Search results for: Susan Harrison

Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

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Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

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Authors: Matthew Heidman, Susan Dallabrida, Analice Costa

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For infant caregivers, choosing an infant formula for their child can be a difficult task in an already stressful environment of caring for a newborn. There exist several channels that influence purchasing decision of infant formula such as, friends and family and their experiences, health care professionals, social media influencers, as well as standard media marketing. This study sought to identify the key channels by which caregivers obtain information regarding infant formula and help them make their purchasing decision. A digital survey was issued for 90 days in the US (n=121) and 30 days in Mexico (n=88) targeting respondents with children ≤4 years of age. Respondents were asked two key questions regarding the influences on their purchasing decisions: 1) “When choosing a formula brand, what do you do to help you make your decision?”, and 2) “When choosing a formula brand, what is most important to you?”. A list of potential answers was provided for each question and respondents were asked to select all that apply to them. Lastly, respondents were provided a 5-point Likert scale and asked to respond to the statement 3) “I am more likely to buy a particular formula brand if my pediatrician recommends it to me”. For question 1, in the US and Mexico, 76% and 95% of respondents respectively, selected “I ask my pediatrician” which represented the top selection. For question 2, 52% and 45% of respondents respectively, selected “On package “Pediatrician Recommended” claim…” which also represented the top selection. For statement 3, 82% and 89% of respondents respectively, stated that they either “somewhat agree” or “strongly agree” with the statement. For infant caregivers, the pediatrician is a very important channel of influence when it comes to purchasing decision of infant formula. Caregivers clearly see the pediatrician as the arbiter of their child’s nutrition and seek their recommendations for infant formula use. For infant formula manufacturers, it is important that they see the pediatrician as the gatekeeper to this market, and they put resources into medical marketing communication to this health care professional group to ensure success.

Keywords: infant formula, pediatrician, purchasing driver, caregiver

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Authors: Kan Yu, Khui Hung Lee, Eben Afrifa-Yamoah, Jing Guo, Katrina Harrison, Jack Goldblatt, Nicholas Pachter, Jitian Xiao, Guicheng Brad Zhang

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Background and Significance of the Study: Congenital Heart Defects (CHDs) are the most common malformation at birth and one of the leading causes of infant death. Although the exact etiology remains a significant challenge, epigenetic modifications, such as DNA methylation, are thought to contribute to the pathogenesis of congenital heart defects. At present, no existing DNA methylation biomarkers are used for early detection of CHDs. The existing CHD diagnostic techniques are time-consuming and costly and can only be used to diagnose CHDs after an infant was born. The present study employed a machine learning technique to analyse genome-wide methylation data in children with and without CHDs with the aim to find methylation biomarkers for CHDs. Methods: The Illumina Human Methylation EPIC BeadChip was used to screen the genome‐wide DNA methylation profiles of 24 infants diagnosed with congenital heart defects and 24 healthy infants without congenital heart defects. Primary pre-processing was conducted by using RnBeads and limma packages. The methylation levels of top 600 genes with the lowest p-value were selected and further investigated by using a random forest approach. ROC curves were used to analyse the sensitivity and specificity of each biomarker in both training and test sample sets. The functionalities of selected genes with high sensitivity and specificity were then assessed in molecular processes. Major Findings of the Study: Three genes (MIR663, FGF3, and FAM64A) were identified from both training and validating data by random forests with an average sensitivity and specificity of 85% and 95%. GO analyses for the top 600 genes showed that these putative differentially methylated genes were primarily associated with regulation of lipid metabolic process, protein-containing complex localization, and Notch signalling pathway. The present findings highlight that aberrant DNA methylation may play a significant role in the pathogenesis of congenital heart defects.

Keywords: biomarker, congenital heart defects, DNA methylation, random forest

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Authors: Jude Harrison

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Child protection is a complex and sensitive practice. The core responsibility is the care and protection of children and young people who have been subject to or who are at risk from abuse and neglect. The work involves investigating allegations of harm, preparing for and making representations to the legal system, and case planning and management across a continuum of complicated care interventions. Professionals’ learning for child protection practice is evident in a range of literature investigating multiple learning processes such as university preparation, student placements, professional supervision, training, and other post-qualifying professional development experiences at work. There is, however, very limited research into how caseworkers learn in and through their daily practice. Little is known, therefore, about how learning at work unfolds for caseworkers, the dimensions in which it can be understood or the ways in which it can be best facilitated and supported. Compounding this, much of the current child protection learning literature reflects an orthodox conception of learning as mentalistic and individualised, in which knowledge is typically understood as abstract theory or as technical skill or competency. This presentation outlines key findings from a PhD research study that explored learning at work for statutory child protection caseworkers from an alternative interpretation of learning using a practice theory approach. Practice theory offers an interpretation of learning as performative and grounded in situated experience. The findings of the study show that casework practice is both a mode and site of learning. The study was ethnographic in design based and followed 17 child protection caseworkers via in-depth interviews, observations and participant reflective journaling. Inductive and abductive analysis was used to organise and interpret the data and expand analysis, leading to themes. Key findings show learning to be a sociomaterial property of doing; the social ontological character of learning; and teleoaffectivity as a feature of learning. The findings contribute to theoretical and practical understandings of learning and practice in child protection, child welfare and the professional learning literature more broadly. The findings have potential to contribute to policy directions at state, territory and national levels to enhance child protection practice and systems.

Keywords: adiult learning, workplace learning, child welfare, sociomaterial, practice theory

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Authors: Humphrey Agevi, Harrison Tsingalia, Richard Onwonga, Shem Kuyah

