Search results for: potential outcomes approach

Authors: Elnaz Alimi, Keriakoula Andriopoulos, Sam Boyer, Weronika Zuczek

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Occupational therapists can use coaching strategies to guide parents in providing therapy for their children with developmental disabilities. Evidence from various fields has shown increased parental self-efficacy and positive child outcomes as benefits of home and community-based parent coaching models. A literature review was conducted to investigate the effectiveness of parent coaching interventions delivered in home and community settings for children with developmental disabilities ages 0-12, on a variety of parent and child outcomes. CINAHL Plus, PsycINFO, PubMed, OTseeker were used as databases. The inclusion criteria consisted of: children with developmental disabilities ages 0-12 and their parents, parent coaching models conducted in the home and community, and parent and child outcomes. Studies were excluded if they were in a language other than English and published before 2000. Results showed that parent coaching interventions led to more positive therapy outcomes in child behaviors and symptoms related to their diagnosis or disorder. Additionally, coaching strategies had positive effects on parental satisfaction with therapy, parental self-efficacy, and family dynamics. Findings revealed decreased parental stress and improved parent-child relationships. Further research on parent coaching could involve studying the feasibility of coaching within occupational therapy specifically, incorporating cultural elements into coaching, qualitative studies on parental satisfaction with coaching, and measuring the quality of life outcomes for the whole family.

Keywords: coaching model, developmental disabilities, occupational therapy, pediatrics

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Authors: Samina Sarwar, Hajra Khalil

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Mycoremediation is emerging as a potential approach for eco-friendly and cost-effective remediation of polluted effluents collected from the dyeing unit of the textile industry was examined. This work dealt with the analyses of the bio remedial capability of some potential indigenous six fungal isolates viz., Aspergillus alliaceus, Aspergillus flavus, Aspergillus fumigatus Aspergillus niger, Penicillium sp. and Rhizopus oryzae were identified and selected for studies. All fungal species were known to bring bioremediation, which had been confirmed by measuring the percentage reduction potential in different parameters, i.e., pH, Electrical Conductivity (EC), Total Suspended Solids (TSS), Total Dissolved Solids (TDS), Biological Oxygen Demand (BOD) and Chemical Oxygen Demand (COD). Rhizopus oryzae showed the highest reduction in pH, EC, and BOD, while Aspergillus fumigatus showed the highest reduction in TDS and TSS, and COD under the optimal conditions of this study. The biodegradation potential of these fungal species was confirmed, evidenced by excellent evaluation of experimental data to propose Rhizopus oryzae and Aspergillus fumigatus as a cost-effective solution to treat the effluents from the dyeing unit of the textile industry.

Keywords: biological reduction, fungal isolates, micromycetes, mycoremediation

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Authors: Samina Sarwar, Hajra Khalil

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Mycoremediation is emerging as a potential approach for eco-friendly and cost-effective remediation of polluted effluents collected from the dyeing unit of the textile industry was examined. This work dealt with the analyses of the bio remedial capability of some potential indigenous six fungal isolates viz., Aspergillus alliaceus, Aspergillus flavus, Aspergillus fumigatus Aspergillus niger, Penicillium sp. and Rhizopus oryzae were identified and selected for studies. All fungal species were known to bring bioremediation, which had been confirmed by measuring the percentage reduction potential in different parameters, i.e., pH, Electrical Conductivity (EC), Total Suspended Solids (TSS), Total Dissolved Solids (TDS), Biological Oxygen Demand (BOD) and Chemical Oxygen Demand (COD). Rhizopus oryzae showed the highest reduction in pH, EC, and BOD, while Aspergillus fumigatus showed the highest reduction in TDS and TSS, and COD under the optimal conditions of this study. The biodegradation potential of these fungal species was confirmed, evidenced by excellent evaluation of experimental data to propose Rhizopus oryzae and Aspergillus fumigatus as a cost-effective solution to treat the effluents from the dyeing unit of the textile industry.

