Search results for: feedback amplifiers

Authors: Prem, Norhaya, Vwrene C., Mohammad Harris A., Amarjit, Fazir M.

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Upper limb surgery is a common orthopedic procedure. After surgery, it is necessary to raise the patient's arm to reduce limb swelling and promote recovery. After an injury or surgery, swelling (edema) in the limbs is common. This swelling can be painful, cause stiffness, and affect movement and ability to do daily activities. One of the easiest ways to manage swelling is to elevate the swollen limb. The goal is to elevate the swollen limb slightly above the level of the heart. This helps the extra fluid move back towards the heart for circulation to the rest of the body. Conventional arm sling or pillows are usually placed under the arm to raise it, but in this way the arm cannot be fixed well and easily slide down, without ideal raising effect. Conventional arm sling need experience to tie the sling and this delay in the application process. To reduce the waiting time and cost, modified Norhaya upper limb elevation sling was designed and made readily available. The sling is made from calico fabric, readily available in the ward. Measurements of patients’ arm lengths are obtained, and fabric sizes are cut into the average arm lengths, as well as 1 size above and below. The cut calico fabric is then sewn together with thick sewing threads. Its application is easy and junior most staff or doctor will be able to apply it on patient. The time taken to set up the sling is also reduced. Feedback gathered from ground staff regarding ease of setting up the sling was tremendous and patient also feel comfort in the modified Norhaya sling. The device can freely adjust the raising height of the affected limb and effectively fix the affected limb to reduce its swelling, thus promoting recovery. This device is worthy to be clinically popularized and applied. The Modified Norhaya upper limb elevation sling is the quickest to set up and the delay in elevating the patient’s hand is significantly reduced. Moreover, it is reproducible and there is also significant cost savings.

Keywords: elevate, effective, sling, timely

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Authors: Yukiko Fujiwara

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As a language learning methodology, Content and Language Integrated Learning (CLIL) has become increasingly prevalent in Japan. Most CLIL classroom practice and its research are conducted in EFL fields. However, much less research has been done in the Japanese language learning setting. Therefore, there are still many issues to work out using CLIL in the Japanese language teaching (JLT) setting. it is expected that more research will be conducted on both authentically and academically. Under such circumstances, this is one of the few classroom-based CLIL researches experiments in JLT and aims to find an effective course design for a class with students at different proficiency levels. The class was called ‘Japanese culture A’. This class was offered as one of the elective classes for International exchange students at a Japanese university. The Japanese proficiency level of the class was above the Japanese Language Proficiency Test Level N3. Since the CLIL approach places importance on ‘authenticity’, the class was designed with materials and activities; such as books, magazines, a film and TV show and a field trip to Kyoto. On the field trip, students experienced making traditional Japanese desserts, by receiving guidance directly from a Japanese artisan. Through the course, designated task sheets were used so the teacher could get feedback from each student to grasp what the class proficiency gap was. After reading an article on Japanese culture, students were asked to write down the words they did not understand and what they thought they needed to learn. It helped both students and teachers to set learning goals and work together for it. Using questionnaires and interviews with students, this research examined whether the attempt was effective or not. Essays they wrote in class were also analyzed. The results from the students were positive. They were motivated by learning authentic, natural Japanese, and they thrived setting their own personal goals. Some students were motivated to learn Japanese by studying the language and others were motivated by studying the cultural context. Most of them said they learned better this way; by setting their own Japanese language and culture goals. These results will provide teachers with new insight towards designing class materials and activities that support students in a multilevel CLIL class.

Keywords: authenticity, CLIL, Japanese language and culture, multilevel class

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Authors: Ali Bayram, Remzi Yiğiter

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Objective: Alzheimer's disease (AD), the most common cause of dementia, is a progressive neurodegenerative disease. At present, diagnosis of AD is rather late in the disease. Therefore, we attempted to find peripheral biomarkers for the early diagnosis of AD. Herein, we conducted a study to investigate the unc-51 like autophagy activating kinase-1 (ULK1) mRNA expression levels in human peripheral blood mononuclear cells from patients with Alzheimer's disease. Method: To determine whether ULK1 gene expression are altered in AD patients, we measured their gene expression in human peripheral blood cell in 50 patients with AD and 50 age and gender matched healthy controls by quantitative real-time PCR technique. Results: We found that both ULK1 gene expression in peripheral blood cell were significantly decreased in patients with AD as compared with controls (p <0.05). Lower levels of ULK1 gene expression were significantly associated with the increased risk for AD. Conclusions: Serine/threonine-protein kinase involved in autophagy in response to starvation. Acts upstream of phosphatidylinositol 3-kinase PIK3C3 to regulate the formation of autophagophores, the precursors of autophagosomes. Part of regulatory feedback loops in autophagy: acts both as a downstream effector and negative regulator of mammalian target of rapamycin complex 1 (mTORC1) via interaction with RPTOR. Activated via phosphorylation by AMPK and also acts as a regulator of AMPK by mediating phosphorylation of AMPK subunits PRKAA1, PRKAB2, and PRKAG1, leading to negatively regulate AMPK activity. May phosphorylate ATG13/KIAA0652 and RPTOR; however such data need additional evidences. Plays a role early in neuronal differentiation and is required for granule cell axon formation. Alzheimer is the most common neurodegenerative disease. Our results provide useful information that the ULK1 gene expression is decreased in the neurodegeneration and AD patients with, indicating their possible systemic involvement in AD.

Keywords: Alzheimer’s sisease, ULK1, mRNA expression, RT-PCR

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Authors: Monika Benedek

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Improvisation is an integral part of music education programmes worldwide since teachers recognize that improvisation helps to broaden stylistic knowledge, develops creativity and various musical skills, in particular, aural skills, and also motivates to learn music theory. In Hungary, where Kodály concept is a core element of music teacher education, improvisation has been relatively neglected subject in both primary school and classical music school curricula. Therefore, improvisation was an important theme of a one-year-long research project carried out at the Liszt Academy of Music in Budapest. The project aimed to develop the music teacher training programme, and among others, focused on testing how improvisation could be used as a teaching tool to improve students’ musical reading and writing skills and creative musical skills. Teacher-researchers first tested various teaching approaches of improvisation with numerous teaching modules in music lessons at public schools and music schools. Data were collected from videos of lessons and from teachers’ reflective notes. After analysing data and developing teaching modules, all modules were tested again in a pilot course in 30 contact lessons for music teachers. Teachers gave written feedback of the pilot programme, tested two modules by their choice in their own teaching and wrote reflecting comments about their experiences in applying teaching modules of improvisation. The overall results indicated that improvisation could be an innovative approach to teaching various musical subjects, in particular, solfege, music theory, and instrument, either in individual or in group instruction. Improvisation, especially with the application of relative solmisation and singing, appeared to have been a beneficial tool to develop various musicianship skills of students and teachers, in particular, the aural, musical reading and writing skills, and creative musical skills. Furthermore, improvisation seemed to have been a motivating teaching tool to learn music theory by creating a bridge between various musical styles. This paper reports on the results of the research project.