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Most of the world ecosystems have been affected by the effects of climate change. Efforts have been made to mitigate against climate change effects. While most studies have been done in forest ecosystems and pure plant plantations, trees on farms including agroforestry have only received attention recently. Agroforestry systems and tree cover on agricultural lands make an important contribution to climate change mitigation but are not systematically accounted for in the global carbon budgets. This study sought to: (i) determine tree diversity in different agroforestry practices; (ii) determine tree biomass in different agroforestry practices. Study area was determined according to the Land degradation surveillance framework (LSDF). Two study sites were established. At each of the site, a 5km x 10km block was established on a map using Google maps and satellite images. Way points were then uploaded in a GPS helped locate the blocks on the ground. In each of the blocks, Nine (8) sentinel clusters measuring 1km x 1km were randomized. Randomization was done in a common spreadsheet program and later be downloaded to a Global Positioning System (GPS) so that during surveys the researchers were able to navigate to the sampling points. In each of the sentinel cluster, two farm boundaries were randomly identified for convenience and to avoid bias. This led to 16 farms in Kakamega South and 16 farms in Kakamega North totalling to 32 farms in Kakamega Site. Species diversity was determined using Shannon wiener index. Tree biomass was determined using allometric equation. Two agroforestry practices were found; homegarden and hedgerow. Species diversity ranged from 0.25-2.7 with a mean of 1.8 ± 0.10. Species diversity in homegarden ranged from 1-2.7 with a mean of 1.98± 0.14. Hedgerow species diversity ranged from 0.25-2.52 with a mean of 1.74± 0.11. Total Aboveground Biomass (AGB) determined was 13.96±0.37 Mgha-1. Homegarden with the highest abundance of trees had higher above ground biomass (AGB) compared to hedgerow agroforestry. This study is timely as carbon budgets in the agroforestry can be incorporated in the global carbon budgets and improve the accuracy of national reporting of greenhouse gases.

Keywords: agroforestry, allometric equations, biomass, climate change

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Authors: Chen Jun

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Antonia Susan Byatt’s Possession: A Romance has been misread as a postmodern pastiche novel since its publication because there are epics, epigraphs, lyrics, fairy tales, epistles, and even critical articles swollen in this work. The word ‘pastiche’ suggests messy, disorganized, and chaotic, which buries its artistic excellence while overlooking its subtitle, A Romance. The center of romance is the quest that the hero sets forth to conquer the adversity, hardship, and danger to accomplish a task to prove his identity or social worth. This paper argues that Byatt’s Possession is not a postmodern pastiche novel but rather a postmodern romance in which the characters in the academic world set forth their quest into the Victorian literary past that is nostalgically identified by Byatt as the Golden Age of English literature. In doing so, these five following issues are addressed: first, the origin of the protagonist Roland, and consequently, the nature of his quest; second, the central image of the dragon created by the fictional Victorian poet Henry Ash; third, Melusine as an image of female serpent created by the fictional Victorian poet Christabel LaMotte; fourth, the images of the two ladies; last, the image of water that links the dragon and the serpent. In Possession, the past is reinvented not as an unfortunate fall but as a Golden Age presented in the imaginative academic adventure. The dragon, a stereotypical symbol of evil, becomes the symbol of life in Byatt’s work, which parallels with the image of the mythical phoenix that can resurrect from its own ash. At the same time, the phoenix symbolizes Byatt’s efforts to revive the Victorian poetic art that is supposed to be dead in the post-capitalism society when the novel is the dominating literary genre and poetry becomes the minority. The fictional Victorian poet Ash is in fact Byatt’s own poetic mask through which she breathes life into the lost poetic artistry in the postmodern era.

Keywords: Byatt, possession, postmodern romance, literary past

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Authors: Lina T. Al Kury, Oleg I. Voitychuk, Ramiz M. Ali, Sehamuddin Galadari, Keun-Hang Susan Yang, Frank Christopher Howarth, Yaroslav M. Shuba, Murat Oz

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A role for anandamide (N-arachidonoyl ethanolamide; AEA), a major endocannabinoid, in the cardiovascular system in various pathological conditions has been reported in earlier studies. In the present work, we have hypothesized that the antiarrhythmic effects reported for AEA are due to its negative inotropic effect and altered action potential (AP) characteristics. Therefore, we tested the effects of AEA on contractility and electrophysiological properties of rat ventricular myocytes. Video edge detection was used to measure myocyte shortening. Intracellular Ca2+ was measured in cells loaded with the fluorescent indicator fura-2 AM. Whole-cell patch-clamp technique was employed to investigate the effect of AEA on the characteristics of APs. AEA (1 μM) caused a significant decrease in the amplitudes of electrically-evoked myocyte shortening and Ca2+ transients and significantly decreased the duration of AP. The effect of AEA on myocyte shortening and AP characteristics was not altered in the presence of pertussis toxin (PTX, 2 µg/ml for 4 h), AM251 and SR141716 (cannabinoid type 1 receptor antagonists) or AM630 and SR 144528 (cannabinoid type 2 receptor antagonists). Furthermore, AEA inhibited voltage-activated inward Na+ (INa) and Ca2+ (IL,Ca) currents; major ionic currents shaping the APs in ventricular myocytes, in a voltage and PTX-independent manner. Collectively, the results suggest that AEA depresses ventricular myocyte contractility, by decreasing the action potential duration (APD), and inhibits the function of voltage-dependent Na+ and L-type Ca2+ channels in a manner independent of cannabinoid receptors. This mechanism may be importantly involved in the antiarrhythmic effects of anandamide.

Keywords: action potential, anandamide, cannabinoid receptor, endocannabinoid, ventricular myocytes

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Authors: Protus A. Lumiti, Susan O. Wekesa, Mary Omondi

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Performance is a key pillar to the accomplishment of the goals of all organizations, whether private, public or non- profit. Employees are the intellectual assets of the organization and they are an avenue to the achievement of competitive advantage. An employee welfare service in an organization is vital in fostering employee motivation and improving their productivity. In view of this, the main goal of this research was to determine the relationship between employee welfare practices and the performance of non-governmental organizations in Kenya. The study was guided by four objectives, namely: to establish, determine, evaluate and assess the relationship between employee welfare practices and the performance of non-governmental organizations in Kenya. The study utilized a survey design using both qualitative and quantitative approaches. In this study, a purposive, stratified and simple random sampling technique was used to arrive at a sample of 355 respondents who comprised senior managers, middle level managers and operational employees out of the targeted population of 14,283 employees of non-governmental organizations working in Nairobi County. The primary data collection tools were questionnaires supplemented by an interview schedule, while secondary data was obtained from reviewed journals, published books and articles. Data analysis was done using Statistical Packages for Social Sciences Software version 23. The study utilized multiple linear regression and a structural equation model. The findings of the study were that: employee welfare practices had a positive and significant relationship with the performance of Non-governmental organizations in Kenya. In addition, there was also a linear relationship between the independent variables and the dependent variable and the study concluded that there was a relationship between the predictor variable and the dependent variable of the study. The study recommended that management of No-governmental organization boards in Kenya should come up with a comprehensive policy document on employee welfare practices in order to enhance the performance of non-governmental organizations in Kenya.

