, randomized control trial with parallel groups aimed to examine the effectiveness of office-based occupational therapy for office workers with low back pain on the intensity of pain and range of motion. Seventy-two male office workers (age: 20-50 years) with chronic low back pain (more than three months with at least two symptoms of chronic low back pain) satisfied eligibility criteria and agreed to participate in this study. The absence of joint burst following magnetic resonance imagining (MRI) was considered as an important inclusion criterion as well. Subjects were randomly assigned to a control or experimental group. The experimental group received the modified package of exercise-based occupational therapy, which included 11 simple exercise movements (derived from Williams and McKenzie), and the control group just received the conventional therapy, which included their routine physiotherapy sessions. The subjects completed the exercises three times a week for a duration of six weeks. Each exercise session was 10-15 minutes. Pain intensity and range of motion were the primary outcomes and were measured at baseline, 6 weeks, and 12 weeks after the end of the intervention using the numerical rating scale (NRS) and goniometer accordingly. Repeated measure ANOVA was used for analyzing data. The results of this study showed that significant decreases in pain intensity (p ≤ 0.05) and an increase in range of motion (p ≤ 0.001) in the experimental group in comparison with the control group after 6 and 12 weeks of intervention (between-group comparisons). In addition, there was a significant decrease in intensity of the pain (p ≤ 0.05) and an increase (p ≤ 0.001) in range of motion in the intervention group in comparison with baseline after 6 and 12 weeks (within-group comparison). This showed a positive effect of exercise-based occupational therapy that could potentially be used with low cost among office workers who suffer from low back pain. In addition, it should be noted that the introduced package of exercise training is easy to do, and there is not a need for a specific introduction.

Keywords: public health, office workers, low back pain, occupational therapy

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1443 Fostering Social Challenges Within Entrepreneur University Systems: The Case of UPV

Authors: Cristobal Miralles Insa

Abstract:

The network of chairs of the "Valencian Public System of Social Services" (VPSSS) is sponsored by the Valencian Institute of Training, Research, and Quality in Social Services and aims to promote research, dissemination, and evaluation of the needs that arise in the field of the public system of social services. It also seeks to transfer knowledge to foster the development of public policies in this field. Given that it is an Interuniversity Chair among the five public universities in Valencia, there is coordination of complementary themes and roles for this objective, with Universitat Politènica de València focusing primarily on promoting innovation and social entrepreneurship to address multiple social challenges through its platform INSSPIRA. This approach is aimed at the entire university community and its various interest groups, carrying out research, teaching, and dissemination activities that promote social inclusion, personal development, and autonomy for groups in situations of vulnerability, lack of protection, dependence, or social urgency. Although it focuses on the Valencian context, both the issues in this context and the tools in process to address them, often have a universal and scalable character and has been inspiring for the innovation system of UPV. This entrepreneurial incubator goes along from early stages of students on the campus until the so-called “StartUPV” system, where students are challenged with social problems that require creative solutions. Therefore, the Chair is conceived with a holistic spirit and an inspiring vocation that engages the whole university community. In this communication, it is described the entities and individuals participating in this UPV Chair of VPSSS, followed by the presentation of different work lines and objectives for the chair. Subsequently, a description of various activities undertaken to promote innovation in social services are described, where support to teaching and extracurricular activities in this field are exposed. It must be noted that some awareness and dissemination of activities are carried out in a transversal mode as they contribute to different objectives simultaneously; with special focus on Learning-Service approaches that achieved very good results which are also summarized.

