Search results for: practice guidelines

Authors: Wei Zhao

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The pandemic crisis disrupted normal classroom practices so that the constraints of the traditional practice became apparent. This turns out to be new opportunities for technology-based learning and teaching. However, how the technology supports the preschool teachers go through this sudden crisis and how preschool teachers conceived of the use of technology, appropriate and design technological artifacts as a mediator of knowledge construction in order to suit young children’s literacy level are rarely explored. This study addresses these issues by looking at the influence of a web-supported teacher community on changes/shifts in preschool teachers’ epistemological beliefs and practices. This teachers’ professional development community was formulated before the pandemic time and developed virtually throughout the home-based learning caused by Covid-19. It served as a virtual and asynchronous community for those teachers to collaboratively plan for and conduct online lessons using the knowledge-building approach for the purpose of sustaining children’s learning curiosity and opening up new learning opportunities during the lock-down period. The knowledge-building approach helps to increase teachers’ collective responsibility to collaboratively work on shared educational goals in the teacher community and awareness of noticing new ideas or innovations in their classroom. Based on the data collected across five months during and after the lock-down period and the activity theory, results show a dynamic interplay between the evolution of the community culture, the growth of teacher community and teachers’ identity transformation and professional development. Technology is useful in this regard not only because it transforms the geographical distance and new gathering guidelines after the outbreak of pandemic into new ways of communal communication and collaboration. More importantly, while teachers selected, monitored and adapted the technology, it acts as a catalyst for changes in teachers’ old teaching practices and epistemological dispositions.

Keywords: activity theory, changes in epistemology and practice, knowledge building, web-based teachers’ professional development community

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Authors: Ramzi Shawahna

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Background: Neonatal intensive care units are high-risk settings where medication errors can occur and cause harm to this fragile segment of patients. This multicenter qualitative study was conducted to describe medication errors that occurred in neonatal intensive care units in Palestine from the perspectives of healthcare providers. Methods: This exploratory multicenter qualitative study was conducted and reported in adherence to the consolidated criteria for reporting qualitative research checklist. Semi-structured in-depth interviews were conducted with healthcare professionals (4 pediatricians/neonatologists and 11 intensive care unit nurses) who provided care services for patients admitted to neonatal intensive care units in Palestine. An interview schedule guided the semi-structured in-depth interviews. The qualitative interpretive description approach was used to thematically analyze the data. Results: The total duration of the interviews was 282 min. The healthcare providers described their experiences with 41 different medication errors. These medication errors were categorized under 3 categories and 10 subcategories. Errors that occurred while preparing/diluting/storing medications were related to calculations, using a wrong solvent/diluent, dilution errors, failure to adhere to guidelines while preparing the medication, failure to adhere to storage/packaging guidelines, and failure to adhere to labeling guidelines. Errors that occurred while prescribing/administering medications were related to inappropriate medication for the neonate, using a different administration technique from the one that was intended and administering a different dose from the one that was intended. Errors that occurred after administering the medications were related to failure to adhere to monitoring guidelines. Conclusion: In this multicenter study, pediatricians/neonatologists and neonatal intensive care unit nurses described medication errors occurring in intensive care units in Palestine. Medication errors occur in different stages of the medication process: preparation/dilution/storage, prescription/administration, and monitoring. Further studies are still needed to quantify medication errors occurring in neonatal intensive care units and investigate if the designed strategies could be effective in minimizing medication errors.

Keywords: medication errors, pharmacist, pharmacology, neonates

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Authors: Abdool Qaiyum Mohabuth

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Transferrable skills are learnt abilities which are mainly acquired when experiencing work. University students have the opportunities to develop the knowledge and aptitude at work when they undertake WBL placement during their studies. There is a range of transferrable skills which students may acquire at their placement settings. Several studies have tried to identify a core set of transferrable skills which students can acquire at their placement settings. However, the different lists proposed have often been criticised for being exhaustive and duplicative. In addition, assessing the achievement of students on practice learning based on the transferrable skills is regarded as being complex and tedious due to the variability of placement settings. No attempt has been made in investigating whether these skills are assessable at practice settings. This study seeks to define a set of generic transferrable skills that can be assessed during WBL practice. Quantitative technique was used involving the design of two questionnaires. One was administered to University of Mauritius students who have undertaken WBL practice and the other was slightly modified, destined to mentors who have supervised and assessed students at placement settings. To obtain a good representation of the student’s population, the sample considered was stratified over four Faculties. As for the mentors, probability sampling was considered. Findings revealed that transferrable skills may be subject to formal assessment at practice settings. Hypothesis tested indicate that there was no significant difference between students and mentors as regards to the application of transferrable skills for formal assessment. A list of core transferrable skills that are assessable at any practice settings has been defined after taking into account their degree of being generic, extent of acquisition at work settings and their consideration for formal assessment. Both students and mentors assert that these transferrable skills are accessible at work settings and require commitment and energy to be acquired successfully.