Keywords: employee, economic, performance, welfare

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Authors: Jessica Achebe, Susan Tighe

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The reduction of material consumption and greenhouse gas emission when maintain and rehabilitating road networks can achieve added benefits including improved life cycle performance of pavements, reduced climate change impacts and human health effect due to less air pollution, improved productivity due to an optimal allocation of resources and reduced road user cost. This is the essence of incorporating environmental sustainability into pavement management. The functionality of performance measurement approach has made it one of the most valuable tool to Pavement Management Systems (PMSs) to account for different criteria in the decision-making process. However measuring the environmental performance of road network is still a far-fetched practice in road network management, more so an ostensive agency-wide environmental sustainability or sustainable maintenance specifications is missing. To address this challenge, this present research focuses on the environmental sustainability performance of network-level pavement management. The ultimate goal is to develop a framework to incorporate environmental sustainability in pavement management systems for network-level maintenance programming. In order to achieve this goal, this paper present the first step, the intention is to review the previous studies that employed environmental performance measures, as well as the suitability of environmental performance indicators for the evaluation of the sustainability of network-level pavement maintenance strategies. Through an industry practice survey, this paper provides a brief forward regarding the pavement manager motivations and barriers to making more sustainable decisions, and data needed to support the network-level environmental sustainability. The trends in network-level sustainable pavement management are also presented, existing gaps are highlighted, and ideas are proposed for network-level sustainable maintenance and rehabilitation programming.

Keywords: pavement management, environment sustainability, network-level evaluation, performance measures

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Authors: Gaoyang Meng, Philip Harrison

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When manufacturing composite laminates, the fibre directions within the laminate are never perfectly straight and inevitably contain some degree of stochastic in-plane waviness or ‘meandering’. In this work we aim to understand the relationship between the degree of meandering of the fibre paths, and the resulting uncertainty in the laminate’s final mechanical properties. To do this, a numerical tool is developed to automatically generate meandering fibre paths in each of the laminate's 8 plies (using Matlab) and after mapping this information into finite element simulations (using Abaqus), the statistical variability of the tensile mechanical properties of a [45°/90°/-45°/0°]s carbon/epoxy (IM7/8552) laminate is predicted. The stiffness, first ply failure strength and ultimate failure strength are obtained. Results are generated by inputting the degree of variability in the fibre paths and the laminate is then examined in all directions (from 0° to 359° in increments of 1°). The resulting predictions are output as flower (polar) plots for convenient analysis. The average fibre orientation of each ply in a given laminate is determined by the laminate layup code [45°/90°/-45°/0°]s. However, in each case, the plies contain increasingly large amounts of in-plane waviness (quantified by the standard deviation of the fibre direction in each ply across the laminate. Four different amounts of variability in the fibre direction are tested (2°, 4°, 6° and 8°). Results show that both the average tensile stiffness and the average tensile strength decrease, while the standard deviations increase, with an increasing degree of fibre meander. The variability in stiffness is found to be relatively insensitive to the rotation angle, but the variability in strength is sensitive. Specifically, the uncertainty in laminate strength is relatively low at orientations centred around multiples of 45° rotation angle, and relatively high between these rotation angles. To concisely represent all the information contained in the various polar plots, rotation-angle dependent Weibull distribution equations are fitted to the data. The resulting equations can be used to quickly estimate the size of the errors bars for the different mechanical properties, resulting from the amount of fibre directional variability contained within the laminate. A longer term goal is to use these equations to quickly introduce realistic variability at the component level.

Keywords: advanced composite laminates, FE simulation, in-plane waviness, tensile properties, uncertainty quantification

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Authors: Houda Oueriemmi, Petra Susan Kidd, Carmen Trasar-Cepeda, Beatriz Rodríguez-Garrido, Mohamed Moussa, Ángeles Prieto-Fernández, Mohamed Ouessar

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Organic amendments are generally used for improving the fertility of arid and semi-arid soils. However, the price of farmyard manure, the organic amendment typically applied to many arid and semi-arid soils has highly increased in the last years. To investigate at field scale whether cheap, highly available organic amendments, such as sewage sludge compost and municipal solid waste compost, may be acceptable as substitutes for farmyard manure is therefore of great interest. A field plots experiment was carried out to assess the effects of a single application of three organic amendments on soil fertility, distribution of trace elements and on barley yield. Municipal solid waste compost (MSWC), farmyard manure (FYM) and sewage sludge compost (SSC) were applied at rates of 0, 20, 40 and 60 t ha⁻¹, and barley was cultivated in two consecutive years. Plant samples and soils were collected for laboratory analyses after two consecutive harvests. Compared with unamended soil, the application of the three organic residues improved the fertility of the topsoil, showing a significant dose-dependent increase of TOC, N, P contents up to the highest dose of 60 t ha⁻¹ (0.74%, 0.06% and 40 mg kg⁻¹, respectively). The enhancement of soil nutrient status impacted positively on grain yield (up to 51%). The distribution of trace elements in the soil, analysed by a sequential extraction procedure, revealed that the MSWC increased the acid-extractable Co and Cu and reducible Ni, while SSC increased reducible Co and Ni and oxidisable Cu, relative to the control soil.

Keywords: municipal solid waste compost, sewage sludge compost, fertility, trace metals

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Authors: Sony Subedi, Colleen Davison, Susan Bartels

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Objective: The aim of this study is to i) investigate the socio-demographics and living conditions of households in Haiti pre- and post 2010 earthquake, ii) determine the household prevalence of emotional and physical abuse in children (aged 2-14) after the earthquake, and iii) explore the association between earthquake-related loss and experience of emotional and physical child abuse in the household while considering potential confounding variables and the interactive effects of a number of social, economic, and demographic factors. Methods: A nationally representative sample of Haitian households from the 2005/6 and 2012 phases of the Demographic and Health Surveys (DHS) was used. Descriptive analysis was summarized using frequencies and measures of central tendency. Chi-squared and independent t-tests were used to compare data that was available pre-earthquake and post-earthquake. The association between experiences of earthquake-related loss and emotional and physical child abuse was assessed using log-binomial regression models. Results: Comparing pre-post-earthquake, noteworthy improvements were observed in the educational attainment of the household head (9.1% decrease in “no education” category) and in possession of the following household items: electricity, television, mobile-phone, and radio post-earthquake. Approximately 77.0% of children aged 2-14 experienced at least one form of physical abuse and 78.5% of children experienced at least one form of emotional abuse one month prior to the 2012 survey period. Analysis regarding the third objective (association between experiences of earthquake-related loss and emotional and physical child abuse) is in progress. Conclusions: The extremely high prevalence of emotional and physical child abuse in Haiti indicates an immediate need for improvements in the enforcement of existing policies and interventions aimed at decreasing child abuse in the household.