Keywords: social innovation, entrepeneurship, university, vulnerable sectors

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1442 Developing Performance Model for Road Side Elements Receiving Periodic Maintenance

Authors: Ayman M. Othman, Hassan Y. Ahmed, Tallat A. Ali

Abstract:

Inadequate maintenance programs and funds allocated for highway networks in the developed countries have led to fast deterioration of road side elements. Therefore, this research focuses on developing a performance model for road side elements periodic maintenance activities. Road side elements that receive periodic maintenance include; earthen shoulder, road signs and traffic markings. Using the level of service concept, the developed model can determine the optimal periodic maintenance intervals for those elements based on a selected level of service suitable with the available periodic maintenance budget. Data related to time periods for progressive deterioration stages for the chosen elements were collected. Ten maintenance experts in Aswan, Sohag and Assiut cities were interviewed for that purpose. Time in months related to 10%, 25%, 40%, 50%, 75%, 90% and 100% deterioration of each road side element was estimated based on the experts opinion. Least square regression analysis has shown that a power function represents the best fit for earthen shoulders edge drop-off and damage of road signs with time. It was also evident that, the progressive dirtiness of road signs could be represented by a quadratic function an a linear function could represent the paint degradation nature of both traffic markings and road signs. Actual measurements of earthen shoulder edge drop-off agree considerably with the developed model.

Keywords: deterioration, level of service, periodic maintenance, performance model, road side element

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1441 The Immediate Effects of Thrust Manipulation for Thoracic Hyperkyphosis

Authors: Betul Taspinar, Eda O. Okur, Ismail Saracoglu, Ismail Okur, Ferruh Taspinar

Abstract:

Thoracic hyperkyphosis, is a well-known spinal phenomenon, refers to an excessive curvature (> 40 degrees) of the thoracic spine. The aim of this study was to explore the effectiveness of thrust manipulation on thoracic spine alignment. 31 young adults with hyperkyphosis diagnosed with Spinal Mouse® device were randomly assigned either thrust manipulation group (n=16, 11 female, 5 male) or sham manipulation group (n=15, 8 female, 7 male). Thrust and sham manipulations were performed by a blinded physiotherapist who is a certificated expert in musculoskeletal physiotherapy. Thoracic kyphosis degree was measured after the interventions via Spinal Mouse®. Wilcoxon test was used to analyse the data obtained before and after the manipulation for each group, whereas Mann-Whitney U test was used to compare the groups. The mean of baseline thoracic kyphosis degrees in thrust and sham groups were 50.69 o ± 7.73 and 48.27o ± 6.43, respectively. There was no statistically significant difference between groups in terms of initial thoracic kyphosis degrees (p=0.51). After the interventions, the mean of thoracic kyphosis degree in thrust and sham groups were measured as 44.06o ± 6.99 and 48.93o ± 6.57 respectively (p=0.03). There was no statistically significant difference between before and after interventions in sham group (p=0.33), while the mean of thoracic kyphosis degree in thrust group decreased significantly (p=0.00). Thrust manipulation can attenuate thoracic hyperkyphosis immediately in young adults by not using placebo effect. Manipulation might provide accurate proprioceptive (sensory) input to the spine joints and reduce kyphosis by restoring normal segment mobility. Therefore thoracic manipulation might be included in the physiotherapy programs to treat hyperkyphosis.

Keywords: hyperkyphosis, manual therapy, spinal mouse, physiotherapy

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1440 Copula Autoregressive Methodology for Simulation of Solar Irradiance and Air Temperature Time Series for Solar Energy Forecasting

Authors: Andres F. Ramirez, Carlos F. Valencia

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The increasing interest in renewable energies strategies application and the path for diminishing the use of carbon related energy sources have encouraged the development of novel strategies for integration of solar energy into the electricity network. A correct inclusion of the fluctuating energy output of a photovoltaic (PV) energy system into an electric grid requires improvements in the forecasting and simulation methodologies for solar energy potential, and the understanding not only of the mean value of the series but the associated underlying stochastic process. We present a methodology for synthetic generation of solar irradiance (shortwave flux) and air temperature bivariate time series based on copula functions to represent the cross-dependence and temporal structure of the data. We explore the advantages of using this nonlinear time series method over traditional approaches that use a transformation of the data to normal distributions as an intermediate step. The use of copulas gives flexibility to represent the serial variability of the real data on the simulation and allows having more control on the desired properties of the data. We use discrete zero mass density distributions to assess the nature of solar irradiance, alongside vector generalized linear models for the bivariate time series time dependent distributions. We found that the copula autoregressive methodology used, including the zero mass characteristics of the solar irradiance time series, generates a significant improvement over state of the art strategies. These results will help to better understand the fluctuating nature of solar energy forecasting, the underlying stochastic process, and quantify the potential of a photovoltaic (PV) energy generating system integration into a country electricity network. Experimental analysis and real data application substantiate the usage and convenience of the proposed methodology to forecast solar irradiance time series and solar energy across northern hemisphere, southern hemisphere, and equatorial zones.

