Search results for: medical knowledge

Authors: Restituto I. Rodelas

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The higher education has adopted the outcomes-based education from K-12. In this approach, the teacher uses any teaching and learning strategies that enable the students to achieve the learning outcomes. The students may be required to exert more effort and figure things out on their own. Hence, outcomes-based students are assumed to be more responsible and more capable of applying the knowledge learned. Another approach that the higher education in the Philippines is starting to adopt from other countries is blended learning. This combination of classroom and fully online instruction and learning is expected to be more effective. Participating in the online sessions, however, is entirely up to the students. Thus, the effect of blended learning on the performance of students in Statistics may be mediated by outcomes-based education. If there is a significant positive mediating effect, then blended learning can be optimized by integrating outcomes-based education. In this study, the sample will consist of four blended learning Statistics classes at Jose Rizal University in the second semester of AY 2015–2016. Two of these classes will be assigned randomly to the experimental group that will be handled using outcomes-based education. The two classes in the control group will be handled using the traditional lecture approach. Prior to the discussion of the first topic, a pre-test will be administered. The same test will be given as posttest after the last topic is covered. In order to establish equality of the groups’ initial knowledge, single factor ANOVA of the pretest scores will be performed. Single factor ANOVA of the posttest-pretest score differences will also be conducted to compare the performance of the experimental and control groups. When a significant difference is obtained in any of these ANOVAs, post hoc analysis will be done using Tukey's honestly significant difference test (HSD). Mediating effect will be evaluated using correlation and regression analyses. The groups’ initial knowledge are equal when the result of pretest scores ANOVA is not significant. If the result of score differences ANOVA is significant and the post hoc test indicates that the classes in the experimental group have significantly different scores from those in the control group, then outcomes-based education has a positive effect. Let blended learning be the independent variable (IV), outcomes-based education be the mediating variable (MV), and score difference be the dependent variable (DV). There is mediating effect when the following requirements are satisfied: significant correlation of IV to DV, significant correlation of IV to MV, significant relationship of MV to DV when both IV and MV are predictors in a regression model, and the absolute value of the coefficient of IV as sole predictor is larger than that when both IV and MV are predictors. With a positive mediating effect of outcomes-base education on the effect of blended learning on student performance, it will be recommended to integrate outcomes-based education into blended learning. This will yield the best learning results.

Keywords: outcome-based teaching, blended learning, face-to-face, student-centered

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Authors: Sudeepti Dayal, Neelesh Gupta

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Image abbreviation is utilized for reducing the size of a file without demeaning the quality of the image to an objectionable level. The depletion in file size permits more images to be deposited in a given number of spaces. It also minimizes the time necessary for images to be transferred. Storage of medical images is a most researched area in the current scenario. To store a medical image, there are two parameters on which the image is divided, regions of interest and non-regions of interest. The best way to store an image is to compress it in such a way that no important information is lost. Compression can be done in two ways, namely lossy, and lossless compression. Under that, several compression algorithms are applied. In the paper, two algorithms are used which are, discrete cosine transform, applied to non-region of interest (lossy), and discrete wavelet transform, applied to regions of interest (lossless). The paper introduces SPIHT (set partitioning hierarchical tree) algorithm which is applied onto the wavelet transform to obtain good compression ratio from which an image can be stored efficiently.

Keywords: Compression ratio, DWT, SPIHT, DCT

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Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

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The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: alcohol screening, AUDIT-C, CAGE, hazardous drinking

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Authors: Majed A. Alsalem

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Universal Design for Learning (UDL) is common theme in education across the US and an influential model and framework that enables students in general and particularly students who are deaf and hard of hearing (DHH) to access the general education curriculum. UDL helps teachers determine how information will be presented to students and how to keep students engaged. Moreover, UDL helps students to express their understanding and knowledge to others. UDL relies on technology to promote students' interaction with content and their communication of knowledge. This study included 120 DHH students who received daily instruction based on UDL principles. This study presents the results of the study and discusses its implications for the integration of UDL in day-to-day practice as well as in the country's education policy. UDL is a Western concept that began and grew in the US, and it has just begun to transfer to other countries such as Saudi Arabia. It will be very important to researchers, practitioners, and educators to see how UDL is being implemented in a new place with a different culture. UDL is a framework that is built to provide multiple means of engagement, representation, and action and expression that should be part of curricula and lessons for all students. The purpose of this study is to investigate the variables associated with the implementation of UDL in Saudi Arabian schools and identify the barriers that could prevent the implementation of UDL. Therefore, this study used a mixed methods design that use both quantitative and qualitative methods. More insights will be gained by including both quantitative and qualitative rather than using a single method. By having methods that different concepts and approaches, the databases will be enriched. This study uses levels of collecting date through two stages in order to insure that the data comes from multiple ways to mitigate validity threats and establishing trustworthiness in the findings. The rationale and significance of this study is that it will be the first known research that targets UDL in Saudi Arabia. Furthermore, it will deal with UDL in depth to set the path for further studies in the Middle East. From a perspective of content, this study considers teachers’ implementation knowledge, skills, and concerns of implementation. This study deals with effective instructional designs that have not been presented in any conferences, workshops, teacher preparation and professional development programs in Saudi Arabia. Specifically, Saudi Arabian schools are challenged to design inclusive schools and practices as well as to support all students’ academic skills development. The total participants in stage one were 336 teachers of DHH students. The results of the intervention indicated significant differences among teachers before and after taking the training sessions associated with their understanding and level of concern. Teachers have indicated interest in knowing more about UDL and adopting it into their practices; they reported that UDL has benefits that will enhance their performance for supporting student learning.

