Search results for: children with communication and interaction difficulties

Authors: Girija Madhavanprabhakaran, Frincy Franacis, Sheeba Elizabeth John

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Introduction: A wide range of prenatal genetic screening is introduced with increasing incidences of congenital anomalies even in low-risk pregnancies and is an emerging standard of care. Being frontline caretakers, the role and responsibilities of nurses and midwives are critical as they are working along with couples to provide evidence-based supportive educative care. The increasing genetic disorders and advances in prenatal genetic screening with limited genetic counselling facilities urge nurses and midwifery nurses with essential competencies to help couples to take informed decision. Objective: This integrative literature review aimed to explore nurse midwives’ knowledge and role in prenatal screening and genetic counselling competency and the challenges faced by them to cater to all pregnant women to empower their autonomy in decision making and ensuring psychological comfort. Method: An electronic search using keywords prenatal screening, genetic counselling, prenatal counselling, nurse midwife, nursing education, genetics, and genomics were done in the PUBMED, SCOPUS and Medline, Google Scholar. Finally, based on inclusion criteria, 8 relevant articles were included. Results: The main review results suggest that nurses and midwives lack essential support, knowledge, or confidence to be able to provide genetic counselling and help the couples ethically to ensure client autonomy and decision making. The majority of nurses and midwives reported inadequate levels of knowledge on genetic screening and their roles in obtaining family history, pedigrees, and providing genetic information for an affected client or high-risk families. The deficiency of well-recognized and influential clinical academic midwives in midwifery practice is also reported. Evidence recommended to update and provide sound educational training to improve nurse-midwife competence and confidence. Conclusion: Overcoming the challenges to achieving informed choices about fetal anomaly screening globally is a major concern. Lack of adequate knowledge and counselling competency, communication insufficiency, need for education and policy are major areas to address. Prenatal nurses' and midwives’ knowledge on prenatal genetic screening and essential counselling competencies can ensure services to the majority of pregnant women around the globe to be better-informed decision-makers and enhances their autonomy, and reduces ethical dilemmas.

Keywords: challenges, genetic counselling, prenatal screening, prenatal counselling

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Authors: Mekdes Getu Chekol, Biniam Tedros Kahsay, Rahwa Berihu Haile

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The main objective of this study is to investigate the marketing strategy practice in the Case of St. George Brewery Factory in Addis Ababa. One of the core activities in a Business Company to stay in business is having a well-developed marketing strategy. It assessed how the marketing strategies were practiced in the company to achieve its goals aligned with segmentation, target market, positioning, and the marketing mix elements to satisfy customer requirements. Using primary and secondary data, the study is conducted by using both qualitative and quantitative approaches. The primary data was collected through open and closed-ended questionnaires. Considering the size of the population is small, the selection of the respondents was carried out by using a census. The finding shows that the company used all the 4 Ps of the marketing mix elements in its marketing strategies and provided quality products at affordable prices by promoting its products by using high and effective advertising mechanisms. The product availability and accessibility are admirable with the practices of both direct and indirect distribution channels. On the other hand, the company has identified its target customers, and the company’s market segmentation practice is geographical location. Communication effectiveness between the marketing department and other departments is very good. The adjusted R2 model explains 61.6% of the marketing strategy practice variance by product, price, promotion, and place. The remaining 38.4% of variation in the dependent variable was explained by other factors not included in this study. The result reveals that all four independent variables, product, price, promotion, and place, have a positive beta sign, proving that predictor variables have a positive effect on that of the predicting dependent variable marketing strategy practice. Even though the marketing strategies of the company are effectively practiced, there are some problems that the company faces while implementing them. These are infrastructure problems, economic problems, intensive competition in the market, shortage of raw materials, seasonality of consumption, socio-cultural problems, and the time and cost of awareness creation for the customers. Finally, the authors suggest that the company better develop a long-range view and try to implement a more structured approach to attain information about potential customers, competitor’s actions, and market intelligence within the industry. In addition, we recommend conducting the study by increasing the sample size and including different marketing factors.

Keywords: marketing strategy, market segmentation, target marketing, market positioning, marketing mix

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Authors: Rafael Castilho Carvalho, Edjair de Souza Mota

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As the largest contributor to the biogeochemical functioning of the Earth system, the Amazon Rainforest has the greatest biodiversity on the planet, harboring about 15% of all the world's flora. Recognition and preservation are the focus of research that seeks to mitigate drastic changes, especially anthropic ones, which irreversibly affect this biome. Functional and low-cost monitoring alternatives to reduce these impacts are a priority, such as those using technologies such as Low Power Wide Area Networks (LPWAN). Promising, reliable, secure and with low energy consumption, LPWAN can connect thousands of IoT devices, and in particular, LoRa is considered one of the most successful solutions to facilitate forest monitoring applications. Despite this, the forest environment, in particular the Amazon Rainforest, is a challenge for these technologies, requiring work to identify and validate the use of technology in a real environment. To investigate the feasibility of deploying LPWAN in remote water quality monitoring of rivers in the Amazon Region, a LoRa-based test bed consisting of a Lora transmitter and a LoRa receiver was set up, both parts were implemented with Arduino and the LoRa chip SX1276. The experiment was carried out at the Federal University of Amazonas, which contains one of the largest urban forests in Brazil. There are several springs inside the forest, and the main goal is to collect water quality parameters and transmit the data through the forest in real time to the gateway at the uni. In all, there are nine water quality parameters of interest. Even with a high collection frequency, the amount of information that must be sent to the gateway is small. However, for this application, the battery of the transmitter device is a concern since, in the real application, the device must run without maintenance for long periods of time. With these constraints in mind, parameters such as Spreading Factor (SF) and Coding Rate (CR), different antenna heights, and distances were tuned to better the connectivity quality, measured with RSSI and loss rate. A handheld spectrum analyzer RF Explorer was used to get the RSSI values. Distances exceeding 200 m have soon proven difficult to establish communication due to the dense foliage and high humidity. The optimal combinations of SF-CR values were 8-5 and 9-5, showing the lowest packet loss rates, 5% and 17%, respectively, with a signal strength of approximately -120 dBm, these being the best settings for this study so far. The rains and climate changes imposed limitations on the equipment, and more tests are already being conducted. Subsequently, the range of the LoRa configuration must be extended using a mesh topology, especially because at least three different collection points in the same water body are required.

Keywords: IoT, LPWAN, LoRa, coverage, loss rate, forest

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Authors: Evgeni Baratashvili, Anzor Abralava, Rusudan Kutateladze, Nino Pailodze, Irma Makharashvili, Larisa Takalandze

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Sinergy as a neological term is reflected in modern sciences. It can be found in the various fields of science including the humanities and technical sciences. Among them are biology and medicine, philology, economy and etc. Synergy is the received surplus of marginal high total effect of the groups, consolidated by one common idea, received through endeavored applies of their combined tools, via obtained effect of the separate independent actions of the groups. In the conditions of market economy, according the terms of new communication terminology, synergy effects on management and marketing successfully as well as on purity defense of native language. The well-known scientist’s and public figure’s Academician I. Prangishvili’s works are especially valuable in this aspect. In our opinion the entropy research is linked to his name in our country. In modern economy, the current qualitative changes shows us that the most number of factors and issues have been regrouped. They have a great influence and even define the economic development. The declining abilities of traditional recourses of economic growth have been related on the use of their physical abilities and their moving closer to the edge. Also it is related on the reduced effectiveness, which at the same time increases the expenditures. This means that the leading must be the innovative process system of products and services in the economic growth model. In our opinion the above mentioned system is distinguished with the synergistic approach. It should be noted that the main components of the innovative system are technological, scientific and scientific-technical, social-organizational, managerial and cognitive changes. All of them are reflected on scientific works and inventions in the proper dosages, in know-how and material source. At any stage they create the reproduction cycle. The innovations are different from each other by technologies, origination, design, innovation and quality, subject-content structure, by the the spread of economic processes and the impact of the level of it’s distribution. We have presented a generalized statement of an innovative approach, which is not a single act of innovation but it is also targeted system of the development, implementation, reconciling-exploitation, production, diffusion and commercialization of news. The innovative approaches should be considered as the creation of news, in-depth process of creativity as an innovative alternative to the realization of innovative and entrepreneurial efforts and measures, in order to meet the requirements of the permanent process.

