Search results for: care knowledge

Authors: Dena A. Hussain

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The objective of this project is to design an Information and Communication Technologies (ICT) tool based on a standardized platform to assist the work-integrated learning process of caretakers of disabled children. The tool should assist the intercommunication between caretakers and improve the learning process through knowledge bridging between all involved caretakers. Some children are born with disabilities while others have special needs after an illness or accident. Special needs children often need help in their learning process and require tools and services in a different way. In some cases the child has multiple disabilities that affect several capabilities in different ways. These needs are to be transformed into different learning techniques that the staff or personal (called caretakers in this project) caring for the child needs to learn and adapt. The caretakers involved are also required to learn new learning or training techniques and utilities specialized for the child’s needs. In many cases the number of people caring for the child’s development is rather large; the parents, specialist pedagogues, teachers, therapists, psychologists, personal assistants, etc. Each group of specialists has different objectives and in some cases the merge between theses specifications is very unique. This makes the synchronization between different caretakers difficult, resulting often in low level cooperation. By better intercommunication between professions both the child’s development could be improved but also the caretakers’ methods and knowledge of each other’s work processes and their own profession. This introduces a unique work integrated learning environment for all personnel involve, merging learning and knowledge in the work environment and at the same time assist the children’s development process. Creating an iterative process generates a unique learning experience for all involved. Using a work integrated platform will help encourage and support the process of all the teams involved in the process.We believe that working with children who have special needs is a continues learning/working process that is always integrated to achieve one main goal, which is to make a better future for all children.

Keywords: information and communication technologies (ICT), work integrated learning (WIL), sustainable learning, special needs children

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Authors: John Gray, Andy Smith, Hazel James

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With the introduction of projects such as GP referral and other medical exercise schemes, there has been a shift in the cosmology underpinning exercise leadership. That is, the knowledge base of exercise leaders, specifically personal trainers, has moved from a cosmology based on aesthetic and physical fitness demands to one requiring interaction with the dominant biomedical model underpinning contemporary medicine. In line with this shift research has demonstrated that personal trainer education has aligned itself to a biotechnological model. However, whilst there is a need to examine exercise as medicine, and consider the role of personal trainers as prescribers of these interventions, the possible issues surrounding the growing medicalization of the exercise cosmology have not been explored. Using a phenomenological methodology, and the novel approach of photo-elicitation, this research examined the practices of successful personal trainers. The findings highlight that a growing focus on an iatro-biological based scientific process of exercise prescription may prove problematical. Through the development of a model of practitioner-based knowledge, it is argued there is a possible growing disconnection between the theoretical basis of exercise science and the working cosmology of exercise practitioners.

Keywords: biomedicine, cosmology, personal training, photo-elicitation

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Authors: Christina Klippel, Lucia Pezzi, Silvio Neto, Rafael Bertani, Priscila Mendes, Flavio Machado, Aline Szeliga, Maria Cosendey, Adilson Mariz, Raquel Santos, Lys Bendett, Pedro Velasco, Thalita Rolleigh, Bruna Bellote, Daria Coelho, Bruna Martins, Julia Almeida, Juliana Cerqueira

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This project presents a framework for teaching intracranial pressure monitoring (ICP) concepts using a low-cost experimental model in a neurointensive care education program. Data concerning ICP monitoring contribute to the patient's clinical assessment and may dictate the course of action of a health team (nursing, medical staff) and influence decisions to determine the appropriate intervention. This study aims to present a safe method for teaching ICP monitoring to medical students in a Simulation Center. Methodology: Medical school teachers, along with students from the 4th year, built an experimental model for teaching ICP measurement. The model consists of a mannequin's head with a plastic bag inside simulating the cerebral ventricle and an inserted ventricular catheter connected to the ICP monitoring system. The bag simulating the ventricle can also be changed for others containing bloody or infected simulated cerebrospinal fluid. On the mannequin's ear, there is a blue point indicating the right place to set the "zero point" for accurate pressure reading. The educational program includes four steps: 1st - Students receive a script on ICP measurement for reading before training; 2nd - Students watch a video about the subject created in the Simulation Center demonstrating each step of the ICP monitoring and the proper care, such as: correct positioning of the patient, anatomical structures to establish the zero point for ICP measurement and a secure range of ICP; 3rd - Students train the procedure in the model. Teachers help students during training; 4th - Student assessment based on a checklist form. Feedback and correction of wrong actions. Results: Students expressed interest in learning ICP monitoring. Tests concerning the hit rate are still being performed. ICP's final results and video will be shown at the event. Conclusion: The study of intracranial pressure measurement based on an experimental model consists of an effective and controlled method of learning and research, more appropriate for teaching neurointensive care practices. Assessment based on a checklist form helps teachers keep track of student learning progress. This project offers medical students a safe method to develop intensive neurological monitoring skills for clinical assessment of patients with neurological disorders.