Keywords: deaf and hard of hearing, professional development, Saudi Arabia, universal design for learning

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Authors: Z. Dedovets, M. Rodionov

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The goal of the modern education system is to prepare students to be able to adapt to ever-changing life situations. They must be able to acquire required knowledge independently; apply such knowledge in practice to solve various problems by using modern technologies; think critically and creatively; competently use information; be communicative, work in a team; and develop their own moral values, intellect and cultural awareness. As a result, the status of education significantly increases; new requirements to its quality have been formed. In recent years, the competency-based approach in education has become of significant interest. This approach is a strengthening of applied and practical characteristics of a school education and leads to the forming of the key students’ competencies which define their success in future life. In this article, the authors’ attention focuses on a range of key competencies, educational, informational and communicative and on the possibility to develop such competencies via STEM education. This research shows the change in students’ attitude towards scientific disciplines such as mathematics, general science, technology and engineering as a result of STEM education. Two-staged analyzes questionnaires completed by students of forms II to IV in the republic of Trinidad and Tobago allowed the authors to categorize students between two levels that represent students’ attitude to various disciplines. The significance of differences between selected levels was confirmed with the use of Pearsons’ chi-squared test. In summary, the analysis of obtained data makes it possible to conclude that STEM education has a great potential for development of core students’ competencies and encourages the development of positive student attitude towards the above mentioned above scientific disciplines.

Keywords: STEM, science, technology, engineering, mathematics, students’ competency, Pearson's chi-squared test

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

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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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Authors: Monika Benedek

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This paper intends to present a pilot study of blended ear-training course at a Finnish university. The course ran for ten weeks and included both traditional (offline) group lessons for 90 minutes each week and an online learning platform. Twelve students majored in musicology and music education participated in the course. The aims of pilot research were to develop a new blended ear-training course at university level, to determine the ideal amount of workload in each part of the blended instruction (offline and online) and to develop the course material. The course material was selected from the Classical period in order to develop students’ aural skills together with their stylistic knowledge. Students were asked to provide written feedback of the course content and learning approaches of face-to-face group lessons and online learning platform each week during the course. Therefore, the teaching material is continuously planned for each week. This qualitative data collection and weekly analysis of data are on progress. However, based on the teacher-researcher’s experiences and the students’ feedback already collected, it could be seen that the blended instruction would be an ideal teaching strategy for ear-trainging at the music programmes of universities to develop students’ aural skills and stylistic knowledge. It is also presumed that such blended instruction with less workload would already improve university students’ aural skills and related musicianship skills. The preliminary findings of research also indicated that students generally found those ear-training tasks the most useful to learn online that combined listening, singing, singing and playing an instrument. This paper intends to summarise the final results of the pilot study.

Keywords: blended-learning, ear-training, higher music education, online-learning, pilot study

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Authors: Mohammad H. Yarmohammadian, Reza Safdari, Mahmoud Keyvanara, Nahid Tavakoli

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One of the greatest challenges in disaster and emergencies is patient tracking. The concept of tracking has different denotations. One of the meanings refers to tracking patients’ physical locations and the other meaning refers to tracking patients ‘medical needs during emergency services. The main goal of patient tracking is to provide patient safety during disaster and emergencies and manage the flow of patient and information in different locations. In most of cases, there are not sufficient and accurate data regarding the number of injuries, medical conditions and their accommodation and transference. The objective of the present study is to survey on patient tracking issue in natural disaster and emergencies. Methods: This was a narrative study in which the population was E-Journals and the electronic database such as PubMed, Proquest, Science direct, Elsevier, etc. Data was gathered by Extraction Form. All data were analyzed via content analysis. Results: In many countries there is no appropriate and rapid method for tracking patients and transferring victims after the occurrence of incidents. The absence of reliable data of patients’ transference and accommodation, even in the initial hours and days after the occurrence of disasters, and coordination for appropriate resource allocation, have faced challenges for evaluating needs and services challenges. Currently, most of emergency services are based on paper systems, while these systems do not act appropriately in great disasters and incidents and this issue causes information loss. Conclusion: Patient tracking system should update the location of patients or evacuees and information related to their states. Patients’ information should be accessible for authorized users to continue their treatment, accommodation and transference. Also it should include timely information of patients’ location as soon as they arrive somewhere and leave therein such a way that health care professionals can be able to provide patients’ proper medical treatment.

Keywords: patient tracking, challenges, disaster, emergency

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Authors: Alfonso Ippolito, Cristiana Bartolomei

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A growing demand is felt today for realistic 3D models enabling the cognition and popularization of historical-artistic heritage. Evaluation and preservation of Cultural Heritage is inextricably connected with the innovative processes of gaining, managing, and using knowledge. The development and perfecting of techniques for acquiring and elaborating photorealistic 3D models, made them pivotal elements for popularizing information of objects on the scale of architectonic structures.

