Search results for: advance care planning

Authors: Zhihua Xu

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In the era of globalization, the urban question is increasingly being posed in the form of a scale question. Scale theory provides a new perspective for analyzing various dynamics and their influences on urban development. After the reunification, how the government of the Hong Kong Special Administrative Region (SAR) interacts with the actors at various scales and carries out state rescaling are the keys to exploring the issue of urban development and governance in Hong Kong. This paper examines the entire planning process of the Hong Kong Section of the Guangzhou-Shenzhen-Hong Kong Express Rail Link, from project conception, design, to consultation, and fund application, to identify the actors at different scales involved in the process, and analyze the modes and consequences of their interaction. This study shows that after the reunification, the Hong Kong SAR Government takes the initiative to scale up to expand its hinterland. Intergovernmental institutional cooperation is an important mode of state rescaling for the Hong Kong SAR government. Meanwhile, the gradually growing civil society plays an important role in the rescaling of urban development. Local actors use scalar politics to construct discourses and take actions at multiple scales to challenge the government’s proposal and trigger a discussion on the project throughout the Hong Kong society. The case study of Hong Kong can deepen the understanding of state rescaling of territorial organizations in the context of institutional transformation and enrich the theoretical connotation of state rescaling. It also helps the Mainland government to better understand the case of Hong Kong and formulate appropriate.

Keywords: Hong Kong, state rescaling, scalar politics, Hong Kong section of the Guangzhou-Shenzhen-Hong Kong express rail link, urban governance

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Authors: Andre Bechuke

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The quality of every learning programme in Higher Education (HE) is dependent on the planning, design, and development of the curriculum decisions. These curriculum development decisions are highly influenced by the knowledge of the end-user, who are not always just the students. When curriculum experts plan, design and develop learning programmes, they always have the end-users in mind throughout the process. Without proper knowledge of the end-user(s), the design and development of a learning programme might be flawed. Curriculum experts often struggle to determine who the real end-user is. As such, it is even more challenging to establish what needs to be known about the end user that should inform the plan, design, and development of a learning programme. This research sought suggest approaches to guide curriculum experts to identify the end-user(s), taking into consideration the pressure and influence other agencies and structures or stakeholders (industry, students, government, universities context, lecturers, international communities, professional regulatory bodies) have on the design of a learning programme and the graduates of the programmes. Considering the influence of these stakeholders, which is also very important, the task of deciding who the real end-user of the learning programme becomes very challenging. This study makes use of criteria 1 and 18 of the Council on Higher Education criteria for programme accreditation to guide the process of identifying the end-users when developing a learning programme. Criterion 1 suggests that designers must ensure that the programme is consonant with the institution’s mission, forms part of institutional planning and resource allocation, meets national requirements and the needs of students and other stakeholders, and is intellectually credible. According to criterion 18, in designing a learning programme, steps must be taken to enhance the employability of students and alleviate shortages of expertise in relevant fields. In conclusion, there is hardly ever one group of end-users to be considered for developing a learning programme, and the notion that students are the end-users is not true, especially when the graduates are unable to use the qualification for employment.

Keywords: council on higher education, curriculum design and development, higher education, learning programme

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Authors: Dalal N. Hammod, Ekhlas K. Gbashi

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Today, cryptography is used in many applications to achieve high security in data transmission and in real-time communications. AES has long gained global acceptance and is used for securing sensitive data in various industries but has suffered from slow processing and take a large time to transfer data. This paper suggests a method to enhance Advance Encryption Standard (AES) Algorithm based on time and permutation. The suggested method (MAES) is based on modifying the SubByte and ShiftRrows in the encryption part and modification the InvSubByte and InvShiftRows in the decryption part. After the implementation of the proposal and testing the results, the Modified AES achieved good results in accomplishing the communication with high performance criteria in terms of randomness, encryption time, storage space, and avalanche effects. The proposed method has good randomness to ciphertext because this method passed NIST statistical tests against attacks; also, (MAES) reduced the encryption time by (10 %) than the time of the original AES; therefore, the modified AES is faster than the original AES. Also, the proposed method showed good results in memory utilization where the value is (54.36) for the MAES, but the value for the original AES is (66.23). Also, the avalanche effects used for calculating diffusion property are (52.08%) for the modified AES and (51.82%) percentage for the original AES.

Keywords: modified AES, randomness test, encryption time, avalanche effects

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Authors: Parimalakrishnan Sundararjan, Madheswaran Murugan, Dhanya Dharman, Yatindra Kumar, Sudhir Singh Gangwar, Guru Prasad Mohanta

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Antibiotic resistance AR is a global issue, India started to redress the issues of antibiotic resistance late and it plans to have: active surveillance of microbial resistance and promote appropriate use of antibiotics. The present study attempted to achieve appropriate use of antibiotics through pharmacists’ intervention at practice point. In a quasi-experimental prospective cohort study, the cases with bacteremia from four hospitals were identified during 2015 and 2016 for intervention. The pharmacists centered intervention: active screening of each prescription and comparing with the selection of antibiotics with susceptibility of the bacteria. Wherever irrationality noticed, it was brought to the notice of the treating physician for making changes. There were two groups: intervention group and control group without intervention. The active screening and intervention in 915 patients has reduced therapeutic regimen time in patients with bacteremia. The intervention group showed the decreased duration of hospital stay 3.4 days from 5.1 days. Further, multivariate modeling of patients who were in control group showed that patients in the intervention group had a significant decrease in both duration of hospital stay and infection-related mortality. Unlike developed countries, pharmacists are not active partners in patient care in India. This unique attempt of pharmacist’ invention was planned in consultation with hospital authorities which proved beneficial in terms of reducing the duration of treatment, hospital stay, and infection-related mortality. This establishes the need for a collaborative decision making among the health workforce in patient care at least for promoting rational use of antibiotics, an attempt to combat resistance.