Keywords: biological reduction, fungal isolates, micromycetes, mycoremediation

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Authors: Daniele Zullino, Gabriel Thorens, Léonice Furtado, Federico Seragnoli, Radu Iuga, Louise Penzenstadler

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Context: Since the start of the 21st century, there has been a resurgence of interest in psychedelics, marked by a renewed focus on scientific investigations into their therapeutic potential. While psychedelic therapy has gained recognition for effectively treating depression and anxiety disorders, notable progress has been made in the clinical development of substances like psilocybin. Moreover, mounting evidence suggests promising applications of Lysergic acid diethylamide (LSD) and psilocybin in the field of addiction medicine. In Switzerland, compassionate treatment with LSD and psilocybin has been permitted since 2014 through exceptional licenses granted by the Federal Office of Public Health. This treatment approach is also available within the Geneva treatment program, extending its accessibility to patients undergoing opioid-assisted treatment involving substances like morphine and diacetylmorphine. The aim of this study is to assess the feasibility of psychedelic-assisted therapy in patients with opioid use disorder who are undergoing opioid-assisted treatment. This study addresses the question of whether psychedelic-assisted therapy can be successfully implemented in patients with opioid use disorder. It also explores the effects of psychedelic therapy on the patient's experiences and outcomes. Methodology: This is an open case series on six patients who have undergone at least one session with either LSD (100-200 micrograms) or psilocybin (20-40 mg). The patients were assessed using the Five Dimensional Altered States of Consciousness (5D-ASC)-Scale. The data were analyzed descriptively to identify patterns and trends in the patients' experiences. Results: The patients experienced substantial positive psychedelic effects during the psychedelic sessions without significant adverse effects. The patients reported positive experiences and improvements in their condition. Conclusion: The findings of this study support the feasibility and potential efficacy of psychedelic-assisted therapy in patients undergoing opioid-assisted treatment.

Keywords: psychedelics, psychedelic-assisted treatment, opioid use disorder, addiction, LSD, psilocybin

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Authors: Surinder Deswal, Mahesh Pal

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The paper investigates the potential of support vector machines based regression approach to model the mass transfer capacity of multiple plunging jets, both vertical (θ = 90°) and inclined (θ = 60°). The data set used in this study consists of four input parameters with a total of eighty eight cases. For testing, tenfold cross validation was used. Correlation coefficient values of 0.971 and 0.981 (root mean square error values of 0.0025 and 0.0020) were achieved by using polynomial and radial basis kernel functions based support vector regression respectively. Results suggest an improved performance by radial basis function in comparison to polynomial kernel based support vector machines. The estimated overall mass transfer coefficient, by both the kernel functions, is in good agreement with actual experimental values (within a scatter of ±15 %); thereby suggesting the utility of support vector machines based regression approach.

Keywords: mass transfer, multiple plunging jets, support vector machines, ecological sciences

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Authors: Ratna Sen

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As due to very high temperature of Plasma it is very difficult to confine it for sufficient time so that nuclear fusion reactions to take place, As we know Plasma escapes faster than the binary collision rates. We studied the ball analogy and the ‘energy principle’ and calculated the total potential energy for the whole Plasma. If δ ⃗w is negative, that is decrease in potential energy then the plasma will be unstable. We also discussed different approaches of stability analysis such as Nyquist Method, MHD approximation and Vlasov approach of plasma stability. So that by using magnetic field configurations we can able to create a stable Plasma in Tokamak for generating energy for future generations.

Keywords: jello, magnetic field configuration, MHD approximation, energy principle

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Authors: J. Niyitegeka, G. Nshimirimana, A. Silverstein, J. Odhiambo, Y. Lin, T. Nkurunziza, R. Riviello, S. Rulisa, P. Banguti, H. Magge, M. Macharia, J. P. Dushime, R. Habimana, B. Hedt-Gauthier