Keywords: economic development, leading process, neological term, synergy

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Authors: Simon Ayorinde Okanlawon

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The youths’ prevalent negative attitude to farming is partly due to amenities and facilities found in the urban centers at the expense of the rural areas. Hence, there is the need to create a befitting and conducive farm environment to retain farm employees and attract the youth to farming. This can be achieved through the provision of services and amenities that will ensure a comfortable standard of living higher than that obtained by a person of equal status in other forms of employment in urban centers, thereby eliminating the psychological feeling of lowered self-esteem associated with farming. This study assessed farm settlements’ facilities and patronage in Oyo State with a view to using the information to encourage sustainable agriculture in Nigeria. The study becomes necessary because of the dearth of information on the state of facilities in the farm settlements as it affects patronage of farm settlements for sustainable agriculture in the developing countries like Nigeria. The study utilized three purposely selected farm settlements- Ogbomoso, Fasola and Ilora out of the seven existing ones n Oyo State. One hundred percent (100%) of the 262 residential buildings in the three settlements were sampled, from where a household head from each of the buildings was randomly chosen. This translates to 262 household heads served with questionnaire out of which 47.7% of the questionnaires were recovered. Information obtained included respondents’ residency categories, residents’ status, residency years, housing types, types of holding and number of acres/holding. Others include the socio-economic attributes such as age, gender, income, educational status of respondents, assessment of existing facilities in the selected sites, the level of patronage of the farm settlements including perceived pull factors that can enhance farm settlements patronage. The study revealed that the residents were not satisfied with the adequacy and quality of all the facilities available in their settlements. Residents’ satisfaction with infrastructural facilities cannot be statistically linked with location across the study area. Findings suggested that residents of Ogbomoso farm settlements were not enjoying adequate provision of water supply and road as much as those from Ilora and Fasola. Patronage of the farm settlements were largely driven by farming activities and sale of farm produce. The respondents agreed that provision of farm resort centers, standard recreational and tourism facilities, vacation employment opportunities for youths, functional internet and communication networks among others are likely to boost the level of patronage of the farm settlements. The study concluded that improvement of the facilities both in quality and quantity will encourage the youths in going back to farming. It then recommends that maintenance of existing facilities and provision of more facilities such as resort centers be ensured.

Keywords: encourage, farm settlements' facilities, Oyo state, patronage

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Authors: Paula Andrea Segura Delgado, Martha Helena Ramírez-Bahena

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Research on how the brain learns has a transcendental application in the educational context. It is crucial for teacher training to understand the nature of brain changes and their direct influence on learning processes. This communication is based on a literature review focused on neuroscience, neuroeducation, and the impact of digital technology on the human brain. Information was gathered from both English and Spanish language sources, using online journals, books and reports. The general objective was to analyze the role of neuroscience knowledge in enriching our understanding of the learning process. In fact, the authors have focused on the impact of digital technology on the human brain as well as its influence in the field of education..Neuroscience knowledge can contribute significantly to improving the training of educators and therefore educational practices. Education as an instrument of change and school as an agent of socialization, it is necessary to understand what it aims to transform: the human brain. Understanding the functioning of the human brain has important repercussions on education: this elucidates cognitive skills, psychological processes and elements that influence the learning process (memory, executive functions, emotions and the circadian cycle); helps identify psychological and neurological deficits that can impede learning processes (dyslexia, autism, hyperactivity); It allows creating environments that promote brain development and contribute to the advancement of brain capabilities in alignment with the stages of neurobiological development. The digital age presents diverse opportunities to every social environment. The frequent use of digital technology (DT) has had a significant and abrupt impact on both the cognitive abilities and physico-chemical properties of the brain, significantly influencing educational processes. Hence, educational community, with the insights from advances in neuroscience, aspire to identify the positive and negative effects of digital technology on the human brain. This knowledge helps ensure the alignment of teacher training and practices with these findings. The knowledge of neuroscience enables teachers to develop teaching methods that are aligned with the way the brain works. For example, neuroscience research has shown that digital technology is having a significant impact on the human brain (addition, anxiety, high levels of dopamine, circadian cycle disorder, decrease in attention, memory, concentration, problems with their social relationships). Therefore, it is important to understand the nature of these changes, their impact on the learning process, and how educators should effectively adapt their approaches based on these brain's changes.

Keywords: digital technology, learn process, neuroscience knowledge, neuroeducation, training proffesors

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Authors: Milica Lilic, Marina Rosales Martínez

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Academic research cannot be oblivious to social problems and needs, so projects that have the capacity for transformation and impact should have the opportunity to go beyond the University circles and bring benefit to society. Apart from patents and R&D research contracts, this opportunity can be achieved through entrepreneurship as one of the most direct tools to turn knowledge into a tangible product. Thus, as an example of good practices, it is intended to analyze the case of an institutional entrepreneurship program carried out at the University of Seville, aimed at researchers interested in assessing the business opportunity of their research and expanding their knowledge on procedures for the commercialization of technologies used at academic projects. The program is based on three pillars: training, teamwork sessions and networking. The training includes aspects such as product-client fit, technical-scientific and economic-financial feasibility of a spin-off, institutional organization and decision making, public and private fundraising, and making the spin-off visible in the business world (social networks, key contacts, corporate image and ethical principles). On the other hand, the teamwork sessions are guided by a mentor and aimed at identifying research results with potential, clarifying financial needs and procedures to obtain the necessary resources for the consolidation of the spin-off. This part of the program is considered to be crucial in order for the participants to convert their academic findings into a business model. Finally, the networking part is oriented to workshops about the digital transformation of a project, the accurate communication of the product or service a spin-off offers to society and the development of transferable skills necessary for managing a business. This blended program results in the final stage where each team, through an elevator pitch format, presents their research turned into a business model to an experienced jury. The awarded teams get a starting capital for their enterprise and enjoy the opportunity of formally consolidating their spin-off company at the University. Studying the results of the program, it has been shown that many researchers have basic or no knowledge of entrepreneurship skills and different ways to turn their research results into a business model with a direct impact on society. Therefore, the described program has been used as an example to highlight the importance of knowledge transfer at the University and the role that this institution should have in providing the tools to promote entrepreneurship within it. Keeping in mind that the University is defined by three main activities (teaching, research and knowledge transfer), it is safe to conclude that the latter, and the entrepreneurship as an expression of it, is crucial in order for the other two to comply with their purpose.