Keywords: antibiotics resistance, intervention, bacteremia, multivariate modeling

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Authors: B. M. M. D. Mendis, L. I. Rajapaksa, P. S. K. Gunathunga, R. C. Fernando, M. Jayalath

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Background / introduction: During the year 2011, 8511 males received services from the sexual health clinics island wide. At present there is only limited information on the risk behaviours of male attendees. Information on risk behaviours related to STI /HIV transmission is helpful in planning suitable prevention interventions. Aim(s)/objectives: The objectives were to determines the sexual partners (other than the marital partner and regular partners) responsible for transmitting STI( Sexually transmitted infections)/ HIV and to understand the practice of safer sex. Methods: Study was a clinic based prospective study conducted for a one year period using an interviewer administered questionnaire. Results: 983 attendees were interviewed. . Mean age was 34.02 years. 75% of the sample had completed GCE O/L (ordinary level examination). Skilled labourers, drivers and forces/police comprised 40% of the sample. 50% admitted sex with a casual female, 12% with a casual male, and 13% with CSW (commercial sex workers) while MSW (male sex workers) exposures were minimal. It was identified that younger males had more contacts with males, and regular female partners while more older males with CSW. Anal sex among males was reported by 11.5%. 20.5% used alcohol frequently and 5.9% used drugs and 1.4% injected. Common STI were genital herpes (7.9%), Non gonococcal urethritis (6.2%) and gonorrhoea (6.2%). Among those who had contacts with FSW 6.7% gonorrhoea (GC), 8.2% non gonococcal urethritis (NGU), 7.5% genital herpes and 0.7% HIV. Non regular partner exposures 3.7% had gonorrhoea, 8.3% NGU, 6.6% genital herpes and 0.8% HIV. Among MSM contacts 10.6% had GC, 4.5% NGU, 5.3% genital herpes, 5.3% secondary syphilis and 0.8% HIV. Only 9.0% used condoms correctly. Friends, doctors, newspapers, internet, and forces were important sources of information on condoms. Non use of condoms were due to worry about satisfaction (24.6%) and faith in the partner (25.6%). Discussion/conclusion: Casual partners for unsafe sex is a concern. MSM and CSW are remained as an important source of infection. Early Syphilis and gonorrhoea infections were mostly seen among MSM exposures. The findings indicate that the male population in the sample had satisfactory education. However, still the unsafe sexual contacts are common. . Newspapers, internet were more important sources of information on condoms. Low condom use remains another concern.. More males contracted STI through casual partners. Therefore strategies used for prevention need to be revisited also emphasizing on general population where casual partners represent. . Increasing awareness of men and women through mass media and primary health care teams may be important strategies that can be used to keep the HIV epidemic in a low level.

Keywords: STI, HIV, Males, safe sex practices

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Authors: Chen-Ya Juan

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In recent years, the increasing number of children with special needs has brought a lot of attention by many scholars and experts in education, which enforced the preschool teachers face the harsh challenge in the classroom. To protect the right of equal education for all children, enhance the quality of children learning, and take care of the needs of children with special needs, the special education paraprofessional becomes one of the future employment trends for students of the department of the early childhood care and education. Problem-based learning is a problem-oriented instruction, which is different from traditional instruction. The instructor first designed an ambiguous problem direction, following the basic knowledge of early intervention, students had to find clues to solve the problem defined by themselves. In the class, the total instruction included 20 hours, two hours per week. The primary purpose of this paper is to investigate the relationship of student academic scores, self-awareness, learning motivation, learning attitudes, and early intervention knowledge. A total of 105 college students participated in this study and 97 questionnaires were effective. The effective response rate was 90%. The student participants included 95 females and two males. The average age of the participants was 19 years old. The questionnaires included 125 questions divided into four major dimensions: (1) Self-awareness, (2) learning motivation, (3) learning attitudes, and (4) early intervention knowledge. The results indicated (1) the scores of self-awareness were 58%; the scores of the learning motivations was 64.9%; the scores of the learning attitudes was 55.3%. (2) After the instruction, the early intervention knowledge has been increased to 64.2% from 38.4%. (3) Student’s academic performance has positive relationship with self-awareness (p < 0.05; R = 0.506), learning motivation (p < 0.05; R = 0.487), learning attitudes (p < 0.05; R = 0.527). The results implied that although students had gained early intervention knowledge by using PBL instruction, students had medium scores on self-awareness and learning attitudes, medium high in learning motivations.

Keywords: college students, children with special needs, problem-based learning, learning motivation

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Authors: Tazeen Fatima

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Use of project management in web & software development projects is very significant. It has been observed that even with the application of effective project management, projects usually do not complete their lifecycle and fail. To minimize these failures, key performance indicators have been introduced in previous studies to counter project failures. However, there are always gaps and problems in the KPIs identified. Despite of incessant efforts at technical and managerial levels, projects still fail. There is no substantial approach to identify and avoid these failures in the very beginning of the project lifecycle. In this study, we aim to answer these research problems by analyzing the concept of predictive analytics which is a specialized technology and is very easy to use in this era of computation. Project organizations can use data gathering, compute power, and modern tools to render efficient Predictions. The research aims to identify such a predictive analytics approach. The core objective of the study was to reduce failures and introduce effective implementation of project management principles. Existing predictive analytics methodologies, tools and solution providers were also analyzed. Relevant data was gathered from projects and was analyzed via predictive techniques to make predictions well advance in time to render effective project management in web & software development industry.

Keywords: project management, predictive analytics, predictive analytics methodology, project failures

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Authors: Nadezda Kobzeva

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Under the current trend of globalization, economic and technological dynamics information and the means by which it is delivered and renewed becomes out-of-date rapidly. Thus, educational systems as well as higher education are being seriously tested. New strategies’ developing that is supported by Information and Communication Technology is urgently required. The essential educators’ mission is to meet the demands of the future by preparing our young learners with proper knowledge, skills and innovation capabilities necessary to advance our competitiveness globally. In response to the modern society and future demands, the oldest Siberian Tomsk Polytechnic University has wisely proposed several initiatives to promote the integration of Information and Communication Technology (ICT) in education, and increase the competitiveness of graduates by emphasizing inquiry-based learning, higher order thinking and problem solving. This paper gives a brief overview of how Web Quest as ICT device is being used for language teaching and describes its use advantages for teaching English as a Foreign Language (EFL), in particular business writing skills. This study proposes to use Web Quest to promote higher order thinking and ICT integration in the process of engineers training in Tomsk Polytechnic University, Russia.