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In low-resource settings, women needing an emergency cesarean section experiences various delays in both reaching and receiving care that is often linked to poor neonatal outcomes. In this study, we quantified different measures of delays and assessed the association between these delays and neonatal outcomes at three rural district hospitals in Rwanda. This retrospective study included 441 neonates and their mothers who underwent emergency cesarean sections in 2015 at Butaro, Kirehe and Rwinkwavu District Hospitals. Four possible delays were measured: Time from start of labor to district hospital admission, travel time from a health center to the district hospital, time from admission to surgical incision, and time from the decision for the emergency cesarean section to surgical incision. Neonatal outcomes were categorized as unfavorable (APGAR < 7 or death) and favorable (APGAR ≥ 7). We assessed the relationship between each type of delay and neonatal outcomes using multivariate logistic regression. In our study, 38.7% (108 out of 279) of neonates’ mothers labored for 12 to 24 hours before hospital admission and 44.7% (159 of 356) of mothers were transferred from health centers that required 30 to 60 minutes of travel time to reach the district hospital. 48.1% (178 of 370) of caesarean sections started within five hours after admission and 85.2% (288 of 338) started more than thirty minutes after the decision for the emergency cesarean section was made. Neonatal outcomes were significantly worse among mothers with more than 90 minutes of travel time from the health center to the district hospital compared to health centers attached to the hospital (OR = 5.12, p = 0.02). Neonatal outcomes were also significantly different depending on decision to incision intervals; neonates with cesarean deliveries starting more than thirty minutes after decision had better outcomes than those started immediately (OR = 0.32, p = 0.04). Interventions that decrease barriers to access to maternal health care services can improve neonatal outcome after emergency cesarean section. Triaging could explain the inverse relationship between time from decision to incision and neonatal outcome; this must be studied more in the future.

Keywords: Africa, emergency obstetric care, rural health delivery, maternal and child health

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Authors: Amares Chattopadhyay, Akanksha Srivastava

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A unified approach to study the reflection of a plane wave in three-dimensional model comprised of the triclinic viscoelastic medium. The phase velocities of reflected qP, qSV and qSH wave have been calculated for the concerned medium by using the eigenvalue approach. The generalized method has been implemented to compute the complex form of amplitude ratios. Further, we discussed the nature of reflection coefficients of qP, qSV and qSH wave. The viscoelastic parameter, polar angle and azimuthal angle are found to be strongly influenced by amplitude ratios. The research article is particularly focused to study the effect of viscoelasticity associated with highly anisotropic media which exhibits the notable information about the reflection coefficients of qP, qSV, and qSH wave. The outcomes may further useful to the better exploration of all types of hydrocarbon reservoir and advancement in the field of reflection seismology.

Keywords: amplitude ratios, three dimensional, triclinic, viscoelastic

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Authors: Scott Ashby, Emily Granger, Mark Connellan

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Objectives: 1) To identify if emergency coronary angiography improves outcomes in studies examining OHCA from assumed cardiac aetiology? 2) If so, is it indicated in all patients resuscitated following OHCA, and if not, who is it indicated for? 3) How effective are investigations for screening for the appropriate patients? Background: Out-of-hospital cardiac arrest is one of the leading mechanisms of death, and the most common causative pathology is coronary artery disease. In-hospital treatment following resuscitation greatly affects outcomes, yet there is debate over the most effective protocol. Methods: A literature search was conducted over multiple databases to identify all relevant articles published from 2005. An inclusion criterion was applied to all publications retrieved, which were then sorted by type. Results: A total of 3 existing reviews and 29 clinical studies were analysed in this review. There were conflicting conclusions, however increased use of angiography has shown to improve outcomes in the majority of studies, which cover a variety of settings and cohorts. Recommendations: Currently, emergency coronary angiography appears to improve outcomes in all/most cases of OHCA of assumed cardiac aetiology, regardless of ECG findings. Until a better tool for screening is available to reduce unnecessary procedures, the benefits appear to outweigh the costs/risks.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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Authors: Netanel Stern

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Artificial intelligence (AI) algorithms have emerged as powerful tools in the field of psychiatry, offering new possibilities for enhancing diagnosis and treatment outcomes. This article explores the utilization of AI algorithms in psychiatry, highlighting their potential to revolutionize patient care. Various AI algorithms, including machine learning, natural language processing (NLP), reinforcement learning, clustering, and Bayesian networks, are discussed in detail. Moreover, ethical considerations and future directions for research and implementation are addressed.