Keywords: good practice, knowledge transfer, a spin-off company, university

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Authors: Muhammad Awais Kiani

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The field of electronics engineering plays a vital role in the marketing of smart materials. Smart materials are innovative, adaptive materials that can respond to external stimuli, such as temperature, light, or pressure, in order to enhance performance or functionality. As the demand for smart materials continues to grow, it is crucial to understand how electronics engineering can contribute to their marketing strategies. This abstract presents an overview of the role of electronics engineering in the marketing of smart materials. It explores the various ways in which electronics engineering enables the development and integration of smart features within materials, enhancing their marketability. Firstly, electronics engineering facilitates the design and development of sensing and actuating systems for smart materials. These systems enable the detection and response to external stimuli, providing valuable data and feedback to users. By integrating sensors and actuators into materials, their functionality and performance can be significantly enhanced, making them more appealing to potential customers. Secondly, electronics engineering enables the creation of smart materials with wireless communication capabilities. By incorporating wireless technologies such as Bluetooth or Wi-Fi, smart materials can seamlessly interact with other devices, providing real-time data and enabling remote control and monitoring. This connectivity enhances the marketability of smart materials by offering convenience, efficiency, and improved user experience. Furthermore, electronics engineering plays a crucial role in power management for smart materials. Implementing energy-efficient systems and power harvesting techniques ensures that smart materials can operate autonomously for extended periods. This aspect not only increases their market appeal but also reduces the need for constant maintenance or battery replacements, thus enhancing customer satisfaction. Lastly, electronics engineering contributes to the marketing of smart materials through innovative user interfaces and intuitive control mechanisms. By designing user-friendly interfaces and integrating advanced control systems, smart materials become more accessible to a broader range of users. Clear and intuitive controls enhance the user experience and encourage wider adoption of smart materials in various industries. In conclusion, electronics engineering significantly influences the marketing of smart materials by enabling the design of sensing and actuating systems, wireless connectivity, efficient power management, and user-friendly interfaces. The integration of electronics engineering principles enhances the functionality, performance, and marketability of smart materials, making them more adaptable to the growing demand for innovative and connected materials in diverse industries.

Keywords: electronics engineering, smart materials, marketing, power management

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Authors: Muhammad Naveed Babur, Maria Liaqat

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Background & Objective: People with disabilities especially neurological disabilities have many unmet health and rehabilitation needs, face barriers in accessing mainstream health-care services, and consequently have poor health. There are not sufficient epidemiological studies from Pakistan which assess barriers to neurorehabilitation and ways to counter it. Objectives: The objective of the study was to determine the challenges and to evaluate the barriers for neuro-rehabilitation services in developing countries. Methods: This is Exploratory sequential qualitative study based on the Panel discussion forum in International rehabilitation sciences congress and national rehabilitation conference 2017. Panel group discussion has been conducted in February 2017 with a sample size of eight professionals including Rehabilitation medicine Physician, Physical Therapist, Speech Language therapist, Occupational Therapist, Clinical Psychologist and rehabilitation nurse working in multidisciplinary/Interdisciplinary team. A comprehensive audio-videography have been developed, recorded, transcripted and documented. Data was transcribed and thematic analysis along with characteristics was drawn manually. Data verification was done with the help of two separate coders. Results: After extraction of two separate coders following results are emerged. General category themes are disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. Barriers identified at the level are high cost, stigma, lengthy course of recovery. Hospital related barriers are lack of social support and individually tailored goal setting processes. Organizational barriers identified are lack of basic diagnostic facilities, lack of funding and human resources. Recommendations given by panelists were investment in education, capacity building, infrastructure, governance support, strategies to promote communication and realistic goals. Conclusion: It is concluded that neurorehabilitation in developing countries need attention in following categories i.e. disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. This study also revealed barriers at the level of patient, hospital, organization. Recommendations were also given by panelists.

Keywords: disability, neurorehabilitation, telerehabilitation, disability

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Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

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Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

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Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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In Canada, as prevalence rates and severity of illness have increased among patients suffering from eating disorders, wait times have grown substantially. Patients in Canada often face wait times in excess of 12 months. It is known that delaying treatment for eating disorders contributes to poor patient outcomes and higher rates of symptom relapse. Improving interim services for adult patients awaiting outpatient treatment is a priority for an outpatient eating disorders clinic in Ontario, Canada. The clinical setting currently provides care for adults diagnosed with anorexia nervosa, bulimia nervosa and binge eating disorder. At present, the only support provided while patients are on the waitlist consists of communication with primary care providers regarding parameters for medical monitoring. The significance of this study will be to test the feasibility, acceptability and efficacy of an intervention to support adult patients awaiting outpatient eating disorder treatment for anorexia nervosa, bulimia nervosa and binge eating disorder. Methods: An intervention including psychoeducation, supportive resources, self-monitoring, and auxiliary referral will be pilot-tested with a group of patients in the summer of 2022 and detailed using a prospective cohort case study research design. The team will host patient focus groups in May 2022 to gather input informing the content of the intervention. The intervention will be pilot tested with newly-referred patients in June and July 2022. Patients who participate in the intervention will be asked to complete a survey evaluating the utility of the intervention and for suggestions, they may have for improvement. Preliminary findings describing the existing literature pertaining to waitlist interventions for patients with eating disorders, data gathered from the focus groups and early pilot testing results will be presented. Data analysis will continue throughout 2022 and early 2023 for follow-up publication and presentation in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to providing interim support to those patients waiting for treatment for eating disorders and, by extension, to improve outcomes for this population.

Keywords: eating disorders, waitlist management, intervention study, pilot test

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Authors: Johannes Günther

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Time Sensitive Networking (TSN), standardized in the IEEE 802.1 standard, has been lent increasing attention in the context of mission critical systems. Such mission critical systems, e.g., in the automotive domain, aviation, industrial, and smart factory domain, are responsible for coordinating complex functionalities in real time. In many of these contexts, a reliable data exchange fulfilling hard time constraints and quality of service (QoS) conditions is of critical importance. TSN standards are able to provide guarantees for deterministic communication behaviour, which is in contrast to common best-effort approaches. Therefore, the superior QoS guarantees of TSN may aid in the development of new technologies, which rely on low latencies and specific bandwidth demands being fulfilled. TSN extends existing Ethernet protocols with numerous standards, providing means for synchronization, management, and overall real-time focussed capabilities. These additional QoS guarantees, as well as management mechanisms, lead to an increased attack surface for potential malicious attackers. As TSN guarantees certain deadlines for priority traffic, an attacker may degrade the QoS by delaying a packet beyond its deadline or even execute a denial of service (DoS) attack if the delays lead to packets being dropped. However, thus far, security concerns have not played a major role in the design of such standards. Thus, while TSN does provide valuable additional characteristics to existing common Ethernet protocols, it leads to new attack vectors on networks and allows for a range of potential attacks. One answer to these security risks is to deploy defense mechanisms according to a moving target defense (MTD) strategy. The core idea relies on the reduction of the attackers' knowledge about the network. Typically, mission-critical systems suffer from an asymmetric disadvantage. DoS or QoS-degradation attacks may be preceded by long periods of reconnaissance, during which the attacker may learn about the network topology, its characteristics, traffic patterns, priorities, bandwidth demands, periodic characteristics on links and switches, and so on. Here, we implemented and tested several MTD-like defense strategies against different attacker models of varying capabilities and budgets, as well as collaborative attacks of multiple attackers within a network, all within the context of TSN networks. We modelled the networks and tested our defense strategies on an OMNET++ testbench, with networks of different sizes and topologies, ranging from a couple dozen hosts and switches to significantly larger set-ups.

Keywords: network security, time sensitive networking, moving target defense, cyber security

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Authors: Rawan K. Al-Duaij, Salem A. Al-Salem

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Projects, the unique and temporary process of achieving a set of requirements have always been challenging; Planning the schedule and budget, managing the resources and risks are mostly driven by a similar past experience or the technical consultations of experts in the matter. With that complexity of Projects in Scope, Time, and execution environment, Adjustment Orders are tools to reflect changes to the original project parameters after Contract signature. Adjustment Orders are the official/legal amendments to the terms and conditions of a live Contract. Reasons for issuing Adjustment Orders arise from changes in Contract scope, technical requirement and specification resulting in scope addition, deletion, or alteration. It can be as well a combination of most of these parameters resulting in an increase or decrease in time and/or cost. Most business leaders (handling projects in the interest of the owner) refrain from using Adjustment Orders considering their main objectives of staying within budget and on schedule. Success in managing the changes results in uninterrupted execution and agreed project costs as well as schedule. Nevertheless, this is not always practically achievable. In this paper, a detailed study through utilizing Industrial Engineering & Systems Management tools such as Six Sigma, Data Analysis, and Quality Control were implemented on the organization’s five years records of the issued Adjustment Orders in order to investigate their prevalence, and time and cost impact. The analysis outcome revealed and helped to identify and categorize the predominant causations with the highest impacts, which were considered most in recommending the corrective measures to reach the objective of minimizing the Adjustment Orders impacts. Data analysis demonstrated no specific trend in the AO frequency in past five years; however, time impact is more than the cost impact. Although Adjustment Orders might never be avoidable; this analysis offers’ some insight to the procedural gaps, and where it is highly impacting the organization. Possible solutions are concluded such as improving project handling team’s coordination and communication, utilizing a blanket service contract, and modifying the projects gate system procedures to minimize the possibility of having similar struggles in future. Projects in the Oil and Gas sector are always evolving and demand a certain amount of flexibility to sustain the goals of the field. As it will be demonstrated, the uncertainty of project parameters, in adequate project definition, operational constraints and stringent procedures are main factors resulting in the need for Adjustment Orders and accordingly the recommendation will be to address that challenge.