Keywords: neurology, intracranial pressure, medical education, simulation

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Authors: Ravija Gunawardana, Banuka Athuraliya

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Machine learning has emerged as a powerful tool for disease diagnosis and prediction. The use of machine learning algorithms has the potential to improve the accuracy of disease prediction, thereby enabling medical professionals to provide more effective and personalized treatments. This study focuses on developing a machine-learning model for disease prediction using symptoms and X-ray images. The importance of this study lies in its potential to assist medical professionals in accurately diagnosing diseases, thereby improving patient outcomes. Respiratory diseases are a significant cause of morbidity and mortality worldwide, and chest X-rays are commonly used in the diagnosis of these diseases. However, accurately interpreting X-ray images requires significant expertise and can be time-consuming, making it difficult to diagnose respiratory diseases in a timely manner. By incorporating machine learning algorithms, we can significantly enhance disease prediction accuracy, ultimately leading to better patient care. The study utilized the Mask R-CNN algorithm, which is a state-of-the-art method for object detection and segmentation in images, to process chest X-ray images. The model was trained and tested on a large dataset of patient information, which included both symptom data and X-ray images. The performance of the model was evaluated using a range of metrics, including accuracy, precision, recall, and F1-score. The results showed that the model achieved an accuracy rate of over 90%, indicating that it was able to accurately detect and segment regions of interest in the X-ray images. In addition to X-ray images, the study also incorporated symptoms as input data for disease prediction. The study used three different classifiers, namely Random Forest, K-Nearest Neighbor and Support Vector Machine, to predict diseases based on symptoms. These classifiers were trained and tested using the same dataset of patient information as the X-ray model. The results showed promising accuracy rates for predicting diseases using symptoms, with the ensemble learning techniques significantly improving the accuracy of disease prediction. The study's findings indicate that the use of machine learning algorithms can significantly enhance disease prediction accuracy, ultimately leading to better patient care. The model developed in this study has the potential to assist medical professionals in diagnosing respiratory diseases more accurately and efficiently. However, it is important to note that the accuracy of the model can be affected by several factors, including the quality of the X-ray images, the size of the dataset used for training, and the complexity of the disease being diagnosed. In conclusion, the study demonstrated the potential of machine learning algorithms for disease prediction using symptoms and X-ray images. The use of these algorithms can improve the accuracy of disease diagnosis, ultimately leading to better patient care. Further research is needed to validate the model's accuracy and effectiveness in a clinical setting and to expand its application to other diseases.

Keywords: K-nearest neighbor, mask R-CNN, random forest, support vector machine

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Authors: Mark Salisbury

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The arrival of artificially intelligent avatars and the automation they bring is worrying many of us, not only for our livelihood but for the jobs that may be lost to our kids. We worry about what our place will be as human beings in this new economy where much of it will be conducted online in the metaverse – in a network of 3D virtual worlds – working with intelligent machines. The Future of Leadership was written to address these fears and show what our place will be – the right place – in this new economy of AI avatars, automation, and 3D virtual worlds. But to be successful in this new economy, our job will be to bring wisdom to our workplace and the marketplace. And we will use AI avatars and 3D virtual worlds to do it. However, this book is about more than AI and the avatars that we will work with in the metaverse. It’s about building Organizational intelligence (OI) -- the capability of an organization to comprehend and create knowledge relevant to its purpose; in other words, it is the intellectual capacity of the entire organization. To increase organizational intelligence requires a new kind of knowledge worker, a wisdom worker, that requires a new kind of leadership. This book begins your story for how to become a leader of wisdom workers and be successful in the emerging wisdom economy. After this presentation, conference participants will be able to do the following: Recognize the characteristics of the new generation of wisdom workers and how they differ from their predecessors. Recognize that new leadership methods and techniques are needed to lead this new generation of wisdom workers. Apply personal and professional values – personal integrity, belief in something larger than yourself, and keeping the best interest of others in mind – to improve your work performance and lead others. Exhibit an attitude of confidence, courage, and reciprocity of sharing knowledge to increase your productivity and influence others. Leverage artificial intelligence to accelerate your ability to learn, augment your decision-making, and influence others.Utilize new technologies to communicate with human colleagues and intelligent machines to develop better solutions more quickly.