Keywords: cultural heritage, databases, non-contact survey, 2D-3D models

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Authors: Rebecca Laycock

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Many Urban Agriculture (UA) initiatives, including community/allotment gardens, Community Supported Agriculture, and community/social farms, depend on volunteers. However, initiatives supported or run by volunteers are often faced with a high turnover of labour as a result of the involvement of episodic volunteers (a term describing ad hoc, one-time, and seasonal volunteers), leading to challenges with maintaining project continuity and retaining skills/knowledge within the initiative. This is a notable challenge given that food growing is a knowledge intensive activity where the fruits of labour appear months or sometimes years after investment. Participatory Action Research (PAR) is increasingly advocated for in the field of UA as a solution-oriented approach to research, providing concrete results in addition to advancing theory. PAR is a cyclical methodological approach involving researchers and stakeholders collaboratively 'identifying' and 'theorising' an issue, 'planning' an action to address said issue, 'taking action', and 'reflecting' on the process. Through iterative cycles and prolonged engagement, the theory is developed and actions become better tailored to the issue. The demand for PAR in UA research means that understanding how to use PAR with episodic volunteers is of critical importance. The aim of this paper is to explore (1) the challenges of doing PAR in UA initiatives with episodic volunteers, and (2) how PAR can be harnessed to advance sustainable development of UA through theoretically-informed action. A 2.5 year qualitative PAR study on three English case study student-led food growing initiatives took place between 2014 and 2016. University UA initiatives were chosen as exemplars because most of their volunteers were episodic. Data were collected through 13 interviews, 6 workshops, and a research diary. The results were thematically analysed through eclectic coding using Computer-Assisted Qualitative Data Analysis Software (NVivo). It was found that the challenges of doing PAR with transient participants were (1) a superficial understanding of issues by volunteers because of short term engagement, resulting in difficulties ‘identifying’/‘theorising’ issues to research; (2) difficulties implementing ‘actions’ given those involved in the ‘planning’ phase often left by the ‘action’ phase; (3) a lack of capacity of participants to engage in research given the ongoing challenge of maintaining participation; and (4) that the introduction of the researcher acted as an ‘intervention’. The involvement of a long-term stakeholder (the researcher) changed the group dynamics, prompted critical reflections that had not previously taken place, and improved continuity. This posed challenges for providing a genuine understanding the episodic volunteering PAR initiatives, and also challenged the notion of what constitutes an ‘intervention’ or ‘action’ in PAR. It is recommended that researchers working with episodic volunteers using PAR should (1) adopt a first-person approach by inquiring into the researcher’s own experience to enable depth in theoretical analysis to manage the potentially superficial understandings by short-term participants; and (2) establish safety mechanisms to address the potential for the research to impose artificial project continuity and knowledge retention that will end when the research does. Through these means, we can more effectively use PAR to conduct solution-oriented research about UA.

Keywords: community garden, continuity, first-person research, higher education, knowledge retention, project management, transience, university

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Authors: Carla O'Connor, Shanta' Robinson, Alaina Neal, Elan Hope, Adam Hengen, Samantha Drotar

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In this paper, we provide a preliminary analysis of the stories teachers tell about their Black students in their efforts to make sense of and professionally resolve the underperformance of Black students in their district. The teachers themselves hail from three demographically distinct districts that participate in the state coordinated inter-district school choice system. The districts are Varuna Hills (a pseudonym, as are all other names in this manuscript), a district that serves a predominantly White and affluent community; Newport, a district that serves a socioeconomically diverse but still majority White population; and Aspen, a district in which the student body is predominantly Black and predominantly working to lower middle class. Relying upon teacher focus group interviews in each of these districts which share a common reform context, we show how teachers’ everyday and narrative discourse makes meaning of the bodies and achievement of Black students and their families. More specifically, we show that these discourses construct Black students as interlopers, as suffering from extraordinary neediness, and in dire need of proper parenting. Our analysis reveals that there are nuances by which the teachers articulate these discourses with the nuances being a function of how the schools of choice reform context intersects with the demographics of each school and beliefs about the demographics of the schools of choice population. We unpack the racialized and classed nature of these narratives and the implications for teachers’ personal practical knowledge.

Keywords: black achievement, educational access and opportunity, race and schooling, teacher knowledge and education

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Authors: Tamara Vagg, Cathy Shortt, Claire Hickey, Joseph A. Eustace, Barry J. Plant, Sabin Tabirca

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Introduction: Paper-based patient passports have been used advantageously for older patients, patients with diabetes, and patients with learning difficulties. However, these passports can experience issues with data security, patients forgetting to bring the passport, patients being over encumbered, and uncertainty with who is responsible for entering and managing data in this passport. These issues could be resolved by transferring the paper-based system to a convenient platform such as a smartphone application (app). Background: Life expectancy for some Cystic Fibrosis (CF) patients are rising and as such new complications and procedures are predicted. Subsequently, there is a need for education and management interventions that can benefit CF adults. This research proposes a CF patient passport to record basic medical information through a smartphone app which will allow CF adults access to their basic medical information. Aim: To provide CF patients with their basic medical information via mobile multimedia so that they can receive care when traveling abroad or between CF centres. Moreover, by recording their basic medical information, CF patients may become more aware of their own condition and more active in their health care. Methods: This app is designed by a CF multidisciplinary team to be a lightweight reflection of a hospital patient file. The passport app is created using PhoneGap so that it can be deployed for both Android and iOS devices. Data entered into the app is encrypted and stored locally only. The app is password protected and includes the ability to set reminders and a graph to visualise weight and lung function over time. The app is introduced to seven participants as part of a stress test. The participants are asked to test the performance and usability of the app and report any issues identified. Results: Feedback and suggestions received via this testing include the ability to reorder the list of clinical appointments via date, an open format of recording dates (in the event specifics are unknown), and a drop down menu for data which is difficult to enter (such as bugs found in mucus). The app is found to be usable and accessible and is now being prepared for a pilot study with adult CF patients. Conclusions: It is anticipated that such an app will be beneficial to CF adult patients when travelling abroad and between CF centres.

