Search results for: healthcare delivery

Authors: Iruka C. Anugwo, Winston M. Shakantu

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The objective of this study is to uncover the basic business-forces that necessitated the survival and sustainable performance of the medium scale contractors in the South African construction market. This study is essential as it set to contribute towards long-term strategic solutions for combating the incessant failure of start-ups construction organizations within South African. The study used a qualitative research methodology; as the most appropriate approach to elicit and understand, and uncover the phenomena that are basic business-forces for the active contractors in the market. The study also adopted a phenomenological study approach; and in-depth interviews were conducted with 20 medium scale contractors in Port Elizabeth, South Africa, between months of August to October 2015. This allowed for an in-depth understanding of the critical and basic business-forces that influenced their survival and performance beyond the first five years of business operation. Findings of the study showed that for potential contractors (startups), to survival in the competitive business environment such as construction industry, they must possess the basic business-forces. These forces are educational knowledge in construction and business management related disciplines, adequate industrial experiences, competencies and capabilities to delivery excellent services and products as well as embracing the spirit of entrepreneurship. Convincingly, it can be concluded that the strategic approach to minimize the endless failure of startups construction businesses; the potential construction contractors must endeavoring to access and acquire the basic educationally knowledge, training and qualification; need to acquire industrial experiences in collaboration with required competencies, capabilities and entrepreneurship acumen. Without these basic business-forces as been discovered in this study, the majority of the contractors gaining entrance in the market will find it difficult to develop and grow a competitive and sustainable construction organization in South Africa.

Keywords: basic business-forces, medium scale contractors, South Africa, sustainable organisations

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Authors: Susan Diamond

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Machine Learning workloads have traditionally been run in high-performance computing (HPC) environments, where users log in to dedicated machines and utilize the attached GPUs to run training jobs on huge datasets. Training of large neural network models is very resource intensive, and even after exploiting parallelism and accelerators such as GPUs, a single training job can still take days. Consequently, the cost of hardware is a barrier to entry. Even when upfront cost is not a concern, the lead time to set up such an HPC environment takes months from acquiring hardware to set up the hardware with the right set of firmware, software installed and configured. Furthermore, scalability is hard to achieve in a rigid traditional lab environment. Therefore, it is slow to react to the dynamic change in the artificial intelligent industry. Watson Deep Learning as a service, a cloud-based deep learning platform that mitigates the long lead time and high upfront investment in hardware. It enables robust and scalable sharing of resources among the teams in an organization. It is designed for on-demand cloud environments. Providing a similar user experience in a multi-tenant cloud environment comes with its own unique challenges regarding fault tolerance, performance, and security. Watson Deep Learning as a service tackles these challenges and present a deep learning stack for the cloud environments in a secure, scalable and fault-tolerant manner. It supports a wide range of deep-learning frameworks such as Tensorflow, PyTorch, Caffe, Torch, Theano, and MXNet etc. These frameworks reduce the effort and skillset required to design, train, and use deep learning models. Deep Learning as a service is used at IBM by AI researchers in areas including machine translation, computer vision, and healthcare. 

Keywords: deep learning, machine learning, cognitive computing, model training

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Authors: Chioma J. Nwakamma, Blessing O. Oyedemi, Garuba Omosun

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This research surveys and documents information on medicinal plants and their botanical preparations used in the treatment of children’s ailments in South-Eastern Nigeria. Children under the age of 5 in developing countries suffer from diseases with high morbidity and mortality rate yearly due to inaccessible and unaffordable healthcare. Structured questionnaires were administered to herbal sellers, traditional medicine practitioners, nursing mothers, and adult dwellers to collect data on the names of plants used to treat the conditions, methods of preparation, duration of treatment, adverse effects, and the methods of administration of the plant materials. A total of 135 plants belonging to 55 families were identified for the management of children’s health in the area. Common pediatric ailments which were said to be treated with herbal remedies by the respondents included malaria, pneumonia, stomach ache, diarrhea, dysentery, measles, chickenpox/smallpox, convulsion, jaundice, pile, ringworm, scabies, eczema, stubborn cough, scurvy, catarrh, wounds, boils, insect bites, food poison, cholera, and umbilical cord complications. Percentages of respondents were; herbal sellers (48.2%), traditional medical practitioners (21.6%), nursing mothers (11.1%), and others (19.1%). The most occurring plant families were Euphorbiaceae, Fabaceae, and Apocynaceae, with 8 species of plants each followed by Annonaceae and Asteriaceae with 7 and 6 species, respectively. The recipes were made from the combination of different parts of two or more plant species, and others were made from single plant parts. Methods of extraction were mostly decoction and raw-squeezing out of the juice and infusion, while oral administration was the main route of administration.

Keywords: ethno-botanicals, children’s health, medicinal plants, South-Eastern Nigeria

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Authors: Kayla Murray, Andrew Green, Gopi Paliyath, Keith Warriner

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Introduction: It is now acknowledged that control of human pathogens associated with fresh produce requires an integrated approach of several interventions as opposed to relying on post-harvest washes to remove field acquired contamination. To this end, current research is directed towards identifying such interventions that can be applied at different points in leafy green processing. Purpose: In the following the efficacy of different gas phase treatments to decontaminate whole lettuce heads during pre-processing storage were evaluated. Methods: Whole Cos lettuce heads were spot inoculated with L. monocytogenes, E. coli O157:H7 or Salmonella spp. The inoculated lettuce heads were then placed in a treatment chamber and exposed to ozone, chlorine dioxide or hydroxyl radicals at different time periods under a range of relative humidity. Survivors of the treatments were enumerated along with sensory analysis performed on the treated lettuce. Results: Ozone gas reduced L. monocytogenes by 2-log10 after ten-minutes of exposure with Salmonella and E. coli O157:H7 being decreased by 0.66 and 0.56-log cfu respectively. Chlorine dioxide gas treatment reduced L. monocytogenes and Salmonella on lettuce heads by 4 log cfu but only supported a 0.8 log cfu reduction in E. coli O157:H7 numbers. In comparison, hydroxyl radicals supported a 2.9 – 4.8 log cfu reduction of model human pathogens inoculated onto lettuce heads but required extended exposure times and relative humidity < 0.8. Significance: From the gas phase sanitizers tested, chlorine dioxide and hydroxyl radicals are the most effective. The latter process holds most promise based on the ease of delivery, worker safety and preservation of lettuce sensory characteristics. Although expose times for hydroxyl radicles was relatively long (24h) this should not be considered a limitation given the intervention is applied in store rooms or in transport containers during transit.