Keywords: metaverse, generative artificial intelligence, automation, leadership, organizational intelligence, wisdom worker

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Authors: Zahra Nouri Sangedehy

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There are two anthropologies considered in Protagoras. The first of them (Protagoras) considers the appearance of man, like all other beings, as the result of a natural evolution without a predetermined plan and aim. Not only the human's corporeal existence is the result of evolution and natural choices, but also his moral and social life can be explained in the light of this factor. In this anthropology, the moral and political laws derive from the contract and the people's majority agreement of society to survive. Society and socio-political institutions are the reason for the education and training (paidia) of virtues in general. The second anthropology is Socrates's, which is not clearly projected and is hidden behind his arguments. In this way, man's moral and social life is intrinsic. Man is intrinsically a moral and social being. Socrates intends to criticize the theory of the contractual nature of ethics by demonstrating the unity of virtues on the one hand and the identity of virtue and knowledge, and the problem of the teaching of virtues based on intrinsic and a priori knowledge of human beings, on the other hand, albeit with a new kind of education and training, which will replace the Sophists' education. Therefore, ethics will have undoubted foundations, and human beings will be defined again.

Keywords: Protagoras, techne, arête, paidia

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Authors: Abdullah Almilaibary, Jeremy Jolley, Mark Hayter

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Background: Despite recent progress in enhancing the accessibility of HIV-related health services worldwide, opportunities to diagnose patients are often missed due to genuine barriers at different levels. The aim of the study is to explore the factors that affect the utilization of HIV testing services by young people aged 17-25 in Saudi Arabia. Methods: A non-experimental descriptive cross-sectional design was used to predict factors that influenced HIV testing among Umm- Al Qura University students aged 17-25 years. A newly developed self-completed online questionnaire was used and the study sample was drawn using a convenience sampling technique. The questionnaire consisted of 52 items divided into three scales: 12 items for HIV/AIDS-related knowledge, 3 items for risk perception, and 37 items for attitudes toward HIV testing. Five experts in the field of HIV/AIDS validated the contents of the questionnaire and agreed that the items included were related to the construct being measured. The reliability of the questionnaire was also assessed using a test/re-test strategy with 27 participants recruited from the population under study. The reliability assessment revealed that the questionnaire was consistent as Cronbach’s Alpha was 0.80 for HIV/ADS knowledge, 0.88 for risk perception and 0.78 for attitudes towards HIV testing. The data were collected between 14th of July and 14th of October 2014. Results: 394 participants completed the questionnaires: 116 (29.4%) male and 278 (70%) female. 50.5% of the participants were aged 20 to 22 years, 34.8% were 17-19 years and 14.7% were aged between 23-25 years; about 93% of the participants were single. Only 20 (6%) participants had previously been tested for HIV. The main reasons for not being tested for HIV were: exposure to HIV was considered unlikely (48%), HIV test was not offered (36%) and unawareness of HIV testing centres (16%). On HIV/AIDS-related knowledge, the male participants scored higher than the females as the mean score for males was (M = 6.4, SD = 2.4) while for females it was (M 5.7, SD 2.5). In terms of risk perception, female participants appeared to have lower levels of risk perception than male participants, with the mean score for males being (M 11.7, SD 2.5) and (M 10.5, SD 2.4) for females. The female participants showed slightly more positive attitudes towards HIV testing than male participants: the mean score for males was (M = 108.14, SD = 17.9) and was (M = 111.32, SD = 17.3) for females. Conclusions: The data reveal that misconceptions about HIV/AIDS in Saudi Arabia are still a challenge. Although the attitudes towards HIV testing were reasonably positive, the utilization of the HIV test was low. Thus, tailoring HIV/AIDS preventive strategies in Saudi Arabia should focus on the needs of young people and other high risk groups in the country.

Keywords: attitude toward hiv testing, hiv testing, hiv/aids related knowledge, risk perception

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Authors: Balasooriya B. M. C. M., Sujeeva N., Thowfeek Z., Siddiqa Omo, Liyanagunawardana J. E., Jayawardana Saiu, Manathunga S. S., Katulanda G. W.