Keywords: Haiti earthquake, physical abuse, emotional abuse, natural disasters, children

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Authors: Susan Lanz, Gary T. Burke, Omid Omidvar

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The intention to transfer ownership control across family generations is acknowledged to be central to developing a theoretical understanding of how family businesses differ and are distinct as a business group. However, in practice, most business-owning families face challenges to transfer their business ownership from one family generation to the next. To date, researchers have paid little attention to how and when ownership is passed across family generations and what the dynamics of such transitions are. This is primarily due to the prevailing assumption that ownership transfer is an unimportant and legalistic issue that occurs within a wider family management succession process. Yet, the limited evidence available suggests that family ownership transfer occurs inside and outside of the management succession process and is a difficult process for business-owning families to navigate. As a result, many otherwise viable family businesses are closing, leading to unnecessary loss of jobs and knowledge. This qualitative paper examines how family members understand and navigate the ownership transfer process. This study uses an inductive qualitative research design, conducted through in-depth interviews within eight business-owning families. It draws on family development theory and shows how a wide range of family-related events and dynamics outside of family business involvement underlie and shape the ownership transfer process. The findings extend the theory on how these events trigger ownership transfer and how they shape the ownership meanings held within business-owning families. This study found that ownership transfer meanings extend beyond that of transferring the legal control and financial appropriation rights of shareholders. The study concludes there are three different stages in the process of ownership transfer -symbolic, re-balancing, and protectionist. Each stage creates distinct family social constructions of the rights of family members to hold business ownership, and each stage occurs within a specific family development phase.

Keywords: business-owning family, family development theory, ownership transfer, process

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Authors: Susan Amirsalari, Azime Khosrinejad, Elham Rahimian

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Objective: Epilepsy is a common brain disorder characterized by a persistent tendency to develop in neurological, cognitive, and psychological contents. Magnetic Resonance Imaging (MRI) is a neuroimaging test facilitating the detection of structural epileptogenic lesions. This study aimed to compare the MRI findings between patients with intractable and drug-responsive epilepsy. Material & methods: This case-control study was conducted from 2007 to 2019. The research population encompassed all 1-16- year-old patients with intractable epilepsy referred to the Shafa Neuroscience Center (n=72) (a case group) and drug-responsive patients referred to the pediatric neurology clinic of Baqiyatallah Hospital (a control group). Results: There were 72 (23.5%) patients in the intractable epilepsy group and 200 (76.5%) patients in the drug-responsive group. The participants' mean age was 6.70 ±4.13 years, and there were 126 males and 106 females in this study Normal brain MRI was noticed in 21 (29.16%) patients in the case group and 184 (92.46%) patients in the control group. Neuronal migration disorder (NMD)was also exhibited in 7 (9.72%) patients in the case group and no patient in the control group. There were hippocampal abnormalities and focal lesions (mass, dysplasia, etc.) in 10 (13.88%) patients in the case group and only 1 (0.05%) patient in the control group. Gliosis and porencephalic cysts were presented in 3 (4.16%) patients in the case group and no patient in the control group. Cerebral and cerebellar atrophy was revealed in 8 (11.11%) patients in the case group and 4 (2.01%) patients in the control group. Corpus callosum agenesis, hydrocephalus, brain malacia, and developmental cyst were more frequent in the case group; however, the difference between the groups was not significant. Conclusion: The MRI findings such as hippocampal abnormalities, focal lesions (mass, dysplasia), NMD, porencephalic cysts, gliosis, and atrophy are significantly more frequent in children with intractable epilepsy than in those with drug-responsive epilepsy.

Keywords: magnetic resonance imaging, intractable epilepsy, drug responsive epilepsy, neuronal migrational disorder

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Authors: Susan Diamond

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

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

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Authors: Susan Marie R. De La Cruz, Bernadette F. De La Cruz, Georgia D. Demavibas

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This study determined the top 10 perceived students’ academic needs, personal needs, personal obstacles in achieving their academic goals, are as they need assistance, and their perceived feelings in math, reading and writing. The North Carolina State College, Student Support Services needs assessment survey was used. The respondents were the randomly chosen122Graduate school students. The top 10 academic needs are as follows: need to improve memory, communication skills, study habits, time management skills, career decisions, vocabulary, math skills, test taking skills, reading comprehension, and the need to reduce math anxiety. Top 10 personal needs are as follows: difficulty meeting deadline, difficulty managing money, inadequate computer skills, afraid of failing graduate school, difficulty participating in class/group discussions, absence from school, anxiety during exams, little or no experience with internet, personal counseling needs, and unsure of university academic procedures. Students’ top 10 perceived personal obstacles were as follows: issues surrounding sickness in family, lack of time management, lack of money, feeling tired, fears to speak in class, poor study habits, problems at home, late in class, too shy, and always feeling sick and easily distracted. Students felt need assistance in areas surrounding personal budget, stress management, motivation, anxiety, depressions, leadership development and goals/decision making. It is recommended that enrichment activities be provided to respond to students’ academic and personal needs. Also, Graduate School Guidance Counselor collaborates with other licensed Guidance Counselors in other colleges to have a well-coordinated and effective delivery of services responsive to students’ needs.

Keywords: academic needs, guidance counsellors, guidance service, needs assessment survey, personal needs, student services

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Authors: Seember Susan Aondoakura

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This paper examines the international legal framework established to address the challenges women and girls experience in situations of violent conflict. The United Nations (UN) women, peace, and security agenda (hereafter WPS agenda, the Agenda) aspire to make wars safer for women. It recognizes women's agency in armed conflict and their victimization and formulates measures for their protection. The Agenda also acknowledges women's participation in conflict transformation and post-conflict reconstruction. It also calls for the involvement of women in conflict transformation, encourages the protection of women from sex and gender-based violence (SGBV), and provides relief and recovery from conflict-related SGBV. Using Third World Critical Feminist Theory, this paper argues that the WPS agenda overly focus on the protection of women from SGBV occurring in the less developed and conflict-ridden states in the global south, obscures the complicity of western states and economies to the problem, and silences the privileges that such states derive from war economies that continue to fuel conflict. This protectionist approach of the UN also obliterates other equally pressing problems in need of attention, like the high rates of economic degradation in conflict-ravaged societies of the global south. Prioritising protection also 'others' the problem, obliterating any sense of interconnections across geographical locations and situating women in the less developed economies of the global south as the victims and their men as the perpetrators. Prioritising protection ultimately situates western societies as saviours of Third World women with no recourse to their role in engendering and sustaining war. The paper demonstrates that this saviour mentality obliterates chances of any meaningful coalition between the local and the international in framing and addressing the issue, as solutions are formulated from a specific lens—the white hegemonic lens.