Keywords: knowledge, skills, assessment, placement, mentors

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Authors: Zeiler M., Stadler D., Schmaderer C.

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Over the years of dialysis treatment, most patients experience significant weight loss. The primary emphasis in earlier research was the underlying mechanism of protein energy wasting and the subsequent malnutrition inflammation syndrome. In the interest to provide an effective and rapid solution for the patients, the aim of this study is identifying individual influences of their assumed reduced dietary intake, such as nausea, appetite loss and taste changes, and to determine whether the patients adhere to their nutrition guidelines. A prospective, controlled study with 38 end-stage renal disease patients was performed using a questionnaire to reflect their diet within the last 12 months. Thereby, the daily intake for the most important macro-and micronutrients was calculated to be compared with the individual KDQOI-guideline value, as well as controls matched in age and gender. The majority of the study population did not report symptoms commonly associated with dialysis, such as nausea or inappetence, and denied any change in dietary behavior since receiving renal replacement therapy. The patients’ daily intake of energy (3080kcal ± 1266) and protein (89,9g [53,4-142,0]) did not differ significantly from the controls (energy intake: 3233kcal ± 1046, p=0,597; protein intake: 103,7g [90,1-125,5], p=0,120). The average difference to the individual calculated KDQOI-guideline was +176,0kcal ± 1156 (p=0,357) for energy intake and -1,75g ± 45,9 (p=0,491) for protein intake. However, there was an observed imbalance in the distribution of macronutrients, with a preference for fats over proteins. The patients’ daily intake of sodium (5,4g [ 2,95-10,1]) was higher than in the controls (4,1g [2,04-5,99], p= 0,058) whereas both values for potassium (3,7g ± 1,84) and phosphorous (1,79g ± 0,91) went significantly below the controls’ values (potassium intake: 4,89g ± 1,74, p=0,014; phosphorous intake: 2,04g ± 0,64, p=0,038). Thus, the values exceeded the calculated KDQOI-recommendation by + 3,3g [0,63-7,90] (p<0,001) for sodium, +1,49g ± 1,84 (p<0,001) for potassium and +0,89g ± 0,91 (p<0,001) for phosphorous. Contrary to the assumption, the patients did not under-eat. Nevertheless, their diets did not align with the recommended values. These findings highlight the need for intervention and education among patients and that regular dietary monitoring could prevent unhealthy nutrition habits. The elaboration of individual references instead of standardized guidelines could increase the compliance to the advised diet so that interdisciplinary comorbidities do not develop or worsen.

Keywords: compliance, dialysis, end-stage renal disease, KDQOI, malnutrition, nutrition guidelines, questionnaire, salt intake

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Authors: Xiangjun Kong, Dongning Yao, Yuanjia Hu

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Therapeutic antibodies have become the most valuable and successful class of biopharmaceutical drugs, with a huge market potential and therapeutic advantages. Antibody patents are, accordingly, extremely important. As the technological limitation of the early stage of this field, the U. S. Patent and Trademark Offices (USPTO) have issued guidelines that suggest an exception for patents claiming a genus of antibodies that bind to a novel antigen, even in the absence of any experimental antibody production. This 'antibody exception' allowed for a broad scope on antibody claims, and led a global trend to patent antibodies without antibodies. Disputes around the pertinent patentability and written description issues remain particularly intense. Yet the validity of such patents had not been overtly challenged until Centocor v. Abbott, which restricted the broad scope of antibody patents and hit the brakes on the 'antibody exception'. The courts tend to uphold the requirement for adequate description of antibodies in the patent specifications, to avoid overreaching antibody claims. Patents following the 'antibody exception' are at risk of being found invalid for inadequately describing what they have claimed. However, the relation between the court and USPTO guidelines remains obscure, and the waning of the 'antibody exception' has led to further disputes around antibody patents. This uncertainty clearly affects patent applications, antibody innovations, and even relevant business performance. This study will give an overview of the emergence, debate, and waning usage of the 'antibody exception' in a number of enlightening cases, attempting to understand the specific concerns and the potential influence of antibody patents. We will then provide some possible strategies for antibody patenting, under the current considerations on the 'antibody exception'.