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Introduction and objectives: Adrenal venous sampling (AVS) is the gold standard to discriminate unilateral primary aldosteronism (UPA) from bilateral disease (BPA). AVS is technically demanding and only performed in a limited number of centers worldwide. To the best of our knowledge, Except for one study conducted in India, no other research studies on this area have been conducted in South Asia. This study aimed to evaluate the effectiveness of AVS in the management of primary aldosteronism. Methods: A total of 32 patients who underwent AVS at the National Hospital of Sri Lanka from April 2021 to April 2023 were enrolled. Demographic, clinical and laboratory data were obtained retrospectively. A procedure was considered successful when adequate cannulation of both adrenal veins was demonstrated. Cortisol gradient across the adrenal vein (AV) and the peripheral vein was used to establish the success of venous cannulation. Lateralization was determined by the aldosterone gradient between the two sides. Continuous and categorical variables were summarized with mean, SD, and proportions, respectively. The mean and standard deviation of the contralateral suppression index (CSI) were estimated with an intercept-only Bayesian inference model. Results: Of the 32 patients, the average age was 52.47 +26.14 and 19 (59.4%) were males. Both AVs were successfully cannulated in 12 (37.5%). Among them, lateralization was demonstrated in 11(91.7%), and one was diagnosed as a bilateral disease. There were no total failures. Right AV cannulation was unsuccessful in 18 (56.25%), of which lateralization was demonstrated in 9 (50%), and others were inconclusive. Left AV cannulation was unsuccessful only in 2 (6.25%); one was lateralized, and the other remained inconclusive. The estimated mean of the CSI was 0.33 (89% credible interval 0.11-0.86). Seven patients underwent unilateral adrenalectomy and demonstrated significant improvement in blood pressure during follow-up. Two patients await surgery. Others were treated medically. Conclusions: Despite failure due to procedural difficulties, AVS remained useful in the management of patients with PA. Moreover, the success of the procedure needs experienced hands and advanced equipment to achieve optimal outcomes in PA.

Keywords: adrenal venous sampling, lateralization, contralateral suppression index, primary aldosteronism

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Authors: Jason T. Hilton

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The ‘post-truth era’ is marked by a shift toward a period in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief. Applying narrative analysis techniques to current public discourses in education that run counter to scientific findings, it becomes possible to identify weakness in modern pedagogy and suggest ways to counter false narratives in the classroom. Results of this study indicate that a failure to engage with popular narratives lessens teachers’ ability to be convincing in the classroom, even when presenting information supported by scientific evidence. This study seeks to empower teachers by illustrating the influence of story within the post-truth era and the ways in which narrative and rhetorical elements take hold in social media contexts. Equipped with this knowledge, teachers can create a shift in pedagogy, away from transmission of knowledge toward the crafting of powerful narratives, built upon evidence, and connected to the lives of modern learners.

Keywords: 21st century learner, critical pedagogy, culture, narrative, post-truth era, social media

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Authors: Bushra Alghamdi, Alla Alsharif, Hamzah Aljohani, Saba Kassim

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Introduction: Collaborative work has always been acknowledged as a fundamental concept in delivering oral health care. Aim: This study aimed to assess the perception and attitude of pharmacists in oral health promotion and to determine the confident levels of pharmacists in delivering advice on oral health problems. Methods: An observational cross-sectional survey, using self-administered anonymous questionnaires, was conducted between March and April 2017. The study recruited a convenience sample of registered community pharmacists who were working in local private pharmaceutical stores in the urban area of Madinah, Kingdom of Saudi Arabia (KSA). A preliminary descriptive analysis was performed. Results: Thirty-five pharmacists have completed the surveys. All participants were males, with a mean age of 35.5 ( ± 6.92) years. Eighty-six percent of the participants reported that pharmacists should have a role in oral health promotion. Eighty percent have reported adequate level of confident when giving advice on most of the common oral health problems that include; oral health related risk behaviors such as tobacco cessation (46%), bleeding gums (63%) and sensitive teeth (60%). However, higher percentages of pharmacists have reported low confident levels when giving advice in relation to specific domain of dentistry, such as lost dental fillings (57%), loose crowns (60%), trauma to teeth (40%), denture-related problems (51%) and oral cancer (6.9%). Conclusion: Community pharmacists recognized their potential role in promoting oral health in KSA. Community pharmacists had varying levels of ability and confidence to offer support for oral health. The study highlighted that inner professional collaboration between pharmacists and dental care healthcare should be enhanced.