Keywords: gas phase sanitizers, iceberg lettuce heads, leafy green processing

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Authors: Yasàlu Haruna

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In every transaction, the use of language is central regardless of form or complexity if any meaning is expected to be harvested therefrom. Students constituting a population group in the learning landscape of Nigeria occupy a central position with a propensity to excel or otherwise in the context of communication, especially in the learning process and social interaction. The nature or quantum of anxiety or confidence in speaking a second language is not only peculiar to societies where the second language is not an official language but to a degree, the linguistic gap created by adoption and adaptation syndrome manifests in created anxiety or lack of confidence especially where mastery of a spoken language becomes a major challenge. This paper explores the manner in which linguistic complexity and cultural barriers combine to widen the adaptation and adoption gap. In much the same way, typical issues of pronouncement, intonation and accent difficulties are vital variables that explain the root cause of anxiety. Using a combination of primary and secondary sources of data expressed in questionnaires, key informant interviews and other available data, the paper concludes that the non-integration of anxiety possibility into the education delivery framework has left a lot to be needed in cultivating second language speakers among students of Nigerian Colleges of Education. In addition, cultural barriers and the absence of integration interfaces in the course of learning within and outside the classroom contribute to further widening the gap. Again, colleagues/mates/conversation partners' mastery of a second language remains a contributory factor largely due to the quality of the preparatory school system in many parts of the country. The paper recommends that national policies and frameworks must be reviewed to consider integration windows where culture and conversation partner deficiencies can be remedied through educational events such as debates, quizzes and symposia; improvements can be attained while commercial advertisements are tailored towards seeking for adoption of second language in commerce and major cultural activities.

Keywords: cultural barriers, integration, college of education and adaptation, second language

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Authors: Douglas Arthur, Oluwayemisi Ekor, Ernest Obese, Andrew Kissi Agyei, Elvis Ofori Ameyaw

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bjective: Pain negatively impacts every aspect of health, and patients with pain disorders create enormous demands on healthcare systems globally, costing economies up to $635 billion annually. The study was therefore conducted at the Cape Coast Teaching Hospital (CCTH), the only Tertiary Hospital in the Central Region of Ghana and was designed to assess pain disorders in patients between 18 and 90 years attending Urology Clinic. Methods: The study employed a descriptive cross-sectional design, and 149 subjects (16-24, 25-34, 35-44, 45-54, 55-64, 65-90 years) were conveniently selected. The McGill Pain Questionnaire (MPQ), a multidimensional instrument that assesses several aspects of pain by the use of words (descriptors) that the patient chooses to express his/her pain, was used as the primary instrument for data collection. A patient profile form (PPF) was also designed to document the demographics and history of patients. Results: The prevalence of pain disorders was higher among females compared to males. The univariate and multivariate analysis showed that females were more likely to experience pain while being married correlated with a lower likelihood of pain. Again, the 45-54 age group exhibited the highest prevalence of pain disorders. Results from the MPQ showed that half of the patients experienced pain on a daily basis, 15.91% had experienced pain for 3-6 months and 37% experienced pain for more than one year. Pain intensity was described by 25% of the subjects as excruciating for their worst pain experience, followed by 21% for the distressing experience. The most frequently reported area of pain was the abdominal region (22.72%). The co-administration of NSAIDs and opioid compounds was provided for 17.46% of the patients with chronic pain. Conclusion: The treatment interventions improved the pain and associated symptoms such as nausea, improved daily activities and ability to sleep. However, attention and resources should be devoted to 45-54 age group.

Keywords: pain, opioids, distressing, excruciating

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Authors: Afaf Manzoor, Abdul Hameed

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Children with hearing impairment face several challenges in accessing primary and secondary education in general and higher education in particular in Pakistan. A large number of these children are excluded from formal education system through segregated special institutions. The enrollment rate of these children at school level is very low and it continues decreasing as they move on the ladder of education. Negligible number of students with hearing impairment gets any chance to be enrolled at tertiary or higher education institutes. The segregated system of education at primary and secondary level makes it even more difficult to adjust in an inclusive classroom at a higher level not only for students with hearing impairment but for their teachers and peers as well. A false belief of teachers and parents about low academic profile of students with hearing impairment is one of the major challenges to overcome for their participation at higher education. This case study was conducted to document an innovative step taken by the Department of Special Education Needs, University of Management & Technology, Lahore Pakistan. The prime objective of this study was to assess the satisfaction level of students with hearing impairment in BS 4 Years and MA Special Education programs at Lahore campus. Structured interviews were of 40 students with hearing impairment to assess the satisfaction on service delivery (admission process, classroom pedagogy, content, assessment/results, access to other services centers i.e. library, cafeteria, hostel, co-curricular activities) and campus life. Their peers without disabilities were also interviewed to assess their acceptance level. The findings of the study revealed positive results about their educational as well as social inclusion in the university. The students also shared their fears at the time of admission and how fear eventually faded out with the passage of time due to the proper academic support system. The findings of the study will be shared in detail with the audience during the presentation.

Keywords: students with hearing impairment, higher education, inclusive education, marginalization

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Authors: Jessica Leigh Thornton

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The South African Constitution outlines provisions for every detainee and sentenced prisoner in relation to the human rights recognized in the country since 1994; but currently, across the country, prisons have yet to meet many of these criteria. Consequently, their day-to-day lives are marked by extreme lack of privacy, high rates of infection, poor nutrition, and deleterious living conditions, which steadily erode prisoners’ mental and physical capacities rather than rehabilitating inmates so that they can effectively reintegrate into society. Even more so, policy reform, advocacy, security, and rehabilitation programs continue to be based on research and theories that were developed to explain the experiences of men, while female offenders are seen as the “special category” of inmates. Yet, the experiences of women and their pathways to incarceration are remarkably different from those of male offenders. Consequently, little is known about the profile, nature and contributing factors and experiences of female offenders which has impeded a comprehensive and integrated understanding of the subject of female criminality. The number of women globally in correctional centers has more than doubled over the past fifteen years (these increases vary from prison to prison and country to country). Yet, female offenders have largely been ignored in research even though the minority status of female offenders is a phenomenon that is not peculiar to South Africa as the number of women incarcerated has increased by 68% within the decade. Within South Africa, there have been minimal studies conducted on the gendered experience of offenders. While some studies have explored the pathways to female offending, gender-sensitive correctional programming for women that respond to their needs has been overlooked. This often leads to a neglect of the needs of female offenders, not only in terms of programs and services delivery to this minority group but also from a research perspective. In response, the aim of the proposed research is twofold: Firstly, the lived experiences and views of rehabilitation and reintegration of female offenders will be explored. Secondly, the various pathways into and out of recidivism amongst female offenders will be investigated regarding their inclusion in educational rehabilitation.