Keywords: improvisation, Kodály concept, music school, public school, teacher training

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Authors: G. Alex Ambrose, Melissa Paulsen, Abrar Fitwi, Masud Akbari

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In 2016, a U.S. business college was awarded a sub grant to work with FHI360, a nonprofit human development organization, to support a university in Afghanistan funded by the State Department’s U.S. Agency for International Development (USAID). A newly designed Master’s Degree in Finance and Accounting is being implemented to support Afghanistan’s goal of 20% females in higher education and industry by 2020 and to use finance and accounting international standards to attract capital investment for economic development. This paper will present a case study to describe the co-construction of an approach to an International Flipped Faculty Development Model grounded in blended learning theory. Like education in general, faculty development is also evolving from the traditional face to face environment and interactions to the fully online and now to a best of both blends. Flipped faculty development is both a means and a model for careful integration of the strengths of the synchronous and asynchronous dynamics and technologies with the combination of intentional sequencing to pre-online interactions that prepares and enhances the face to face faculty development and mentorship residencies with follow-up post-online support. Initial benefits from this model include giving the Afghan faculty an opportunity to experience and apply modern teaching and learning strategies with technology in their own classroom. Furthermore, beyond the technological and pedagogical affordances, the reciprocal benefits gained from the mentor-mentee, face-to-face relationship will be explored. Evidence to support this model includes: empirical findings from pre- and post-Faculty Mentor/ Mentee survey results, Faculty Mentorship group debriefs, Faculty Mentorship contact logs, and student early/end of semester feedback. In addition to presenting and evaluating this model, practical challenges and recommendations for replicating international flipped faculty development partnerships will be provided.

Keywords: educational development, faculty development, international development, flipped learning

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Authors: Celeste Lawson

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Learning to embrace and value teamwork assessment at a university level is critical for students, as graduates enter a real-world working environment where teamwork is likely to occur virtually. Student disdain for teamwork exercises is an area often overlooked or disregarded by academics. This research explored the implementation of an online teamwork assessment approach at a regional Australian university with a significant cohort of Distance Education students. Students had disliked teamwork for three reasons: it was not relevant to their study, the grading was unfair amongst team members, and managing the task was challenging in a virtual environment. Teamwork assessment was modified so that the task was an authentic task that could occur in real-world practice; team selection was based on the task topic rather than randomly; grading was based on the individual’s contribution to the task, and students were provided virtual team management skills as part of a the assessment. In this way, management of the team became an output of the task itself. Data was gathered over three years from student satisfaction surveys, failure rates, attrition figures, and unsolicited student comments. In one unit where this approach was adopted (Advanced Public Relations), student satisfaction increased from 3.6 (out of 5) in 2012 to 4.6 in 2016, with positive comments made about the teamwork approach. The attrition rate for another unit (Public Relations and the Media) reduced from 20.7% in 2012 to 2.2% in 2015. In 2012, criticism of teamwork assessment made up 50% of negative student feedback in Public Relations and the Media. By 2015, following the successful implementation of the teamwork assessment approach, only 12.5% of negative comments on the student satisfaction survey were critical of teamwork, while 33% of positive comments related to a positive teamwork experience. In 2016, students explicitly nominated teamwork as the best part of this unit. The approach is transferable to other disciplines and was adopted by other academics within the institution with similar results.

Keywords: assessment, distance education, teamwork, virtual

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Authors: Ulriikka Savela-Huovinen, Hanni Muukkonen, Auli Toom

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The development of workplace as a learning environment has been emphasized in research field of workplace learning. The prior literature on sensory performance emphasized the individual’s competences as assessor, while the competences in the collaborative interactional and knowledge creation practices as workplace learning method are not often mentioned. In the present study aims to find out what kinds of competences and contexts are central when assessor conducts food sensory evaluation in authentic professional context. The aim was to answer the following questions: first, what kinds of competences does sensory evaluation require according to assessors? And second, what kinds of contexts for sensory evaluation do assessors report? Altogether thirteen assessors from three Finnish food companies were interviewed by using semi-structural thematic interviews to map practices and development intentions as well as to explicate already established practices. The qualitative data were analyzed by following the principles of abductive and inductive content analysis. Analysis phases were combined and their results were considered together as a cross-analysis. When evaluated independently required competences were perception, knowledge of specific domains and methods and cognitive skills e.g. memory. Altogether, 42% of analysis units described individual evaluation contexts, 53% of analysis units described collaborative interactional contexts, and 5% of analysis units described collaborative knowledge creation contexts. Related to collaboration, analysis reviewed learning, sharing and reviewing both external and in-house consumer feedback, developing methods to moderate small-panel evaluation and developing product vocabulary collectively between the assessors. Knowledge creation contexts individualized from daily practices especially in cases product defects were sought and discussed. The study findings contribute to the explanation that sensory assessors learn extensively from one another in the collaborative interactional and knowledge creation context. Assessors learning and abilities to work collaboratively in the interactional and knowledge creation contexts need to be ensured in the development of the expertise.

Keywords: assessor, collaboration, competences, contexts, learning and practices, sensory evaluation

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Authors: Kehinde Agbele, Longe Olumide, Daniel Ekong, Dele Seluwa, Akintoye Onamade

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One major problem of most existing information retrieval systems (IRS) is that they provide even access and retrieval results to individual users specially based on the query terms user issued to the system. When using IRS, users often present search queries made of ad-hoc keywords. It is then up to IRS to obtain a precise representation of user’s information need, and the context of the information. In effect, the volume and range of the Internet documents is growing exponentially and consequently causes difficulties for a user to obtain information that precisely matches the user interest. Diverse combination techniques are used to achieve the specific goal. This is due, firstly, to the fact that users often do not present queries to IRS that optimally represent the information they want, and secondly, the measure of a document's relevance is highly subjective between diverse users. In this paper, we address the problem by investigating the optimization of IRS to individual information needs in order of relevance. The paper addressed the development of algorithms that optimize the ranking of documents retrieved from IRS. This paper addresses this problem with a two-fold approach in order to retrieve domain-specific documents. Firstly, the design of context of information. The context of a query determines retrieved information relevance using personalization and context-awareness. Thus, executing the same query in diverse contexts often leads to diverse result rankings based on the user preferences. Secondly, the relevant context aspects should be incorporated in a way that supports the knowledge domain representing users’ interests. In this paper, the use of evolutionary algorithms is incorporated to improve the effectiveness of IRS. A context-based information retrieval system that learns individual needs from user-provided relevance feedback is developed whose retrieval effectiveness is evaluated using precision and recall metrics. The results demonstrate how to use attributes from user interaction behavior to improve the IR effectiveness.