Keywords: community, oral health, promotion, pharmacist

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Authors: Shu-Ching Chen, Li-Yun Lee

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The purpose of the study was to identify the factors associated with head and neck cancer-related lymphoedema (HNCRL)-related symptoms, body image, and HNCRL-related functional outcomes among patients with resected advanced head and neck cancer. A cross-sectional correlational design was conducted to examine the predictors of HNCRL-related functional outcomes in patients with resected advanced head and neck cancer. Eligible patients were recruited from a single medical center in northern Taiwan. Consecutive patients were approached and recruited from the Radiation Head and Neck Outpatient Department of this medical center. Eligible subjects were assessed for the Symptom Distress Scale–Modified for Head and Neck Cancer (SDS-mhnc), Brief International Classification of Functioning, Disability and Health (ICF) Core Set for Head and Neck Cancer (BCSQ-H&N), Body Image Scale–Modified (BIS-m), The MD Anderson Head and Neck Lymphedema Rating Scale (MDAHNLRS), The Foldi’s Stages of Lymphedema (Foldi’s Scale), Patterson’s Scale, UCLA Shoulder Rating Scale (UCLA SRS), and Karnofsky’s Performance Status Index (KPS). The results showed that the worst problems with body HNCRL functional outcomes. Patients’ HNCRL symptom distress and performance status are robust predictors across over for overall HNCRL functional outcomes, problems with body HNCRL functional outcomes, and activity and social functioning HNCRL functional outcomes. Based on the results of this period research program, we will develop a Cancer Rehabilitation and Lymphedema Care Program (CRLCP) to use in the care of patients with resected advanced head and neck cancer.

Keywords: head and neck cancer, resected, lymphedema, symptom, body image, functional outcome

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Authors: Eman Elsebaie, A. Sedrak, R. Ziada

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Introduction: In the recent decades, heart failure (HF) has become one of the most prevalent cardio-vascular disease (CVDs), especially in the elderly and the main cause of hospitalization in Egypt cardiology departments. By 2030, the prevalence of HF is expected to increase by 25%. Total direct costs will increase to $818 billion, and the total indirect cost in terms of lost productivity is close to $275 billion. The current study was conducted to estimate the economic costs of services delivered for heart failure patients at the cardiology department in Cairo University Hospitals (CUHs). Aim: To gain an understanding of the cost of heart failure disease and its main drivers aiming to minimize associated health care costs. Subjects and Methods: Economic cost analysis study was conducted for a prospective group of all cases of HF admitted to the cardiology department in CUHs from end of March till end of April 2016 and another retrospective randomized sample from patients with HF, during the first 3 months of 2016 to measure estimated average cost per patient per day. Results: The mean age of the prospective group was 48.6 ± 17.16 years versus 52.3 ± 11.5 years for the retrospective group. The median (IQR) of Length of stay was 15 (15) days in the prospective group versus 9 (16) days in the retrospective group. The average HF inpatient cost/day in the cardiology department during April 2016 was 362.32 (255.5) L.E. versus 391.2(255.9) L.E. during January and February 2016. Conclusion: Up to 70% of expenditure in the management of HF is related to hospital admission. The average cost of such an admission was 5540.03 (IQR=7507.8) L.E. and 4687.4 (IQR=7818.8) L.E. with the average cost per day estimated at 362.32 (IQR=255.5) L.E. and 386.2(IQR=255.9) L.E. in prospective and retrospective groups respectively.

Keywords: health care cost, heart failure, hospitalization, inpatient

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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: Sajjad Ahmed, Knut Hinkelmann, Flavio Corradini

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Fake news detection research is still in the early stage as this is a relatively new phenomenon in the interest raised by society. Machine learning helps to solve complex problems and to build AI systems nowadays and especially in those cases where we have tacit knowledge or the knowledge that is not known. We used machine learning algorithms and for identification of fake news; we applied three classifiers; Passive Aggressive, Naïve Bayes, and Support Vector Machine. Simple classification is not completely correct in fake news detection because classification methods are not specialized for fake news. With the integration of machine learning and text-based processing, we can detect fake news and build classifiers that can classify the news data. Text classification mainly focuses on extracting various features of text and after that incorporating those features into classification. The big challenge in this area is the lack of an efficient way to differentiate between fake and non-fake due to the unavailability of corpora. We applied three different machine learning classifiers on two publicly available datasets. Experimental analysis based on the existing dataset indicates a very encouraging and improved performance.

Keywords: fake news detection, natural language processing, machine learning, classification techniques.

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Authors: Blessing Dwumah Manu, Dawn Wallin

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This study aims to explore school principal instructional leadership capabilities (Robinson, 2010) that support school performance in senior high schools in Ghana’s Northern Region. It explores the ways in which leaders (a) use deep leadership content knowledge to (b) solve complex school-based problems while (c) building relational trust with staff, parents, and students as they engage in the following instructional leadership dimensions: establishing goals and expectations; resourcing strategically; ensuring quality teaching; leading teacher learning and development and ensuring an orderly and safe environment (Patuawa et al, 2013). The proposed research utilizes a constructivist approach to explore the experiences of 18 school representatives (including principals, deputy principals, department heads, teachers, parents, and students) through an interview method.