Keywords: Cystic Fibrosis, digital patient passport, mHealth, self management

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Authors: Luke S. Carlos A. Thompson

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The medical model of disability, though beneficial for the medical professional, is often exclusionary, restrictive and dehumanizing when applied to the lived experience of disability. As a result, a critique of this model was constructed called the social model of disability. Much of the language used to articulate the purpose behind the social model of disability can be summed up within the word inclusion. However, this essay asserts that inclusiveness is an incomplete aspiration. The social model, as it currently stands, does not aid in creating a society where those with impairments actually belong. Rather, the social model aids in lessening the visibility, or negative consequence of, difference. Therefore, the social model does not invite society to welcome those with physical and intellectual impairments. It simply aids society in ignoring the existence of impairment by removing explicit forms of exclusion. Rather than simple inclusion, then, this essay uses John Swinton’s concept of friendship and Jean Vanier’s understanding of belonging to better articulate the intended outcome of the social model—a society where everyone can belong.

Keywords: belong, community, differently-able, disability, exclusion, friendship, inclusion, normality

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Authors: Elysee Guy Yohou

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Côte d'Ivoire established a National Commission for Sustainable Development with a view to implementing the ESD. This study aims to understand the knowledge, attitude and practice about education for sustainability of teachers, students, principals, and staff in secondary schools in Côte d’Ivoire while exploring the barriers, levers and examines the leadership skills needed to help carrying out ESD. The data collection took place in October and December 2015. Questionnaires were administered to 400 participants, which involved teachers, students, principals and staff in 25 public and private secondary schools in four regional offices of education. 297 questionnaires were collected producing a collection-rate of 74.25%. Descriptive statistics, independent t-test, dependent sample t-test, One way ANOVA, Pearson correlation were used to analyze the data. Thereupon, knowledge, attitudes about education for sustainability of teachers, principals and staff in secondary school are better than students. However, there is little practice of ESD. 68.3% of participants are not familiar with the Decade of Education for Sustainable Development. In addition, 92.8% of schools do not have a school Agenda 21. The major barriers that prevent the teaching of education for sustainability are lack of access to technical tools, insufficient funding and lack of information. The main levers are teacher and staff training, financing, awareness of students, and public engagement. Principals do possess good human and technical skills but limited conceptual skills. The study showed that conceptual and human skills are convenient assets which rhyme more with education for sustainability. Thereupon, if schools’ principal need to improve education for sustainability through practice, they need more conceptual skills.

Keywords: Côte d'Ivoire, education for sustainability, leadership skills, secondary school

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Authors: Steve Fish, Chris Lambert

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Cumbria is a geo-political county in Northwest England within which the Lake District National Park, a UNESCO World Heritage site is located. Whilst the area has a formidable reputation for natural beauty and historic assets, the innovation ecosystem is described as ‘patchy’ for a number of reasons. The county is one of the largest in England by area and is sparsely populated. This paper describes the needs, development and delivery of an SME business-support programme funded by the European Regional Development Fund, Lancaster University and the University of Cumbria. The Cumbria Innovations Platform (CUSP) Project has been designed to respond to the nuanced needs of SMEs in this locale, whilst promoting the adoption of research and innovation. CUSP utilizes a funnel method to support rural businesses with access to university innovation intervention. CUSP has been built on a three-tier model: Communicate, Collaborate and Create. The paper describes this project in detail and presents results in terms of output indicators achieved, a beneficiary telephone survey and wider economic forecasts. From a pragmatic point-of-view, the paper provides experiences and reflections of those people who are delivering and evaluating knowledge exchange. The authors discuss some of the benefits, challenges and implications for both policy makers and practitioners. Finally, the paper aims to serve as an invitation to others who may consider adopting a similar method of university-industry collaboration in their own region.

Keywords: regional business support, rural business support, university-industry collaboration, collaborative R&D, SMEs, knowledge exchange

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Authors: Salim Yaren, Nergis Canturk

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Signatures are signs that are handwritten by person in order to confirm values such as information, amount, meaning, time and undertaking that bear on a document. It is understood that the signature of a document and the accuracy of the information on the signature is accepted and approved. Forged signatures are formed by forger without knowing and seeing original signature of person that forger will imitate and as a result of his/her effort for hiding typical characteristics of his/her own signatures. Forged signatures are often signed by starting with the initials of the first and last name or persons of the persons whose fake signature will be signed. The similarities in the signatures are completely random. Within the scope of the study, forged signatures are collected from 100 people both their original signatures and forged signatures signed referring to 5 imaginary people. These signatures are compared for 14 signature analyzing criteria by 2 signature analyzing experts except the researcher. 1 numbered analyzing expert who is 9 year experience in his/her field evaluated signatures of 39 (39%) people right and of 25 (25%) people wrong and he /she made any evaluations for signatures of 36 (36%) people. 2 numbered analyzing expert who is 16 year experienced in his/her field evaluated signatures of 49 (49%) people right and 28 (28%) people wrong and he /she made any evaluations for signatures of 23 (23%) people. Forged signatures that are signed by 24 (24%) people are matched by two analyzing experts properly, forged signatures that are signed by 8 (8%) people are matched wrongfully and made up signatures that are signed by 12 (12%) people couldn't be decided by both analyzing experts. Signatures analyzing is a subjective topic so that analyzing and comparisons take form according to education, knowledge and experience of the expert. Consequently, due to the fact that 39% success is achieved by analyzing expert who has 9 year professional experience and 49% success is achieved by analyzing expert who has 16 year professional experience, it is seen that success rate is directly proportionate to knowledge and experience of the expert.