Keywords: conflict, protection, security, SGBV

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Authors: Ahmed Elbeltagy, Francesca Bertolini, Damarius Fleming, Angelica Van Goor, Chris Ashwell, Carl Schmidt, Donald Kugonza, Susan Lamont, Max Rothschild

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The major factor in shaping genomic variation of the African indigenous rural chicken is likely natural selection drives the development genetic footprints in the chicken genomes. To investigate such a hypothesis of a selection footprint, a total of 292 birds were randomly sampled from three indigenous ecotypes from East Africa (Uganda, Rwanda) and North Africa (Egypt) and two registered Egyptian breeds (Fayoumi and Dandarawi), and from the synthetic Kuroiler breed. Samples were genotyped using the Affymetrix 600K Axiom® Array. A total of 526,652 SNPs were utilized in the downstream analysis after quality control measures. The intra-population runs of homozygosity (ROH) that were consensuses in > 50% of individuals of an ecotype or > 75% of a breed were studied. To identify inter-population differentiation due to genetic structure, FST was calculated for North- vs. East- African populations in addition to population-pairwise combinations for overlapping windows (500Kb with an overlap of 250Kb). A total of 28,563 ROH were determined and were classified into three length categories. ROH and Fst detected sweeps were identified on several autosomes. Several genes in these regions are likely to be related to adaptation to local environmental stresses that include high altitude, diseases resistance, poor nutrition, oxidative and heat stresses and were linked to gene ontology terms (GO) related to immune response, oxygen consumption and heme binding, carbohydrate metabolism, oxidation-reduction, and behavior. Results indicated a possible effect of natural selection forces on shaping genomic structure for adaptation to local environmental stresses.

Keywords: African Chicken, runs of homozygosity, FST, selection footprints

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Authors: April Hueimin Lu, Liangj-Ju Yao, Jun-Tin Lin, Susan Siru Liu

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This paper discusses the application of aerial survey technology and 3D laser scanning technology in the surveying and mapping work of the settlements and slate houses of the old Taiwanese aborigines. The relics of old Taiwanese aborigines with thousands of history are widely distributed in the deep mountains of Taiwan, with a vast area and inconvenient transportation. When constructing the basic data of cultural assets, it is necessary to apply new technology to carry out efficient and accurate settlement mapping work. In this paper, taking the old Paiwan as an example, the aerial survey of the settlement of about 5 hectares and the 3D laser scanning of a slate house were carried out. The obtained orthophoto image was used as an important basis for drawing the settlement map. This 3D landscape data of topography and buildings derived from the aerial survey is important for subsequent preservation planning as well as building 3D scan provides a more detailed record of architectural forms and materials. The 3D settlement data from the aerial survey can be further applied to the 3D virtual model and animation of the settlement for virtual presentation. The information from the 3D scanning of the slate house can also be used for further digital archives and data queries through network resources. The results of this study show that, in large-scale settlement surveys, aerial surveying technology is used to construct the topography of settlements with buildings and spatial information of landscape, as well as the application of 3D scanning for small-scale records of individual buildings. This application of 3D technology, greatly increasing the efficiency and accuracy of survey and mapping work of aboriginal settlements, is much helpful for further preservation planning and rejuvenation of aboriginal cultural heritage.

Keywords: aerial survey, 3D scanning, aboriginal settlement, settlement architecture cluster, ecological landscape area, old Paiwan settlements, slat house, photogrammetry, SfM, MVS), Point cloud, SIFT, DSM, 3D model

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Authors: Susan Ka Yee Chow

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The Coronavirus disease (COVID-19) reached Hong Kong in 2019 resulting in epidemic in late January 2020. Considering the epidemic development, tertiary institutions made announcements that all on-campus classes were suspended since 01/29/2020. In Tung Wah College, e-learning was adopted in all courses for all programmes. For the undergraduate nursing students, the contact hours and curriculum are bounded by the Nursing Council of Hong Kong to ensure core competence after graduation. Unlike the usual e-learning where students are allowed having flexibility of time and place in their learning, real time learning mode using Blackboard was used to mimic the actual classroom learning environment. Students were required to attend classes according to the timetable using online platform. For lectures, voice over PowerPoint file was the initial step for mass lecturing. Real time lecture was then adopted to improve interactions between teacher and students. Post-lecture quizzes were developed to monitor the effectiveness of lecture delivery. The seminars and tutorials were conducted using real time mode where students were separated into small groups with interactive discussions with teacher within the group. Live time demonstrations were conducted during laboratory sessions. All teaching sessions were audio/video recorded for students’ referral. The assessments including seminar presentation and debate were retained. The learning mode creates an atmosphere for students to display the visual, audio and written works in a non-threatening atmosphere. Other students could comment using text or direct voice as they desired. Real time online learning is the pedagogy to replace classroom contacts in the emergent and unforeseeable circumstances. The learning pace and interaction between students and students with teacher are maintained. The learning mode has the advantage of creating an effective and beneficial learning experience.

Keywords: e-learning, nursing curriculum, real time mode, teaching and learning

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Authors: Jessica Achebe, Susan Tighe

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The recent Canadian infrastructure report card reveals the unhealthy state of municipal infrastructure intensified challenged faced by municipalities to maintain adequate infrastructure performance thresholds and meet user’s required service levels. For a road agency, huge funding gap issue is inflated by growing concerns of the environmental repercussion of road construction, operation and maintenance activities. As the reduction of material consumption and greenhouse gas emission when maintain and rehabilitating road networks can achieve added benefits including improved life cycle performance of pavements, reduced climate change impacts and human health effect due to less air pollution, improved productivity due to optimal allocation of resources and reduced road user cost. Incorporating environmental sustainability measure into pavement management is solution widely cited and studied. However measuring the environmental performance of road network is still a far-fetched practice in road network management, more so an ostensive agency-wide environmental sustainability or sustainable maintenance specifications is missing. To address this challenge, this present research focuses on the environmental sustainability performance of network-level pavement management. The ultimate goal is to develop a framework to incorporate environmental sustainability in pavement management systems for network-level maintenance programming. In order to achieve this goal, this study reviewed previous studies that employed environmental performance measures, as well as the suitability of environmental performance indicators for the evaluation of the sustainability of network-level pavement maintenance strategies. Through an industry practice survey, this paper provides a brief forward regarding the pavement manager motivations and barriers to making more sustainable decisions, and data needed to support the network-level environmental sustainability. The trends in network-level sustainable pavement management are also presented, existing gaps are highlighted, and ideas are proposed for sustainable network-level pavement management.