Keywords: instructional leadership, leadership content knowledge, solving complex problems, building relational trust and school performance

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Authors: Oluwatobiloba Moody

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On October 12, 2014, the Nagoya Protocol, negotiated by Parties to the Convention on Biological Diversity (CBD), entered into force. The Protocol was negotiated to implement the third objective of the CBD which relates to the fair and equitable sharing of benefits arising from the utilization of genetic resources (GRs). The Protocol aims to ‘protect’ GRs and traditional knowledge (TK) associated with GRs from ‘biopiracy’, through the establishment of a binding international regime on access and benefit sharing (ABS). In reflecting on the question of ‘effectiveness’ in the Protocol’s implementation, this paper argues that the underlying problem of ‘biopiracy’, which the Protocol seeks to address, is one which goes beyond the ABS regime. It rather thrives due to indispensable factors emanating from the global intellectual property (IP) regime. It contends that biopiracy therefore constitutes an international problem of ‘borders’ as much as of ‘regimes’ and, therefore, while the implementation of the Protocol may effectively address the ‘trans-border’ issues which have hitherto troubled African provider countries in their establishment of regulatory mechanisms, it remains unable to address the ‘trans-regime’ issues related to the eradication of biopiracy, especially those issues which involve the IP regime. This is due to the glaring incoherence in the Nagoya Protocol’s implementation and the existing global IP system. In arriving at conclusions, the paper examines the ongoing related discussions within the IP regime, specifically those within the WIPO Intergovernmental Committee on Intellectual Property and Genetic Resources, Traditional Knowledge and Folklore (IGC) and the WTO TRIPS Council. It concludes that the Protocol’s effectiveness in protecting TK associated with GRs is conditional on the attainment of outcomes, within the ongoing negotiations of the IP regime, which could be implemented in a coherent manner with the Nagoya Protocol. It proposes specific ways to achieve this coherence. Three main methodological steps have been incorporated in the paper’s development. First, a review of data accumulated over a two year period arising from the coordination of six important negotiating sessions of the WIPO Intergovernmental Committee on Intellectual Property and Genetic Resources, Traditional Knowledge and Folklore. In this respect, the research benefits from reflections on the political, institutional and substantive nuances which have coloured the IP negotiations and which provide both the context and subtext to emerging texts. Second, a desktop review of the history, nature and significance of the Nagoya Protocol, using relevant primary and secondary literature from international and national sources. Third, a comparative analysis of selected biopiracy cases is undertaken for the purpose of establishing the inseparability of the IP regime and the ABS regime in the conceptualization and development of solutions to biopiracy. A comparative analysis of select African regulatory mechanisms (Kenya, South Africa and Ethiopia and the ARIPO Swakopmund Protocol) for the protection of TK is also undertaken.

Keywords: biopiracy, intellectual property, Nagoya protocol, traditional knowledge

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Authors: Bhawat Chiamjinnawat

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The agri-food market transformation has implied market growth for the fruit industry in Thailand. This article focuses on analysis of farmer competence and farm resources which affect market strategies used by fruit farmers in Chanthaburi province of Thailand. The survey data were collected through the use of face-to-face interviews with structured questionnaires. This study identified 14 drivers related to farmer competence and farm resources of which some had significant effect on the decision to use either high-value markets or traditional markets. The results suggest that farmers who used high-value markets were better educated and they had longer experience and larger sized business. Identifying the important factors that match with the market transformation provides policy with opportunities to support the fruit farmers to increase their market power. Policies that promote business expansion of agricultural cooperatives and knowledge sharing among farmers are recommended to reduce limitations due to limited knowledge, low experience, and small business sizes.

Keywords: farmer competence, farm resources, fruit industry, high-value markets, Thailand

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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: 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: Muhammad Yayat Afianto, Darmawan, Agung Putra Utama, Hari Kushardanto

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Fish Forever, Rare’s innovative coastal fisheries program, combined community-based conservation management approach with spatial management to restore and protect Indonesia’s small-scale fisheries by establishing Fishing Managed Access Area. A ‘TURF-Reserve’ is a fishery management approach that positions fishers at the center of fisheries management, empowering them to take care of and make decisions about the future of their fishery. After two years of the program, social marketing campaigns succeeded in changing their behavior by adopting the new conservation behavior. The Pride-TURF-R campaigns developed an overarching hypothesis of impact that captured the knowledge, attitude and behavior changes needed to reduce threats and achieve conservation results. Rare help Batu Belah fishers to develop their group, developed with their roles, sustainable fisheries plan, and the budget plan. On 12th February 2017, the Head of Loka Kawasan Konservasi Perairan Nasional (LKKPN) which is a Technical Implementation Unit for National Marine Conservation Areas directly responsible to the Directorate General for Marine Spatial Management in the Ministry of Marine Affairs and Fisheries had signed a Partnership Agreement with the Head of Batu Belah Village to manage a TURF+Reserve area as wide as 909 hectares. The fishers group have been collecting the catch and submitting the report monthly, initiated the installation of the buoy markers for the No Take Zone, and formed the Pokmaswas (community-based surveillance group). Prior to this behavior adoption, they don’t have any fisheries data, no group of fishers, and they have still fishing inside the No Take Zone. This is really a new behavior adoption for them. This paper will show the process and success story of the social marketing campaign to conserve marine habitat in Anambas through Pride-TURF-R program.