Keywords: forensic signature, forensic signature analysis, signature analysis criteria, forged signature

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support the operational decision of the Emergency Medical Service (EMS) regarding the assignment of medical emergency requests to Emergency Departments (ED). In the literature, this problem is also known as “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies are mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a request. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the transport time and release the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs, considering information relating to the subsequent phases of the process, such as the case-mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to evaluate different hospital selection policies. Therefore, the next steps of the research consisted of the development of a general simulation architecture, its implementation in the AnyLogic software and its validation on a realistic dataset. The hospital selection policy that produced the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, which is based on a retrospective estimate of the TTP, and a dynamic approach, which is based on a predictive estimate of the TTP determined with a constantly updated Winters model. Findings reveal that considering the minimization of TTP as a hospital selection policy raises several benefits. It allows to significantly reduce service throughput times in the ED with a minimum increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case-mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms of TTP estimation than a retrospective approach but entails a more difficult application. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: discrete event simulation, emergency medical services, forecast model, hospital selection

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Authors: Mamdouh Milad Adly Morkos

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Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health

Keywords: electromagnetic solar system, nano-material, nano pharmacology, pharmacovigilance, quantum theoryclinical simulation, education, pharmacology, simulation, virtual learning low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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Authors: Moet Moet Myint Lay

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Continuing professional development involves acquiring new knowledge and skills for current work and improving career opportunities in the field through continuing education (OECD, 2000). This article examines the effectiveness of CPD in improving teacher quality and the resulting need for CPD for teacher educators in Myanmar. The purpose of this study is to explore a deeper understanding of teacher-to-teacher continuing professional development in improving teacher education programs. Research questions: (1) How do teachers in Myanmar understand the idea of continuous professional development for professional development? (2) What CPD activities are required for all teachers in teachers' colleges? (3) What are the main challenges of CPD implementation in Myanmar Education College? A qualitative method using semi-structured interviews was used in this study. Seven teacher educators from Mandalay Education College participated in this study. There are three male teacher educators and four female teacher educators. All participants who responded to the semi-structured interviews were between 29 and 45 years old.The interviews revealed that professional development involves acquiring the necessary pedagogical knowledge and skills to encourage students to think creatively and critically. Teachers must participate in a variety of activities, including professional interviews, lesson study, training programs, workshops, and seminars. All results showed that teachers need English and ICT skills for teaching and learning, including extended ICT courses for those who have completed a foundation course, access to e-libraries, and inclusive education (including language teaching and learning), facilitate the assessment (formative and summative), practicum, mentoring, and coaching skills. The study concludes with practical findings that suggest an urgent need for CPD activities for teachers.

Keywords: continuous professional development, teacher educator, teacher training program), mentoring

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Authors: N. Khodarahmi, L. Ford

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Decades of research on the impact of trauma in early childhood suggest severe risks to the mental health, emotional, social and physical development of a young child. Trauma-exposed students can pose a variety of different levels of challenges to schools and educators of young children and to date, few studies have addressed ECE teachers’ role in providing trauma support. The present study aims to contribute to this literature by exploring the beliefs of British Columbia’s (BC) early childhood education (ECE) teachers in their level of readiness and capability to work within a trauma-informed practice (TIP) framework to support their trauma-exposed students. Through a sequential, mix-methods approach, a self-report questionnaire and semi-structured interviews will be used to gauge BC ECE teachers’ knowledge of TIP, their preparedness, and their ability in using this framework to support their most vulnerable students. Teacher participants will be recruited through the ECEBC organization and various school districts in the Greater Vancouver Area. Questionnaire data will be primarily collected through an online survey tool whereas interviews will be taking place in-person and audio-recorded. Data analysis of survey responses will be largely descriptive, whereas interviews, once transcribed, will be employing thematic content analysis to generate themes from teacher responses. Ultimately, this study hopes to highlight the necessity of utilizing the TIP framework in BC ECE classrooms in order to support both trauma-exposed students and provide essential resources to compassionate educators of young children.

Keywords: early childhood education, early learning classrooms, refugee students, trauma-exposed students, trauma-informed practice

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Authors: Zsolt Szabolcsi

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Political communication in Hungary has undergone a significant change in the 2010s. One element of the transformation is the Flashnews. This media product was launched in March 2015 and since then 40-50 blocks are broadcasted, daily, on 5 channels. Flashnews blocks are condensed news sessions, containing the summary of political narratives. It starts with the introduction of the narrator, then, usually four news topics are presented and, finally, the narrator concludes the block. The block lasts only one minute and, therefore, it provides a blink session into the main narratives of political communication at the time. Beyond its rapid pace, what makes its avoidance difficult is that these blocks are always in the first position in the commercial break of a non-political media product. Although it is only one minute long, its significance is high. The content of the Flashnews reflects the main governmental narratives and, therefore, the Flashnews is part of the agenda-setting capacity of political communication. It reaches media consumers who have limited knowledge and interest in politics, and their use of media products is not politically related. For this audience, the Flashnews pops up in the same way as commercials. Due to its structure and appearance, the impact of Flashnews seems to be similar to commercials, imbedded into the break of media products. It activates existing knowledge constructs, builds up associational links and maintains their presence in a way that the recipient is not aware of the phenomenon. The research aims to examine the extent to which the Flashnews and the main news narratives are identical in their content. This aim is realized with the content analysis of the two news products by examining the Flashnews and the evening news during main sport events from 2016 to 2018. The initial hypothesis of the research is that Flashnews is a contribution to the news management technique for an effective articulation of political narratives in public service media channels.