Keywords: female incarceration, educational rehabilitation, exclusion, experiences of female offenders

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Authors: Maryam Parsian, Pelin Mutlu, Ufuk Gunduz

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Two-dimensional cell culture affords simplicity and low cost, but it has serious limitations; lacking cell-cell and cell-matrix interactions that are present in tissues. Cancer cells grown in 3D culture systems have distinct phenotypes of adhesion, growth, migration, invasion as well as profiles of gene and protein expression. These interactions cause the 3D-cultured cells to acquire morphological and cellular characteristics relevant to in vivo tumors. Palbociclib is a chemotherapeutic agent for the treatment of ER-positive and HER-negative metastatic breast cancer. Poly-amidoamine (PAMAM) dendrimer is a well-defined, special three-dimensional structure and has a multivalent surface and internal cavities that can play an essential role in drug delivery systems. In this study, palbociclib is loaded onto the magnetic PAMAM dendrimer. Hanging droplet method was used in order to form 3D spheroids. The possible toxic effects of both free drug and drug loaded nanoparticles were evaluated in 2D and 3D MCF-7, MD-MB-231 and SKBR-3 breast cancer cell culture models by performing MTT cell viability and Alamar Blue assays. MTT analysis was performed with six different doses from 1000 µg/ml to 25 µg/ml. Drug unloaded PAMAM dendrimer did not demonstrate significant toxicity on all breast cancer cell lines. The results showed that 3D spheroids are clearly less sensitive than 2D cell cultures to free palbociclib. Also, palbociclib loaded PAMAM dendrimers showed more toxic effect than free palbociclib in all cell lines at 2D and 3D cultures. The results suggest that the traditional cell culture method (2D) is insufficient for mimicking the actual tumor tissue. The response of the cancer cells to anticancer drugs is different in the 2D and 3D culture conditions. This study showed that breast cancer cells are more resistant to free palbociclib in 3D cultures than in 2D cultures. However, nanoparticle loaded drugs can be more cytotoxic when compared to free drug.

Keywords: 2D and 3D cell culture, breast cancer, palbociclibe, PAMAM magnetic nanoparticles

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Authors: Franco Miguel Nodado, Adrienne Marie Bugayong Janagap, Allen Claire Arances, Kirsten Anne Gerez, Frances Catherine Rosario, Charise Alvyne Samaniego, Matt Andrew Secular, Rommel Gestuveo, Marilyn Sumayo, Joseph Arbizo, Philip Ian Padilla

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COVID-19 pandemic adversely affected the delivery of health care services, but its impacts on Maternal, Newborn, Child Health and Nutrition (MNCHN) programs in rural municipalities in the Philippines remains understudied. Thus, this study explored the effects of the pandemic on MNCHN indicators in the municipalities of Miagao, Iloilo and Sibunag, Guimaras. A cross-sectional design was employed to compare the MNCHN indicators before and during the pandemic, and between Miagao and Sibunag. Key informant interviews (KII) were performed to identify the factors affecting access to MNCHN programs. During the pandemic, Miagao had a significant increase in positive outcomes of eight out of ten maternal health indicators, while Sibunag showed a significant decrease in six indicators. For child health and nutrition, Miagao obtained significant improvements in five of seven indicators, while Sibunag showed a significant increase in positive outcomes for six. KII data showed that the primary concern of mothers in Miagao is accessibility, while mothers in Sibunag raised concerns on accessibility, availability, and affordability of these MNCHN services. Miagao MHO employed various strategies such as telemedicine, activation of barangay health workers, and decentralization of health services to Barangay Health Centers, which can explain the improvements in MNCHN indicators. Sibunag also decentralized its health services, but its limited resources might have led them to prioritize child health and nutrition services. The findings suggest that the impacts of the COVID-19 pandemic on MNCHN depend on local health measures employed by the municipality, while telemedicine is a very useful tool in mitigating the negative effects of disrupted health services.

Keywords: maternal, child, COVID-19, Miagao, Sibunag, nutrition

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Authors: Ozlem Oral, Seval Kilic, Ozlem Yedier, Serap Dokmeci, Devrim Gozuacik

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Autophagy is a degradation pathway, activating under stress conditions. It digests macromolecules, such as abnormal proteins and long-lived organelles by engulfing them and by subsequent delivery of the cargo to lysosomes. The members of the phospholipid-dependent serine/threonine kinases, involved in many signaling pathways, which are necessary for the regulation of cellular metabolic activation. Previous studies implicate that, serine/threonine kinases have crucial roles in the mechanism of many diseases depend on the activated and/or inactivated signaling pathway. Data indicates, the signaling pathways activated by serine/threonine kinases are also involved in activation of autophagy mechanism. However, the information about the effect of serine/threonine kinases on autophagy mechanism and the roles of these effects in disease formation is limited. In this study, we investigated the effect of activated serine/threonine kinases on autophagic pathway. We performed a commonly used autophagy technique, GFP-LC3 dot formation and by using microscopy analyses, we evaluated promotion and/or inhibition of autophagy in serine/threonine kinase-overexpressed fibroblasts as well as cancer cells. In addition, we carried out confocal microscopy analyses and examined autophagic flux by utilizing the differential pH sensitivities of RFP and GFP in mRFP-GFP-LC3 probe. Based on the shRNA-library based screening, we identified autophagy-related proteins affected by serine/threonine kinases. We further studied the involvement of serine/threonine kinases on the molecular mechanism of newly identified autophagy proteins and found that, autophagic pathway is indirectly controlled by serine/threonine kinases via specific autophagic proteins. Our data indicate the molecular connection between two critical cellular mechanisms, which have important roles in the formation of many disease pathologies, particularly cancer. This project is supported by TUBITAK-1001-Scientific and Technological Research Projects Funding Program, Project No: 114Z836.