Keywords: web quest, web quest in pedagogy, resume (CVs) and cover letter writing skills, ICT integration

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Authors: Narottam Puri, Gurvinder Kaur

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Background: The National Accreditation Board for Hospitals & Healthcare Providers (NABH) is India’s apex standard setting accrediting body in health care which evaluates and accredits healthcare organizations. NABH requires accredited organizations to become reaccredited every three years. It is often though that once the initial accreditation is complete, the foundation is set and reaccreditation is a much simpler process. Fortis Hospital, Shalimar Bagh, a part of the Fortis Healthcare group is a 262 bed, multi-specialty tertiary care hospital. The hospital was successfully accredited in the year 2012. On completion of its first cycle, the hospital underwent a reaccreditation assessment in the year 2015. This paper aims to gain a better understanding of the challenges that accredited hospitals face when preparing for a renewal of their accreditations. Methods: The study was conducted using a cross-sectional mixed methods approach; semi-structured interviews were conducted with senior leadership team and staff members including doctors and nurses. Documents collated by the QA team while preparing for the re-assessment like the data on quality indicators: the method of collection, analysis, trending, continual incremental improvements made over time, minutes of the meetings, amendments made to the existing policies and new policies drafted was reviewed to understand the challenges. Results: The senior leadership had a concern about the cost of accreditation and its impact on the quality of health care services considering the staff effort and time consumed it. The management was however in favor of continuing with the accreditation since it offered competitive advantage, strengthened community confidence besides better pay rates from the payors. The clinicians regarded it as an increased non-clinical workload. Doctors felt accountable within a professional framework, to themselves, the patient and family, their peers and to their profession; but not to accreditation bodies and raised concerns on how the quality indicators were measured. The departmental leaders had a positive perception of accreditation. They agreed that it ensured high standards of care and improved management of their functional areas. However, they were reluctant in sparing people for the QA activities due to staffing issues. With staff turnover, a lot of work was lost as sticky knowledge and had to be redone. Listing the continual quality improvement initiatives over the last 3 years was a challenge in itself. Conclusion: The success of any quality assurance reaccreditation program depends almost entirely on the commitment and interest of the administrators, nurses, paramedical staff, and clinicians. The leader of the Quality Movement is critical in propelling and building momentum. Leaders need to recognize skepticism and resistance and consider ways in which staff can become positively engaged. Involvement of all the functional owners is the start point towards building ownership and accountability for standards compliance. Creativity plays a very valuable role. Communication by Mail Series, WhatsApp groups, Quizzes, Events, and any and every form helps. Leaders must be able to generate interest and commitment without burdening clinical and administrative staff with an activity they neither understand nor believe in.

Keywords: NABH, reaccreditation, quality assurance, quality indicators

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Authors: Judson P. LaGrone

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Simulation-based education in curricula was once a luxurious component of nursing programs but now serves as a vital element of an individual’s learning experience. A debriefing occurs after the simulation scenario or clinical experience is completed to allow the instructor(s) or trained professional(s) to act as a debriefer to guide a reflection with a purpose of acknowledging, assessing, and synthesizing the thought process, decision-making process, and actions/behaviors performed during the scenario or clinical experience. Debriefing is a vital component of the simulation process and educational experience to allow the learner(s) to progressively build upon past experiences and current scenarios within a safe and welcoming environment with a guided dialog to enhance future practice. The aim of this integrative review was to assess current practices of debriefing models in simulation-based education for health care professionals and students. The following databases were utilized for the search: CINAHL Plus, Cochrane Database of Systemic Reviews, EBSCO (ERIC), PsycINFO (Ovid), and Google Scholar. The advanced search option was useful to narrow down the search of articles (full text, Boolean operators, English language, peer-reviewed, published in the past five years). Key terms included debrief, debriefing, debriefing model, debriefing intervention, psychological debriefing, simulation, simulation-based education, simulation pedagogy, health care professional, nursing student, and learning process. Included studies focus on debriefing after clinical scenarios of nursing students, medical students, and interprofessional teams conducted between 2015 and 2020. Common themes were identified after the analysis of articles matching the search criteria. Several debriefing models are addressed in the literature with similarities of effectiveness for participants in clinical simulation-based pedagogy. Themes identified included (a) importance of debriefing in simulation-based pedagogy, (b) environment for which debriefing takes place is an important consideration, (c) individuals who should conduct the debrief, (d) length of debrief, and (e) methodology of the debrief. Debriefing models supported by theoretical frameworks and facilitated by trained staff are vital for a successful debriefing experience. Models differed from self-debriefing, facilitator-led debriefing, video-assisted debriefing, rapid cycle deliberate practice, and reflective debriefing. A reoccurring finding was centered around the emphasis of continued research for systematic tool development and analysis of the validity and effectiveness of current debriefing practices. There is a lack of consistency of debriefing models among nursing curriculum with an increasing rate of ill-prepared faculty to facilitate the debriefing phase of the simulation.

Keywords: debriefing model, debriefing intervention, health care professional, simulation-based education

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Authors: Lulu Liao, Huijing Chen, Yinan Zhao, Hongting Ning, Hui Feng

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Urinary tract infection rate is an important index of care quality in nursing homes. The aim of the study is to understand the nursing assistant's current knowledge and attitudes of urinary incontinence and to explore related stakeholders' viewpoint about urinary incontinence training. This explanatory sequential study used Knowledge, Practice, and Attitude Model (KAP) and Adult Learning Theories, as the conceptual framework. The researchers collected data from 509 nursing assistants in sixteen nursing homes in Hunan province in China. The questionnaire survey was to assess the knowledge and attitude of urinary incontinence of nursing assistants. On the basis of quantitative research and combined with focus group, training demands were identified, which nurse managers should adopt to improve nursing assistants’ professional practice ability in urinary incontinence. Most nursing assistants held the poor knowledge (14.0 ± 4.18) but had positive attitudes (35.5 ± 3.19) toward urinary incontinence. There was a significant positive correlation between urinary incontinence knowledge and nursing assistants' year of work and educational level, urinary incontinence attitude, and education level (p < 0.001). Despite a general awareness of the importance of prevention of urinary tract infections, not all nurse managers fully valued the training in urinary incontinence compared with daily care training. And the nursing assistants required simple education resources to equip them with skills to address problem about urinary incontinence. The variety of learning methods also highlighted the need for educational materials, and nursing assistants had shown a strong interest in online learning. Related education material should be developed to meet the learning need of nurse assistants and provide suitable training method for planned quality improvement in urinary incontinence.