Keywords: flashnews, political communication, political marketing, news management

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Authors: Sakshi V. Tantak, Vishap K. Malik, Neelanjney Pilarisetty

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A patent is an exclusive right granted for an invention. It can be a product or a process that provides an innovative method of doing something, or offers a new technical perspective or solution to a problem. A patent can be obtained by making the technical information and details about the invention publicly available. The patent owner has exclusive rights to prevent or stop anyone from using the patented invention for commercial uses. Any commercial usage, distribution, import or export of a patented invention or product requires the patent owner’s consent. It has been observed that the central and important parts of patents are scripted in idiosyncratic and complex linguistic structures that can be difficult to read, comprehend or interpret for the masses. The abstracts of these patents tend to obfuscate the precise nature of the patent instead of clarifying it via direct and simple linguistic constructs. This makes it necessary to have an efficient access to this knowledge via concise and transparent summaries. However, as mentioned above, due to complex and repetitive linguistic constructs and extremely long sentences, common extraction-oriented automatic text summarization methods should not be expected to show a remarkable performance when applied to patent documents. Other, more content-oriented or abstractive summarization techniques are able to perform much better and generate more concise summaries. This paper proposes an efficient summarization system for patents using artificial intelligence, natural language processing and deep learning techniques to condense the knowledge and essential information from a patent document into a single summary that is easier to understand without any redundant formatting and difficult jargon.

Keywords: abstractive summarization, deep learning, natural language Processing, patent document

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Authors: Victor Kang, Sirene Bellahnid, Amy Al-Simaani

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Efficient documentation and completion of clerical tasks are pillars of efficient patient-centered care in acute settings such as the emergency department (ED). Medical scribes aid physicians with documentation, navigation of electronic health records, results gathering, and communication coordination with other healthcare teams. However, the use of medical scribes is not widespread, with some hospitals even continuing to discontinue their programs. One reason for this could be the lack of studies that have outlined concrete improvements in efficiency and patient and provider satisfaction in emergency departments before and after incorporating scribes. Methods: We conducted a review of the literature concerning the implementation of a medical scribe program and emergency department performance. For this review, a narrative synthesis accompanied by textual commentaries was chosen to present the selected papers. PubMed was searched exclusively. Initially, no date limits were set, but seeing as the electronic medical record was officially implemented in Canada in 2013, studies published after this date were preferred as they provided insight into the interplay between its implementation and scribes on quality improvement. Results: Throughput, efficiency, and cost-effectiveness were the most commonly used parameters in evaluating scribes in the Emergency Department. Important throughput metrics, specifically door-to-doctor and disposition time, were significantly decreased in emergency departments that utilized scribes. Of note, this was shown to be the case in community hospitals, where the burden of documentation and clerical tasks would fall directly upon the attending physician. Academic centers differ in that they rely heavily on residents and students; so the implementation of scribes has been shown to have limited effect on these metrics. However, unique to academic centers was the provider’s perception of incrased time for teaching was unique to academic centers. Consequently, providers express increased work satisfaction in relation to time spent with patients and in teaching. Patients, on the other hand, did not demonstrate a decrease in satisfaction in regards to the care that was provided, but there was no significant increase observed either. Of the studies we reviewed, one of the biggest limitations was the lack of significance in the data. While many individual studies reported that medical scribes in emergency rooms improved relative value units, patient satisfaction, provider satisfaction, and increased number of patients seen, there was no statistically significant improvement in the above criteria when compiled in a systematic review. There is also a clear publication bias; very few studies with negative results were published. To prove significance, data from more emergency rooms with scribe programs would need to be compiled which also includes emergency rooms who did not report noticeable benefits. Furthermore, most data sets focused only on scribes in academic centers. Conclusion: Ultimately, the literature suggests that while emergency room physicians who have access to medical scribes report higher satisfaction due to lower clerical burdens and can see more patients per shift, there is still variability in terms of patient and provider satisfaction. Whether or not this variability exists due to differences in training (in-house trainees versus contractors), population profile (adult versus pediatric), setting (academic versus community), or which shifts scribe work cannot be determined based on the studies that exist. Ultimately, more scribe programs need to be evaluated to determine whether these variables affect outcomes and prove whether scribes significantly improve emergency room efficiency.

Keywords: emergency medicine, medical scribe, scribe, documentation

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Authors: Birgit Rasmussen, Thomas Maribo, Bente S. Toft

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BACKGROUND: Cardiac rehabilitation is the standard treatment for ischemic heart disease. Cardiac rehabilitation improves quality of life, reduces mortality and the risk of readmission, and provides patients with valuable knowledge and encouragement from peers and staff. Still, less than half of eligible patients enroll. Face-to-face interventions have the potential to support patients' decision-making and increase enrolment in cardiac rehabilitation. However, we lack knowledge of the content and characteristics of interventions. AIM: The aim was to outline and evaluate the content and characteristics of studies that have reported on face-to-face interventions to encourage enrolment in cardiac rehabilitation in patients with ischemic heart disease. METHOD: This scoping review followed the Joanne Briggs Institute methodology. Based on an a-priori protocol that defined the systematic search criteria, six databases were searched for studies published between 2001 and 2023. Two reviewers independently screened and selected studies. All authors discussed the summarized data prior to the narrative presentation. RESULTS: After screening and full text review of 5583 records, 20 studies of heterogeneous design and content were included. Four studies described the key contents in face-to-face interventions to be education, support of autonomy, addressing reasons for change, and emotional and cognitive support while showing understanding. Two studies used motivational interviewing to target patients' experiences and address worries and anticipated difficulties. Four quantitative studies found associations between enrolment and intention to attend, cardiac rehabilitation barriers, exercise self-efficacy, and perceived control. When patients asked questions, enrolment rates were higher, while providing reassurance and optimism could lead to non-attendance if patients had a high degree of worry. In qualitative studies, support to overcome barriers and knowledge about health benefits from participation in cardiac rehabilitation facilitated enrolment. Feeling reassured that the cardiac condition was good could lead to non-attendance. DISCUSSION AND CONCLUSION: To support patients' enrolment in cardiac rehabilitation, it is recommended that interventions integrate a person-centered dialogue. Individual worries and barriers to cardiac rehabilitation should be jointly explored. When talking with patients for whom worries predominate, the recommendation is to focus on the patients' perspectives and avoid too much focus on reassurance and problem-solving. The patients' perspectives, the mechanisms of change, and the process evaluation of the intervention including person-centeredness are relevant to include in future studies.