Keywords: AI, software engineering, psychiatry, neuroimaging

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Authors: Amer Ait Sidhoum

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Interest in sustainability has gained ground among practitioners, academics and policy-makers due to growing stakeholders’ awareness of environmental and social concerns. This is particularly true for agriculture. However, relatively little research has been conducted on the quantification of social sustainability and the contribution of social issues to the agricultural production efficiency. This research's main objective is to propose a method for evaluating prices of social outputs, more precisely shadow prices, by allowing for the stochastic nature of agricultural production that is to say for production uncertainty. In this article, the assessment of social outputs’ shadow prices is conducted within the methodological framework of nonparametric Data Envelopment Analysis (DEA). An output-oriented directional distance function (DDF) is implemented to represent the technology of a sample of Catalan arable crop farms and derive the efficiency scores the overall production technology of our sample is assumed to be the intersection of two different sub-technologies. The first sub-technology models the production of random desirable agricultural outputs, while the second sub-technology reflects the social outcomes from agricultural activities. Once a nonparametric production technology has been represented, the DDF primal approach can be used for efficiency measurement, while shadow prices are drawn from the dual representation of the DDF. Computing shadow prices is a method to assign an economic value to non-marketed social outcomes. Our research uses cross sectional, farm-level data collected in 2015 from a sample of 180 Catalan arable crop farms specialized in the production of cereals, oilseeds and protein (COP) crops. Our results suggest that our sample farms show high performance scores, from 85% for the bad state of nature to 88% for the normal and ideal crop growing conditions. This suggests that farm performance is increasing with an improvement in crop growth conditions. Results also show that average shadow prices of desirable state-contingent output and social outcomes for efficient and inefficient farms are positive, suggesting that the production of desirable marketable outputs and of non-marketable outputs makes a positive contribution to the farm production efficiency. Results also indicate that social outputs’ shadow prices are contingent upon the growing conditions. The shadow prices follow an upward trend as crop-growing conditions improve. This finding suggests that these efficient farms prefer to allocate more resources in the production of desirable outputs than of social outcomes. To our knowledge, this study represents the first attempt to compute shadow prices of social outcomes while accounting for the stochastic nature of the production technology. Our findings suggest that the decision-making process of the efficient farms in dealing with social issues are stochastic and strongly dependent on the growth conditions. This implies that policy-makers should adjust their instruments according to the stochastic environmental conditions. An optimal redistribution of rural development support, by increasing the public payment with the improvement in crop growth conditions, would likely enhance the effectiveness of public policies.

Keywords: data envelopment analysis, shadow prices, social sustainability, sustainable farming

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Authors: Lisa Chandler, Alistair Ward

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A significant component of design pedagogy is the need to foster design thinking in various contexts and to support students in understanding links between educational exercises and their potential application in professional design practice. It is also important that educators provide opportunities for students to engage with new technologies and encourage them to imagine applying their design skills for a range of outcomes. Problem solving is central to design so it is also essential that students understand that there can be multiple solutions to a design brief, and are supported in undertaking creative experimentation to generate imaginative outcomes. This paper presents a case study examining some innovative approaches to addressing these elements of design pedagogy. It investigates the effectiveness of the Immerse Lab, a three wall projection room at the University of the Sunshine Coast, Australia, as a learning context for design practice, for generating ideas and for supporting learning involving the comparative display of design outcomes. The project required first year design students to create a simple graphic design derived from an ordinary object and to incorporate specific design criteria. Utilizing custom-designed software, the students’ solutions were projected together onto the Immerse walls to create a large-scale, immersive grid of images, which was used to compare and contrast various responses to the same problem. The software also enabled individual student designs to be transformed, multiplied and enlarged in multiple ways and prompted discussions around the applicability of the designs in real world contexts. Teams of students interacted with their projected designs, brainstorming imaginative applications for their outcomes. Analysis of 77 anonymous student surveys revealed that the majority of students found: learning in the Immerse Lab to be beneficial; comparative review more effective than in standard tutorial rooms; that the activity generated new ideas; it encouraged students to think differently about their designs; it inspired students to develop their existing designs or create new ones. The project demonstrates that curricula involving immersive spaces can be effective in supporting engaging and relevant design pedagogy and might be utilized in other disciplinary areas.