Keywords: autophagy, GFP-LC3 dot formation assay, serine/threonine kinases, shRNA-library screening

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Authors: Odunayo S. Faluse, Roger Telfer

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Customer relationship management is a business strategy that is centred on the idea that ‘Customer is the driving force of any business’ i.e. Customer is placed in a central position in any business. However, this belief coupled with the advancement in information technology in the past twenty years has experienced a change. In any form of business today it can be concluded that customers are the modern dictators to whom the industry always adjusts its business operations due to the increase in availability of information, intense market competition and ever growing negotiating ideas of customers in the process of buying and selling. The most vital role of any organization is to satisfy or meet customer’s needs and demands, which eventually determines customer’s long-term value to the industry. Therefore, this paper analyses and describes the application of customer relationship management operational strategies in some of the major industries in business. Both developed and up-coming companies nowadays value the quality of customer services and client’s loyalty, they also recognize the customers that are not very sensitive when it comes to changes in price and thereby realize that attracting new customers is more tasking and expensive than retaining the existing customers. However, research shows that several factors have recently amounts to the sudden rise in the execution of CRM strategies in the marketplace, such as a diverted attention of some organization towards integrating ideas in retaining existing customers rather than attracting new one, gathering data about customers through the use of internal database system and acquiring of external syndicate data, also exponential increase in technological intelligence. Apparently, with this development in business operations, CRM research in Academia remain nascent; hence this paper gives detailed critical analysis of the recent advancement in the use of CRM and key research opportunities for future development in using the implementation of CRM as a determinant factor for successful business optimization.

Keywords: agriculture, banking, business strategies, CRM, education, healthcare

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Authors: Mohammad K. Rumjaun, Sana Amjed, Muhammad A. Ghazi, Safa G. Attar, Jason Raw

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Background: National Health Service (NHS) in England is one of the leading healthcare systems in the world and it heavily relies on the recruitment of overseas doctors. 30.7% of the doctors currently serving in NHS are overseas doctors. Most of these doctors do not receive the essential induction required to work in the NHS when they first arrive and therefore, they mostly struggle to work effectively in the first few months of their new jobs as compared to UK graduates. In our hospital, the clinical need for a dedicated induction programme for the International Medical Graduates (IMGs) was identified for their initial settling period and this programme was designed to achieve this. Methods: A questionnaire was designed for the previous 7 IMGs (Group 1) in order to identify the difficulties they faced in their initial phase. Thereafter, an induction programme consisting of presentations explaining the NHS and hospital framework, communication skills practice sessions, the clinical ceiling of care and patient simulation training was implemented for 6 new IMGs (Group 2). Another survey was done and compared with the previous. Results: After this programme, group 2 required only 1 week to understand the complexity of the IT systems as compared 3 weeks in group 1. 83% of group 2 was well-supported for their on-call duties after this programme as compared to 29% and 100% of group 2 was aware of their role in the job after the induction as compared to 0%. Furthermore, group 2 was able to function independently and confidently in their roles after only 1 month as compared to an average of 3 months for group 1. After running the PDSA cycles, our results show clear evidence that this programme has tremendously benefitted the IMGs in settling in the NHS. The IMGs really appreciated this initiative and have given positive feedback. Conclusion: Leaving your home country to begin your career in a different country is not an easy transition and undoubtedly, everyone struggles. It is important to invest in a well-structured induction programme for the IMGs in the initial phase of their jobs as this will improve not only their confidence and efficacy but also patients’ safety.

Keywords: induction programme, international medical graduates, NHS, overseas doctors struggles.

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Authors: Jose Melena, Rosa Santander, Tanya Gonzalez, Richard Duque, Juan Illanes

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Ecuador is one of the countries with the greatest aquatic biodiversity worldwide. In particular, there are at least a dozen native marine species with great aquaculture potential locally. This research concerns one of those species. It has proposed to implement experimental protocols in order to induce spawning and to generate the early larval development of the penshell Atrina maura under controlled conditions. Bioassays were carried out with one adult batch (n= 26) with an average valvar length of 307,6 ± 9,4 mm, which were collected in the Puerto El Morro Mangrove (2° 42' 33'' S, 80° 14' 28'' W), Guayas Province. During a short acclimation stage, five adults of penshell A. maura were sacrificed in order to determine their sexual maturity degree and to estimate their sex ratio. Dissection showed that three were ripe females (60%) and two were ripe males (40%). Later, three groups (n= 7 by each) were tested with two treatments in order to induce the broodstock spawning: thermal stress, osmotic shock, and one control. Spawning induction was achieved by the immersion in water to 0 g L⁻¹ per 1 h and immersion in sea water to 34 g L⁻¹ per 1 h. After the delivery of gametes, it was achieved 1,35 × 10⁶ viable zygotes. As results, fertilized eggs had 60 µm diameter; while first and second cell divisions were observed to 1 h post-fertilization, with individual average length of 65 ± 4 µm and polar body. Latter cell divisions, including gastrula stage, appeared at 9 h post-fertilization, with individual average length of 71 ± 4 µm; and trochophore stage at 16 h post-fertilization with individual average length of 75 ± 5 µm. In addition, veliger stage was registered at 20 h post-fertilization with individual average length of 81 ± 5 µm. Umboned larvae appeared at day 8 post-fertilization, with individual average length of 145 ± 6 µm. These pioneering results in Ecuador can strengthen the local conservation process of the overexploited A. maura and to encourage its production for commercial purposes.

Keywords: Atrina maura, Ecuador, larval development, spawning induction

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Authors: Kuan Yin Hsiao, Shyh Ming Kuo, Yi Jhen Wu, Chin Wen Chuang, Chuen-Fu Lin, Wei-qing Yang, Han Hsiang Huang

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Anti-tumor effects of natural products, like compounds from marine sponges and soft corals, have been investigated for decades. Polymeric nanoparticles prepared from biodegradable and biocompatible molecules, such as Hyaluronan (HA), Chitosan (CHI) and gelatin have been widely studied. Encapsulation of anti-cancer therapies by the biopolymeric nanoparticles in drug delivery system is potentially capable of improving the therapeutic effects and attenuating their toxicity. In the current study, the anti-bladder cancer effects of heteronemin extracted from the sponge Hippospongia sp. with or without HA and CHI nanoparticle encapsulation were assessed and evaluated in vitro. Results showed that IC50 (half maximal inhibitory concentration) of heteronemin toward T24 human bladder cancer cell viability is approximately 0.18 µg/mL. Both plain and HA nanoparticles-encapsulated heteronemin at 0.2 and 0.4 µg/mL significantly reduced T24 cell viability (P<0.001) while HA nanoparticles-encapsulated heteronemin showed weaker viability-inhibitory effects on L929 fibroblasts compared with plain heteronemin at the identical concentrations. HA and CHI nanoparticles-encapsulated heteronemin exhibited significantly stronger inhibitory effects against migration of T24 human bladder cancer cell than those exerted by plain heteronemin at the same concentrations (P<0.001). The flow cytometric results showed that 0.2 µg/mL HA and CHI nanoparticles-encapsulated heteronemin induced higher early apoptosis rate than that induced by plain heteronemin at the same concentration. These results show that HA and CHI nanoparticle encapsulation is able to elevate anti-migratory and apoptosis-inducing effects exerted by heteronemin against bladder cancer cells in vitro. The in vivo anti-bladder cancer effects of the compound with or without HA/CHI nanoparticle encapsulation will be further investigated and examined using murine tumor models. The data obtained from this study will extensively evaluate of the anti-bladder cancer effects of heteronemin as well as HA/CHI-encapsulated heteronemin and pave a way to develop potential bladder cancer treatment.