Keywords: mixed methods, nursing assistants, nursing homes, urinary incontinence

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Authors: Kamyar Fakhr, Roozbeh Salmani

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Alphonse Bertillon developed the first biometric security system in the 1800s. Today, many governments and giant companies are considering or have procured biometrically enabled security schemes. Iris is a kaleidoscope of patterns and colors. Each individual holds a set of irises more unique than their thumbprint. Every single day, giant companies like Google and Apple are experimenting with reliable biometric systems. Now, after almost 200 years of improvements, face ID does not work with masks, it gives access to fake 3D images, and there is no global usage of biometric recognition systems as national identity (ID) card. The goal of this paper is to demonstrate the advantages of iris recognition overall biometric recognition systems. It make two extensions: first, we illustrate how a very large amount of internet fraud and cyber abuse is happening due to bugs in face recognition systems and in a very large dataset of 3.4M people; second, we discuss how establishing a secure global network of iris recognition devices connected to authoritative convolutional neural networks could be the safest solution to this dilemma. Another aim of this study is to provide a system that will prevent system infiltration caused by cyber-attacks and will block all wireframes to the data until the main user ceases the procedure.

Keywords: biometric system, convolutional neural network, cyber-attack, secure

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Authors: Abubakar Sadiq Mensah

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The Knowledge of the population growth of a nation is paramount to national planning. The population of a place is studied and a model developed over a period of time, Matrices is used to form model for population growth. The eigenvalue ƛ of the matrix A and its corresponding eigenvector X is such that AX = ƛX is calculated. The stable age distribution of the population is obtained using the eigenvalue and the characteristic polynomial. Hence, estimation could be made using eigenvalues and eigenvectors.

Keywords: eigenvalues, eigenvectors, population, growth/stability

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Authors: Karen V. Lee

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The background and significance of this study involves autoethnographic research about a music teacher learning how education and curriculum planning can help her overcome harmful and lasting career consequences from sexual violence. Curriculum surrounding intervention resources from education helps her cope with consequences influencing her career as music teacher. Basic methodology involves the qualitative method of research as theoretical framework where the author is drawn into a deep storied reflection about political issues surrounding teachers who need to overcome social, psychological, and health risk behaviors from violence. Sub-themes involve counseling, curriculum, adult education to ensure teachers receive social, emotional, physical, spiritual, and intervention resources that evoke visceral, emotional responses from the audience. Major findings share how stories provide helpful resources to teachers who have been victims of violence. It is hoped the research dramatizes an episodic yet incomplete story that highlights the circumstances surrounding the protagonist’s life as teacher with previous sexual violence. In conclusion, the research has a reflexive storied framework with video and music from curriculum planning that embraces harmful and lasting consequences from sexual violence. The reflexive story of the sensory experience critically seeks verisimilitude by evoking lifelike and believable feelings from others. Thus, the scholarly importance of using education and curriculum as intervention resources to accompany storied research can provide transformative aspects that can contribute to social change. Overall, the circumstance surrounding the story about sexual violence is not uncommon in society. Thus, continued education and curriculum that supports the moral mission to help teachers overcome sexual violence that socially impacts their professional lives as victims.

Keywords: education, curriculum, sexual violence, storied autoethnography

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Authors: D. Calogine, O. Chau, S. Dotti, O. Ramiarinjanahary, P. Rasoavonjy, F. Tovondahiniriko

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Mafate is a natural circus in the north-western part of Reunion Island, without an electrical grid and road network. A micro-grid concept is being experimented in this area, composed of a photovoltaic production combined with electrochemical batteries, in order to meet the local population for self-consumption of electricity demands. This work develops a discrete model as well as a stochastic model in order to reach an optimal equilibrium between production and consumptions for a cluster of houses. The management of the energy power leads to a large linearized programming system, where the time interval of interest is 24 hours The experimental data are solar production, storage energy, and the parameters of the different electrical devices and batteries. The unknown variables to evaluate are the consumptions of the various electrical services, the energy drawn from and stored in the batteries, and the inhabitants’ planning wishes. The objective is to fit the solar production to the electrical consumption of the inhabitants, with an optimal use of the energies in the batteries by satisfying as widely as possible the users' planning requirements. In the discrete model, the different parameters and solutions of the linear programming system are deterministic scalars. Whereas in the stochastic approach, the data parameters and the linear programming solutions become random variables, then the distributions of which could be imposed or established by estimation from samples of real observations or from samples of optimal discrete equilibrium solutions.

Keywords: photovoltaic production, power consumption, battery storage resources, random variables, stochastic modeling, estimations of probability distributions, mixed integer linear programming, smart micro-grid, self-consumption of electricity.

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Authors: Yakin Ekin, Onur Akbulut

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This study aims not only to create a summarized background for the effective and efficient use of the potential of Izmir by providing the strategic planning works and institutional and sectoral strategy documents with different purposes realized by all relevant institutions and organizations in Izmir and Aegean Region to steer towards the same priorities and aims, but also focuses on a criticism and comparison viewpoint about tourism sector in Izmir.