Keywords: context, document relevance, information retrieval, personalization, user search behaviors

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Authors: Maryvone Cunha de Morais, Lilian Cristine Hübner

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Based on a translanguaging theoretical approach, which considers language not as separate entities but as an entire repertoire available to bilingual individuals, this systematic review aimed at analyzing the methods (aims, samples investigated, type of stimuli, and analyses) adopted by studies on translanguaging practices associated with written and oral tasks (separately or integrated) in bilingual education. The PRISMA criteria for systematic reviews were adopted, with the descriptors "translanguaging", "bilingual education" and/or “written and oral tasks" to search in Pubmed/Medline, Lilacs, Eric, Scopus, PsycINFO, and Web of Science databases for articles published between 2017 and 2021. 280 registers were found, and after following the inclusion/exclusion criteria, 24 articles were considered for this analysis. The results showed that translanguaging practices were investigated on four studies focused on written production analyses, ten focused on oral production analysis, whereas ten studies focused on both written and oral production analyses. The majority of the studies followed a qualitative approach, while five studies have attempted to study translanguaging with quantitative statistical measures. Several types of methods were used to investigate translanguaging practices in written and oral production, with different approaches and tools indicating that the methods are still in development. Moreover, the findings showed that students’ interactions have received significant attention, and studies have been developed not just in language classes in bilingual education, but also including diverse educational and theoretical contexts such as Content and Language Integrated Learning, task repetition, Science classes, collaborative writing, storytelling, peer feedback, Speech Act theory and collective thinking, language ideologies, conversational analysis, and discourse analyses. The studies, whether focused either on writing or oral tasks or in both, have portrayed significant research and pedagogical implications, grounded on the view of integrated languages in bi-and multilinguals.

Keywords: bilingual education, oral production, translanguaging, written production

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Authors: Zhang Dongqing

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Concern for students' mental health and the application of intelligent advanced technologies are driving changes in teaching models. The traditional teacher-centered classroom is beginning to transform into a student-centered smart interactive learning environment. Nowadays, smart classrooms are compatible with constructivist learning. This theory emphasizes the role of teachers in the teaching process as helpers and facilitators of knowledge construction, and students learn by interacting with them. The spatial design of classrooms is closely related to the teaching model and should also be developed in the direction of smart classroom design. The goal is to explore the impact of smart classroom layout on student-centered teaching environment and teacher-student interaction under the guidance of constructivist learning theory, by combining the design process and feedback analysis of the smart transformation project on the campus of Tongji University in Shanghai. During the research process, the theoretical basis of constructivist learning was consolidated through literature research and case analysis. The integration and visual field analysis of the traditional and transformed indoor floor plans were conducted using space syntax tools. Finally, questionnaire surveys and interviews were used to collect data. The main conclusions are as followed: flexible spatial layouts can promote students' learning effects and mental health; the interactivity of smart classroom layouts is different and needs to be combined with different teaching models; the public areas of teaching buildings can also improve the interactive learning atmosphere by adding discussion space. This article provides a data-based research basis for improving students' learning effects and mental health, and provides a reference for future smart classroom design.

Keywords: spatial layout, smart classroom, space syntax, renovation, educational environment

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Authors: Armando T. Zúñiga

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As the number of English Language Learners (ELLs) in public schools continues to grow, so does the achievement gap between ELLs and other student populations. In an effort to support classroom teachers with effective instructional strategies for this student population, many districts have created instructional coaching positions specifically to support classroom teachers of ELLs—ELL Teachers on Special Assignment (ELL TOSAs). This study employed a gap analysis framework to the ELL TOSA professional support program in one California school district to examine knowledge, motivation, and organizational influences (KMO) on the ELL TOSAs’ goal of supporting classroom teachers of ELLs. Three themes emerged as a result of data analysis. First, there was evidence to illustrate the interaction between knowledge and the organization. Data from ELL TOSAs indicated an understanding of the role that collaboration plays in coaching and how to operationalize it in their support of teachers. Further, all of the ELL TOSAs indicated they have received professional development on effective strategies for instructional coaching. Additionally, a large percentage of the ELL TOSAs indicated a knowledge of modeling as an effective coaching practice. Accordingly, all of the ELL TOSAs indicated that they had knowledge of feedback as an effective coaching strategy. However, there was not sufficient evidence to support that they learned the latter two strategies through professional development. A second theme surfaced as there was evidence to illustrate an interaction between motivation and the organization. Some ELL TOSAs indicated that their sense of self-efficacy was affected by conflicting roles and expectations for the job. Most of the ELL TOSAs indicated that their sense of self-efficacy was affected by an increased workload brought about by fiscal decision making. Finally, there was evidence illustrating the interaction between the organization and motivation. The majority of the of ELL TOSAs indicated that there is confusion about how their roles are perceived, leaving the ELL TOSAs to feel that their actions did not contribute to instructional change. In conclusion, five research-based recommendations to support ELL TOSA goal attainment and considerations for future research on instructional coaches for classroom teachers of ELLs are provided.