Keywords: ischemic heart disease, cardiac rehabilitation, enrolment, person-centered, in-hospital interventions

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Authors: Maria Sonto Maputle, Rhulani C. Shihundla, Rachel T. Lebese

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Background: Patients’ information must be complete and accurately documented in order to foster quality and continuity of care. The multidisciplinary health care members use patients’ documentation to communicate about health status, preventive health services, treatment, planning and delivery of care. The purpose of this study was to determine the practice of nursing documentation of patients’ information at selected Primary Health Care (PHC) facilities in Vhembe District, Limpopo Province, South Africa. Methods: The research approach adopted was qualitative while exploratory and descriptive design was used. The study was conducted at selected PHC facilities. Population included twelve professional nurses. Non-probability purposive sampling method was used to sample professional nurses who were willing to participate in the study. The criteria included participants’ whose daily work and activities, involved creating, keeping and updating nursing documentation of patients’ information. Qualitative data collection was through unstructured in-depth interviews until no new information emerged. Data were analysed through open–coding of, Tesch’s eight steps method. Results: Following data analysis, it was found that professional nurses’ had knowledge deficit related to insufficient training on updates and rendering multiple services daily had negative impact on accurate documentation of patients’ information. Conclusion: The study recommended standardization of registers, books and forms used at PHC facilities, and reorganization of PHC services into open day system.

Keywords: documentation, knowledge, patient care, patient’s information, training

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Authors: Biva Samadder, Samita Manna

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India is a melting pot of races, tribes, castes and communities. The population of India can be roughly branched into the huge majority of “Civilized” Indians of the Plains and the minority of Tribal population of the hill area and the forest who constituting almost 16 percent of total population of India. The Kirat community composed of four ethnic tribes: Limbu, Lepcha, Dhimal, and Rai. These Kirat people were found to be rich in indigenous knowledge, skill and practices especially for the use on medicinal plants and livelihood purposes. The “Mundhum" is the oral scripture or the “Bible of the Limbus” which serves as the canon of the codes of the Limbu socialization, their moral values and the very orientation of their lifestyle. From birth till death the Limbus are disciplined in the life with full of religious rituals, traditions and culture governed by community norms with a rich legacy of indigenous knowledge and traditional practices. The present study has been conducted using both secondary as well as primary data by applying social methodology consisting of the social survey, questionnaire, interviews and observations in the Kalimpong Block-I of Darjeeling District of west Bengal of India, which is a heterogeneous zone in terms of its ethnic composition and where the Limbus are pre-dominantly concentrated. Due to their close contact with other caste and communities Limbus are now adjusted with the changing situation by borrowing some cultural traits from the other communities and changes that have taken place in their cultural practices, religious beliefs, economic aspects, languages and in social roles and relationships which is bringing the change in their material culture. Limbu language is placed in the Tibeto- Burman Language category. But due to the political and cultural domination of educationally sound and numerically dominant Bengali race, the different communities in this area forced to come under the one umbrella of the Nepali or Gorkhali nation (nation-people). Their respective identities had to be submerged in order to constitute as a strong force to resist Nepali domination and ensure their common survival. As Nepali is a lingua-franca of the area knowing and speaking Nepali language helps them in procuring economic and occupational facilities. Ironically, present day younger generation does not feel comfortable speaking in their own Limbu tongue. The traditional knowledge about medicinal plants, healing, and health culture is found to be wear away due to the lack of interest of young generation. Not only poverty, along with exclusion due to policies they are in the phase of extinction, but their capabilities are ignored and not documented and preserved especially in the case of Limbus who having a great cultural heritage of an oral tradition. Attempts have been made to discuss the persistence and changes in socioeconomic pattern of life in relation to the social structure, material culture, cultural practices, social relationships, indigenous technology, ethos and their values and belief system.

Keywords: changing social relationship, cultural transition, identity, indigenous knowledge, language

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Authors: Stephanie Yun Yu Law

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Background: This study aims to investigate into communication between trainee doctors and patients, especially how doctor’s reaction to patient’s emotional issues expressed in the consultation affect patient’s satisfaction. Objectives: Thus, there are three aims in this study, 1.) how do trainee doctors react to patients emotional cues in OSCE station? 2.) Any differences in the respond type to emotional cues between first year students and third year students? 3.) Is response type (reducing space) related to OSCE outcome (patient satisfaction and expert rating)? Methods: Fifteen OSCE stations was videotaped, in which 9 were stations with first-year students and 6 were with third-year students. OSCE outcomes were measured by Communication Assessment Tool and Examiners Checklist. Analyses: All patient’s cues/concerns and student’s reaction were coded by Verona Coding Definitions of Emotional Sequence. Descriptive data was gathered from Observer XT and logistic regression (two-level) was carried out to see if occurrence of reducing space response can be predicted by OSCE outcomes. Results: Reducing space responses from all students were slightly less than a half in total responses to patient’s cues. The mean percentage of reducing space behaviours was lower among first year students when compared to third year students. Patient’s satisfaction significantly (p<0.05) and negatively predicted reducing space behaviours. Conclusions: Most of the medical students, to some extent, did not provide adequate responses for patient’s emotional cues. But first year students did provide more space for patients to talk about their emotional issues when compared to third year students. Lastly, patients would feel less satisfied if trainee doctors use more reducing space responses in reaction to patient’s expressed emotional cues/concerns. Practical implications: Firstly, medical training programme can be tailored on teaching students how to detect and respond appropriately to emotional cues in order to improve underperformed student’s communication skills in healthcare setting. Furthermore, trainee doctor’s relationship with patients in clinical practice can also be improved by reacting appropriately to patient’s emotive cues in consultations (such as limit the use of reducing space behaviours).