Keywords: regional plan, Izmir, tourism, sectoral strategy

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Authors: Vladimir Littva, Peter Kutis

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Based on common practice, we know that an empathic approach to a patient is one of the characteristics of a physiotherapist. Although empathy is regarded as an essential condition of the psychotherapeutic relationship, it has taken quite a while for attention to be paid to it in clinical practice. Patients who are experiencing a sense of understanding from health care providers are more willing to cooperate, and treatment within the optimistic attunes a more comfortable framework of care. Age, experience, family, education and the working environment may have an impact on the degree of empathy for paramedics. Within the KEGA project no. 003KU-4-2021, we decided to investigate the level of empathy in the work of physiotherapists in Slovakia. Research sample and Methods: The sample comprised 194 respondents – physiotherapists working on the territory of Slovakia. 112 were men and 82 women. The age of respondents was between 21 and 64 years of age. 133 were married, 51 were single and ten were divorced. 98 were living in the countryside and 96 in towns. Twenty-two grew up without siblings, 95 with one sibling and 77 with two and more siblings. In the survey, we used the Empathy Assessment Questionnaire (EAQ) with 18 questions with four possible answers: strongly disagree, disagree, agree; and strongly agree, which we validated linguistically and psychometrically. All data were statistically processed by SPSS 25. Results: We evaluated the intrinsic reliability of the questionnaire EAQ using Cronbach's Alpha and the coefficient is 0.756 in the whole set. This means that the questionnaire is a quite strong and reliable measurement tool. The mean for individual questions ranged from 2.39 to 3.74 (maximum was 4). In Pearson's correlations, we confirmed the significant differences between the groups regarding sex in 8 questions out of 18, regarding age in 5 questions, regarding family status in 4 questions and regarding siblings in 4 questions out of 18 at the level 5% (p <0.05). Conclusion: The results obtained during the research show the importance of adequate communication with the patient due to his health and well-being. Empathy in the physiotherapists’ profession is very important. It would be worthwhile if the students of physiotherapy would receive a course during their study that would deal exclusively with empathy, empathic approach, burnout, or psycho-emotional hygiene.

Keywords: empathy, approach, clinical practice, physiotherapists

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Authors: Taonga Temwani Chibaka

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This qualitative research study was conducted to identify the common risk factors that affect the construction industry in Malawi in the building and infrastructure (civil works) projects. The study then evaluates the possible risk responses that are done to mitigate the various risk factors that were identified. I addition the research also established the barriers to risk management implementation with lastly mapping out as where the identified risk factors fall on which stage of the project and then also map out the knowledge areas that need to be worked on the cases on Malawian construction industry in order to mitigate most of the identified risk factors. The study involved the interviewing the professionals from the construction industry in Malawi where insights and ideas were collected, analysed and interpreted. The key study findings show that risks related to clients group are perceived as most critical followed by the contractor related, consultant related and then external group related factors respectively where preventive measures are the most applied risk response technique where the aim to avoid most of the risk factors from happening. Most of the risk factors identified were internal risks and in managerial category which suggested that risk planning was to be emphasized at pre-contract stage to minimize these risks since a bigger percentage of the risk factors were mapped out at implementation stage. Furthermore, barriers to risk management were identified and the key barriers were lack of awareness; lack of knowledge; lack of formal policies in place; regarded as costly and limited time which resulted in proposing that regulating authorities to purposefully introduce intense training on risk management to make known of this new knowledge area. The study then recommends that organisation should formally implement risk management where policies should be introduced to enforce all parties to undertake this. Risk planning was regarded as paramount and this to be done from pre-contract phase so as to mitigate 80% of the risk factors. Finally, training should be done on all project management knowledge areas.

Keywords: risk management, risk factors, risks, malawi

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Authors: Aryati Yashadhana, Ted Fields Jnr., Wendy Fernando, Kelvin Brown, Godfrey Blitner, Francis Hayes, Ruby Stanley, Brian Donnelly, Bridgette Jerrard, Anthea Burnett, Anthony B. Zwi

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Indigenous Australians experience some of the worst health outcomes globally, with life expectancy being significantly poorer than those of non-Indigenous Australians. This is largely attributed to preventable diseases such as diabetes (prevalence 39% in Indigenous Australian adults > 55 years), which is attributed to a raised risk of diabetic visual impairment and cataract among Indigenous adults. Our study aims to explore the interface between structural and sociocultural determinants and human agency, in order to understand how they impact (1) accessibility of eye health and chronic disease services and (2) the potential for Indigenous patients to achieve positive clinical eye health outcomes. We used Participatory Action Research methods, and aimed to privilege the voices of Indigenous people through community collaboration. Semi-structured interviews (n=82) and patient focus groups (n=8) were conducted by Indigenous Community-Based Researchers (CBRs) with diabetic Indigenous adults (> 40 years) in four remote communities in Australia. Interviews (n=25) and focus groups (n=4) with primary health care clinicians in each community were also conducted. Data were audio recorded, transcribed verbatim, and analysed thematically using grounded theory, comparative analysis and Nvivo 10. Preliminary analysis occurred in tandem with data collection to determine theoretical saturation. The principal investigator (AY) led analysis sessions with CBRs, fostering cultural and contextual appropriateness to interpreting responses, knowledge exchange and capacity building. Identified themes were conceptualised into three spheres of influence: structural (health services, government), sociocultural (Indigenous cultural values, distrust of the health system, ongoing effects of colonialism and dispossession) and individual (health beliefs/perceptions, patient phenomenology). Permeating these spheres of influence were three core determinants: economic disadvantage, health literacy/education, and cultural marginalisation. These core determinants affected accessibility of services, and the potential for patients to achieve positive clinical outcomes at every level of care (primary, secondary, tertiary). Our findings highlight the clinical realities of institutionalised and structural inequities, illustrated through the lived experiences of Indigenous patients and primary care clinicians in the four sampled communities. The complex determinants surrounding inequity in health for Indigenous Australians, are entrenched through a longstanding experience of cultural discrimination and ostracism. Secure and long term funding of Aboriginal Community Controlled Health Services will be valuable, but are insufficient to address issues of inequity. Rather, working collaboratively with communities to build trust, and identify needs and solutions at the grassroots level, while leveraging community voices to drive change at the systemic/policy level are recommended.