Keywords: antibody exception, antibody patent, USPTO (U. S. Patent and Trademark Offices) guidelines, written description requirement

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Authors: Dereje Habte, Jane Namasasu

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Background: The aim of the analysis was to assess the practice of family planning (FP) among HIV-infected women and the influence of women’s awareness of HIV-positive status in the practice of FP. Methods: The analysis was made among 489 non-pregnant, sexually active, fecund women living with HIV. Result: Of the 489 confirmed HIV positive women, 184 (37.6%) reported that they knew they are HIV positive. The number of women with current use and unmet need of any family planning method were found to be 251 (51.2%) and 107 (21.9%) respectively. Women’s knowledge of HIV-positive status (AOR: 2.32(1.54,3.50)), secondary and above education (AOR: 2.36(1.16,4.78)), presence of 3-4 (AOR: 2.60(1.08,6.28)) and more than four alive children (AOR: 3.03(1.18,7.82)) were significantly associated with current use of family planning. Conclusion: Women’s awareness of HIV-positive status was found to significantly predict family planning practice among women living with HIV.

Keywords: family planning, HIV, Malawi, women

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Authors: Ishrar Tabassum, Jay Andrew Saptok, Khalid Raihan Kabir, Elmee Tabassum

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The purpose of this study is to bring light to the current state of the working environments in the corporate environment and other such institutions with a particular focus on the Bangladesh National Building Code (BNBC) and its guidelines for accommodating the physically disabled. Data were collected via semi-formal interviews, site visits and focus groups conducted using a preset questionnaire as the guidelines. After conducting surveys at corporate offices of 20 organizations from major commercial sectors in Dhaka city, the auditing showed many inadequacies, as aside from the larger corporate offices, the offices have little to no accessibility for the physically disabled. This study hopes to shed light on the fact that the existing BNBCs lack of emphasis on ensuring the accessibility of the handicapped in corporate buildings in the hope that, in the future, the physically disabled will have greater opportunities at being productive members of the workforce.

Keywords: person with disability, PWD, corporate buildings, Dhaka City

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Authors: R. Tariq, R. Lee

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Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

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Authors: Xu Xiao China, Xu Lei China

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After the 1990s, the concept of urban sustainable development has been increasing attention in urban planning and urban design. High carbon city, not a sustainable city construction model, has become an important problem which restricts the sustainable development of the city. Therefore, low-carbon city construction is the urgent need to solve the problem, and China is one of the core areas of low-carbon city construction in the world. The research work of low-carbon cities were participated by the Chinese government and academic institutes on theory and practice since 2007, and nowadays it comes to a practice stage with six low-carbon pilot provinces and 36 low-carbon pilot cities identified. To achieve the low-carbon target, developing low-carbon energy, adopting non-pollution technique, constructing green buildings and adopting ecolife-style are suggest by the government. Meanwhile, besides a new standard system and a new eco-environmental status evaluation method, the government also established the Chinese urban development institute including the Low-Carbon City Group. Finally, we want to transform the modern industrial civilization into an ecological civilization and realize sustainable urban development.

Keywords: low-carbon city, China, development practice, system construction, urban sustainability

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Authors: Kamyar Kildashti, Rasoul Mirghaderi

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This paper describes the three-dimensional seismic performance assessment of a high-rise steel moment-frame setback tower, designed and detailed per the 2010 ASCE7, under multiple support excitations. The vulnerability analyses are conducted based on nonlinear history analyses under a set of multi-directional strong ground motion records which are scaled to design-based site-specific spectrum in accordance with ASCE41-13. Spatial variation of input motions between far distant supports of each part of the tower is considered by defining time lag. Plastic hinge monotonic and cyclic behavior for prequalified steel connections, panel zones, as well as steel columns is obtained from predefined values presented in TBI Guidelines, PEER/ATC72 and FEMA P440A to include stiffness and strength degradation. Inter-story drift ratios, residual drift ratios, as well as plastic hinge rotation demands under multiple support excitations, are compared to those obtained from uniform support excitations. Performance objectives based on acceptance criteria declared by TBI Guidelines are compared between uniform and multiple support excitations. The results demonstrate that input motion discrepancy results in detrimental effects on the local and global response of the tower.

Keywords: high-rise building, nonlinear time history analysis, multiple support excitation, performance-based design

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Authors: Vijayalakshmi Marella, NageswaraRaoPilli

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This paper describes a simple, rapid and sensitive liquid chromatography / tandem mass spectrometry assay for the determination of montelukast in human plasma using montelukast d6 as an internal standard. Analyte and the internal standard were extracted from 50 µL of human plasma via solid phase extraction technique without evaporation, drying and reconstitution steps. The chromatographic separation was achieved on a C18 column by using a mixture of methanol and 5mM ammonium acetate (80:20, v/v) as the mobile phase at a flow rate of 0.8 mL/min. Good linearity results were obtained during the entire course of validation. Method validation was performed as per FDA guidelines and the results met the acceptance criteria. A run time of 2.5 min for each sample made it possible to analyze more number of samples in short time, thus increasing the productivity. The proposed method was found to be applicable to clinical studies.