Keywords: heteronemin, nanoparticles, hyaluronan, chitosan, bladder cancer

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Authors: Rukia Yosuf

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Diabetes is a national healthcare crisis related to both macrovascular and microvascular complications. We hypothesized that higher levels of physical activity are associated with lower total and visceral fat mass, lower systolic blood pressure, and increased insulin sensitivity. Participant inclusion criteria: 21-50 years old, BMI ≥ 30 kg/m2, hemoglobin A1C 5.7-6.4, fasting glucose 100-125 mg/dL, and HOMA IR ≥ 2.5. Exclusion criteria: history of diabetes, hypertension, HIV, renal disease, hearing loss, alcoholic intake over four drinks daily, use of organic nitrates or PDE5 inhibitors, and decreased cardiac function. Total physical activity was measured using accelerometers, body composition using DXA, and insulin resistance via fsIVGTT. Clinical and biochemical cardiometabolic risk factors, blood pressure and heart rate were obtained using a calibrated sphygmomanometer. Anthropometric measures, fasting glucose, insulin, lipid profile, C-reactive protein, and BMP were analyzed using standard procedures. Within our study, we found correlations between levels of physical activity in a heterogeneous group of prediabetic adults. Patients with more physical activity had a higher degree of insulin sensitivity, lower blood pressure, total visceral adipose tissue, and overall lower total mass. Total physical activity levels showed small, but significant correlations with systolic blood pressure, visceral fat, lean mass and insulin sensitivity. After normalizing for the race, age, and gender using multiple regression, these associations were no longer significant considering our small sample size. More research into prediabetes will decrease the population of diabetics overall. In the future, we could increase sample size and conduct cross sectional and longitudinal studies in various populations with prediabetes.

Keywords: diabetes, kidney disease, nephrology, prediabetes

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Authors: Ilyes Athimni, Mouna Bouzazi, Mongi Boulehmi, Ahmed Ferchichi

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The principles of good governance, universal values, and digitization are among the tools to fight corruption and improve the quality of service delivery. In recent years, these tools have become one of the most controversial topics in the field of education and a concern of many international organizations and institutions against the problem of corruption. Corruption in the education sector, particularly in higher education, has negative impacts on the quality of education systems and on the quality of administrative or educational services. Currently, the health crisis due to the spread of the COVID-19 pandemic reveals the difficulties encountered by education systems in most countries of the world. Due to the poor governance of these systems, many educational institutions were unable to continue working remotely. To respond to these problems encountered by most education systems in many countries of the world, our initiative is to propose a methodology to reinvent education systems based on global values and digital technologies. This methodology includes a work strategy for educational institutions, whether in the provision of administrative services or in the teaching method, based on information and communication technologies (ICTs), intelligence artificial, and intelligent agents. In addition, we will propose a supervisory law that will be implemented and monitored by intelligent agents to improve accountability, transparency, and accountability in educational institutions. On the other hand, we will implement and evaluate a field experience by applying the proposed methodology in the operation of an educational institution and comparing it to the traditional methodology through the results of teaching an educational program. With these specifications, we can reinvent quality education systems. We also expect the results of our proposal to play an important role at local, regional, and international levels in motivating governments of countries around the world to change their university governance policies.

Keywords: artificial intelligence, corruption in education, distance learning, education systems, ICTs, intelligent agents, good governance

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Authors: Petronella Jonck, Freda van der Walt

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Despite the benefits of innovation diffusion in the South African public service, implementation thereof seems to be problematic, particularly with regard to e-governance which would enhance the quality of service delivery, especially accessibility, choice, and mode of operation. This paper reports on differences between the public service and the private sector in terms of innovation diffusion. Innovation diffusion will be investigated to explore identified obstacles that are hindering successful implementation of e-governance. The research inquiry is underpinned by the diffusion of innovation theory, which is premised on the assumption that innovation has a distinct channel, time, and mode of adoption within the organisation. A comparative thematic document analysis was conducted to investigate organisational differences with regard to innovation diffusion. A similar approach has been followed in other countries, where the same conceptual framework has been used to guide document analysis in studies in both the private and the public sectors. As per the recommended conceptual framework, three organisational characteristics were emphasised, namely the external characteristics of the organisation, the organisational structure, and the inherent characteristics of the leadership. The results indicated that the main difference in the external characteristics lies in the focus and the clientele of the private sector. With regard to organisational structure, private organisations have veto power, which is not the case in the public service. Regarding leadership, similarities were observed in social and environmental responsibility and employees’ attitudes towards immediate supervision. Differences identified included risk taking, the adequacy of leadership development, organisational approaches to motivation and involvement in decision making, and leadership style. Due to the organisational differences observed, it is recommended that differentiated strategies be employed to ensure effective innovation diffusion, and ultimately e-governance. It is recommended that the results of this research be used to stimulate discussion on ways to improve collaboration between the mentioned sectors, to capitalise on the benefits of each sector.

Keywords: E-governance, ICT, innovation diffusion, comparative analysis

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Authors: Virakti Dhaval Shah

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Advances in technology and the changes in lifestyle and work expectations amid the COVID-19 pandemic are requiring changes to vocational assessment, provision of vocational training, and identification of job matches for individuals with intellectual disability. Vocational assessment involves the assessment of interests, skills, abilities, and strengths/weaknesses, as well as a detailed understanding of healthcare, familial, social, community, workplace-related and policy-level protective and risk factors impacting the individual. In India, vocational assessment procedures such as interviews play a major role in vocational placement today. Unfortunately, many of the most widely used vocational assessment instruments in India were developed in the 1970s to 2000s and have not been revised since. Hence, there is a dire need to update existing tools and prepare a structured approach for vocational service providers to meet the unique employment needs of individuals with intellectual disabilities. To address this need, this project designed a multi-domain assessment toolkit for a structured approach to vocational assessment, training, and job placement for individuals with intellectual disabilities in India. Methods included conducting an empirical review of the available tools currently in use in India for the vocational assessment of persons with intellectual disabilities. Domains addressed in the instrument review were organized into a structured system, and additional items related to contemporary technology, pandemic-related experiences of persons with disabilities, and changes in lifestyle and work expectations due to the pandemic were added. Items assessing behaviors, provision of vocational training, and identification of job matches for individuals with intellectual disabilities were developed. The proposed tool has the potential to benefit organizations working with and preparing individuals with intellectual disabilities to find successful employment by undertaking a structured approach to vocational assessment, rehabilitation, training, and placement. It can be particularly useful for guiding new professionals doing vocational rehabilitation in India.