Keywords: adjustment orders, data analysis, oil and gas sector, systems management

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Authors: Mohammadjavad Sotoudeheian, Navid Farahmandian

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Cardiac hypertrophy arises in response to persistent increases in hemodynamic loads. In comparison, diabetic cardiomyopathy is defined by an abnormal myocardial changes without other cardiac-related risk factors. Pathological cardiac hypertrophy and myocardial remodeling are hallmarks of cardiovascular diseases and are risk factors for heart failure. The transcription factor forkhead box class O (FOXOs) can protect heart tissue by hostile oxidative stress and stimulating apoptosis and autophagy. FOXO proteins, as sensitive elements and mediators in response to environmental changes, have been revealed to prevent and inverse cardiac hypertrophy. FOXOs are inhibited by insulin and are critical mediators of insulin action. Insulin deficiency and uncontrolled diabetes lead to a catabolic state. FOXO1 acts downstream of the insulin-dependent pathways, which are dysregulated in diabetes. It regulates cardiomyocyte hypertrophy downstream of IGF1R/PI3K/Akt activation, which are critical regulators of cardiac hypertrophy. The complex network of signaling pathways comprising insulin/IGF-1 signaling, AMPK, JNK, and Sirtuins regulate the development of cardiovascular dysfunction by modulating the activity of FOXOs. Insulin receptors and IGF1R act via the PI3k/Akt and the MAPK/ERK pathways. Activation of Akt in response to insulin or IGF-1 induces phosphorylation of FOXOs. Increased protein synthesis induced by activation of the IGF-I/Akt/mTOR signaling pathway leads to hypertrophy. This pathway and the myostatin/Smad pathway are potent negative muscle development regulators. In cardiac muscle, insulin receptor substrates (IRS)-1 or IRS-2 activates the Akt signaling pathway and inactivate FOXO1. Under metabolic stress, p38 MAPK promotes degradation of IRS-1 and IRS-2 in cardiac myocytes and activates FOXO1, leading to cardiomyopathy. Sirt1 and FOXO1 interaction play an essential role in starvation-induced autophagy in cardiac metabolism. Inhibition of Angiotensin-II induced cardiomyocyte hypertrophy is associated with reduced FOXO1 acetylation and activation of Sirt1. The NF-κB, ERK, and FOXOs are de-acetylated by SIRT1. De-acetylation of FOXO1 induces the expression of genes involved in autophagy and stimulates autophagy flux. Therefore, under metabolic stress, FOXO1 can cause diabetic cardiomyopathy. The overexpression of FOXO1 leads to decreased cardiomyocyte size and suppresses cardiac hypertrophy through inhibition of the calcineurin–NFAT pathway. Diabetes mellitus is associated with elevation of O-GlcNAcylation. Some of its binding partners regulate the substrate selectivity of O-GlcNAc transferase (OGT). O-GlcNAcylation of essential contractile proteins may inhibit protein-protein interactions, reduce calcium sensitivity, and modulate contractile function. Uridine diphosphate (UDP)-GlcNAc is the obligatory substrate of OGT, which catalyzes a reversible post-translational protein modification. The increase of O-GlcNAcylation is accompanied by impaired cardiac hypertrophy in diabetic hearts. Inhibition of O-GlcNAcylation blocks activation of ERK1/2 and hypertrophic growth. O-GlcNAc modification on NFAT is required for its translocation from the cytosol to the nucleus, where NFAT stimulates the transcription of various hypertrophic genes. Inhibition of O-GlcNAcylation dampens NFAT-induced cardiac hypertrophic growth. Transcriptional activity of FOXO1 is enriched by improved O-GlcNAcylation upon high glucose stimulation or OGT overexpression. In diabetic conditions, the modification of FOXO1 by O-GlcNAc is promoted in cardiac troponin I and myosin light chain 2. Therefore targeting O-GlcNAcylation represents a potential therapeutic option to prevent hypertrophy in the diabetic heart.

Keywords: diabetes, cardiac hypertrophy, O-GlcNAcylation, FOXO1, Akt, PI3K, AMPK, insulin

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Authors: Gurjeet Singh, Harinder Singh

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In this paper, we present "The Language of Science in Higher Education: Related Questions and Discussions". Linguists have written and researched in depth the role of language in science. On this basis, it is clear that language is not just a medium or vehicle for communicating knowledge and ideas. Nor are there mere signs of language knowledge and conversion of ideas into code. In the process of reading and writing, everyone thinks deeply and struggles to understand concepts and make sense. Linguistics play an important role in achieving concepts. In the context of such linguistic diversity, there is no straightforward and simple answer to the question of which language should be the language of advanced science and technology. Many important topics related to this issue are as follows: Involvement in practical or Deep theoretical issues. Languages for the study of science and other subjects. Language issues of science to be considered separate from the development of science, capitalism, colonial history, the worldview of the common man. The democratization of science and technology education in India is possible only by providing maximum reading/resource material in regional languages. The scientific research should be increase to chances of understanding the subject. Multilingual instead or monolingual. As far as deepening the understanding of the subject is concerned, we can shed light on it based on two or three experiences. An attempt was made to make the famous sociological journal Economic and Political Weekly Hindi almost three decades ago. There were many obstacles in this work. The original articles written in Hindi were not found, and the papers and articles of the English Journal were translated into Hindi, and a journal called Sancha was taken out. Equally important is the democratization of knowledge and the deepening of understanding of the subject. However, the question is that if higher education in science is in Hindi or other languages, then it would be a problem to get job. In fact, since independence, English has been dominant in almost every field except literature. There are historical reasons for this, which cannot be reversed. As mentioned above, due to colonial rule, even before independence, English was established as a language of communication, the language of power/status, the language of higher education, the language of administration, and the language of scholarly discourse. After independence, attempts to make Hindi or Hindustani the national language in India were unsuccessful. Given this history and current reality, higher education should be multilingual or at least bilingual. Translation limits should also be increased for those who choose the material for translation. Writing in regional languages on science, making knowledge of various international languages available in Indian languages, etc., is equally important for all to have opportunities to learn English.