Keywords: behavior adoption, community participation, no take zone, pride-TURF-R

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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: 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: Pongsiri Kamkankaew

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This paper experiments to consider brand equity thought in Thai academic works. This essay employs that the first emerging of brand equity in Thai academic works and the components of brand equity which explore the extent to the convoluted approach with other Thai social condition. In Thailand, brand equity is supposed to provide branding and brand management replacement. However, the commitment of brand equity imposes in its proposal for seemly application in Thai context – to develop the brand equity framework by the Thai social – culture and Thai utilization style which it is questionable whether the brand equity in western conception is useful for characterizing the brand equity in Thailand context. In this position, brand equity also aspects several major questions: How can western conception lead to apply in Thai business? How can diversification be given within Thai SMEs business running? Can corporate brand valuation approach adopt in real business doing? So this paper argues that Thai brand equity notion should reduce disturb over improvement of its self-restraint and business area. Instead, Thai academic who are interested in brand equity can harmonize different mature bodies of discipline and other investigative a frame of references to complete and open the recognizing of brand equity.

Keywords: Thai brand equity, knowledge critical, brand management, branding

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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: Milagros S. Salibad, Levita B. Grana

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The presence and role of Indigenous Peoples (IPs) residing in key biodiversity, protected, and watershed areas within the ancestral domain in the Caraga region, Mindanao, Philippines, hold immense significance. Recognizing their importance and rights, this study aimed to determine the level of biodiversity conservation practices and extent of environmental stewardship among the Mamanwas, Manobos, and Higaonons, assess potential differences in these practices, and identify factors that facilitate or hinder them. Employing an explanatory sequential mixed-method research design, 421 respondents participated through a researcher-made questionnaire. Additional data were collected through focus group discussions, key informant interviews, researcher field notes, community immersions, and secondary sources. The results revealed a high level of biodiversity conservation practices across the three IP groups, with variations influenced by their cultural and traditional practices, awareness, and access to resources and information. Each group exhibited unique environmental practices shaped by their distinct cultures, traditions, and customary knowledge. They have a strong sense of ownership and responsibility towards their ancestral lands and territories and adopt traditional knowledge and practices that promote sustainable resource management and biodiversity conservation. These practices align with the Indigenous Peoples Rights Act (IPRA), also known as Republic Act No. 8371. Various facilitating and hindering factors influenced their conservation efforts. To uphold the region's biodiversity resources, it is recommended that government agencies continue to evaluate and monitor the sustainability of IPs' local biodiversity conservation practices. Additionally, efforts should be made to involve IP communities as essential contributors and stakeholders in these conservation endeavors.

Keywords: biodiversity, conservation, indigenous peoples, traditional knowledge, environmental stewardship

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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: Lokvendra S. Budania, Yogesh K Gaude, Vamsidhar Chamala

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Introduction: Congenitally corrected transposition of great arteries (CCTGA) is a complex congenital heart disease where there are both atrioventricular and ventriculoarterial discordances, usually accompanied by other cardiovascular malformations. Case Report: A 24-year-old primigravida known case of CCTGA at 37 weeks of gestation was referred to our hospital for safe delivery. Her electrocardiogram showed HR-40/pm, echocardiography showed Ejection Fraction of 65% and CCTGA. Temporary pacemaker was inserted by cardiologist in catheterization laboratory, before giving trial of labour in view of complete heart block. She was planned for normal delivery, but emergency Caesarean section was planned due to non-reassuring foetal Cardiotocography Pre-op vitals showed PR-50 bpm with temporary pacemaker, Blood pressure-110/70 mmHg, SpO2-99% on room air. Nil per oral was inadequate. Patency of two peripheral IV cannula checked and left radial arterial line secured. Epidural Anaesthesia was planned, and catheter was placed at L2-L3. Test dose was given, Anaesthesia was provided with 5ml + 5ml of 2% Lignocaine with 25 mcg Fentanyl and further 2.5Ml of 0.5% Bupivacaine was given to achieve a sensory level of T6. Cesarean section was performed and baby was delivered. Cautery was avoided during this procedure. IV Oxytocin (15U) was added to 500 mL of ringer’s lactate. Hypotension was treated with phenylephrine boluses. Patient was shifted to post-operative care unit and later to high dependency unit for monitoring. Post op vitals remained stable. Temporary pacemaker was removed after 24 hours of surgery. Her post-operative period was uneventful and discharged from hospital. Conclusion: Rare congenital cardiac disorders require detail knowledge of pathophysiology and associated comorbidities with the disease. Meticulously planned and carefully titrated neuraxial techniques will be beneficial for such cases.