Keywords: Montelukast, tandem mass spectrometry, montelukast d6, FDA guidelines

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Authors: André M. Senna, Mary L. G. S. Senna, Rosa M. Machado-de-Sena

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One of the great challenges presented in educational practice is how to ensure the students not only acquire knowledge of training courses throughout their academic life, but also how to apply it in their current professional activities. Consequently, aiming to incite changes in the education system of healthcare professionals noticed the inadequacy of the training providers to solve the social problems related to health, the education related to these procedures should initiate in the earliest years of process. Following that idea, there is another question that needs an answer: If the change in the education should start sooner, in the period of basic training of healthcare professionals, what guidelines should a permanent education program incorporate to promote changes in an already established system? For this reason, the objective of this paper is to present different views of the teaching-learning process, with the purpose of better understanding the behavior adopted by healthcare professionals, through bibliographic study. The conclusion was that more than imparting knowledge to the individual, a larger approach is necessary on permanent education programs concerning the performance of professional health services in order to foment significant changes in education.

Keywords: Health Education, continuing education, training, behavior

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Authors: Mahmoud Hassanin, Roshan Thawale, Kiran Yelamati

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Background: During current practice, intraoperative regular endotracheal cuff pressure monitoring is not routine, despite the significant number of clinicians interested in checking it after intubation to ensure a good seal and adequate ventilation. Aims and objectives: to highlight that the current practice has no guidance related to regular intra-operative monitoring of the endotracheal tube cuff pressure, which can improve patient safety and post-operative experience. Methods: local department survey was done targeting anaesthetists' current practice, measuring their knowledge and problem awareness to improve patient satisfaction and change the current approach. Results: The participants were not using the manometer, despite their interest in ensuring that the cuff pressure was high enough and there was a proper seal. More than 50% of the participant don't know the ideal range of the endotracheal tube cuff pressure range, and 32% don't know whether it is available or not in the theatre. Despite the previous finding, 100% of the participants used different methods to ensure adequate cuff pressure. The collected data revealed that at least 26% of the participant confirmed that they had seen patients having post-intubation complications. Conclusion: There is an increasing importance placed on quality assurance. Clinical practice varies widely among practitioners, with the only consistency being the omission of cuff manometers during routine intra-operative management, despite their proven benefit and efficacy. Encourage the anaesthetists and ODPs to use cuff pressure manometers. The availability of portable pressure manometers can help to maintain safe cuff pressures in patients requiring endotracheal intubation.

Keywords: endotracheal cuff pressure, intra-operative monitoring, current practice, patient satisfaction

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Authors: Tara Hunter, Kristine Concepcion, Wendy Cheng, Brianna Pike, Jane Estoesta, Anne Stuart

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In 2015, Family Planning NSW was contracted by the NSW Ministry of Health to design and deliver Sexual Safety Policy training (SSPT) to mental health professionals across NSW. The training was based on their current guidelines and developed in consultation with an expert reference group. From October 2015 to April 2017 it was delivered to over 2,400 mental health professionals with a view to supporting implementation of consistent prevention and intervention related to sexual safety in the mental health setting. An evaluation was undertaken to determine the knowledge and confidence of participants related to sexual safety before and after the training, and whether any improvements were translated into changes in practice. Participants were invited to complete a survey prior to the training, upon completion and three to six months thereafter. Telephone interviews were conducted among service managers and mental health champions six months post-training. Prior to training, the majority of mental health professionals reported being slightly to moderately confident in identifying a sexual safety incident. When asked on their understanding of sexual safety, gender sensitive practice and trauma informed care, they reported no confidence, slight confidence and moderate confidence. Immediately after the training, 54.5% reported being very confident and 10.9% extremely confident in identifying a sexual safety incident. More than half felt very confident or extremely confident in their understanding of sexual safety principles. The impact survey (six months later) found that the majority of participants (91%) were highly confident in identifying a sexual safety incident. Telephone interviewees reported a change in workplace culture and increased awareness after the training. Mental health professionals experienced increased knowledge and confidence about sexual safety principles following the training and were able to implement positive changes and concrete actions to better address sexual safety issues in their workplace.