Keywords: English language development, English language acquisition, language and leadership, language coaching, English language learners, second language acquisition

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Authors: Muhammad Afzal, Shahbaz Mushtaq, Duc-Anh-An-Vo, Kathryn Reardon Smith, Thanh Ma

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Climate change has become one of the most challenging environmental issues in the 21st century. Climate change-induced natural disasters, especially floods, are the major factors of livelihood vulnerability, impacting millions of individuals worldwide. Evaluating and mitigating the effects of floods requires an in-depth understanding of the relationship between vulnerability and livelihood capital assets. Using an integrated approach, sustainable livelihood framework, and system thinking approach, the study developed a conceptual model of a generalized livelihood system in District Rajanpur, Pakistan. The model visualizes the livelihood vulnerability system as a whole and identifies the key feedback loops likely to influence the livelihood vulnerability. The study suggests that such conceptual models provide effective communication and understanding tools to stakeholders and decision-makers to anticipate the problem and design appropriate policies. It can also serve as an evaluation technique for rural livelihood policy and identify key systematic interventions. The key finding of the study reveals that household income, health, and education are the major factors behind the livelihood vulnerability of the rural poor of District Rajanpur. The Pakistani government tried to reduce the livelihood vulnerability of the region through different income, health, and education programs, but still, many changes are required to make these programs more effective especially during the flood times. The government provided only cash to vulnerable and marginalized families through income support programs, but this study suggests that along with the cash, the government must provide seed storage facilities and access to crop insurance to the farmers. Similarly, the government should establish basic health units in villages and frequent visits of medical mobile vans should be arranged with advanced medical lab facilities during and after the flood.

Keywords: livelihood vulnerability, rural communities, flood, sustainable livelihood framework, system dynamics, Pakistan

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Authors: Luke Taylor, Samantha J. Hall, Kenneth I. Cumming, Jakki Bardsley, Scott S. P. Wildman

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Medway School of Pharmacy, as part of an Equality Diversity and Inclusivity (EDI) initiative run by the University of Kent, decided to take steps to try and negate disparities in numeracy competencies within students undertaking the Master of Pharmacy degree in order to combat a trend in pharmacy students’ numerical abilities upon entry. This included a research driven project 1) to identify if pharmacy students are aware of weaknesses in their numeracy capabilities, and 2) recognise where their numeracy skillset is lacking. In addition to gaining this student perspective, a number of actions have been implemented to support students in improving their numeracy competencies. Reflective and quantitative analysis has shown promising improvements for the final year cohort of 2014/15 when compared to previous years. The method of involving student feedback into the structure of numeracy teaching/support has proven to be extremely beneficial to both students and teaching staff alike. Students have felt empowered and in control of their own learning requirements, leading to increased engagement and attainment. School teaching staff have received quality data to help improve existing initiatives and to innovate further in the area of numeracy teaching. In light of the recognised improvements, further actions are currently being trialled in the area of numeracy support. This involves utilising Virtual Learning Environment platforms to provide individualised support as a supplement to the increased numeracy mentoring (staff and peer) provided to students. Mentors who provide group or one-to-one sessions are now given significant levels of training in dealing with situations that commonly arise from mentoring schemes. They are also provided with continued support throughout the life of their degree. Following results from this study, Medway School of Pharmacy hopes to drive increasing numeracy standards within Pharmacy (primarily through championing peer mentoring) as well as other healthcare professions including Midwifery and Nursing.

Keywords: attainment, ethnicity, numeracy, pharmacy, support

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Authors: Lucia Vodanovic, Bryan Pirolli

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The London College of Communication is one of the only universities in the world to offer a lifestyle journalism master’s degree. A hybrid originally constructed largely out of a generic journalism program crossed with numerous cultural studies approaches, the degree has developed into a leading lifestyle journalism education attracting students worldwide. This research project seeks to present a framework for structuring the degree as well as to understand how students in this emerging field of study value the program. While some researchers have addressed questions about journalism and higher education, none have looked specifically at the increasingly important genre of lifestyle journalism, which Folker Hanusch defines as including notions of consumerism and critique among other identifying traits. Lifestyle journalism, itself poorly researched by scholars, can relate to topics including travel, fitness, and entertainment, and as such, arguably a lifestyle journalism degree should prepare students to engage with these topics. This research uses the existing Masters of Arts and Lifestyle Journalism at the London College of Communications as a case study to examine the school’s approach. Furthering Hanusch’s original definition, this master’s program attempts to characterizes lifestyle journalism by a specific voice or approach, as reflected in the diversity of student’s final projects. This framework echoes the ethos and ideas of the university, which focuses on creativity, design, and experimentation. By analyzing the current degree as well as student feedback, this research aims to assist future educators in pursuing the often neglected field of lifestyle journalism. Through a discovery of the unique mix of practical coursework, theoretical lessons, and broad scope of student work presented in this degree program, researchers strive to develop a framework for lifestyle journalism education, referring to Mark Deuze’s ten questions for journalism education development. While Hanusch began the discussion to legitimize the study of lifestyle journalism, this project strives to go one step further and open up a discussion about teaching of lifestyle journalism at the university level.

Keywords: education, journalism, lifestyle, university

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Authors: Lonna Mabandla, Godfrey Musvoto

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Transportation is a catalytic feature in cities. Transport and land use activity are interdependent and have a feedback loop between how land is developed and how transportation systems are designed and used. This recursive relationship between land use and transportation is reflected in how public transportation routes internal to the inner-city enhance accessibility, therefore creating spaces that are conducive to business activity, while the business activity also informs public transportation routes. It is for this reason that the focus of this research is on public transportation within inner-city areas where the dynamic is evident. Durban is the chosen case study where the dominating form of public transportation within the central business district (CBD) is minibus taxis. The paradox here is that minibus taxis still form part of the informal economy even though they are the leading form of public transportation in South Africa. There have been many attempts to formalise this industry to follow more regulatory practices, but minibus taxis are privately owned, therefore complicating any proposed intervention. The argument of this study is that the application of collaborative planning through a sustainable partnership between the public and private sectors will improve the social and environmental sustainability of public transportation. One of the major challenges that exist within such collaborative endeavors is power dynamics. As a result, a key focus of the study is on power relations. Practically, power relations should be observed over an extended period, specifically when the different stakeholders engage with each other, to reflect valid data. However, a lengthy data collection process was not possible to observe during the data collection phase of this research. Instead, interviews were conducted focusing on existing procedural planning practices between the inner-city minibus taxi association (South and North Beach Taxi Association), the eThekwini Transport Authority (ETA), and the eThekwini Town Planning Department. Conclusions and recommendations were then generated based on these data.