Keywords: copula autoregressive, solar irradiance forecasting, solar energy forecasting, time series generation

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1439 EU Policies in Determining Refugee Status

Authors: Adriano Mortada

Abstract:

Human history is rife with conflict, and the question of refugee status determination and their rehabilitation has been up for debate since. Refugee Status Determination is the administrative or legal process by which UNHCR or governments determine whether a person seeking international protection or asylum can be identified as a refugee under international, regional, or national law. Refugee Status Determination is considered to be a vital process in aiding refugees’ realization of their rights under international law. One of the major reasons why the refugee status determination is considered an “issue”, and is one that is much debated upon annually, is the fact that the national bureaucratic systems are rigid and unbending. This is particularly concerning in the 21st century despite human advancement in policy and diplomacy, working in tandem with the United Nations and their charters and resolutions on human rights and dignity. The paper seeks to criticize the European member states' response to the refugee crisis and their inflexible and prejudiced bureaucratic systems when it comes to refugee status determination. The paper looks at multiple case studies as primary evidence and the alternate case studies where the system helped refugees, like those in Jordan, Pakistan, Turkey, and Lebanon. The main concern of the paper is to highlight the bias in the selected European systems, which do not stem from the Human Rights Charter but rather on the basis of geographical backgrounds, cultural and religious affiliations of those seeking refugee status or asylum in their respective countries. The paper hopes to not only create awareness about this issue but also provide a research background to advocacy programs to bring a change in the systems.

Keywords: refugee status determination, human rights, bureaucracy, United Nations, European Union

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1438 The Effects of Mountain Biking as Psychomotor Instrument in Physical Education: Balance’s Evaluation

Authors: Péricles Maia Andrade, Temístocles Damasceno Silva, Hector Luiz Rodrigues Munaro

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The school physical education is going through several changes over the years, and diversification of its content from specific interests is one of the reasons for these changes, soon, the formality in education do not have to stay out, but needs to open up the possibilities offered by the world, so the Mountain Bike, an adventure sport, offers several opportunities for intervention Its application in the school allows diverse interventions in front of the psychomotor development, besides opening possibilities for other contents, respecting the previous experiences of the students in their common environment. The choice of theme was due to affinity with the practice and experience of the Mountain Bike at different levels. Both competitive as recreational, professional standard and amateur, focus as principle the bases of the Cycling, coupled with the inclusion in the Centre for Studies in Management of Sport and Leisure and of the Southwest Bahia State University and the preview of the modality's potential to help the children’s psychomotor development. The goal of this research was to demonstrate like a pilot project the effects of the Mountain Bike as psychomotor instrument in physical education at one of the psychomotor valences, Balance, evaluating Immobility, Static Balance and Dynamic Balance. The methodology used Fonseca’s Psychomotor Battery in 10 students (n=10) of a brazilian public primary’s school, with ages between 9 and 11 years old to use the Mountain Biking contents. The balance’s skills dichotomized in Regular and Good. Regarding the variable Immobility, in the initial test, regardless of gender, 70% (n = 7) were considered Regular. After four months of activity, the Good profile, which had only 30% (n = 3) of the sample, evolved to 60% (n = 6). As in Static and Dynamic Balance there was an increase of 30% (n = 3) and 50% (n = 5) respectively for Good. Between genders, female evolution was better for Good in Immobility and in Static Equilibrium. Already the male evolution was better observed in the Dynamic Equilibrium, with 66.7% (n = 4) for Good. Respecting the particularities of the motor development, an indication of the positive effects of the MTB for the evolution in the balance perceived, necessitating studies with greater sampling.