Keywords: intellectual disability, rehabilitation, vocational assessment, vocational rehabilitation

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Authors: Yongrong Li, Ralf Domroes

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Due to significant energy savings, enablement of higher machining speed as well as environmentally friendly features, Minimum Quantity Lubrication (MQL) has been used for many machining processes efficiently. However, in the deep hole drilling field (small tool diameter D < 5 mm) and long tool (length L > 25xD) it is always a bottle neck for a single channel MQL system. The single channel MQL, based on the Venturi principle, faces a lack of enough oil quantity caused by dropped pressure difference during the deep hole drilling process. In this paper, a system concept based on a bypass design has explored its possibility to dynamically reach the required pressure difference between the air inlet and the inside of aerosol generator, so that the deep hole drilling demanded volume of oil can be generated and delivered to tool tips. The system concept has been investigated in static and dynamic laboratory testing. In the static test, the oil volume with and without bypass control were measured. This shows an oil quantity increasing potential up to 1000%. A spray pattern test has demonstrated the differences of aerosol particle size, aerosol distribution and reaction time between single channel and bypass controlled single channel MQL systems. A dynamic trial machining test of deep hole drilling (drill tool D=4.5mm, L= 40xD) has been carried out with the proposed system on a difficult machining material AlSi7Mg. The tool wear along a 100 meter drilling was tracked and analyzed. The result shows that the single channel MQL with a bypass control can overcome the limitation and enhance deep hole drilling with a small tool. The optimized combination of inlet air pressure and bypass control results in a high quality oil delivery to tool tips with a uniform and continuous aerosol flow.

Keywords: deep hole drilling, green production, Minimum Quantity Lubrication (MQL), near dry machining

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Authors: Abir Dey, Shams Noman

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Introduction: Offshore Island is the remote and isolated area from the terrestrial mainland. They are deprived of their needs. The children from an offshore island are usually underserved in the case of health care because it is a remote area where the health care systems are quite poor compared to mainland. So, the proper information is required for appropriate planning to reduce underlying causes behind visual deprivation among the surviving children of the Offshore Island. Purpose: The purpose of this study was to determine ocular morbidities, knowledge, and barriers of eye care services among children in an Offshore Island. Methods: The study team visited, and all data were collected from different rural communities at Sandwip Upazila, Chittagong district for screening the children aged 5-16 years old by doing spot examination. The whole study was conducted in both qualitative and quantitative methods. To determine ocular status of children, examinations were done under skilled Ophthalmologists and Optometrists. A focus group discussion was held. The sample size was 490. It was a community based descriptive study and the sampling method was purposive sampling. Results: In total 490 children, about 56.90% were female and 43.10% were male. Among them 456 were school-going children (93.1%) and 34 were non-school going children (6.9%). In this study the most common ocular morbidity was Allergic Conjunctivitis (35.2%). Other mentionable ocular morbidities were Refractive error (27.7%), Blepharitis (13.8%), Meibomian Gland Dysfunction (7.5%), Strabismus (6.3%) and Amblyopia (6.3%). Most of the non-school going children were involved in different types of domestic work like farming, fishing, etc. About 90.04% children who had different ocular abnormalities could not attend to the doctor due to various reasons. Conclusions: The ocular morbidity was high in rate on the offshore island. Eye health care facility was also not well established there. Awareness should be raised about necessity of maintaining hygiene and eye healthcare among the island people. Timely intervention through available eye care facilities and management can reduce the ocular morbidity rate in that area.

Keywords: morbidities, screening, barriers, offshore island, knowledge

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Authors: Ravi Patel, Krishna K. Krishnan

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In global supply chains, appropriate and sustainable suppliers play a vital role in supply chain development and feasibility. In a larger organization with huge number of suppliers, it is necessary to divide suppliers based on their past history of quality and delivery of each product category. Since performance of any organization widely depends on their suppliers, well evaluated selection criteria and decision-making models lead to improved supplier assessment and development. In this paper, SCOR® performance evaluation approach and ISO standards are used to determine selection criteria for better utilization of supplier assessment by using hybrid model of Analytic Hierchchy Problem (AHP) and Fuzzy Techniques for Order Preference by Similarity to Ideal Solution (FTOPSIS). AHP is used to determine the global weightage of criteria which helps TOPSIS to get supplier score by using triangular fuzzy set theory. Both qualitative and quantitative criteria are taken into consideration for the proposed model. In addition, a multi-product and multi-time period model is selected for order allocation. The optimization model integrates multi-objective integer linear programming (MOILP) for order allocation and a hybrid approach for supplier selection. The proposed MOILP model optimizes order allocation based on manufacturing process and product tolerances as per manufacturer’s requirement for quality product. The integrated model and solution approach are tested to find optimized solutions for different scenario. The detailed analysis shows the superiority of proposed model over other solutions which considered individual decision making models.

Keywords: AHP, fuzzy set theory, multi-criteria decision making, multi-objective integer linear programming, TOPSIS

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Authors: Sutapa Som Chaudhury, Chitrangada Das Mukhopadhyay

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Alzheimer’s disease is a well-known form of dementia since its discovery in 1906. Current Food and Drug Administration approved medications e.g. cholinesterase inhibitors, memantine offer modest symptomatic relief but do not play any role in disease modification or recovery. In last three decades many small molecules, chaperons, synthetic peptides, partial β-secretase enzyme blocker have been tested for the development of a drug against Alzheimer though did not pass the 3rd clinical phase trials. Here in this study, we designed a PEGylated, aminogenic, tripeptidic polymer with two different molecular weights based on the aggregation prone amino acid sequence 17-20 in amyloid beta (Aβ) 1-42. Being conjugated with poly-ethylene glycol (PEG) which self-assembles into hydrophilic nanoparticles, these PEGylated tripeptides constitute a very good drug delivery system crossing the blood brain barrier while the peptide remains protected from proteolytic degradation and non-specific protein interactions. Moreover, being completely aminogenic they would not raise any side effects. These peptide inhibitors were evaluated for their effectiveness against Aβ42 fibrillation at an early stage of oligomer to fibril formation as well as preformed fibril clearance via Thioflavin T (ThT) assay, dynamic light scattering analyses, atomic force microscopy and scanning electron microscopy. The inhibitors were proved to be safe at a higher concentration of 20µM by the reduction assay of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) dye. Moreover, SHSY5Y neuroblastoma cells have shown a greater survivability when treated with the inhibitors following Aβ42 fibril and oligomer treatment as compared with the control Aβ42 fibril and/or oligomer treated neuroblastoma cells. These make the peptidic inhibitors a promising compound in the aspect of the discovery of alternative medication for Alzheimer’s disease.