Keywords: doctors-patients communication, applied clinical psychology, health psychology, healthcare professionals

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Authors: Verónica Muñoz-Rivero

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The historically marginalized indigenous communities in the Atacama Desert continue to experience and struggle curricular hegemony in a prevalent monocultural educational context that denies heritage, culture and epistemologies in a documented attempted knowledge negation by the educational policies, the national curriculum and educational culture. The ancestral indigenous community of Toconce demands a territorial-based intercultural education and a school in their ancestral land to prevent the progressive cultural loss as they reclaim their memory and identity negated. This case study makes use of the intercultural theoretical framework and open qualitative methodology to analyze local socio-educational reality integrating aspects related to the educational experience, education demands for future generations and importance given to formal education. The interlocutors: elders, parents, caretakers and former teachers raised the educational experience for the indigenous childhood as an intergenerational voice that experienced discrimination, exclusion and racism on their K-12 trajectories. By center, the indigenous epistemologies, geography and memory, this research proposes a project-based learning approach anchored to the Limpia de Canales ceremony to develop a situated territorial intercultural curriculum unpacking from the local epistemology and structure thinking. The work on terraces gives students the opportunity to co-create a real-life application with practical purpose and present the importance of reinforcing notions related to the relevance of a situated intercultural curriculum for social justice in the formative development of prospective teachers.

Keywords: cultural studies, decolonial education, epistemic symmetry, intercultural curriculum, multidimensional curriculum

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Authors: Mrinal Kanti Bhowmik, Shawli Bardhan Jr., Debotosh Bhattacharjee

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Human skin containing temperature value more than absolute zero, discharges infrared radiation related to the frequency of the body temperature. The difference in infrared radiation from the skin surface reflects the abnormality present in human body. Considering the difference, detection and forecasting the temperature variation of the skin surface is the main objective of using Medical Infrared Thermography(MIT) as a diagnostic tool for pain detection. Medical Infrared Thermography(MIT) is a non-invasive imaging technique that records and monitors the temperature flow in the body by receiving the infrared radiated from the skin and represent it through thermogram. The intensity of the thermogram measures the inflammation from the skin surface related to pain in human body. Analysis of thermograms provides automated anomaly detection associated with suspicious pain regions by following several image processing steps. The paper represents a rigorous study based survey related to the processing and analysis of thermograms based on the previous works published in the area of infrared thermal imaging for detecting inflammatory pain diseases like arthritis, spondylosis, shoulder impingement, etc. The study also explores the performance analysis of thermogram processing accompanied by thermogram acquisition protocols, thermography camera specification and the types of pain detected by thermography in summarized tabular format. The tabular format provides a clear structural vision of the past works. The major contribution of the paper introduces a new thermogram acquisition standard associated with inflammatory pain detection in human body to enhance the performance rate. The FLIR T650sc infrared camera with high sensitivity and resolution is adopted to increase the accuracy of thermogram acquisition and analysis. The survey of previous research work highlights that intensity distribution based comparison of comparable and symmetric region of interest and their statistical analysis assigns adequate result in case of identifying and detecting physiological disorder related to inflammatory diseases.

Keywords: acquisition protocol, inflammatory pain detection, medical infrared thermography (MIT), statistical analysis

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Authors: Ajmal Hussain

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In Indian music parlance, Rasa denotes a distinct aesthetic experience that builds up in the mind of the listeners while listening to a piece of Indian classical music. The distinction of the experience is rooted in the concept that it gives rise to an enhanced awareness about the Self or God and creates a mental state detached from mundane issues of everyday life. The theory of Rasa was initially proposed in the context of theatre but became a part of Indian musicological discourse roughly two thousand years ago, however, to this day, it remains shrouded in mystery due to its religious associations and connotations. This paper attempts to demystify the theory of Rasa in the light of available scientific knowledge fund particularly in Brain and Mind sciences. The paper initially describes the religious context of the theory of Rasa and then discusses its classical formulations by Bharata and Abhinavagupta including the steps and stages laid down by the latter to explain the creation of musical experience. The classical formulations are then interpreted with reference to the scientific knowledge fund about the human mind and mechanics of perception. The study uses the model of human mind as proposed by Portuguese-American neuroscientist Antonio Damasio in his theory ‘A Nesting Principle’. On the basis of the findings by Damasio, the paper interprets the experience of Rasa from a scientific perspective and clarifies the sequence of steps and stages involved in the making of musical experience. The study concludes that although the classical formulations of Rasa identify key aspects of musical experience, the association of Rasa with religion is misleading. The association with religion does not depend upon musical stimulus but the intellectual orientation of the listener. It further establishes that the function of Rasa is more profound as, from an evolutionary perspective, it can be seen as a catalyst for higher consciousness.

Keywords: aesthetic, consciousness, music, Rasa

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