Keywords: collaborative planning, sustainability, public transport, minibus taxis

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Authors: Chia-Ying Lin

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This paper explains how to enhance doctor-patient communication and nurse-patient communication through multiple intelligence signing methods and user-centered. It is hoped that through the implementation of the "electronic consent", the problems faced by the paper consent can be solved: storage methods, resource utilization, convenience, correctness of information, integrated management, statistical analysis and other related issues. Make better use and allocation of resources to provide better medical quality. First, invite the ｍedical records department to assist in the inventory of paper consent in the hospital: organising, classifying, merging, coding, and setting. Second, plan the electronic consent configuration file: set the form number, consent form group, fields and templates, and the corresponding doctor's order code. Next, Summarize four types of rapid methods of electronic consent: according to the doctor's order, according to the medical behavior, according to the schedule, and manually generate the consent form. Finally, system promotion and adjustment: form an "electronic consent promotion team" to improve, follow five major processes: planning, development, testing, release, and feedback, and invite clinical units to raise the difficulties faced in the promotion, and make improvements to the problems. The electronic signature rate of the whole hospital will increase from 4% in January 2022 to 79% in November 2022. Use the saved resources more effectively, including: reduce paper usage (reduce carbon footprint), reduce the cost of ink cartridges, re-plan and use the space for paper medical records, and save human resources to provide better services. Through the introduction of information technology and technology, the main spirit of "lean management" is implemented. Transforming and reengineering the process to eliminate unnecessary waste is also the highest purpose of this project.

Keywords: smart signature, electronic consent, electronic medical records, user-centered, doctor-patient communication, nurse-patient communication

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Authors: Samar Swaid

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Today, corporates are moving toward the adoption of Design-Thinking techniques to develop products and services, putting their consumer as the heart of the development process. One of the leading companies in Design-Thinking, IDEO (Innovation, Design, Engineering Organization), defines Design-Thinking as an approach to problem-solving that relies on a set of multi-layered skills, processes, and mindsets that help people generate novel solutions to problems. Design thinking may result in new ideas, narratives, objects or systems. It is about redesigning systems, organizations, infrastructures, processes, and solutions in an innovative fashion based on the users' feedback. Tim Brown, president and CEO of IDEO, sees design thinking as a human-centered approach that draws from the designer's toolkit to integrate people's needs, innovative technologies, and business requirements. The application of design thinking has been witnessed to be the road to developing innovative applications, interactive systems, scientific software, healthcare application, and even to utilizing Design-Thinking to re-think business operations, as in the case of Airbnb. Recently, there has been a movement to apply design thinking to machine learning and artificial intelligence to ensure creating the "wow" effect on consumers. The Association of Computing Machinery task force on Data Science program states that" Data scientists should be able to implement and understand algorithms for data collection and analysis. They should understand the time and space considerations of algorithms. They should follow good design principles developing software, understanding the importance of those principles for testability and maintainability" However, this definition hides the user behind the machine who works on data preparation, algorithm selection and model interpretation. Thus, the Data Science program includes design thinking to ensure meeting the user demands, generating more usable machine learning tools, and developing ways of framing computational thinking. Here, describe the fundamentals of Design-Thinking and teaching modules for data science programs.

Keywords: data science, design thinking, AI, currculum, transformation

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Authors: Munirah Alaboudi

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This paper discusses a research project carried out with 12 first-year graduate students enrolled in research methods course prior to undertaking a graduate thesis during the academic year 2019. The research was designed for the objective of creating research methods course structure that embraces an individualized and activity-based approach to learning in a highly engaging group environment. This approach targeted innovating the traditional research methods lecture-based, theoretical format where students reported less engagement and limited learning. This study utilized action research methodology in developing a different approach to research methods course instruction where student performance indicators and feedback were periodically collected to assess the new teaching method. Student learning was achieved through utilizing the flipped classroom approach where students learned the material at home and classroom activities were designed to implement and experiment with the newly acquired information, with the guidance of the course instructor. Student learning in class was practiced through a series of activities based on different research methods. With the goal of encouraging student engagement, a wide range of activities was utilized including workshops, role play, mind-mapping, presentations, peer evaluations. Data was collected through an open-ended qualitative questionnaire to establish whether students were engaged in the material they were learning, and to what degree were they engaged, and to test their mastery level of the concepts discussed. Analysis of the data presented positive results as around 91% of the students reported feeling more engaged with the active learning experience and learning research by “actually doing research, not just reading about it”. The students expressed feeling invested in the process of their learning as they saw their research “gradually come to life” through peer learning and practice during workshops. Based on the results of this study, the research methods course structure was successfully remodeled and continues to be delivered.

Keywords: research methods, higher education instruction, flipped classroom, graduate education

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Authors: Misra Ayse Adsiz, Selim Selvi

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In today's world, technology is competing with time. In order to catch up with the world's companies and adapt quickly to the changes, it is necessary to speed up the processes and keep pace with the rate of change of the technology. The missile system design processes, which are handled with classical methods, keep behind in this race. Because customer requirements are not clear, and demands are changing again and again in the design process. Therefore, in the system design process, a methodology suitable for the missile system design dynamics has been investigated and the processes used for catching up the era are examined. When commonly used design processes are analyzed, it is seen that any one of them is dynamic enough for today’s conditions. So a hybrid design process is established. After a detailed review of the existing processes, it is decided to focus on the Scrum Framework and Agile Philosophy. Scrum is a process framework. It is focused on to develop software and handling change management with rapid methods. In addition, agile philosophy is intended to respond quickly to changes. In this study, it is aimed to integrate Scrum framework and agile philosophy, which are the most appropriate ways for rapid production and change adaptation, into the missile system design process. With this approach, it is aimed that the design team, involved in the system design processes, is in communication with the customer and provide an iterative approach in change management. These methods, which are currently being used in the software industry, have been integrated with the product design process. A team is created for system design process. The roles of Scrum Team are realized with including the customer. A scrum team consists of the product owner, development team and scrum master. Scrum events, which are short, purposeful and time-limited, are organized to serve for coordination rather than long meetings. Instead of the classic system design methods used in product development studies, a missile design is made with this blended method. With the help of this design approach, it is become easier to anticipate changing customer demands, produce quick solutions to demands and combat uncertainties in the product development process. With the feedback of the customer who included in the process, it is worked towards marketing optimization, design and financial optimization.