Keywords: language, linguistics, literature, culture, ethnography, punjabi, gurmukhi, higher education

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Authors: Tania Chalton

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In June 2013, an independent review of the Liverpool Care Pathway (LCP) identified a number of problems with the implementation of the LCP in the UK and recommended that it be replaced by individual care plans for each patient. As a result of the UK findings, in November 2013 the Ministry of Health (MOH) commissioned the Palliative Care Council to initiate a programme of work to investigate an appropriate approach for the care of people in their last days of life in New Zealand (NZ). The Last Days of Life Working Group commenced a process to develop national consensus on the care of people in their last days of life in April 2014. In order to develop its advice for the future provision of care to people in their last days of life, the Working Group (WG) established a comprehensive work programme and as a result has developed a series of working papers. Specific areas of focus included: An analysis of the UK Independent Review findings and an assessment of these findings to the NZ context. A stocktake of services providing care to people in their last days of life, including aged residential care (ARC); hospices; hospitals; and primary care. International and NZ literature reviews of evidence and best practice. Survey of family to understand the consumer perspective on the care of people in their last days of life. Key aspects of care that required further considerations for NZ were: Terminology: clarify terminology used in the last days of life and in relation to death and dying. Evidenced based: including specific review of evidence regarding, spiritual, culturally appropriate care as well as dementia care. Diagnosis of dying: need for both guidance around the diagnosis of dying and communication with family. Workforce issues: access to an appropriate workforce after hours. Nutrition and hydration: guidance around appropriate approaches to nutrition and hydration. Symptom and pain management: guidance around symptom management. Documentation: documentation of the person’s care which is robust enough for data collection and auditing requirements, not ‘tick box’ approach to care. Education and training: improved consistency and access to appropriate education and training. Leadership: A dedicated team or person to support and coordinate the introduction and implementation of any last days of life model of care. Quality indicators and data collection: model of care to enable auditing and regular reviews to ensure on-going quality improvement. Cultural and spiritual: address and incorporate any cultural and spiritual aspects. A final document was developed incorporating all the evidence which provides guidance to the health sector on best practice for people at end of life: “Principles and guidance for the last days of life: Te Ara Whakapiri”.

Keywords: end of life, guidelines, New Zealand, palliative care

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Authors: Nijanthan Mohan, Rolf Gross, Fabian Theis

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The conventional method used in the construction industries often resulted in significant rework since most of the decisions were taken onsite under the pressure of project deadlines and also due to the improper information flow, which results in ineffective coordination. However, today’s architecture, engineering, and construction (AEC) stakeholders demand faster and accurate deliverables, efficient buildings, and smart processes, which turns out to be a tall order. Hence, the building information modelling (BIM) concept was developed as a solution to fulfill the above-mentioned necessities. Even though BIM is successfully implemented in most of the world, it is still in the early stages in Germany, since the stakeholders are sceptical of its reliability and efficiency. Due to the huge capital requirement, the small and medium-sized construction companies are still reluctant to implement BIM workflow in their projects. The purpose of this paper is to analyse the opportunities and obstacles to implementing BIM for prefabrication. Among all other advantages of BIM, pre-fabrication is chosen for this paper because it plays a vital role in creating an impact on time as well as cost factors of a construction project. The positive impact of prefabrication can be explicitly observed by the project stakeholders and participants, which enables the breakthrough of the skepticism factor among the small scale construction companies. The analysis consists of the development of a process workflow for implementing prefabrication in building construction, followed by a practical approach, which was executed with two case studies. The first case study represents on-site prefabrication, and the second was done for off-site prefabrication. It was planned in such a way that the first case study gives a first-hand experience for the workers at the site on the BIM model so that they can make much use of the created BIM model, which is a better representation compared to the traditional 2D plan. The main aim of the first case study is to create a belief in the implementation of BIM models, which was succeeded by the execution of offshore prefabrication in the second case study. Based on the case studies, the cost and time analysis was made, and it is inferred that the implementation of BIM for prefabrication can reduce construction time, ensures minimal or no wastes, better accuracy, less problem-solving at the construction site. It is also observed that this process requires more planning time, better communication, and coordination between different disciplines such as mechanical, electrical, plumbing, architecture, etc., which was the major obstacle for successful implementation. This paper was carried out in the perspective of small and medium-sized mechanical contracting companies for the private building sector in Germany.

Keywords: building information modelling, construction wastes, pre-fabrication, small and medium sized company

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Authors: Sylvie Michel, Sylvie Gerbaix, Marc Bidan

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The COVID-19 pandemic has been a major and global disruption that has affected all supply chains on a worldwide scale. Consequently, the question posed by this communication is to understand how - in the face of such disruptions - supply chains, including their actors, management tools, and processes, react, survive, adapt, and even improve. To do so, the concepts of resilience and antifragility applied to a supply chain have been leveraged. This article proposes to perceive resilience as a step to surpass in moving towards antifragility. The research objective is to propose an analytical framework to measure and compare resilience and antifragility, with antifragility seen as a property of a system that improves when subjected to disruptions rather than merely resisting these disruptions, as is the case with resilience. A unique case study was studied - MSF logistics (France) - using a qualitative methodology. Semi-structured interviews were conducted in person and remotely in multiple phases: during and immediately after the COVID crisis (8 interviews from March 2020 to April 2021), followed by a new round from September to November 2023. A Delphi method was employed. The interviews were analyzed using coding and a thematic framework. One of the theoretical contributions is consolidating the field of supply chain resilience research by precisely characterizing the dimensions of resilience for a humanitarian supply chain (Reorganization, Collaboration mediated by IS, Humanitarian culture). In this regard, a managerial contribution of this study is providing a guide for managers to identify the four dimensions and sub-dimensions of supply chain resilience. This enables managers to focus their decisions and actions on dimensions that will enhance resilience. Most importantly, another contribution is comparing the concepts of resilience and antifragility and proposing an analytical framework for antifragility—namely, the mechanisms on which MSF logistics relied to capitalize on uncertainties, contingencies, and shocks rather than simply enduring them. For MSF Logistics, antifragility manifested through the ability to identify opportunities hidden behind the uncertainties and shocks of COVID-19, reducing vulnerability, and fostering a culture that encourages innovation and the testing of new ideas. Logistics, particularly in the humanitarian domain, must be able to adapt to environmental disruptions. In this sense, this study identifies and characterizes the dimensions of resilience implemented by humanitarian logistics. Moreover, this research goes beyond the concept of resilience to propose an analytical framework for the concept of antifragility. The organization studied emerged stronger from the COVID-19 crisis due to the mechanisms we identified, allowing us to characterize antifragility. Finally, the results show that the information system plays a key role in antifragility.

Keywords: antifragility, humanitarian supply chain, information systems, qualitative research, resilience.

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Authors: Chux Gervase Iwu, Simon Nsengimane

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Entrepreneurship stimulates socio-economic development in many countries, if not all. It creates jobs and decreases unemployment and inequality. There are other benefits that are accruable from entrepreneurship, namely the empowerment of women and the promotion of better livelihoods. Innovation has become a weapon for business competition, growth, and sustainability. Paradoxically, it is a threat to businesses because products can be duplicated; new products may decrease the market share of existing ones or delete them from the market. This creates a constant competitive environment that calls for updates, innovation, and the invention of new products and services. Thus, the importance of higher education in instilling a good entrepreneurial mindset in students has become even more critical. It can be argued that the business environment is under enormous pressure from several factors, including the fourth industrial revolution, which calls for the adoption and use of information and communication technology, which is the catalyst for many innovations and organisational changes. Therefore, it is crucial that higher education students are equipped with relevant knowledge and skills to respond effectively to the needs of the business environment and create a vibrant entrepreneurship ecosystem. In South Africa, entrepreneurship education or some form of it has been a privilege for economic and management fields of study, leaving behind other fields. Entrepreneurship should not be limited to business faculties but rather extended to other fields of study. This is perhaps the reason for low levels of entrepreneurship uptake among South African graduates if they are compared with the graduates in other countries. There may be other reasons for the low entrepreneurship uptake. Some of these have been documented in extant literature to include (1) not enough time was spent teaching entrepreneurship in the business faculties, (2) the skills components in the curricula are insufficient, and (3) the overall attitudes/mindsets necessary to establish and run sustainable enterprises seem absent. Therefore, four important areas are recognised as crucial for the effective implementation of entrepreneurship education: policy, private sector engagement, curriculum development, and teacher development. The purpose of this research is to better comprehend the views, aspirations, and expectations of students and faculty members to design an entrepreneurial teaching model for higher education institutions. A qualitative method will be used to conduct a purposive interview with undergraduate and graduate students in select higher institutions. Members of faculty will also be included in the sample as well as, where possible, two or more government personnel responsible for higher education policy development. At present, interpretative analysis is proposed for the analysis of the interviews with the support of Atlas Ti. It is hoped that an entrepreneurship education model in the South African context is realised through this study.