Keywords: sexual safety, mental health professionals, trauma informed care, policy training

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Authors: Tharwat Ibrahim Rushdy, Warda Youssef Mohammed Morsy, Hanaa Ali Ahmed Elfeky

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Background: Intra-aortic balloon pump (IABP) is the first and the most commonly used mechanical circulatory support for patients with acute coronary syndromes and cardiogenic shock. Therefore, critical care nurses not only have to know how to monitor and operate the IABP, but also to provide interventions for preventing possible complications. Aim of the study: To assess nurses' knowledge and practices regarding care of patients connected to IABP at the ICUs of Cairo University Hospitals. Research design: A descriptive exploratory design was utilized. Sample: Convenience samples of 40 nurses were included in the current study. Setting: This study was carried out at the Intensive Care Units of Cairo University Hospitals. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a- Nurses' personal background sheet, b- IABP nurses' knowledge self-administered questionnaire, and c- IABP Nurses' practice observational checklist. Results: The majority of the studied sample had unsatisfactory knowledge and practice level (88% & 95%) respectively with a mean of 9.45+2.94 and 30.5+8.7, respectively. Unsatisfactory knowledge was found regarding description and physiological effects, nursing care, indications, contraindications, complications, weaning, and removal of IABP in percentage of 95%, 90%, 72.5%, and 57.5%, respectively, with a mean total knowledge score of 9.45 +2.94. In addition, unsatisfactory practice was found regarding about preparation and initiation of IABP therapy, nursing practice during therapy, weaning, and removal of IABP in percentages of (97.5%, 97.5%, and 90%), respectively. Finally, knowledge level was found to differ significantly in relation to gender (t = 2.46 at P ≤ 0.018). However, gender didn't play a role in relation to practice (t = 0.086 at P≤ 0.932). Conclusion: In spite of having vital role in assessment and management of critically ill patients, critical care nurses in the current study had in general unsatisfactory knowledge and practice regarding care of patients connected to IABP. Recommendation: updating knowledge and practice of ICU nurses through carrying out continuing educational programs about IABP; strict observation of nurses' practice when caring for patients connected to IABP and provision of guidance to correct of poor practices and replication of this study on larger probability sample selected from different geographical locations.

Keywords: knowledge, practice, intra-aortic balloon pump (IABP), ICU nurses, intensive care unit (ICU), introduction

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Authors: Antonio Sepúlveda, Camila Marques, Carlos Bolonha, Igor De Lazari, Henrique Rangel

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The judicial practice faces a tension between normative discretion and institutional capacities. There are clarity graduations of the statutory text that might induce different specialization levels of the judges. A major problem stemming from that tension is a greater discretion without a proportional specialization. The normative clarity, although its absence can be overcome through specialization, avoids problems related to disproportionate discretion and judicial dissonance. When judicial interpretation deals with the lack of legal clarity, a significant juridical insecurity frame is verified. Decisional uniformity mechanisms are created in order to surpass these problems. Brazil brings great examples, such as the súmulas, the enunciados, and the súmulas vinculantes. Despite of the resistance presented to the latter, mainly based on judges’ independence, even countries of the Common Law tradition develop such mechanisms. The British Guidelines face the lack of legal clarity problem and promote a decisional consonance system.

Keywords: generalist judges, institutional capacities, normative clarity, normative discretion

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Authors: S. Mani, M. Kafil, E. Asadi

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Condition Monitoring (CM) of electrical equipment has gained remarkable importance during the recent years; due to huge production losses, substantial imposed costs and increases in vulnerability, risk and uncertainty levels. Power cables feed numerous electrical equipment such as transformers, motors, and electric furnaces; thus their condition assessment is of a very great importance. This paper investigates electrical, structural and environmental failure sources, all of which influence cables' performances and limit their uptimes; and provides a comprehensive framework entailing practical CM guidelines for maintenance of cables in industries. The multilevel CM framework presented in this study covers performance indicative features of power cables; with a focus on both online and offline diagnosis and test scenarios, and covers short-term and long-term threats to the operation and longevity of power cables. The study, after concisely overviewing the concept of CM, thoroughly investigates five major areas of power quality, Insulation Quality features of partial discharges, tan delta and voltage withstand capabilities, together with sheath faults, shield currents and environmental features of temperature and humidity; and elaborates interconnections and mutual impacts between those areas; using mathematical formulation and practical guidelines. Detection, location, and severity identification methods for every threat or fault source are also elaborated. Finally, the comprehensive, practical guidelines presented in the study are presented for the specific case of Electric Arc Furnace (EAF) feeder MV power cables in Mobarakeh Steel Company (MSC), the largest steel company in MENA region, in Iran. Specific technical and industrial characteristics and limitations of a harsh industrial environment like MSC EAF feeder cable tunnels are imposed on the presented framework; making the suggested package more practical and tangible.