Keywords: agile, design, missile, scrum

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Authors: H. B. Grobler, K. Du Plooy, P. Kruger, S. Ellis

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Objectives: The primary objective of the study was to determine the common mental disorders (CMD) identified by professional South African rugby players and its correlation with their mental toughness, as a first step towards developing such a programme within a larger research project. Design: Survey research, within the theoretical perspective of field theory, was conducted, utilising an adaptation of an already existing mental health questionnaire. The aim was to obtain feedback from as many possible professional South African rugby players in order to make certain generalizations and come to conclusions with regard to the current mental health experiences of these rugby players. Methods: Non-randomized sampling was done, linking it with internet research in the form of the online completion of a questionnaire. A sample of 215 rugby players participated and completed the online questionnaire. Permission was obtained to make use of an existing questionnaire, previously used by the specific authors with retired professional rugby players. A section on mental toughness was added. Data were descriptively analysed by means of the SPSS software platform. Results: Results indicated that the most significant problem that the players are experiencing, is a problem with alcohol (47.9%). Other problems that featured are distress (16.3%), sleep disturbances (7%), as well as anxiety and depression (4.2%). 4.7% of the players indicated that they smoke. 3.3% of the players experience themselves as not being mentally tough. A positive correlation between mental toughness and sound sleep (0.262) was found while a negative correlation was found between mental toughness and the following: anxiety/depression (-0.401), anxiety/depression positive (-0.423), distress (-0.259) and common mental disorder problems in general (-0.220). Conclusions: Although the presence of CMD at first glance do not seem significantly high amongst all the players, it must be considered that if one player in a team experiences the presence of CMD, it will have an impact on his mental toughness and most likely on his performance, as well as on the performance of the whole team. It is therefore important to ensure mental health in the whole team, by addressing individual CMD problems. A mental health support programme is therefore needed to be implemented to the benefit of these players within the South African context.

Keywords: common mental disorders, mental toughness, professional athletes, rugby players

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Authors: Karen Jacob

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Over the last decades, there has been a rise in the use of CLIL (content and language integrated learning) methodology as a way of reinforcing FL (foreign language) acquisition. CLIL techniques have also been transferred to the formal instruction-based FL classroom where through content-based lessons and project work it can very often say that teachers are ‘clilling’ in the FL classroom. When it comes to motivating students to acquire an FL, we have to take into account that English is not your run-of-the-mill FL: English is an international language (EIL). Consequently, this means that EFL students should be able to use English as an international medium of communication. This leads to the assumption that along with FL competence, speakers of EIL will need to become competent international citizens with knowledge of other societies, both contextually and geographically, and be flexible, open-minded, respectful and sensitive towards other world groups. Rather than ‘intercultural’ competence we should be referring to ‘transcultural’ competence. This paper reports the implementation of a content- and task-based approach to EFL teaching which was applied to two groups of 15 year-olds from two schools on the Spanish island of Mallorca during the school year 2015-2016. Students worked on three units of work that aimed at ‘internationalising’ the classroom by introducing topics that would encourage them to become transculturally aware of the world in which they live. In this paper we discuss the feedback given by the teachers and students on various aspects of the approach in order to answer the following research questions: 1) To what extent were the students motivated by the content and activities of the classes?; 2) Did this motivation have a positive effect on the students’ overall results for the subject; 3) Did the participants show any signs of becoming transculturally aware. Preliminary results from qualitative data show that the students enjoyed the move away from the more traditional EFL content and, as a result, they became more competent in speaking and writing. Students also appeared to become more knowledgeable and respectful towards the ‘other’. The EFL approach described in this paper takes a more qualitative approach to research by describing what is really going on in the EFL classroom and makes a conscious effort to provide real examples of not only the acquisition of linguistic competence but also the acquisition of other important communication skills that are of utmost importance in today's international arena.

Keywords: CLIL, content- and task-based learning, internationalisation, transcultural competence

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Authors: Naira Poghosyan

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In knowledge society the content of the studies, the methods used and the requirements for an educator’s professionalism regularly undergo certain changes. It follows that in knowledge society the aim of education is not only to educate professionals for a certain field but also to help students to be aware of cultural values, form human mutual relationship, collaborate, be open, adapt to the new situation, creatively express their ideas, accept responsibility and challenge. In this viewpoint, the development of communicative language competence requires a through coordinated approach to ensure proper comprehension and memorization of subject-specific words starting from high school level. On the other hand, ESP (English for Specific Purposes) teachers and practitioners are increasingly faced with the task of developing and exploiting new ways of assessing their learners’ literacy while learning and teaching ESP. The presentation will highlight the latest achievements in this field. The author will present some practical methodological issues and principles associated with learning, teaching and assessing ESP skills of the learners, using the two software programs of EXE 2.0 and Hot Potatoes 6. On the one hand the author will display the advantages of the two programs as self-learning and self-assessment interactive tools in the course of academic study and professional development of the CLIL learners, on the other hand, she will comprehensively shed light upon some methodological aspects of working out appropriate ways of selection, introduction, consolidation of subject specific materials via EXE 2.0 and Hot Potatoes 6. Then the author will go further to distinguish ESP courses by the general nature of the learners’ specialty identifying three large categories of EST (English for Science and Technology), EBE (English for Business and Economics) and ESS (English for the Social Sciences). The cornerstone of the presentation will be the introduction of the subject titled “The methodology of teaching ESP in non-linguistic institutions”, where a unique case of teaching ESP on Architecture and Construction via EXE 2.0 and Hot Potatoes 6 will be introduced, exemplifying how the introduction, consolidation and assessment can be used as a basis for feedback to the ESP learners in a particular professional field.

Keywords: ESP competences, ESP skill assessment/ self-assessment tool, eXe 2.0 / HotPotatoes software program, ESP teaching strategies and techniques

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Authors: JungYeon Park, Jooyong Park

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Brainstorming and discussion are widely used around the world as formal techniques of collaborative creative problem solving. This study investigated whether a web-based peer review system would improve collaborative creative problem solving. In order to assess the efficiency of using web-based peer review system before brainstorming and discussion, we conducted a between-group design study for two conditions (a web-based peer review system vs. face-to-face brainstorming only) using two different scenarios. One hundred and twenty participants were divided into teams of four and randomly assigned to one of the four conditions. The participants were given problems for them to solve. The participants in the experimental group first generated ideas independently for 20 minutes and wrote down their ideas. Afterwards, they reviewed the list of ideas of their peers and gave and received feedback for 10 minutes. These activities were performed on-line. The last activity was face-to-face brain-storming and discussion for 30 minutes. In contrast, the control group participated in brainstorming and discussion for 60 minutes. The quantity and the quality of ideas were measured as dependent variables of creative problem solving. Two evaluators rated the quantity and quality of the proposed ideas. Inter-rater agreement rate was good or strong. The results showed that both the average number of unique ideas and the average quality of ideas generated for the experimental condition were significantly higher than those for the control condition in both scenarios. The results of this study support the hypothesis that collaborative creative problem solving is enhanced when individuals write their thoughts individually and review ideas written by peers before face-to-face brainstorming and discussion. The present study provides preliminary evidence that a web-based peer review system can be instrumental in improving creative problem solving for teams. This system also offers an effective means to quantify the contribution of each member in collaborative team activity. We are planning to replicate these results in real-life situations.