Keywords: entrepreneurship education, higher education institution, graduate unemployment, curriculum development

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Authors: Chiahsu Yang, Peiling Wu, Ted Ho

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From emphasizing economic development to stressing public happiness, the international community mainly hopes to be able to understand whether the quality of life for the public is becoming better. The Better Life Index (BLI) constructed by OECD uses living conditions and quality of life as starting points to cover 11 areas of life and to convey the state of the general public’s well-being. In light of the BLI framework, the Directorate General of Budget, Accounting and Statistics (DGBAS) of the Executive Yuan instituted the Gross National Happiness Index to understand the needs of the general public and to measure the progress of the aforementioned conditions in residents across the island. Whereas living conditions consist of income and wealth, jobs and earnings, and housing conditions, health status, work and life balance, education and skills, social connections, civic engagement and governance, environmental quality, personal security. The ICT area consists of health care, living environment, ICT-enabled communication, transportation, government, education, pleasure, purchasing, job & employment. In the wake of further science and technology development, rapid formation of information societies, and closer integration between lifestyles and information societies, the public’s well-being within information societies has indeed become a noteworthy topic. the Board of Science and Technology of the Executive Yuan use the OECD’s BLI as a reference in the establishment of the Taiwan-specific ICT-Enabled Better Life Index. Using this index, the government plans to examine whether the public’s quality of life is improving as well as measure the public’s satisfaction with current digital quality of life. This understanding will enable the government to gauge the degree of influence and impact that each dimension of digital services has on digital life happiness while also serving as an important reference for promoting digital service development. The content of the ICT Enabled Better Life Index. Information and communications technology (ICT) has been affecting people’s living styles, and further impact people’s quality of life (QoL). Even studies have shown that ICT access and usage have both positive and negative impact on life satisfaction and well-beings, many governments continue to invest in e-government programs to initiate their path to information society. This research is the few attempts to link the e-government benchmark to the subjective well-being perception, and further address the gap between user’s perception and existing hard data assessment, then propose a model to trace measurement results back to the original public policy in order for policy makers to justify their future proposals.

Keywords: information and communications technology, quality of life, satisfaction, well-being

Procedia PDF Downloads 326

Authors: Federica Verna, Alessandra Pautasso, Maria Caramelli, Cristiana Maurella, Walter Mignone, Cristina Casalone

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Mosquito-Borne Diseases (MBDs) are dangerously increasing in prevalence, geographical distribution and severity, representing an emerging threat for both humans and animals. Interaction between multiple disciplines is needed for an effective early warning, surveillance and control of MBDs, according to the One Health concept. This work reports the integrated surveillance system enforced by IZSPLV in Piedmont, Liguria and Valle d’Aosta regions (Northwestern Italy) in order to control MDBs spread. Veterinary services and local human health authority are involved in an information network, to connect the surveillance of human clinical cases with entomological surveillance and veterinary monitoring in order to implement control measures in case of outbreak. A systematic entomological surveillance is carried out during the vector season using mosquitoes traps located in sites selected according to risk factors. Collected mosquitoes are counted, identified to species level by morphological standard classification keys and pooled by collection site, date and species with a maximum of 100 individuals. Pools are analyzed, after RNA extraction, by Real Time RT-PCR distinctive for West Nile Virus (WNV) Lineage 1 and Lineage 2, Real Time RT-PCR USUTU virus (USUV) and a traditional flavivirus End-point RT-PCR. Positive pools are sequenced and the related sequences employed to perform a basic local alignment search tool (BLAST) in the GenBank library. Positive samples are sent to the National Reference Centre for Animal Exotic Diseases (CESME, Teramo) for confirmation. With particular reference to WNV, after the confirmation, as provided by national legislation, control measures involving both local veterinary and human health services are activated: equine sera are randomly sampled within a 4 km radius from the positive collection sites and tested with ELISA kit and WNV NAT screening of blood donors is introduced. This surveillance network allowed to detect since 2011 USUV circulation in this area of Italy. WNV was detected in Piedmont and Liguria for the first time in 2014 in mosquitoes. During the 2015 vector season, we observed the expansion of its activity in Piedmont. The virus was detected in almost all Provinces both in mosquitoes (6 pools) and animals (19 equine sera, 4 birds). No blood bag tested resulted infected. The first neuroinvasive human case occurred too. Competent authorities should be aware of a potentially increased risk of MBDs activity during the 2016 vector season. This work shows that this surveillance network allowed to early detect the presence of MBDs in humans and animals, and provided useful information to public authorities, in order to apply control measures. Finally, an additional value of our diagnostic protocol is the ability to detect all viruses belonging to the Flaviviridae family, considering the emergence caused by other Flaviviruses in humans such as the recent Zika virus infection in South America. Italy has climatic and environmental features conducive to Zika virus transmission, the competent vector and many travellers from Brazil reported every year.

Keywords: integrated surveillance, mosquito borne disease, West Nile virus, Zika virus

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Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

Procedia PDF Downloads 64

Authors: Niina Meriläinen

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Digital platforms are arenas for dialogue, various kinds of political debates, information and news gathering, policymaking, and social change processes. Human rights serve as examples of social and political issues that are universally noted as principles and yet often violated on digital platforms as well as in the analog world. Digital platforms in this study are different Internet sites, blogs, discussion platforms, social media apps, and gaming. Various actors, from human rights activists and non-governmental organizations to individual people, governments, and corporations, use digital platforms along with analog arenas to discuss and defend human rights, while violators can find new victims and continue violating rights on the same platforms. Digital platforms create opportunities for various women and minorities to empower themselves and others and to be active in various arenas of society and policymaking. At the same time, digital platforms pose threats to human rights globally, especially to women, girls, and minorities. The results of this meta-study of n=120 academic case studies indicate that more research is needed to determine the framework of human rights and human rights on digital platforms. A broad discussion must be had on what human rights require in the digital realm and how ICTs may enhance or threaten our ability to respect, protect, and fulfill a wide variety of human rights while various digital platforms pose multiple threats to human rights. This relates to the willingness of political decision-makers to act upon various crimes committed on and with online platforms. More research is needed to determine the framework of digital human rights and human rights on digital platforms in relation to political communication and decision-making. It is important to develop a framework in which these are defined. It must be discussed who participates in this process: those whose rights are violated, companies that profit by selling our personal data, activists, governments, and some unknown actors. In the end, the question comes back to who has the power to define what we talk about, when, and where. This use of power plays a big role. Digital platforms illustrate the darker side of technological progress, which, on the one hand, has given various people the possibility to engage in society, empower themselves, and take ownership of their rights globally. At the same time, the platforms enable others to use the same platforms to find victims, abuse them, and exploit them. Bullying, harassment, and violence are rampant on various digital platforms, where minorities and people with limited support are victims. There is indeed a need for a discussion of normative values in the era of fake news, the power of influencers, Trumpism, and institutionalized disregard for human rights, gender equality, and the elimination of gender-based violence online. Attention and obligations must be placed on politicians and internet architecture, such as corporations, and their roles in human rights and their violations online.