Keywords: condition monitoring, diagnostics, insulation, maintenance, partial discharge, power cables, power quality

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Authors: Nino Chomakhashvili, Nino Chikhladze, Nato Pitskhelauri, Maia Bitskhinashvili

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The dental practice is associated with occupational health challenges. Ergonomic risks in the workplace can significantly impair a dentist's work capacity and may even result in the premature end of their career. Implementing ergonomic principles in dental practice aims to prevent work-related musculoskeletal disorders. Many studies have been conducted in various countries such as Sweden, Denmark, Germany, Poland, and Australia to examine the prevalence of musculoskeletal disorders among dentists. However, to the best of authors knowledge there have been no studies on the application of ergonomic principles in dental practice in Georgia. This study focused on evaluating the ergonomic conditions of dental practice in Georgia and determining how common musculoskeletal disorders are among them. The survey was conducted using a random sampling method in selected dental clinics. A tailored questionnaire consisting of 40 questions, created using insights from international practices, was utilized for the study. Two hundred ninety-one filled questionnaires were used for the analysis. Most respondents reported that their workplaces adhered to ergonomic standards. However, 53.6% experienced frequent back pain, with 50.9% suffering from neck pain, 47.9% from shoulder pain, and 47.1% from lower back pain. Many noted that pain had caused them to reduce their working hours. Nearly all respondents expressed a desire to enhance their knowledge about ergonomics and the prevention of occupational diseases. They indicated a preference for participating in continuous professional development programs (61.5%), receiving information through leaflets (12.0%), and attending online webinars (26.6%). Integrating ergonomic principles into the dental practice is crucial for preventing work-related musculoskeletal disorders. It is essential to offer continuous professional development programs and provide information to dentists, via leaflets, thematic online or hybrid webinars.

Keywords: dental practice, ergonomic risks, musculoskeletal disorders, occupational health

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Authors: Hsiao-Wen Hsu

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It is generally believed that the teacher’s use of motivational strategies can enhance student motivation, especially in a place like Taiwan where teacher usually dominates student EFL learning. However, only little empirical studies support this claim. This study examined the connection between teachers’ use of motivational teaching practice and observed student motivated behavior in rural junior high schools in Taiwan. The use of motivational strategies by 12 teachers in five recognized rural junior high schools was investigated observed using a classroom observation instrument, the Motivation Orientation of Language Teaching. Meanwhile, post-lesson teacher evaluations accomplished by both the researcher and the teacher were functioning as part of the measure of teacher motivational practice. The data collected through observation scheme follows the real-time coding principle to examine observable teacher motivational practice and learner motivated behaviors. The results support the previous research findings that teachers’ use of motivational strategies is associated with the student motivated behaviors as well as the students’ level of motivation regarding English learning.

Keywords: English learning, motivational strategies, student motivation, teacher motivational practices

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Authors: Rina Yadav, Lih-Yau Song

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The claim for elderly care center has increased enormously with the world demographic revolution as the number of senior citizens increased in the 21st century. As per the world progress into contemporaneousness, a large number of people are engaged in daily routine to bring about the senior citizens to lose the care that they in fact need. New design suggestions have been made on the basis of available guidelines and two case studies in Taiwan. Interior design can provide positive and sensory stimulation through memory stimulation, and by creating a friendly and comfortable environment for demented older people, which can reduce patient anxiety and reduce stress on caregivers. This report pursues to reveal the better design of an elderly care center with a new tactic in a direction to offer better service for demented elderly people which could upraise their living standard.

Keywords: daycare center, dementia patients, interior designing, older adults

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Authors: Anyia Nduka, Aslan Bin Amad Senin, Ayu Azrin Bte Abdul Aziz

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A management practice characterised by a value chain as its relatively flexible culture is replacing the old bureaucratic model of organisational practice that was built on dominance. Using a management practice fruition paradigm, the study delves into the implications of organisational culture and leadership. Developing a theory of leadership called the “cultural model” of organisational leadership by explaining how the shift from bureaucracy to management practises altered the roles and interactions of leaders. This model is well-grounded in leadership theory, considering the concept's adaptability to different leadership ideologies. In organisations where operational procedures and borders are not clearly defined, hierarchies are flattened, and work collaborations are sometimes based on contracts rather than employment. This cultural model of organizational leadership is intended to be a useful tool for predicting how effectively a leader will perform.

Keywords: leadership, organizational culture, management practices, efficiency

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Authors: Massimiliano Nastri

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The study is part of the scientific references on executive design in engineering and architecture, understood as an interdisciplinary field aimed at anticipating and simulating, planning and managing, guiding and instructing construction operations on site. On this basis, the study intends to provide an analysis of a theoretical, methodological, and guiding character aimed at constituting the disciplinary sphere of the executive design, often in the absence of supporting methodological and procedural guidelines in engineering and architecture. The basic methodologies of the study refer to the investigation of the theories and references that can contribute to constituting the scenario of the executive design as the practice of modelling, visualization, and simulation of the construction phases, through the practices of projection of the pragmatic issues of the building. This by proposing a series of references, interrelations, and openings intended to support (for intellectual, procedural, and applicative purposes) the executive definition of the project, aimed at activating the practices of cognitive acquisition and realization intervention within reality.