Keywords: brainstorming, creative problem solving, peer-review, team efficiency

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Authors: T. Frawley, G. O'Kelly

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The UCD School of Nursing, Midwifery and Health Systems Higher Diploma in Mental Health (HDMH) nursing programme commenced in January 2017. Forty students successfully completed the programme. Programme evaluation was conducted from the outset. Research ethics approval was granted by the UCD Human Research Ethics Committee – Sciences in November 2016 (LS-E-16-163). Plan for Sustainability: Each iteration of the programme continues to be evaluated and adjusted accordingly. Aims: The ultimate purpose of the HDMH programme is to prepare registered nurses (registered children’s nurse (RCN), registered nurse in intellectual disability (RNID) and registered general nurse (RGN)) to function as effective registered psychiatric nurses in all settings which provide care and treatment for people experiencing mental health difficulties. Curriculum evaluation is essential to ensure that the programme achieves its purpose, that aims and expected outcomes are met and that required changes are highlighted for the programme’s continuing positive development. Methods: Both quantitative and qualitative methods were used in the evaluation. A series of questionnaires were used (the majority pre and post programme) to determine student perceptions of the programme, behaviour and attitudinal change from commencement to completion. These included the student assessment of learning gains (SALG); mental health knowledge schedule (MAKS); mental health clinician attitudes scale (MICA); reported and intended behaviour scale (RIBS); and community attitudes towards the mentally ill (CAMI). In addition, student and staff focus groups were conducted. Evaluation methods also incorporated module feedback. Outcome/Results: The evaluation highlighted a very positive response in relation to the achievement of programme outcomes and preparation for future work as registered psychiatric nursing. Some areas were highlighted for further development, which have been taken cognisance of in the 2019 iteration of the programme.

Keywords: learning gains, mental health, nursing, stigma

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Authors: Carmen Silvia Gabriel, Dsniele Bernardi da Costa, Andrea Bernardes, Sabrina Elias Mikael, Daniele da Silva Ramos

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The goal of this quantitative study is to investigate patient safety culture from the perspective of professional from the hospital nursing team.It was conducted in two Brazilian hospitals,.The sample included 282 nurses Data collection occurred in 2013, through the questionnaire Hospital Survey on Patient Safety Culture.Based on the assessment of the dimensions is stressed that, in the dimension teamwork across hospital units, 69.4% of professionals agree that when a lot of work needs to be done quickly, they work together as a team; about the dimension supervisor/ manager expectations and actions promoting safety, 70.2% agree that their supervisor overlooks patient safety problems.Related to organizational learning and continuous improvement, 56.5% agree that there is evaluation of the effectiveness of the changes after its implementation.On hospital management support for patient safety, 52.8% refer that the actions of hospital management show that patient safety is a top priority.On the overall perception of patient safety, 57.2% disagree that patient safety is never compromised due to higher amount of work to be completed.In what refers to feedback and communication about error, 57.7% refer that always and usually receive such information. Relative to communication openness, 42.9% said they never or rarely feel free to question the decisions / actions of their superiors.On frequency of event reporting, 64.7% said often and always notify events with no damages to patients..About teamwork across hospital units is noted similarity between the percentages of agreement and disagreement, as on the item there is a good cooperation among hospital units that need to work together, that indicates 41.4% and 40.5% respectively.Related to adequacy of professionals, 77.8 % disagree on the existence of sufficient amount of employees to do the job, 52.4% agree that shift changes are problematic for patients. On nonpunitive response to errors, 71.7% indicate that when an event is reported it seems that the focus is on the person.On the patient safety grade of the institution, 41.6 % classified it as very good. it is concluded that there are positive points in the safety culture, and some weaknesses as a punitive culture and impaired patient safety due to work overload .

Keywords: quality of health care, health services evaluation, safety culture, patient safety, nursing team

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Authors: Soraya Tharani

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Social media has changed how public opinion is shaped by enabling more diversified and inclusive participation of audiences. New online forums provide spaces in which governments, NGOs and other organizations can create content and receive feedback. These forums are sites where debate can constitute public opinion. Studies of audience engagement can give an understanding of how different voices from the civil society participate in debates and how discussions can reinforce or bring into question established societal beliefs. The UN’s refugee agency, UNHCR, produces audio-visual stories about displaced people for global audiences on social media platforms. The availability of many views in these forums can give insight into how dialogues regarding transnational issues are formed. The public sphere, as defined by Habermas, is a discursive arena where reasoned debate can take place. Habermas’ concept is combined with theories on celebrity advocacy, and discussions about the role and effect celebrities have in raising public awareness for humanitarian issues. The personal and public lives of celebrities often create emotional engagement from their fans and other audiences. In this study, quantitative and qualitative methods have been used on YouTube comments for uncovering how emotion and reason are constituted in a global public debate on celebrity endorsed UNHCR stories of displaced people. The study shows that engagement intensity is not equally distributed between comment threads; comments presented as facts or emotional claims are often supported by recourse to intertextuality, and specific linguistic strategies are used to put forward emotional and reasoned claims regarding individual and group identities. The findings from this research aim to contribute to an understanding of audience engagement on issues of human survival and solidarity in a global social media public sphere.

Keywords: emotions, engagement, global public sphere, linguistic strategies, reason, refugees, social media, UNHCR

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Authors: Deniz Guven, Wil Ward, Jinming Duan, Li Bai

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Over the past two decades or so, Optical Coherence Tomography (OCT) has been used to diagnose retina and optic nerve diseases. The retinal nerve fibre layer, for example, is a powerful diagnostic marker for detecting and staging glaucoma. With the advances in optical imaging hardware, the adoption of OCT is now commonplace in clinics. More and more OCT images are being generated, and for these OCT images to have clinical applicability, accurate automated OCT image segmentation software is needed. Oct image segmentation is still an active research area, as OCT images are inherently noisy, with the multiplicative speckling noise. Simple edge detection algorithms are unsuitable for detecting retinal layer boundaries in OCT images. Intensity fluctuation, motion artefact, and the presence of blood vessels also decrease further OCT image quality. In this paper, we introduce a new method for segmenting three-dimensional (3D) OCT images. This involves the use of a Kalman filter, which is commonly used in computer vision for object tracking. The Kalman filter is applied to the 3D OCT image volume to track the retinal layer boundaries through the slices within the volume and thus segmenting the 3D image. Specifically, after some pre-processing of the OCT images, points on the retinal layer boundaries in the first image are identified, and curve fitting is applied to them such that the layer boundaries can be represented by the coefficients of the curve equations. These coefficients then form the state space for the Kalman Filter. The filter then produces an optimal estimate of the current state of the system by updating its previous state using the measurements available in the form of a feedback control loop. The results show that the algorithm can be used to segment the retinal layers in OCT images. One of the limitations of the current algorithm is that the curve representation of the retinal layer boundary does not work well when the layer boundary is split into two, e.g., at the optic nerve, the layer boundary split into two. This maybe resolved by using a different approach to representing the boundaries, such as b-splines or level sets. The use of a Kalman filter shows promise to developing accurate and effective 3D OCT segmentation methods.