Keywords: psychomotricity, balance, mountain biking, education

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1437 Palliative Orthovoltage Radiotherapy and Subcutaneous Infusion of Carboplatin for Treatment of Appendicular Osteosarcoma in Dogs

Authors: Kathryn L. Duncan, Charles A. Kuntz, Alessandra C. Santamaria, James O. Simcock

Abstract:

Access to megavoltage radiation therapy for small animals is limited in many locations around the world. This can preclude the use of palliative radiation therapy for the treatment of appendicular osteosarcoma in dogs. The objective of this study was to retrospectively assess the adverse effects and survival times of dogs with appendicular osteosarcoma that were treated with hypofractionated orthovoltage radiation therapy and adjunctive carboplatin chemotherapy administered via a single subcutaneous infusion. Medical records were reviewed retrospectively to identify client-owned dogs with spontaneously occurring appendicular osteosarcoma that was treated with palliative orthovoltage radiation therapy and a single subcutaneous infusion of carboplatin. Data recorded included signalment, tumour location, results of diagnostic imaging, haematologic and serum biochemical analyses, adverse effects of radiation therapy and chemotherapy, and survival times. Kaplan-Meier survival analysis was performed, and log-rank analysis was used to determine the impact of specific patient variables on survival time. Twenty-three dogs were identified that met the inclusion criteria. Median survival time for dogs was 182 days. Eleven dogs had adverse haematologic effects, 3 had adverse gastrointestinal effects, 6 had adverse effects at the radiation site and 7 developed infections at the carboplatin infusion site. No statistically significant differences were identified in survival times based on sex, tumour location, development of infection, or pretreatment serum alkaline phosphatase. Median survival time and incidence of adverse effects were comparable to those previously reported in dogs undergoing palliative radiation therapy with megavoltage or cobalt radiation sources and conventional intravenous carboplatin chemotherapy. The use of orthovoltage palliative radiation therapy may be a reasonable alternative to megavoltage radiation in locations where access is limited.

Keywords: radiotherapy, veterinary oncology, chemotherapy, osteosarcoma

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1436 Association of Alcohol Consumption with Active Tuberculosis in Taiwanese Adults: A Nationwide Population-Based Cohort Study

Authors: Yung-Feng Yen, Yun-Ju Lai

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Background: Animal studies have shown that alcohol exposure may cause immunosuppression and increase the susceptibility to tuberculosis (TB) infection. However, the temporality of alcohol consumption with subsequent TB development remains unclear. This nationwide population-based cohort study aimed to investigate the impact of alcohol exposure on TB development in Taiwanese adults. Methods: We included 46 196 adult participants from three rounds (2001, 2005, 2009) of the Taiwan National Health Interview Survey. Alcohol consumption was classified into heavy, regular, social, or never alcohol use. Heavy alcohol consumption was defined as intoxication at least once/week. Alcohol consumption and other covariates were collected by in-person interviews at baseline. Incident cases of active TB were identified from the National Health Insurance database. Multivariate logistic regression was used to estimate the association between alcohol consumption and active TB, with adjustment for age, sex, smoking, socioeconomic status, and other covariates. Results: A total of 279 new cases of active TB occurred during the study follow-up period. Heavy (adjusted odds ratio [AOR], 5.21; 95% confident interval [CI], 2.41-11.26) and regular alcohol use (AOR, 1.73; 95% CI, 1.26-2.38) were associated with higher risks of incident TB after adjusting for the subject demographics and comorbidities. Moreover, a strong dose-response effect was observed between increasing alcohol consumption and incident TB (AOR, 2.26; 95% CI, 1.59-3.21; P <.001). Conclusion: Heavy and regular alcohol consumption were associated with higher risks of active TB. Future TB control programs should consider strategies to lower the overall level of alcohol consumption to reduce the TB disease burden.