Keywords: human rights, digital platforms, violations, internet, social media

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Authors: Doreen Mekunda

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This paper is built on the premise that the current socio-political crisis in the two restive regions of Cameroon, though enveloped with destructive and devastating trends (effects) on both property and human lives, is not without its strengths and merits. It is incontestable that many cultures, to a greater extent, are going to be destroyed as people forcibly move from war-stricken habitats to non-violent places. Many cultural potentials, traditional shrines, artifacts, art, and crafts, etc., are unknowingly or knowingly disfigured, and many other ugly things will, by the end of the crisis, affect the cultures of these two regions under siege and of the receiving population. A plethora of other problems like the persecution of Internally Displaced Persons (IDPs) for being displaced and blamed for increased crime rates and the existence of cultural and ethnic differences that produce both inter-tribal and interpersonal conflicts and conflicts between communities will abound. However, there is the emergence of rapid literature, and other forms of cultural productions, whether written or oral, is visible, thereby precipitating a rich cultural diversity due to the coming together of a variety of cultures of both the IDPs and the receiving populations, rapid urbanization, improvement of health-related issues, the rebirth of indigenous cultural practices, the development of social and lingua-cultural competences, dependence on alternative religions, faith and spirituality. Even financial and economic dependence, though a burden to others by IDPs, has its own merits as it improves the living standards of the IDPs. To be able to obtain plausible results, cultural materialism, which is a literary theory that hinges on the empirical study of socio-cultural systems within a materialist infrastructure-super-structure framework, is employed together with the postcolonial theory. Postcolonial theory because the study deals with postcolonial experiences/tenets of migration, hybridity, ethnicity, indignity, language, double consciousness, migration, center/margin binaries, and identity, amongst others. The study reveals that the involuntary movement of persons from their habitual homes brings about movement in cultures, thus, the emergence of new cultures. The movement of people who hold fast to their cultural heritage can only influence new forms of literature, the development of new communication competences, the rise of alternative religion, faith and spirituality, the re-emergence of customary and traditional legal systems that might have been abandoned for the new judicial systems, and above all the revitalization of traditional health care systems.

Keywords: alternative religion, emergence, socio-political crisis, spirituality, lingua-cultural competences

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Authors: Nasim Hashemi, Abbas Sheikhtaheri

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Telemedicine is the use of telecommunication and information technologies to provide health care services that would often not be consistently available in distant rural communities to people at these remote areas. Teleophthalmology is a branch of telemedicine that delivers eye care through digital medical equipment and telecommunications technology. Thus, teleophthalmology can overcome geographical barriers and improve quality, access, and affordability of eye health care services. Since teleophthalmology has been widespread applied in recent years, the aim of this study was to determine the different applications of teleophthalmology in the world. To this end, three bibliographic databases (Medline, ScienceDirect, Scopus) were comprehensively searched with these keywords: eye care, eye health care, primary eye care, diagnosis, detection, and screening of different eye diseases in conjunction with telemedicine, telehealth, teleophthalmology, e-services, and information technology. All types of papers were included in the study with no time restriction. We conducted the search strategies until 2015. Finally 70 articles were surveyed. We classified the results based on the’type of eye problems covered’ and ‘the type of telemedicine services’. Based on the review, from the ‘perspective of health care levels’, there are three level for eye health care as primary, secondary and tertiary eye care. From the ‘perspective of eye care services’, the main application of teleophthalmology in primary eye care was related to the diagnosis of different eye diseases such as diabetic retinopathy, macular edema, strabismus and aged related macular degeneration. The main application of teleophthalmology in secondary and tertiary eye care was related to the screening of eye problems i.e. diabetic retinopathy, astigmatism, glaucoma screening. Teleconsultation between health care providers and ophthalmologists and also education and training sessions for patients were other types of teleophthalmology in world. Real time, store–forward and hybrid methods were the main forms of the communication from the perspective of ‘teleophthalmology mode’ which is used based on IT infrastructure between sending and receiving centers. In aspect of specialists, early detection of serious aged-related ophthalmic disease in population, screening of eye disease processes, consultation in an emergency cases and comprehensive eye examination were the most important benefits of teleophthalmology. Cost-effectiveness of teleophthalmology projects resulted from reducing transportation and accommodation cost, access to affordable eye care services and receiving specialist opinions were also the main advantages of teleophthalmology for patients. Teleophthalmology brings valuable secondary and tertiary care to remote areas. So, applying teleophthalmology for detection, treatment and screening purposes and expanding its use in new applications such as eye surgery will be a key tool to promote public health and integrating eye care to primary health care.

Keywords: applications, telehealth, telemedicine, teleophthalmology

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Authors: Maryam Alkhalosi, Ahmad Naddaf, Rana Alani

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Qatar National Library has its main accounts on social media, which presents the general image of the library and its daily news. A paper will be presented based on a case study researching the outcome of having a separate Instagram account led by librarians, not the Communication Department of the library. The main purpose of the librarians-led account is to promote librarians’ services and events, such as research consultation, reference questions, community engagement programs, collection marketing, etc. all in the way that librarians think it reflects their role in the community. Librarians had several obstacles to help users understanding librarians' roles. As was noticed that Instagram is the most popular social media platform in Qatar, it was selected to promote how librarians can help users through a focused account to create a direct channel between librarians and users. Which helps librarians understand users’ needs and interests. This research will use a quantitative approach depending on the case study, librarians have used their case in the department of Research and learning to find out the best practices might help in promoting the librarians' services and reaching out to a bigger number of users. Through the descriptive method, this research will describe the changes observed in the numbers of community users who interact with the Instagram account and engaged in librarians’ events. Statistics of this study are based on three main sources: 1. The internal monthly statistics sheet of events and programs held by the Research and Learning Department. 2. The weekly tracking of the Instagram account statistics. 3. Instagram’s tools such as polls, quizzes, questions, etc. This study will show the direct effect of a librarian-led Instagram account on the number of community members who participate and engage in librarian-led programs and services. In addition to highlighting the librarians' role directly with the community members. The study will also show the best practices on Instagram, which helps reaching a wider community of users. This study is important because, in the region, there is a lack of studies focusing on librarianship, especially on contemporary problems and its solution. Besides, there is a lack of understanding of the role of a librarian in the Arab region. The research will also highlight how librarians can help the public and researchers as well. All of these benefits can come through one popular easy channel in social media. From another side, this paper is a chance to share the details of this experience starting from scratch, including the phase of setting the policy and guidelines of managing the social media account, until librarians reached to a point where the benefits of this experience are in reality. This experience had even added many skills to the librarians.

Keywords: librarian’s role, social media, instagram and libraries, promoting libraries’ services

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Authors: Inna Kornienko, Svetlana Guryeva, Natalia Danilova, Elena Petersen

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Drug toxicity often goes undetected until clinical trials, the most expensive and dangerous phase of drug development. Both human cell culture and animal studies have limitations that cannot be overcome by improvements in drug testing protocols. Tissue engineering is an emerging alternative approach to creating models of human malignant tumors for experimental oncology, personalized medicine, and drug discovery studies. This new generation of bioengineered tumors provides an opportunity to control and explore the role of every component of the model system including cell populations, supportive scaffolds, and signaling molecules. An area that could greatly benefit from these models is cancer research. Recent advances in tissue engineering demonstrated that decellularized tissue is an excellent scaffold for tissue engineering. Decellularization of donor organs such as heart, liver, and lung can provide an acellular, naturally occurring three-dimensional biologic scaffold material that can then be seeded with selected cell populations. Preliminary studies in animal models have provided encouraging results for the proof of concept. Decellularized Organs preserve organ microenvironment, which is critical for cancer metastasis. Utilizing 3D tumor models results greater proximity of cell culture morphological characteristics in a model to its in vivo counterpart, allows more accurate simulation of the processes within a functioning tumor and its pathogenesis. 3D models allow study of migration processes and cell proliferation with higher reliability as well. Moreover, cancer cells in a 3D model bear closer resemblance to living conditions in terms of gene expression, cell surface receptor expression, and signaling. 2D cell monolayers do not provide the geometrical and mechanical cues of tissues in vivo and are, therefore, not suitable to accurately predict the responses of living organisms. 3D models can provide several levels of complexity from simple monocultures of cancer cell lines in liquid environment comprised of oxygen and nutrient gradients and cell-cell interaction to more advanced models, which include co-culturing with other cell types, such as endothelial and immune cells. Following this reasoning, spheroids cultivated from one or multiple patient-derived cell lines can be utilized to seed the matrix rather than monolayer cells. This approach furthers the progress towards personalized medicine. As an initial step to create a new ex vivo tissue engineered model of a cancer tumor, optimized protocols have been designed to obtain organ-specific acellular matrices and evaluate their potential as tissue engineered scaffolds for cultures of normal and tumor cells. Decellularized biomatrix was prepared from animals’ kidneys, urethra, lungs, heart, and liver by two decellularization methods: perfusion in a bioreactor system and immersion-agitation on an orbital shaker with the use of various detergents (SDS, Triton X-100) in different concentrations and freezing. Acellular scaffolds and tissue engineered constructs have been characterized and compared using morphological methods. Models using decellularized matrix have certain advantages, such as maintaining native extracellular matrix properties and biomimetic microenvironment for cancer cells; compatibility with multiple cell types for cell culture and drug screening; utilization to culture patient-derived cells in vitro to evaluate different anticancer therapeutics for developing personalized medicines.