Keywords: indigenous, Australia, culture, public health, eye health, diabetes, social determinants of health, sociology, anthropology, health equity, aboriginal and Torres strait islander, primary care

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Authors: Sinead Impey, Gaye Stephens, Lucy Hederman, Declan O'Sullivan

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Continued paper use in the clinical area post-Electronic Health Record (EHR) adoption is regularly linked to hardware and software usability challenges. Although paper is used as a workaround to circumvent challenges, including limited availability of a computer, this perspective does not consider the important role paper, such as the nurses’ handover sheet, play in practice. The purpose of this study is to confirm the hypothesis that paper use post-EHR adoption continues as paper provides both a cognitive tool (that assists with workflow) and a compensation tool (to circumvent usability challenges). Distinguishing the different motivations for continued paper-use could assist future evaluations of electronic record systems. Methods: Qualitative data were collected from three clinical care environments (ICU, general ward and specialist day-care) who used an electronic record for at least 12 months. Data were collected through semi-structured interviews with 22 nurses. Data were transcribed, themes extracted using an inductive bottom-up coding approach and a thematic index constructed. Findings: All nurses interviewed continued to use paper post-EHR adoption. While two distinct motivations for paper use post-EHR adoption were confirmed by the data - paper as a cognitive tool and paper as a compensation tool - further finding was that there was an overlap between the two uses. That is, paper used as a compensation tool could also be adapted to function as a cognitive aid due to its nature (easy to access and annotate) or vice versa. Rather than present paper persistence as having two distinctive motivations, it is more useful to describe it as presenting on a continuum with compensation tool and cognitive tool at either pole. Paper as a cognitive tool referred to pages such as nurses’ handover sheet. These did not form part of the patient’s record, although information could be transcribed from one to the other. Findings suggest that although the patient record was digitised, handover sheets did not fall within this remit. These personal pages continued to be useful post-EHR adoption for capturing personal notes or patient information and so continued to be incorporated into the nurses’ work. Comparatively, the paper used as a compensation tool, such as pre-printed care plans which were stored in the patient's record, appears to have been instigated in reaction to usability challenges. In these instances, it is expected that paper use could reduce or cease when the underlying problem is addressed. There is a danger that as paper affords nurses a temporary information platform that is mobile, easy to access and annotate, its use could become embedded in clinical practice. Conclusion: Paper presents a utility to nursing, either as a cognitive or compensation tool or combination of both. By fully understanding its utility and nuances, organisations can avoid evaluating all incidences of paper use (post-EHR adoption) as arising from usability challenges. Instead, suitable remedies for paper-persistence can be targeted at the root cause.

Keywords: cognitive tool, compensation tool, electronic record, handover sheet, nurse, paper persistence

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Authors: Nicki Mohammadi, Emma Reford, Natalia Romano Spica, Laura Tabacof, Jenna Tosto-Mancuso, David Putrino, Christopher P. Kellner

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Introductory Statement: The onset of the COVID-19 pandemic demanded an unprecedented need for the rapid development, dispersal, and application of infection testing. However, despite the impressive mobilization of resources, individuals were incredibly limited in their access to tests, particularly during the initial months of the pandemic (March-April 2020) in New York City (NYC). Access to COVID-19 testing is crucial in understanding patients’ illness experiences and integral to the development of COVID-19 standard-of-care protocols, especially in the context of overall access to healthcare resources. Succinct Description of basic methodologies: 18 Patients in a COVID-19 Remote Patient Monitoring Program (Precision Recovery within the Mount Sinai Health System) were interviewed regarding their experience with COVID-19 during the first wave (March-May 2020) of the COVID-19 pandemic in New York City. Patients were asked about their experiences navigating COVID-19 diagnoses, the health care system, and their recovery process. Transcribed interviews were analyzed for thematic codes, using grounded theory to guide the identification of emergent themes and codebook development through an iterative process. Data coding was performed using NVivo12. References for the domain “testing” were then extracted and analyzed for themes and statistical patterns. Clear Indication of Major Findings of the study: 100% of participants (18/18) referenced COVID-19 testing in their interviews, with a total of 79 references across the 18 transcripts (average: 4.4 references/interview; 2.7% interview coverage). 89% of participants (16/18) discussed the difficulty of access to testing, including denial of testing without high severity of symptoms, geographical distance to the testing site, and lack of testing resources at healthcare centers. Participants shared varying perspectives on how the lack of certainty regarding their COVID-19 status affected their course of recovery. One participant shared that because she never tested positive she was shielded from her anxiety and fear, given the death toll in NYC. Another group of participants shared that not having a concrete status to share with family, friends and professionals affected how seriously onlookers took their symptoms. Furthermore, the absence of a positive test barred some individuals from access to treatment programs and employment support. Concluding Statement: Lack of access to COVID-19 testing in the first wave of the pandemic in NYC was a prominent element of patients’ illness experience, particularly during their recovery phase. While for some the lack of concrete results was protective, most emphasized the invalidating effect this had on the perception of illness for both self and others. COVID-19 testing is now widely accessible; however, those who are unable to demonstrate a positive test result but who are still presumed to have had COVID-19 in the first wave must continue to adapt to and live with the effects of this gap in knowledge and care on their recovery. Future efforts are required to ensure that patients do not face barriers to care due to the lack of testing and are reassured regarding their access to healthcare. Affiliations- 1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 2Abilities Research Center, Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY

Keywords: accessibility, COVID-19, recovery, testing

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Authors: Abdul Qayyum, Hafiz Muhammad Saeed, Mamoona Hanif, Etrat Noor, Waqas Malik, Shoaib Liaqat

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Salinity is extremely serious problem that has a drastic effect on maize crop, environment and causes economic losses of country. An advance technique to overcome salinity is to develop salt tolerant geno types which require screening of huge germplasm to start a breeding program. Therefore, present study was undertaken to screen out 25 maize hybrids of different origin for salinity tolerance at seedling stage under three levels of salt stress 250 and 300 mM NaCl including one control. The existence of variation for tolerance to enhanced NaCl salinity levels at seedling stage in maize proved that hybrids had differing ability to grow under saline environment and potential variability within specie. Almost all the twenty five maize hybrids behaved varyingly in response to different salinity levels. However, the maize hybrids H6, H13, H21, H23 and H24 expressed better performance under salt stress in terms of all six characters and proved to be as highly tolerant while H22, H17 H20, H18, H4, H9, and H8 were identified as moderately tolerant. Hybrids H14, H5, H11 and H3 H12, H2, were expressed as most sensitive to salinity suggesting that screening is an effective tool to exploit genetic variation among maize hybrids and salt tolerance in maize can be enhanced through selection and breeding procedure.