Keywords: pavement management, sustainability, network-level evaluation, environment measures

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Authors: Chinwe Susan Oguejiofor, Daniel Osamwonyi Iyioha

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Over the last two decades, Nigeria has witnessed an upsurge in graduate unemployment occasioned by the lack of industries and proliferation of tertiary institutions churning out thousands of graduates every year to compete for the few available job space. The astronomical rise in the unemployment rate amongst Nigerian graduates however, is principally assumed to be the defective curricula of the universities and other tertiary institutions whose focus is on training for white-collar jobs. Although graduate unemployment has become a global scourge, its adverse economic impact is believed to be more in developing economies like Nigeria with a huge young population within the working age who cannot seem to find gainful employment to make out a respectable livelihood. Thus, higher institutions especially Universities found itself under pressure and intense competition to produce graduates who can think outside the box and create jobs; hence there was the need to focus on instilling hands-on practical job skills into their students that will make them job creators rather than job seekers on graduation. In the same vein stakeholders in education have continued to lend their voices to the philosophy that the undergraduate curricula should be completely overhauled to accomodate the development of hand-on practical skills and innovative capacity relevant to creating solutions to societal problems. In a bid to correct this anomaly, the Federal Government of Nigeria in conjunction with the Ministry of Commerce, Industry and Investment inaugurated a programme tagged “University Entrepreneurship Development Programme” (UNEDEP) whose objective was basically to promote self-employment among the youth right from the institutions of higher learning. But the question is whether the objectives of the programme have actually been achieved. Despite the inclusion in Nigerian educational curriculum close to two decades now,, one wonder if the essence has been aborted. Thus, the paper focused on the concept of entrepreneurship education, objectives of entrepreneurship education, Graduates unemployment, rethinking entrepreneurship education programme in tertiary institution for employment generation , role of entrepreneurship in job creation, challenges of entrepreneurship education in tertiary institution in Nigeria, conclusion and recommendations were drawn accordingly.

Keywords: rethinking, entrepreneurship education, remedy, unemployment, job creation

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Authors: Narissa Lewis, Susan Geertshuis

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The global and national employability agenda is changing the higher education landscape as academic staff are faced with the responsibility of developing employability capabilities and attributes in addition to delivering discipline specific content and skills. They realise that the shift towards teaching sustainable capabilities means a shift in the way they teach. But what that shift should be or how they should bring it about is unclear. As part of a national funded project, representatives from several New Zealand (NZ) higher education institutions and the NZ Association of Graduate Employers partnered to discover, trial and disseminate means of embedding employability in the curriculum. Findings from four focus groups (n=~75) and individual interviews (n=20) with staff from several NZ higher education institutions identified factors that enable or hinder embedded employability development within their respective institutions. Participants believed that higher education institutions have a key role in developing graduates for successful lives and careers however this requires a significant shift in culture within their respective institutions. Participants cited three main barriers: lack of strategic direction, support and guidance; lack of understanding and awareness of employability; and lack of resourcing and staff capability. Without adequate understanding and awareness of employability, participants believed it is difficult to understand what employability is let alone how it can be embedded in the curriculum. This presentation will describe some of the impacts that the employability agenda has on staff as they try to move from traditional to contemporary forms of teaching to develop employability attributes of students. Changes at the institutional level are required to support contemporary forms of teaching, however this is often beyond the sphere of influence at the teaching staff level. The study identified that small changes to teaching practices were necessary and a simple model to facilitate change from traditional to contemporary forms of teaching was developed. The model provides a framework to identify small but impactful teaching practices and exemplar teaching practices were identified. These practices were evaluated for transferability into other contexts to encourage small but impactful changes to embed employability in the curriculum.

Keywords: curriculum design, change management, employability, teaching exemplars

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Authors: Matthew Heidman, Susan Dallabrida, Analice Costa

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Background:Accuracy of caregiver reported outcomes is essential for infant growth and tolerability study success. Crying/fussiness, stool consistencies, and other gastrointestinal characteristics are important parameters regarding tolerability, and inter-caregiver reporting can see a significant amount of subjectivity and vary greatly within a study, compromising data. This study sought to elucidate how caregiver reported questions related to stool frequency are answered before and after a short amount of training and how training impacts caregivers’ understanding, and how they would answer the question. Methods:A digital survey was issued for 90 daysin the US (n=121) and 30 days in Mexico (n=88), targeting respondents with children ≤4 years of age. Respondents were asked a question in two formats, first without a line of training text and second with a line of training text. The question set was as follows, “If your baby had stool in his/her diaper and you changed the diaper and 10 min later there was more stool in the diaper, how many stools would you report this as?” followed by the same question beginning with “If you were given the instruction that IF there are at least 5 minutes in between stools, then it counts as two (2) stools…”.Four response items were provided for both questions, 1) 2 stools, 2) 1stool, 3) it depends on how much stool was in the first versus the second diaper, 4) There is not enough information to be able to answer the question. Response frequencies between questions were compared. Results: Responses to the question without training saw some variability in the US, with 69% selecting “2 stools”,11% selecting “1 stool”, 14% selecting “it depends on how much stool was in the first versus the second diaper”, and 7% selecting “There is not enough information to be able to answer the question” and in Mexico respondents selected 9%, 78%, 13%, and 0% respectively. However, responses to the question after training saw more consolidation in the US, with 85% of respondents selecting“2 stools,” representing an increase in those selecting the correct answer. Additionally in Mexico, with 84% of respondents selecting “1 episode” representing an increase in the those selecting the correct response. Conclusions: Caregiver reported outcomes are critical for infant growth and tolerability studies, however, they can be highly subjective and see a high variability of responses without guidance. Training is critical to standardize all caregivers’ perspective regarding how to answer questions accurately in order to provide an accurate dataset.