Keywords: congenitally corrected transposition of great arteries, complete heart block, emergency LSCS, epidural anaesthesia

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Authors: Altaf Hussain, Norashidah Hashim

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An important aspect needed for promoting entrepreneurship is to encourage individuals for becoming entrepreneurs by endowing them with the required skills and knowledge for identifying the opportunities and turning these opportunities into successful ventures. Literature has recognized entrepreneurship education has significant role in motivating individual’s intention to become an entrepreneurs. Developing upon the insights based on dynamic view of human capital theory, this conceptual paper explores the role of entrepreneurial alertness in a linkage between entrepreneurial education and intentions to become an entrepreneur. Prior knowledge which can be acquired through entrepreneurship education and or experience is an antecedent for developing specific human capital of alertness for identifying the opportunities which impact on individual intentions. This suggests cause & effect relationship between entrepreneurship education and intentions through entrepreneurial alertness by impacting on the attitude, social norms and perceived behavioral control of an individual which can motivate individual intention of becoming an entrepreneur. Thus, alertness skill acquired through entrepreneurship education for identifying the profitable opportunities mediates the relationship between entrepreneurship education and intentions.

Keywords: entrepreneurship, entrepreneurship education, alertness, intentions, human capital

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Authors: Ila Shrestha

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Bridim Village Development Committee (VDC) is one of the medicinal plants hot spots of Nepal. It is located on a ridge above the lower Langtang Khola, steep and narrow spot in between 1944 m to 4833 m altitude. The study area is homogeneously inhabited by Tamang communities. An investigation on folk herbal medicine on the basis of traditional uses of medicinal plants was done in 2014. The local traditional healers, elder men and women, traders and teachers, were consulted as key informants for documentation of indigenous knowledge on the medicinal plants. It was found that altogether seventy-one medicinal plant species belonging to sixty genera and thirty-three families were used by local people for twenty-seven diseases. Roots of thirty-four species were the most frequently used plant parts and bigger numbers of species were found to be used in fever of ten species. Most medicines were prepared in the form of juice of forty species. The attempt of the study was to document ethno medicinal practices to treat different diseases in the study area for conservation of indigenous knowledge.

Keywords: Bridim village, ethnomedicine, national park, plants

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Authors: Mykah W. Sumoldao, Maria Erissa C. Susa, Triny Cate M. Telan, Christian Arvin M. Torres, Jasmine I. Udasco, Franceis Jeramil M. Walis, Shellyn S. Wandagan, Janine May M. Warding, Queenie Diana Rose P. Zalun Hope Lulet A. Lomioan

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This descriptive phenomenological study explored the lived experiences of the primary caregiver of schizophrenia patients at the Acute Crisis Intervention Service in Cagayan Valley Medical Center. The research aimed to understand the emotional, physical, and financial challenges these primary caregivers face. Data was gathered through interviews with nine (9) primary caregivers and analyzed using Colaizzi’s seven-step method. Two main themes emerged: Experience/ Challenges (Emotional, Physical, and Financial Challenges) and Managing Mechanisms (Support Systems and Resilience and Commitment). The study found that primary caregivers deal with a complex mix of difficulties, often with limited resources. They rely heavily on personal strength, faith, family, friends and community support to manage their roles. The findings highlighted the need for better support systems to ease primary caregivers' burdens. Financial aid, respite care, and mental health support are crucial for improving primary caregivers' quality of life and the care they provide. Additionally, raising awareness about primary caregivers' challenges can foster a supportive community, with more help from local organizations and government entities. Thus, this study provided insights into the caregiving experiences of those supporting schizophrenia patients. It emphasized the importance of practical support and emotional resilience. By addressing these needs, a more supportive environment can be created, benefiting both primary caregivers and their patients.

Keywords: primary caregiver burden, mental health, primary caregiver well-being, primary caregiver

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