Keywords: 3D models, decellularization, drug discovery, drug toxicity, scaffolds, spheroids, tissue engineering

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Authors: Maria David, Tunde A. Tasko, Katalin Hejja-Nagy, Laszlo Dorner

Abstract:

The authors have been concerned with research on learning since 1998. Recently, the focus of our interest is how prevalent use of information and communication technology (ICT) influences students' learning abilities, skills of self-regulated learning and learning efficiency. Nowadays, there are three dominant theories about the psychic effects of ICT use: According to social optimists, modern ICT devices have a positive effect on thinking. As to social pessimists, this effect is rather negative. And, regarding the views of biological optimists, the change is obvious, but these changes can fit into the mankind's evolved neurological system as did writing long ago. Mentality of 'digital natives' differ from that of elder people. They process information coming from the outside world in an other way, and different experiences result in different cerebral conformation. In this regard, researchers report about both positive and negative effects of ICT use. According to several studies, it has a positive effect on cognitive skills, intelligence, school efficiency, development of self-regulated learning, and self-esteem regarding learning. It is also proven, that computers improve skills of visual intelligence such as spacial orientation, iconic skills and visual attention. Among negative effects of frequent ICT use, researchers mention the decrease of critical thinking, as permanent flow of information does not give scope for deeper cognitive processing. Aims of our present study were to uncover developmental characteristics of self-regulated learning in different age groups and to study correlations of learning efficiency, the level of self-regulated learning and frequency of use of computers. Our subjects (N=1600) were primary and secondary school students and university students. We studied four age groups (age 10, 14, 18, 22), 400 subjects of each. We used the following methods: the research team developed a questionnaire for measuring level of self-regulated learning and a questionnaire for measuring ICT use, and we used documentary analysis to gain information about grade point average (GPA) and results of competence-measures. Finally, we used computer tasks to measure cognitive abilities. Data is currently under analysis, but as to our preliminary results, frequent use of computers results in shorter response time regarding every age groups. Our results show that an ordinary extent of ICT use tend to increase reading competence, and had a positive effect on students' abilities, though it didn't show relationship with school marks (GPA). As time passes, GPA gets worse along with the learning material getting more and more difficult. This phenomenon draws attention to the fact that students are unable to switch from guided to independent learning, so it is important to consciously develop skills of self-regulated learning.

Keywords: digital natives, ICT, learning efficiency, reading competence, self-regulated learning

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Authors: Nadjet Mekaouche, Hanane Zitouni, Fatma Boudia, Habiba Fetati, A. Saleh, A. Lardjam, H. Geniaux, A. Coubret, H. Toumi

Abstract:

Medicines have undeniably played a major role in prolonging shelf life and improving quality. The absolute efficacy of the drug remains a lever for innovation, its benefit/risk balance is not always assured and it does not always have the expected effects. Prior to marketing, knowledge about adverse drug reactions is incomplete. Once on the market, phase IV drug studies begin. For years, the drug was prescribed with less care to a large number of very heterogeneous patients and often in combination with other drugs. It is at this point that previously unknown adverse effects may appear, hence the need for the implementation of a pharmacovigilance system. Pharmacovigilance represents all methods for detecting, evaluating, informing and preventing the risks of adverse drug reactions. The most severe adverse events occur frequently in hospital and that a significant proportion of adverse events result in hospitalizations. In addition, the consequences of hospital adverse events in terms of length of stay, mortality and costs are considerable. It, therefore, appears necessary to develop ‘hospital pharmacovigilance’ aimed at reducing the incidence of adverse reactions in hospitals. The most widely used monitoring method in pharmacovigilance is spontaneous notification. However, underreporting of adverse drug reactions is common in many countries and is a major obstacle to pharmacovigilance assessment. It is in this context that this study aims to describe the experience of the pharmacovigilance service at the University Hospital of Oran (EHUO). This is a retrospective study extending from 2011 to 2017, carried out on archived records of declarations collected at the level of the EHUO Pharmacovigilance Department. Reporting was collected by two methods: ‘spontaneous notification’ and ‘active pharmacovigilance’ targeting certain clinical services. We counted 217 statements. It involved 56% female patients and 46% male patients. Age ranged from 5 to 78 years with an average of 46 years. The most common adverse reaction was drug toxidermy. For the drugs in question, they were essentially according to the ATC classification of anti-infectives followed by anticancer drugs. As regards the evolution of declarations by year, a low rate of notification was noted in 2011. That is why we decided to set up an active approach at the level of some services where a resident of reference attended the staffs every week. This has resulted in an increase in the number of reports. The declarations came essentially from the services where the active approach was installed. This highlights the need for ongoing communication between all relevant health actors to stimulate reporting and secure drug treatments.

Keywords: adverse drug reactions, hospital, pharmacovigilance, spontaneous notification

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Authors: Nisa Mohan

Abstract:

Adverse drug event (ADE) related hospital admissions are common among older people. The first step in prevention is accurately estimating the prevalence of ADE admissions. Clinical coding is an efficient method to estimate the prevalence of ADE admissions. The objective of the study is to estimate the rate of under-coding of ADE admissions in older people in New Zealand and to explore how clinical coders decide whether or not to code an admission as an ADE. There has not been any research in New Zealand to explore these areas. This study is done using a mixed-methods approach. Two common and serious ADEs in older people, namely bleeding and hypoglycaemia were selected for the study. In study 1, eight hundred medical records of people aged 65 years and above who are admitted to hospital due to bleeding and hypoglycemia during the years 2015 – 2016 were selected for quantitative retrospective medical records review. This selection was made to estimate the proportion of ADE-related bleeding and hypoglycemia admissions that are not coded as ADEs. These files were reviewed and recorded as to whether the admission was caused by an ADE. The hospital discharge data were reviewed to check whether all the ADE admissions identified in the records review were coded as ADEs, and the proportion of under-coding of ADE admissions was estimated. In study 2, thirteen clinical coders were selected to conduct qualitative semi-structured interviews using a general inductive approach. Participants were selected purposively based on their experience in clinical coding. Interview questions were designed in a way to investigate the reasons for the under-coding of ADE admissions. The records review study showed that 35% (Cl 28% - 44%) of the ADE-related bleeding admissions and 22% of the ADE-related hypoglycemia admissions were not coded as ADEs. Although the quality of clinical coding is high across New Zealand, a substantial proportion of ADE admissions were under-coded. This shows that clinical coding might under-estimate the actual prevalence of ADE related hospital admissions in New Zealand. The interviews with the clinical coders added that lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing might be the potential reasons for the under-coding of the ADE admissions. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. These results highlight that further work is needed on interventions to improve the clinical coding of ADE admissions, such as providing education to coders about the importance of ADEs, education to clinicians about the importance of clear and confirmed medical records entries, availing pharmacist service to improve the detection and clear documentation of ADE admissions and including a mandatory field in the discharge summary about external causes of diseases.

Keywords: adverse drug events, bleeding, clinical coders, clinical coding, hypoglycemia

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