Keywords: alcohol consumption, tuberculosis, risk factor, cohort study

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1435 Evaluation of Complications Observed in Porcelain Fused to Metal Crowns Placed at a Teaching Institution

Authors: Shizrah Jamal, Robia Ghafoor, Farhan Raza

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Porcelain fused to metal crown is the most versatile variety of crown that is commonly placed worldwide. Various complications have been reported in the PFM crowns with use over the period of time. These include chipping of the porcelain, recurrent caries, loss of retention, open contacts, and tooth fracture. The objective of the present study was to determine the frequency of these complications in crowns cemented over a period of five years in a tertiary care hospital and also to report the survival of these crowns. A retrospective study was conducted in Dental clinics, Aga Khan University Hospital in which 150 PFM crowns cemented over a period of five years were evaluated. Patient demographics, oral hygiene habits, para-functional habits, crown insertion and follow-up dates were recorded in a specially designed proforma. All PFM crowns fulfilling the inclusion criteria were assessed both clinically and radiographically for the presence of any complication. SPSS version 22.0 was used for statistical analysis. Frequency distribution and proportion of complications were determined. Chi-square test was used to determine the association of complications of PFM crowns with multiple variables including tooth wear, opposing dentition and betel nut chewing. Kaplan- meier survival analysis was used to determine the survival of PFM crowns over the period of five years. Level of significance was kept at 0.05. A total of 107 patients, with a mean age of 43.51 + 12.4 years, having 150 PFM crowns were evaluated. The most common complication observed was open proximal contacts (8.7%) followed by porcelain chipping (6%), decementation (5.3%), and abutment fracture (1.3%). Chi square test showed that there was no statistically significant association of PFM crown complication with tooth wear, betel nut and opposing dentition (p-value <0.05). The overall success and survival rates of PFM crowns turned out to be 78.7 and 84.7% respectively. Within the limitations of the study, it can be concluded that PFM crowns are an effective treatment modality with high success and survival rates. Since it was a single centered study; the results should be generalized with caution.

Keywords: chipping, complication, crown, survival rate

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1434 Comparison of Virtual and Face to Face Training Program in Reducing Pain and Quality of Life of Female Students with Dysmenorrhea

Authors: Nilofar Mohammadi Ahvazi, Somayeh Ansari, Mohammad Hossein Haghighizadeh, Zahra Abbaspoor

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Introduction: Dysmenorrhea is one of the common causes of decreased efficiency at work, education and decreased quality of life of women. The aim of this study was to compare virtual and face-to-face training programs in reducing pain and improving the quality of life of female students with primary dysmenorrhea in Ahvaz. Methods: In this quasi-experimental study, 112 female students living in the dormitories of Ahvaz University of Medical Sciences with moderate to severe primary dysmenorrhea were divided into two face-to-face and virtual groups using blocks of size 4. The educational intervention was carried out in two groups at a specific hour before the start of the first menstrual cycle. Data were collected with the help of a quality-of-life questionnaire (Sf-36), visual analog scale (VAS), and McGill questionnaire and were analyzed using descriptive and analytical tests with the help of SPSS version 25 software. Findings: The average age of the research subjects was 25.93±2.00, and the average duration of dysmenorrhea in each period was 2.49 days. There was no statistically significant difference in the quality of life of the students before the intervention, but after the educational intervention, a statistically significant difference was found between the two groups in terms of the quality of life and its dimensions (p<0.001). They were the same before the intervention, But after the intervention, the difference became significant (p<0.001). Conclusion: The virtual training method, like face-to-face training, can improve the quality of life and reduce the severity of primary dysmenorrhea pain in students. Therefore, depending on the conditions, both educational methods can be used.

Keywords: primary dysmenorrhea, face-to-face training, virtual, training

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