Keywords: infant nutrition, clinical trial optimization, stool reporting, decentralized clinical trials

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Authors: Sabir Hussain, Muhammad Naeem, Yousif Aldryhim, Susan E. Halbert, Qingjun Wu

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Plant viruses annually cause severe economic losses in crop production and globally, different aphid species are responsible for the transmission of such viruses. Additionally, aphids are also serious pests of trees, and agricultural crops. Al Bahah Province, Kingdom of Saudi Arabia (KSA) has a high native and introduced plant species with a temperate climate that provides ample habitats for aphids. In this study, we surveyed virus-transmitting aphids from the Province to highlight their spatial distributions and hot spot areas for their target control strategies. During our fifteen month's survey in Al Bahah Province, three hundred and seventy samples of aphids were collected using both beating sheets and yellow water pan traps. Consequently, fifty-four aphid species representing 30 genera belonging to four families were recorded from Al Bahah Province. Alarmingly, 35 aphid species from our records are virus transmitting species. The most common virus transmitting aphid species based on number of collecting samples, were Macrosiphum euphorbiae (Thomas, 1878), Brachycaudus rumexicolens (Patch, 1917), Uroleucon sonchi (Linnaeus, 1767), Brachycaudus helichrysi (Kaltenbach, 1843), and Myzus persicae (Sulzer, 1776). The numbers of samples for the forementioned species were 66, 24, 23, 22, and 20, respectively. The widest range of plant hosts were found for M. euphorbiae (39 plant species), B. helichrysi (12 plant species), M. persicae (12 plant species), B. rumexicolens (10 plant species), and U. sonchi (9 plant species). The hottest spot areas were found in Al-Baha, Al Mekhwah and Biljarashi cities of the province on the basis of their abundance. This study indicated that Al Bahah Province has relatively rich aphid diversity due to the relatively high plant diversity in a favorable climatic condition. ArcGIS tools can be helpful for biologists to implement the target control strategies against these pests in the integrated pest management, and ultimately to save money and time.

Keywords: Al Bahah province, aphid-virus interaction, biodiversity, global information system

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Authors: Susan Lubbers

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This study applies critical discourse analysis to the language used by educators to frame international students of Asian backgrounds in Anglo-Western universities as quiet, shy, passive and unable to think critically. Emphasis is on the self-promoted ‘internationalised’ Australian tertiary context, where negative stereotypes are commonly voiced not only in the academy but also in the media. Parallels are drawn as well with other Anglo-Western educational contexts. The study critically compares the discourse of these persistent negative stereotypes, with in-class and interview discourses of international students of Asian and Western language, cultural and educational backgrounds enrolled in a Media and Popular Culture unit in an Australian university. The focus of analysis of the student discourse is on their engagement in critical dialogic interactions on the topics of culture and interculturality. The evidence is also drawn from student interviews and focus groups and from observation of whole-class discussion participation rates. The findings of the research project provide evidence that counters the myth of student as problem. They point rather to the widespread lack of intercultural awareness of Western educators and students as being at the heart of the negative perceptions of students of Asian backgrounds. The study suggests the efficacy of an approach to developing intercultural competence that is embedded, or integrated, into tertiary programs. The presentation includes an overview of the main strategies that have been developed by the tertiary educator (author) to support the development of intercultural competence of and among the student cohort. The evidence points to the importance of developing intercultural competence among tertiary educators and students. The failure by educators to ensure that the diverse voices, ideas and perspectives of students from all cultural, educational and language backgrounds are heard in our classrooms means that our universities can hardly be regarded or promoted as genuinely internationalised. They will continue as undemocratic institutions that perpetrate persistent Western educational hegemony.

Keywords: critical discourse analysis, critical thinking, embedding, intercultural competence, interculturality, international student, internationalised education

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Authors: Mike T. Wei, Douglas N. Mintz, Lisa A. Mandl, Arielle W. Fein, Jayme C. Burket, Yuo-Yu Lee, Wei-Ti Huang, Vivian P. Bykerk, Mark P. Figgie, Edward F. Di Carlo, Bruce N. Cronstein, Susan M. Goodman

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Background/Purpose: Rheumatoid arthritis (RA) patients have excellent total hip arthroplasty (THA) survival, and methotrexate (MTX), an anti-inflammatory disease modifying drug which may affect bone reabsorption, may play a role. The purpose of this study is to determine the diagnosis leading to revision THA (rTHA) in RA patients and to assess the association of radiographic lucency with MTX use. Methods: All patients with validated diagnosis of RA in the institution’s THA registry undergoing rTHA from May 2007 - February 2011 were eligible. Diagnosis leading to rTHA and medication use was determined by chart review. Osteolysis was evaluated on available radiographs by measuring maximum lucency in each Gruen zone. Differences within RA patients with/without MTX in osteolysis, demographics, and medications were assessed with chi-squared, Fisher's exact tests or Mann-Whitney U tests as appropriate. The error rate for multiple comparisons of lucency in the different Gruen zones was corrected via false discovery rate methods. A secondary analysis was performed to determine differences in diagnoses leading to revision between RA and matched OA controls (2:1 match by sex age +/- 5 years). OA exclusion criteria included presence of rheumatic diseases, use of MTX, and lack of records. Results: 51 RA rTHA were identified and compared with 103 OA. Mean age for RA was 57.7 v 59.4 years for OA (p = 0.240). 82.4% RA were female v 83.5% OA (p = 0.859). RA had lower BMI than OA (25.5 v 28.2; p = 0.166). There was no difference in diagnosis leading to rTHA, including infection (RA 3.9 v OA 6.8%; p = 0.719) or dislocation (RA 23.5 v OA 23.3%; p = 0.975). There was no significant difference in the length of time the implant was in before revision: RA 11.0 v OA 8.8 years (p = 0.060). Among RA with/without MTX, there was no difference in use of biologics (30.0 v 43.3%, p = 0.283), steroids (47.6 v 50.0%, p = 0.867) or bisphosphonates (23.8 v 33.3%, p = 0.543). There was no difference in rTHA diagnosis with/without MTX, including loosening (52.4 v 56.7%, p = 0.762). There was no significant difference in lucencies with MTX use in any Gruen zone. Patients with MTX had femoral stem subsidence of 3.7mm v no subsidence without MTX (p = 0.006). Conclusion: There was no difference in the diagnosis leading to rTHR in RA and OA, although RA trended longer prior to rTHA. In this small retrospective study, there were no significant differences associated with MTX exposure or radiographic lucency among RA patients. The significance of subsidence is not clear. Further study of arthroplasty survival in RA patients is warranted.