Keywords: modelling and simulation technology, executive design, discretization of the construction, engineering design for building

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Authors: Tamara Zappaterra

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The Learning Difficulties have an evolutionary nature. The international research has focused its analysis on the characteristics of Learning Difficulties in childhood, but we are still far from a thorough understanding of the nature of such disorders in adolescence and adulthood. Such issues become even more urgent in the university context. Spelling, meaning, and appropriate use of the specific vocabulary of the various disciplines represent an additional challenge for the dyslexic student. This paper explores the characteristics of Learning Difficulties in adulthood and the impact with the university teaching. It presents the results of an interdisciplinary project (educational, medical and engineering area) at University of Florence. The purpose of project is to design of a protocol for usability of teaching and individual study at university level. The project, after a first reconnaissance of user needs that have been reached with the participation of the very same protagonists, is at the stage of guidelines drafting for inclusion and education, to be used by teachers, students and administrative staff. The methodologies used are a questionnaire built on purpose and a series of focus groups with users. For collecting data during the focus groups it was decided to use a method typical of the Quality Function Deployment, a tool originally used for quality management, whose versatility makes it easy to use in a number of different context. The paper presents furthermore the findings of the project, the most significant elements of the guidelines for teaching, i.e. the section for teachers, whose aim is to implement a Learning Difficulties-friendly teaching, even at the university level, in compliance with italian Law 170/2010. The Guidelines for the didactic and inclusion of Learning Difficulties students of the University of Florence are articulated around a global and systemic plan of action, meant to accompany and protect the students during their study career, even before enrolling at the University, with different declination: the logistical, relational, educational, and didactic levels have been considered. These guidelines in Italy received the endorsement of the CNUDD. It is a systemic intervention plan for Learning Difficulties students, which roused and keeps rousing the interest of all the university system, with a radical consideration on academic teaching. Since while we try to provide the best Learning Difficulties-friendly didactic in compliance with the rules, no one can be exempted from a wider consideration on the nature and the quality of university teaching offered to all students.

Keywords: didactic tools, learning difficulties, special and inclusive education, university teaching

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Authors: Muhammad Naveed Iftikhar, Farah Khalid

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Global best practices as ordained by international organizations comprise a broader top-down approach to development problems, without taking into account country-specific factors. The political economy of each country is extremely different and the failure of several attempts of international organizations to implement global best practice models in developing countries each with its unique set of variables, goes on to show that this is not the most efficient solution to development problems. This paper is a humble attempt at shedding light on some specific examples of failures of the global best practices. Pakistan has its unique set of problems and unless those are added to the broader equation of development, country-specific reform and growth will continue to pose a challenge to reform programs initiated by international organizations. The three case studies presented in this paper are just a few prominent examples of failure of the global best practice, top-down, universalistic approach to development as ordained by international organizations. Development and reform can only be achieved if local dynamics are given their due importance. The modus operandi of international organizations needs to be tailored according to each country’s unique politico-economic environment.

Keywords: best practice, development, context

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Authors: Akbar Salimi, Mehdi Moghimi

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Goal: Today, the cooperative and systemic work is of importance and guarantees higher efficiency. This research was done with the aim of understanding the guidelines for co-op between police and the national media in order to reduce the juvenile delinquency. Method: This research is applied in terms of goal and of a compound type, which was done through a descriptive-analytical methodology. The data were collected through field surveys and documents. The statistical population included the professors of a higher education center in the area of education affairs, where as many as 36 people were randomly selected. The data collection procedure was by way of interview and researcher made questionnaire. Findings and results: Problems caused by the national media in the area of adolescents are categorized in three levels of production, broadcasting and consumption and elimination and reduction of the problems entail a set of estimations and predictions and also some education which the police forces has the capability to operationalize them. Thus, three hypotheses were defined and by conducting t and Friedman tests, all three hypotheses were confirmed and their rating was identified.

Keywords: management, media, TV, adolscents, delinquency

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Authors: U. N. Bhatty, A. Bhatia, A. George, F. Fiaz

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Post-operatively, patients with the neck of femur fractures are the high-risk of venous thromboembolic events (VTE). NICE have issued guidelines in this regard. We investigated whether these guidelines were being followed. 124 patients undergoing neck of femur fracture surgery were retrospectively analysed at a major orthopaedic centre in England. 9% of patients received adequate anticoagulation (16.5% mortality). An education campaign subsequently took place, circular emails were sent to junior doctors and posters advertised. A reaudit 4 months later showed only 12% of the 68 patients received adequate anticoagulation (11.8% mortality). The education campaign failed to improve prescribing behaviours. Furthermore, as morbidity was not measured, the consequence of poor prescription is underestimated. Perhaps, poor prescribing is because of the silent nature of effective thromboprophylaxis; reducing its perceived effectiveness. Simple interventions are insufficient to change these habits and more intense work is needed; such as compulsory proformas for all high-risk patients.