Keywords: Alzheimer’s disease, alternative medication, amyloid beta, PEGylated peptide

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Authors: Tamekloe Michael Kossivi, Kenichi Matsui

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Irrigation access is one of the essential rural development investment options that can significantly improve smallholder farmers’ agriculture productivity. Investment in irrigation infrastructural development to supply adequate water could improve food security, growth in income for farmers, poverty alleviation, and improve business and livelihood. This paper assesses smallholder farmers’ constraints and the needs to adopt small-scale irrigation for crops production in the South Tongu District of Ghana. The data collection involved database search, questionnaire survey, interview, and field work. The structured questionnaire survey was administered from September to November 2020 among 120 respondents in six purposively sampled irrigation communities in the District. The questions focused on small-scale irrigation development constraints and needs. As a result, we found that the respondents relied mainly on rainfall for agriculture production. They did not have adequate irrigation access. Even though the District is blessed with open arable lands and rich water sources for rice and vegetable production on a massive scale, water sources like the Lower Volta River, Tordzi River, and Avu Lagoon were not close enough to the respondents. The respondents faced inadequate credit support (100%), unreliable rainfall (76%), insufficient water supply (54%), and unreliable water delivery challenges on their farms (53%). Physical constraints for the respondents to adopt irrigation included flood (77%), drought (93%), inadequate irrigation technology (59%), and insufficient technical know-how (65%). Farmers were interested in investing in irrigation infrastructural development to enhance productivity on their farms only if they own the farmlands. External support from donors on irrigation systems did not allow smallholder farmers to control irrigation facilities.

Keywords: constraints, food security, needs, smallholder farmers, small-scale irrigation

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Authors: Eveline Muika Kabongo, Peter Delobelle, Ferdinand Mukumbang, Edward Nicol

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Introduction: Studies have been conducted to establish the effect of the MomConnect program in South Africa, but these studies did not focus on the stakeholders' and implementers' perspectives and the underlying program theory of the MomConnect initiative program. We strived to obtain stakeholders’ perspectives and assumptions on the MomConnect program and develop an initial program theory (IPT) of how the MomConnect initiative was expected to work. Methods: A realist-informed explanatory design used. The interviewer was performed with 10 key informants selected purposively among MomConnect key informants at the a national level of NDoH South Africa. The interview was done via zoom and lasted for 30 to 60 minutes. Introduction and abduction inferencing approaches were applied. The deductive and inductive approaches were performed during the analysis. ICAMO hereustic framework was used to analysed the data in order to get key informants expectations on how the MomConnect will work or not. Results: We developed three folk’s theories illustrating how the key informants’ expected the MomConnect to work. These theories showed that the MomConnect intended to provide users with health information and education that will empower and motivate them with knowledge which will allow the improvement of health services delivery among HCPs and improvement of the uptake of MCH services among pregnant women and mothers and decrease the rate of maternal and child mortality in the country. The lack of an updated mechanism to link women to the outcome was an issue. Another problem enlightened was the introduction of the WhatsApp program instead of SMS messaging, which was free of charge to women. Conclusion: The Folk’s theory developed from this study provided an insight into how the MomConnect was expected to work and what did not work. The folk’s theory will be merged with information from candidate theories on synthesis review and document review to develop our initial program theory of the MomConnect initiative.

Keywords: mHealth, MomConnect program, realist evaluation, maternal and child health, maternal and child health services, introduction, theory-driven

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Authors: Lynette Sheridan Burns, Benjamin J. Matthews

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The context of post-industrial journalism is one in which the material circumstances of mechanical publication have been displaced by digital technologies, increasing the distance between the orthodoxy of the newsroom and the culture of journalistic writing. Content is, with growing frequency, created for delivery via the internet, publication on web-based ‘platforms’ and consumption on screen media. In this environment, the question is not ‘who is a journalist?’ but ‘what is journalism?’ today. The changes bring into sharp relief new distinctions between journalistic work and journalistic labor, providing a key insight into the current transition between the industrial journalism of the 20^th century, and the post-industrial journalism of the present. In the 20^th century, the work of journalists and journalistic labor went hand-in-hand as most journalists were employees of news organizations, whilst in the 21^st century evidence of a decoupling of ‘acts of journalism’ (work) and journalistic employment (labor) is beginning to appear. This 'decoupling' of the work and labor that underpins journalism practice is far reaching in its implications, not least for institutional structures. Under these conditions we are witnessing the emergence of expanded ‘entrepreneurial’ journalism, based on smaller, more independent and agile - if less stable - enterprise constructs that are a feature of creative industries. Entrepreneurial journalism is realized in a range of organizational forms from social enterprise, through to profit driven start-ups and hybrids of the two. In all instances, however, the primary motif of the organization is an ideological definition of journalism. An example is the Scoop Foundation for Public Interest Journalism in New Zealand, which owns and operates Scoop Publishing Limited, a not for profit company and social enterprise that publishes an independent news site that claims to have over 500,000 monthly users. Our paper demonstrates that this journalistic work meets the ideological definition of journalism; conducted within the creative industries using an innovative organizational structure that offers a new, viable post-industrial future for journalism.