Keywords: optical coherence tomography, image segmentation, Kalman filter, object tracking

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Authors: Guannan Ren, Thomas Mazzuchi, Shahram Sarkani

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Electric vehicle battery recycling has emerged as a critical process in the transition toward sustainable transportation. As the demand for electric vehicles continues to rise, so does the need to address the end-of-life management of their batteries. Electric vehicle battery recycling benefits resource recovery and supply chain stability by reclaiming valuable metals like lithium, cobalt, nickel, and graphite. The reclaimed materials can then be reintroduced into the battery manufacturing process, reducing the reliance on raw material extraction and the environmental impacts of waste. Current battery recycling rates are insufficient to meet the growing demands for raw materials. While significant progress has been made in electric vehicle battery recycling, many areas can still improve. Standardization of battery designs, increased collection and recycling infrastructures, and improved efficiency in recycling processes are essential for scaling up recycling efforts and maximizing material recovery. This work delves into key factors, such as regulatory frameworks, economic incentives, and technological processes, that influence the cost-effectiveness and efficiency of battery recycling systems. A system dynamics model that considers variables such as battery production rates, demand and price fluctuations, recycling infrastructure capacity, and the effectiveness of recycling processes is created to study how these variables are interconnected, forming feedback loops that affect the overall supply chain efficiency. Such a model can also help simulate the effects of stricter regulations on battery disposal, incentives for recycling, or investments in research and development for battery designs and advanced recycling technologies. By using the developed model, policymakers, industry stakeholders, and researchers may gain insights into the effects of applying different policies or process updates on electric vehicle battery recycling rates.

Keywords: environmental engineering, modeling and simulation, circular economy, sustainability, transportation science, policy

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Authors: Mustafa Hyder, Shamaila Burney, Roohi Mumtaz

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The aim of this study is to determine the consequences of silent or hidden messages and their effectiveness in deteriorating or altering our ethical norms and values. The study also focuses the repercussions of subconscious messages and possibilities of ethical diffusion in our society. The research based on the question that what are the different factors that motivate advertisers to include subliminal messages and how much these unspoken truths affecting our ethical values silently. What are the causes and effects of the subliminal messages in general and the level of ethical diffusion and its acceptance? The concept of advertising is to promote and highlight the salient features of the products and services, a company offers. Advertising is the best option nowadays to convey the related information to the consumers so that they attracted more towards the products or services proposed. The other thing advertisers concentrate, is the psychological characteristics using to persuade consumers choice. Using skills and tactics of advertising to promote a product in such a way that it creates a sensation, controversy or brand consciousness among the consumers or customers. The purpose to have increase purchase or to gain popularity in comparison to their competitors, they sometimes use such tactics and techniques, which is highly unethical and immoral for any society. These kinds of stuff used very smartly within the ads that only the conscious mind subconsciously catches the meaning of those glittery images, posters, phrases, tag lines and non-verbal clues. This study elucidates the subliminal advertising their repercussions and impact on consumer’s behaviour in our society with the help of few ads embedded subliminally and the trends of profitability. The methods used to accomplish our research are based on qualitative research along with the research articles, books and feedback from focused groups regarding the topic. The basic objective of this study was that, there is no significant change in the behaviour and attitude observed. These messages capture very short-term life on the viewer’s subconscious mind but in long run people get used to it and hence not only have the diffusion power but also has the high level of acceptance as well that reflects mostly through their social behaviours and attitudes.

Keywords: ethical diffusion, subconscious, subliminal advertising, unspoken facts

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Authors: R. Stoyanova, R. Dimova, M. Tarnovska, T. Boeva, R. Dimov, I. Doykov

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Patient safety culture (PSC) is an essential component of quality of healthcare. Improving PSC is considered a priority in many developed countries. Specialized software platform for registration and evaluation of hospital patient safety culture has been developed with the support of the Medical University Plovdiv Project №11/2017. The aim of the study is to assess the status of PSC in Bulgarian hospitals and to compare it to that in USA and Croatian hospitals. Methods: The study was conducted from June 01 to July 31, 2018 using the web-based Bulgarian Version of the Hospital Survey on Patient Safety Culture Questionnaire (B-HSOPSC). Two hundred and forty-eight medical professionals from different hospitals in Bulgaria participated in the study. To quantify the differences of positive scores distributions for each of the 42 HSOPSC items between Bulgarian, Croatian and USA samples, the x²-test was applied. The research hypothesis assumed that there are no significant differences between the Bulgarian, Croatian and US PSCs. Results: The results revealed 14 significant differences in the positive scores between the Bulgarian and Croatian PSCs and 15 between the Bulgarian and the USA PSC, respectively. Bulgarian medical professionals provided less positive responses to 12 items compared with Croatian and USA respondents. The Bulgarian respondents were more positive compared to Croatians on the feedback and communication of medical errors (Items - C1, C4, C5) as well as on the employment of locum staff (A7) and the frequency of reported mistakes (D1). Bulgarian medical professionals were more positive compared with their USA colleagues on the communication of information at shift handover and across hospital units (F5, F7). The distribution of positive scores on items: ‘Staff worries that their mistakes are kept in their personnel file’ (RA16), ‘Things ‘fall between the cracks’ when transferring patients from one unit to another’ (RF3) and ‘Shift handovers are problematic for patients in this hospital’ (RF11) were significantly higher among Bulgarian respondents compared with Croatian and US respondents. Conclusions: Significant differences of positive scores distribution were found between Bulgarian and USA PSC on one hand and between Bulgarian and Croatian on the other. The study reveals that distribution of positive responses could be explained by the cultural, organizational and healthcare system differences.

Keywords: patient safety culture, healthcare, HSOPSC, medical error

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