Keywords: fracture, hip, orthopaedics, thromboembolism

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Authors: Botirjon Kosimov

Abstract:

This work sheds light on the reforms towards the independence of the judiciary in Uzbekistan, as well as issues of further ensuring judicial independence in the country based on international values, particularly the legal practice of the United States. In every democratic state infringed human rights are reinstated and violated laws are protected by the help of justice based on the strict principle of judicial independence. The realization of this principle in Uzbekistan has been paid much attention since the proclamation of its independence. In the country, a series of reforms have been implemented in the field of the judiciary in order to actualize the principle of judicial independence. Uzbekistan has been reforming the judiciary considering both international and national values and practice of foreign countries. While forming a democratic state based on civil society, Uzbekistan shares practice with the most developed countries in the world. The United States of America can be a clear example which is worth learning how to establish and ensure an independent judiciary. It seems that although Uzbekistan has reformed the judiciary efficiently, it should further reform considering the legal practice of the United States.

Keywords: dependent judges, independent judges, judicial independence, judicial reforms, judicial life tenure, obstacles to judicial independence

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Authors: Y. T. Gee, I. N. Umar

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Students’ achievement and motivation in learning English in Malaysia is a worrying trend as it is lagging behind several other countries in Asia. Thus, necessary actions have to be taken by the parties concerned to overcome this problem. The purpose of this research was to study the effects of drill and practice courseware on students’ achievement and motivation in learning English language. A multimedia courseware was developed for this purpose. The independent variable was the drill and practice courseware while the dependent variables were the students’ achievement and motivation. Their achievement was measured using pre-test and post-test scores, while motivation was measured using a questionnaire adapted from Keller’s (1979) Instructional Materials Motivation Scale. A total of 60 students from three vernacular primary schools in a northern state in Malaysia were randomly selected in this study. The findings indicate: (1) a significant difference between the students’ pre-test and post-test scores after using the courseware, (2) no significant difference in the achievement score between male and female students after using the courseware, (3) a significant difference in motivation score between the female and the male students, and (4) while the female students scored significantly higher than the male students in the aspects of relevance, confidence and satisfaction, no significant difference in terms of attention was observed between them. Overall, the findings clearly indicate that although the female students are significantly more motivated than their male students, they are equally good in terms of achievement after learning from the courseware. Through this study, the drill and practice courseware is proven to influence the students’ learning and motivation.

Keywords: courseware, drill and practice, English learning, motivation

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Authors: Nalini Chitanand

Abstract:

Given the dynamic nature of the higher education landscape, induction programmes for new academics has become the norm nowadays to support academics negotiate these rough terrain. This study investigates an induction programme for new academics in a higher education institution to establish what difference it has made to participants. The findings revealed that the benefits ranged from creating safe spaces for collaboration and networking to fostering reflective practice and contributing to the scholarship of teaching and learning. The study also revealed that some of the intentions of the programme may not have been achieved, for example transformative learning. This led to questioning whether this intention is an appropriate one given the short duration of the programme and the long, drawn out process of transformation. It may be concluded that the academic induction programme in this study serves to sow the seeds for transformative learning through fostering critically reflective practice. Recommendations for further study could include long term impact of the programme on student learning and success, these being the core business of higher education. It is also recommended that in addition to an induction programme, the university invests in a mentoring programme for new staff and extend the support for academics in order to sustain critical reflection and which may contribute to transformative educational practice.

Keywords: induction programme, reflective practice, scholarship of teaching, transformative learning

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Authors: Evangelia Kotrotsiou, Mairy Gouva, Theodosios Paralikas, Maria Fiaka, Styliani Kotrotsiou, Maria Malliarou

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The purpose of this research is to investigate the way nurses perceive the care provided in comparison to the way patients perceive it, taking into account existing literature. As far as the sample of research is concerned, it has come from the population of nurses working in the General Hospital of Thessaloniki, St. Paul and the patients of its surgical clinic. In the present study, the sample consists of 100 nurses and 88 patients. The questionnaire used was the Caring Nurse-Patient Interactions Scale: 23-Item Version, created by Cossette et al. (2006). In the case of both patients and nurses, a high score was observed in relational care in the case of the frequency of nursing care in daily practice, as well as the satisfaction of providing nursing care. Overall, patients rated higher clinical care in the case of the frequency of nursing care in daily practice, as well as the satisfaction of the clinical care they were given. On the other hand, nurses rated higher comfort care in the case of the frequency of nursing care in everyday practice, as well as relational care in the area of the importance of nursing care in everyday practice.

Keywords: nursing care, patient needs, patient satisfaction, care giving

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