Keywords: creative industries, digital communication, journalism, post industrial

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Authors: Resham Badri

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Cities today are unable to justify equitable distribution of theirsocio- economic and infrastructural benefits to the marginalized urban poor, and the emergence of a pressing pandemic like COVID-19 has amplified its impact. Lack of identity, vulnerability, and inaccessibility contribute to exclusion. Owing to systemic gaps in institutional processes, urban development policiesfail to represent and cater to the urban poor. This paper aims to be a roadmap for the Indian Government to understand the significance of the designation of a navigable spatial identity to slum dwellers in the form of a digital address, which can form the fundamental basis of identification to enable accessibility to not only basic servicesbut also other utilities. Capitalizing on such a granular and technology backed approach shall allow to target and reach out to the urban poor strategically andaid effective urban governance. This paper adopts a three-pronged approach;(i) Policy analysis- understanding gaps in existing urban policies of India, such as the Pradhan Mantri Awas Yojana, Swachh Bharat Mission, and Adhaar Card policy, (ii) Program Evaluation- analyzing a case study, where slum dwellers in Kolhapur city in India have been provided with navigable addresses using Google Plus Codes and have gained access to basic services, vaccinations, and other emergency deliveries in COVID-19 times, (iii) Policy recommendation. This designation of a navigable spatial identity has tremendous potential to form the foundation on which policies can further base their data collection and service delivery processes to not only provide basic services but also other infrastructural and social welfare initiatives. Hence, a massive window of opportunity lies in addressing the unaddressed to elevate their living standards and respond to their basic needs.

Keywords: policy analysis, urban poor, navigable spatial identity, accessibility

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Authors: Natividad Natalia Angeles Manuel

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In the Dominican Republic, American-Dominican veterans face unique challenges due to their dual identities and wartime experiences. This case study examines an 85-year-old veteran with memory impairments and emotional distress linked to military service. A neuropsychological assessment using standardized tools evaluated cognitive domains and functional abilities. Significant deficits in memory, orientation, semantic memory, and executive functions, alongside symptoms of Post-Traumatic Stress Disorder and depression, were identified. A six-month cognitive stimulation program included tailored interventions to enhance memory, attention, and executive skills through weekly sessions and group activities. Medical and physical therapy support aimed to improve overall cognitive, functional, and emotional outcomes. Follow-up evaluations showed improvements in memory retention, attention, task proficiency, and reduced depressive symptoms, highlighting the program's effectiveness in promoting emotional well-being and quality of life. Despite ongoing memory challenges and military-related nightmares, the veteran responded positively to interventions, demonstrating resilience and motivation. This study emphasizes the importance of personalized neuropsychological interventions for American-Dominican veterans in the Dominican Republic. Through assessment tools and focused cognitive stimulation strategies, healthcare providers can successfully alleviate cognitive and emotional challenges stemming from traumatic experiences in elderly veterans. Overall, integrated neuropsychological assessment and stimulation programs are shown to enhance cognitive resilience and emotional well-being, thus contributing to an enhanced quality of life for aging American-Dominican veterans.

Keywords: neuropsychology, cognitive stimulation, American-Dominican veterans, Dominican Republic, PTSD, memory deficits

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Authors: Anthony Khawaja, Jacques Prioux, Ghassan Maalouf, Rawad El Hage

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The regular practice of physical activities characterized by significant mechanical stresses stimulates bone formation and improves bone mineral density (BMD) in the most solicited sites. The purpose of this study was to explore the relationships between maximum power and bone variables in a group of young adult men. Identification of new determinants of BMD, bone mineral content (BMC) and hip geometric indices in young adult men, would allow screening and early management of future cases of osteopenia and osteoporosis. Fifty-three young adult men (18 – 35yr) voluntarily participated in this study. Weight and height were measured, and body mass index was calculated. Body composition, BMC and BMD were determined for each individual by Dual-energy X-ray absorptiometry (DXA; GE Healthcare, Madison, WI) at whole body (WB), lumbar spine (L1-L4), total hip (TH), and femoral neck (FN). FN cross-sectional area (CSA), strength index (SI), buckling ratio (BR), FN section modulus (Z), cross-sectional moment of inertia (CSMI) and L1-L4 TBS were also evaluated by DXA. The vertical jump was evaluated using a field test (sargent test). Two main parameters were retained: vertical jump performance (cm) and power (w). The subjects performed three jumps with 2 minutes of recovery between jumps. The highest vertical jump was selected. Maximum power (P max, in watts) was calculated. Maximum power was positively correlated to WB BMD (r = 0.41; p < 0.01), WB BMC (r = 0.65; p < 0.001), L1-L4 BMC (r = 0.54; p < 0.001), FN BMC (r = 0.35; p < 0.01), TH BMC (r = 0.50; p < 0.001), CSMI (r = 0.50; p < 0.001), CSA (r = 0.33; p < 0.05). Vertical jump was positively correlated to WB BMC (r = 0.31; p < 0.05), L1-L4 BMC (r = 0.40; p < 0.01), CSMI (r = 0.29; p < 0.05). The current study suggests that maximum power is a positive determinant of BMD, BMC and hip geometric indices in young adult men. In addition, it shows also that maximum power is a stronger positive determinant of bone variables than vertical jump in this population. Implementing strategies to increase maximum power in young adult men may be useful for preventing osteoporotic fractures later in life.

Keywords: bone variables, maximum power, osteopenia, osteoporosis, vertical jump, young adult men

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Authors: Joan Esper Kuhnly, Jess Holden, Lynn Shelley, Nicole Kuhnly

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Empathy serves as a foundational nursing principle inherent in the nurse’s ability to form those relationships from which to care for patients. Evidence supports, including empathy in nursing and healthcare education, but there is limited data on what methods are effective to do so. Building evidence supports experiential and interactive learning methods to be effective for students to gain insight and perspective from a personalized experience. The purpose of this project is to evaluate learning activities designed to promote the attainment of empathic behaviors across 5 levels of the nursing curriculum. Quantitative analysis will be conducted on data from pre and post-learning activities using the Toronto Empathy Questionnaire. The main hypothesis, that simulation learning activities will increase empathy, will be examined using a repeated measures Analysis of Variance (ANOVA) on Pre and Post Toronto Empathy Questionnaire scores for three simulation activities (Stroke, Poverty, Dementia). Pearson product-moment correlations will be conducted to examine the relationships between continuous demographic variables, such as age, credits earned, and years practicing, with the dependent variable of interest, Post Test Toronto Empathy Scores. Krippendorff’s method of content analysis will be conducted to identify the quantitative incidence of empathic responses. The researchers will use Colaizzi’s descriptive phenomenological method to describe the students’ simulation experience and understand its impact on caring and empathy behaviors employing bracketing to maintain objectivity. The results will be presented, answering multiple research questions. The discussion will be relevant to results and educational pedagogy in the nursing curriculum as they relate to the attainment of empathic behaviors.

Keywords: curriculum, empathy, nursing, simulation

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