Keywords: salinity, hybrids, maize, variation

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Authors: Zahra Abdolkarimi, Naser Zourikalatehsamad,

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Up to 40 years ago, after recognition of epilepsy, it was generally believed that these attacks occurred randomly and suddenly. However, thanks to the advance of mathematics and engineering, such attacks can be predicted within a few minutes or hours. In this way, various algorithms for long-term prediction of the time and frequency of the first attack are presented. In this paper, by considering the nonlinear nature of brain signals and dynamic recorded brain signals, ANFIS model is presented to predict the brain signals, since according to physiologic structure of the onset of attacks, more complex neural structures can better model the signal during attacks. Contribution of this work is the co-evolution algorithm for optimization of ANFIS network parameters. Our objective is to predict brain signals based on time series obtained from brain signals of the people suffering from epilepsy using ANFIS. Results reveal that compared to other methods, this method has less sensitivity to uncertainties such as presence of noise and interruption in recorded signals of the brain as well as more accuracy. Long-term prediction capacity of the model illustrates the usage of planted systems for warning medication and preventing brain signals.

Keywords: co-evolution algorithms, brain signals, time series, neural networks, ANFIS model, physiologic structure, time prediction, epilepsy suffering, illustrates model

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Authors: Chimuanya Osuji, Kido Uyamasi, Morgan Bradley

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Introduction: Obesity is a major risk factor for many chronic diseases, with higher rates occurring among certain populations. Even though disparities in obesity rates exist for those with disabilities, few studies have assessed the association between disability and obesity status. This study aims to examine the association between type of disability and obesity status among US adults during the Covid-19 pandemic (2019-2021). Methods: Data for this cross-sectional study was obtained from the 2019, 2020 and 2021 NHIS. Multinomial logistic regressions were used to assess the relationship between each type of disability and obesity status (reference= normal/underweight). Each model adjusted for demographic, health status and health-related quality of life variables. Statistical analyses were conducted using SAS version 9.4. Results: Of the 82,632 US adults who completed the NHIS in 2019, 2020, and 2021. 8.9% (n= 7,354) reported at least 1 disability-related condition. Respondents reported having a disability across vision (1.5%), hearing (1.5%), mobility (5.3%), communication (0.8%), cognition (2.4%) and self-care (1.1%) domains. After adjusting for covariates, adults with at least 1 disability-related condition were about 30% more likely to have moderate-severe obesity (AOR=1.3; 95% CI=1.11, 1.53). Mobility was the only disability category positively associated with mild obesity (AOR=1.16; 95% CI=1.01, 1.35) and moderate/severe obesity (AOR=1.6; 95% CI=1.35, 1.89). Individuals with vision disability were about 35% less likely to have mild obesity (AOR=0.66; 95% CI=0.51, 0.86) and moderate-severe obesity (AOR=0.66; 95% CI= 0.48, 0.9). Individuals with hearing disability were 28% less likely to have mild obesity (AOR=0.72; 95% CI= 0.56, 0.94). Individuals with communication disability were about 30% less likely to be overweight (AOR=0.66; 95% CI=0.47, 0.93) and 50% less likely to have mild obesity (AOR=0.45; 95% CI= 0.29, 0.71). Individuals with cognitive disability were about 25% less likely to have mild obesity and about 35% less likely to have moderate-severe obesity. Individuals with self-care disability were about 30% less likely to be overweight. Conclusion: Mobility-related disabilities are significantly associated with obesity status among adults residing in the United States. Researchers and policy makers should implement obesity intervention methods that can address the gap in obesity prevalence rates among those with and without disabilities.

Keywords: cognition, disability, mobility, obesity

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Authors: Shazia Shinwari

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In the 21st century, South Asia is becoming one of the rising sub-regions of the world. In the whole of Asia, South Asia is going to be the center part of opportunities, development, and challenges. The increasing economy and its geopolitical importance are changing the landscape of South Asia. Despite intensifying the opportunities and development, the region is also facing the challenges of security, poverty, and conflicts. It is one of the most populated sub-regions and has many internal conflicts because of which the region remains for a long time a least developed region in the world. But now South Asia is transforming into the developing process and trying to utilize its potentials and to remove the hurdles in the way of development. South Asia is one of the distinctive regions of the world and could play an important role at the global level if the potentials of the region are properly utilized. South Asia is one of the most important regions of the world and assumed more importance after the British withdrawal from the region. Now South Asia is playing an important role in world politics due to its strategic and geographical location. That is why the importance of this region in the international political systems cannot be ignored. Day by day, changes have been taking place in the structure of the global economy, and South Asia could take advantage of these changes to advance as an economic region. For this, South Asia will need to look at its history, and that changes, particularly in the India and Pakistan relations, are necessary for the development of the South Asian region. Despite having challenges in the region, South Asia is also rising as the land of opportunities and development if the potentials of the region are properly utilized and smoothen the way for regional integration.

Keywords: challenges, development, opportunities, South Asia

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Authors: Meinrad Haule Lembuka

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Ubuntu is an African philosophy and model with the meaning of 'humanity to others' or 'care for other’s needs because of the guiding principle of interdependence’ that embraces collective and holistic efforts in development through the human face. The study uses a literature review method reflecting Julius Nyerere’s contributions in realizing Ubuntu and social work practice. Nyerere strived to restore Africa development in the lens of humanism through the values of solidarity, communal participation, compassion, care, justice etc; He later founded developmental social work through Ujamaa model, educational for self reliance and African dignity. Nyerere was against post-colonial syndromes through African socialism that envisioned values and principles of social work to provide social justice, human dignity, social change and social development. Also, he managed to serve the primary mission of the social work profession to enhance human wellbeing and help meet basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty with African Ubuntu practice of equal distribution of resources. Nyerere further endorsed social work legal framework that embraced universal human rights: service, equality, social justice, and human dignity, Importance of human relationship, integrity and competence. Nyerere proved that Indigenous model can work with formal system like Social work profession. In 2014 the National Heritage Council of South Africa (NHC) honored him an Award of African Ubuntu champion. Nyerere strongly upheld to be an ambassador of social work through his remarkably contributions in developmental social work (Ujamaa model), social change, human dignity, equality, social unity and social justice in Africa and globe at large.