Keywords: hip arthroplasty, methotrexate, revision arthroplasty, rheumatoid arthritis

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Authors: Susan Dodd

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This presentation details the methodology for teachers to identify and support a population of students who have historically been overlooked in regards to their educational needs. The twice exceptional (2e) student is a learner who is considered gifted and also has a learning disability, as defined by the Individuals with Disabilities Education Act (IDEA). Many of these students remain underserved throughout their educational careers because their exceptionalities may mask each other, resulting in a special population of students who are not achieving to their fullest potential. There are three common scenarios that may make the identification of a 2e student challenging. First, the student may have been identified as gifted, and her disability may go unnoticed. She could also be considered an under-achiever, or she may be able to compensate for her disability under the school works becomes more challenging. In the second scenario, the student may be identified as having a learning disability and is only receiving remedial services where his giftedness will not be highlighted. His overall IQ scores may be misleading because they were impacted by his learning disability. In the third scenario, the student is able to compensate for her ability well enough to maintain average scores, and she goes undetected as both gifted and learning disabled. Research in the area identifies the complexity involved in identifying 2e students, and how multiple forms of assessment are required. It is important for teachers to be aware of the common characteristics exhibited by many 2e students, so these learners can be identified and appropriately served. Once 2e students have been identified, teachers are then challenged to meet the varying needs of these exceptional learners. Strength-based teaching entails simultaneously providing gifted instruction as well as individualized accommodations for those students. Research in this field has yielded strategies that have proven helpful for teaching 2e students, as well as other students who may be struggling academically. Differentiated instruction, while necessary in all classrooms, is especially important for 2e students, as is encouragement for academic success. Teachers who take the time to really know their students will have a better understanding of each student’s strengths and areas for growth, and therefore tailor instruction to extend the intellectual capacities for optimal achievement. Teachers should also understand that some learning activities can prove very frustrating to students, and these activities can be modified based on individual student needs. Because 2e students can often become discouraged by their learning challenges, it is especially important for teachers to assist students in recognizing their own strengths and maintaining motivation for learning. Although research on the needs of 2e students has spanned across two decades, this population remains underserved in many educational institutions. Teacher awareness of the identification of and the support strategies for 2e students is critical for their success.

Keywords: gifted, learning disability, special needs, twice exceptional

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Authors: E. V. Fakhrutdinova, K. R. Maksimova, P. B. Chursin

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At the present stage of the society progress the health care is an integral part of both the economic system and social, while in the second case the medicine is a major component of a number of basic and necessary social programs. Since the foundation of the health system are highly qualified health professionals, it is logical proposition that increase of doctor`s professionalism improves the effectiveness of the system as a whole. Professionalism of the doctor is a collection of many components, essential role played by such personal-psychological factors as honesty, willingness and desire to help people, and motivation. A number of researchers consider motivation as an expression of basic human needs that have passed through the “filter” which is a worldview and values learned in the process of socialization by the individual, to commit certain actions designed to achieve the expected result. From this point of view a number of researchers propose the following classification of highly skilled employee’s needs: 1. the need for confirmation the competence (setting goals that meet the professionalism and receipt of positive emotions in their decision), 2. The need for independence (the ability to make their own choices in contentious situations arising in the process carry out specialist functions), 3. The need for ownership (in the case of health care workers, to the profession and accordingly, high in the eyes of the public status of the doctor). Nevertheless, it is important to understand that in a market economy a significant motivator for physicians (both legal and natural persons) is to maximize its own profits. In the case of health professionals duality motivational structure creates an additional contrast, as in the public mind the image of the ideal physician; usually a altruistically minded person thinking is not primarily about their own benefit, and to assist others. In this context, the question of the real motivation of health workers deserves special attention. The survey conducted by the American researcher Harrison Terni for the magazine "Med Tech" in 2010 revealed the opinion of more than 200 medical students starting courses, and the primary motivation in a profession choice is "desire to help people", only 15% said that they want become a doctor, "to earn a lot". From the point of view of most of the classical theories of motivation this trend can be called positive, as intangible incentives are more effective. However, it is likely that over time the opinion of the respondents may change in the direction of mercantile motives. Thus, it is logical to assume that well-designed system of motivation of doctor`s labor should be based on motivational foundations laid during training in higher education.

Keywords: motivation, quality of working life, health system, personal-psychological factors, motivational structure

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Authors: Susan Ka Yee Chow

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Effective clinical preceptorship is affecting students’ competence and fostering their growth in applying theoretical knowledge and skills in clinical settings. Any difference between the expected and actual learning experience will reduce nursing students’ interest in clinical practices and having a negative consequence with their clinical performance. This cross-sectional study is an attempt to compare the differences between preferred and actual preceptorship experience of final year nursing students, and to examine the relationship between the actual preceptorship experience and perceived clinical competence of the students in a tertiary institution. Participants of the study were final year bachelor nursing students of a self-financing tertiary institution in Hong Kong. The instruments used to measure the effectiveness of clinical preceptorship was developed by the participating institution. The scale consisted of five items in a 5-point likert scale. The questions including goals development, critical thinking, learning objectives, asking questions and providing feedback to students. The “Clinical Competence Questionnaire” by Liou & Cheng (2014) was used to examine students’ perceived clinical competences. The scale consisted of 47 items categorized into four domains, namely nursing professional behaviours; skill competence: general performance; skill competence: core nursing skills and skill competence: advanced nursing skills. There were 193 questionnaires returned with a response rate of 89%. The paired t-test was used to compare the differences between preferred and actual preceptorship experiences of students. The results showed significant differences (p<0.001) for the five questions. The mean for the preferred scores is higher than the actual scores resulting statistically significance. The maximum mean difference was accepted goal and the highest mean different was giving feedback. The Pearson Correlation Coefficient was used to examine the relationship. The results showed moderate correlations between nursing professional behaviours with asking questions and providing feedback. Providing useful feedback to students is having moderate correlations with all domains of the Clinical Competence Questionnaire (r=0.269 – 0.345). It is concluded that nursing students do not have a positive perception of the clinical preceptorship. Their perceptions are significantly different from their expected preceptorship. If students were given more opportunities to ask questions in a pedagogical atmosphere, their perceived clinical competence and learning outcomes could be improved as a result.

Keywords: clinical preceptor, clinical competence, clinical practicum, nursing students

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