Keywords: ubuntu, Indiginious knowledge, Indiginious social work, ubuntu social work

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Authors: Shu Hwang Ang, Choo Yee Yu, Geik Yong Ang, Yean Yean Chan, Yatimah Binti Alias, And Sook Mei Khor

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With the high prevalence of Type 2 diabetes mellitus across the world, the morbidities and mortalities associated with Type 2 diabetes have significant impact on the production line for a nation. With routine scheduled clinical visits to manage Type 2 diabetes, diabetic patients with hectic lifestyles can have low clinical compliance. Hence, it often decreases the effectiveness of diabetic management personalized for each diabetic patient. Here, we report a useful developed point-of-care (POC) device that detect glycated hemoglobin (HbA1c, biomarker for long-term Type 2 diabetic management). In fact, the established POC devices certified to be used in clinical setting are not only expensive ($ 8 to $10 per test), they also require skillful practitioners to perform sampling and interpretation. As a paper-based biosensor, the developed HbA1c biosensor utilized lateral flow principle to offer an alternative for cost-effective (approximately $2 per test) and end-user friendly device for household testing. Requiring as little as 2 L of finger-picked blood, the test can be performed at the household with just simple dilution and washings. With visual interpretation of numbers of test lines shown on the developed biosensor, it can be interpreted as easy as a urine pregnancy test, aided with scale of intensity provided. In summary, the developed HbA1c immunosensor has been tested to have high selectivity towards HbA1c, and is stable with reasonably good performance in clinical testing. Therefore, our developed HbA1c immunosensor has high potential to be an effective diabetic management tool to increase patient compliance and thus contain the progression of the diabetes.

Keywords: blood, glycated hemoglobin (HbA1c), lateral flow, type 2 diabetes mellitus

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Authors: Muqadis Shazia Rajpar, Lawrence Mitelberg, Rubaiat S. Ahmed, Jemer Garrido, Rukhsana Hossain, Sergey M. Motov

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Distraction techniques have been used as a means to reduce pain, anxiety, and stress in various healthcare settings to facilitate care and make visits less unpleasant. Using virtual reality (VR) in the pediatric emergency setting can be a valuable, effective, and safe non-pharmacological alternative to the current standard of care for pain and anxiety management in pediatric patients. Our pilot study aimed to evaluate the effectiveness of a VR-based intervention as an alternative distraction modality to alleviate pain and anxiety associated with pediatric emergency department (ED) visits and acute pain conditions. The pilot study period was from November 16 to December 9, 2022, for pediatric ED visits for pain, anxiety, or both. Patients were selected based on a novel VR protocol to receive the VR intervention with the administration of pre and post-intervention surveys concerning pain/anxiety ratings and pain scores (Wong-Baker FACES/NRS). Descriptive statistics, paired t-test, and a Fisher Exact Test were used for data analysis, assuming a p-value of 0.05 for significance. A total of 33 patients (21 females, 12 males), ages 5-20 (M = 10.5, SD = 3.43) participated in this study – 12 patients had pain, 2 patients had anxiety, and 19 patients had both pain and anxiety. There was a statistically significant decrease in post-intervention pain scores of less than one point on the rating scale (6.48 vs. 5.62, p < .001). There was a statistically significant reduction in the percentage of patients suffering from “considerable” or “great” pain after the VR intervention (51.6% to 42.3%, p < .001). Similarly, we noticed an increase in the number of patients with “slight” or “moderate” pain post–VR intervention (48.4% to 57.7%, p < .001). Lastly, we demonstrated a decrease in anxiety among patients after utilizing VR (63.6% vs. 36.4%, p < .001). To conclude, VR can alleviate pain and anxiety in pediatric patients and be a useful non-pharmacological tool in the emergency setting.

Keywords: anxiety, emergency room, pain management, pediatric emergency medicine, virtual reality

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Authors: Julieta Alos

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Following the explicitation hypothesis, it has been proposed that explicitation is a translation universal, i.e., one of those features that characterize translated texts, and cannot be traced back to interference from a particular language. The explicitation hypothesis has been enthusiastically endorsed by some scholars, and firmly rejected by others. Focusing on the translation of promotional material from English into Arabic, specifically in the luxury goods market, the aims of this study are twofold: First, to contribute to the debate regarding the notion of explicitation in order to advance our understanding of what has become a contentious concept. Second, to add to the growing body of literature on non-professional translation by shedding light on this particular aspect of it. To this end, our study uses a combination of qualitative and quantitative methods to explore a corpus of brochures pertaining to the luxury industry, translated into Arabic at the local marketing agencies promoting the brands in question, by bilingual employees who have no translation training. Our data reveals a preference to avoid creative language choices in favor of more direct advertising messages, suggestive of a general tendency towards explicitation in non-professional translation, beyond what is dictated by the grammatical and stylistic constraints of Arabic. We argue, further, that this translation approach is at odds with the principles of luxury advertising, which emphasize implicitness and ambiguity, and view language as an extension of the creative process involved in the production of the luxury item.

Keywords: English-Arabic translation, explicitation, non-professional translation, promotional texts

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Authors: Cameron Brown, Jessica Vanburen, Scott Hunt

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This study analyzed 411 international newspaper stories pertaining to gambling-related crimes from January 2013 to December 2014. These stories included accounts of crimes committed to fund gambling or pay gambling debts or that occurred at gambling establishments. Our analysis pays particular attention to those crimes that were imputed to be committed by “problem” or “addictive” gamblers, who commit crimes to fund gambling or pay gambling debts. Previous research on problem/addictive gambling has focused on its etiology or prevalence rates and has not attended to the media portrayals of this behavior and its association with crime. Using frame analysis concepts, the data demonstrate that the newspaper stories typically frame the events as “crimes” and not the result of illness or addiction. The “evidence” of motive that could have indicated psychological problems or additions were rather framed as “criminal motive.” This framing practice advances an identity of a “problem/addictive gambler” as a deviant criminal perpetrator and not a victim of addiction. The paper concludes with a discussion of how these findings can be used to advance research on social portrayals of problem/addictive gamblers. Specifically, we consider how these media frames impede an understanding of problem/addictive gambling as a public health problem.

Keywords: problem gambling, addictive gambling, identity resonace, frame analysis

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