Keywords: design pedagogy, immersive education, technology-enhanced learning, visualization

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Authors: Jade Fersterer, Tristan Snell, Mark Rickinson

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This paper is designed to provide a review of the literature concerning the impact of natural environments on student learning and wellbeing in Australia. Specific areas of interest include how child-led and teacher-led pedagogies differ in outdoor learning settings, and the impact of each approach on children’s well-being, behavior, relationships with others as well as educational outcomes. The review will include links to possibilities for future research, including a Ph.D. currently being undertaken in Australia, which aims to fulfill a considerable gap in psychological, educational and outdoor learning research, regarding how natural environments are being used by teachers to improve learning and wellbeing among primary school students. The proposed study aims to understand if children’s experience of learning, 1. in a natural environment, and 2. in a child-led way, can support and strengthen their skills across several areas of development, including those required for positive educational outcomes. Data will be collected from a sample of primary school students and teachers via both quantitative and qualitative methods, including a pre- and post-questionnaire, direct observation, and semi-structured interviews. The study will have valuable implications for the provision of quality education as well as the promotion of good health and wellbeing. The implications of the research will be useful not only for teachers and parents but also for Psychologists working with children and young people in both a school and clinical setting. Understanding the impacts and implications of child-led learning and exposure to natural environments provides the opportunity to build on the current school curriculum. The inclusion of child-led experiences in nature may provide a simple way to build enthusiasm for school and learning, cultivating skills for life and relationships as well as meeting current curriculum requirements and building capacity for ongoing academic pursuits. In addition, understanding the impact of learning in a natural environment on wellbeing will assist in the development and dissemination of an educational model that could help mitigate the negative health outcomes associated with reduced physical activity and decreasing contact with nature among children.

Keywords: child-led learning, educational outcomes, natural environments, wellbeing

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Authors: Majed Ahmed Alfayad

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Technology is now present in almost all areas and practices globally, and this has led governments around the world to adopt technology in the public sector. Therefore, electronic government has been introduced as a means of the automation of government services. New technologies and trends appear every single day, and governments need to meet the citizen’s requirements and expectations in order to succeed in the E-Government program. This research investigates the potential of mobile government as an enhancement force for the E-Government project in the Kingdom of Saudi Arabia, where the usage of mobile technology is coming to be favoured by citizens. Qualitative methodology has been adopted in this study for the data collection and analysis, and in particular the grounded theory approach.

Keywords: e-government, e-participation, m-government, mobile technology

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Authors: Stephen Grant Atkins

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Radical use of project-based learning (PBL) in a small New Zealand business school provides an opportunity to longitudinally examine its effects over a decade of pre-Covid data. Prior to this business school’s implementation of PBL, starting in 2012, the business pedagogy literature presented just one example of PBL replacing an entire core-set of courses. In that instance, a British business school merged four of its ‘degree Year 3’ accounting courses into one PBL semester. As radical as that would have seemed, to students aged 20-to-22, the PBL experiment conducted in a New Zealand business school was notably more extreme: 41 nationally-approved Learning Outcomes (L.O.s), these deriving from 8 separate core courses, were aggregated into one grand set of L.O.s, and then treated as a ‘full-year’/‘full-time’ single course. The 8 courses in question were all components of this business school’s compulsory ‘degree Year 1’ curriculum. Thus, the students involved were notably younger (…ages 17-to-19…), and no ‘part-time’ enrolments were allowed. Of interest are this PBL experiment’s effects on subsequent performance outcomes in ‘degree Years 2 & 3’ (….which continued to operate in their traditional ways). Of special interest is the quality of ‘group project’ outcomes. This is because traditionally, ‘degree Year 1’ course assessments are only minimally based on group work. This PBL experiment altered that practice radically, such that PBL ‘degree Year 1’ alumni entered their remaining two years of business coursework with far more ‘project group’ experience. Timeline-wise, thus of interest here, firstly, is ‘degree Year 2’ performance outcomes data from years 2010-2012 + 2016-2018, and likewise ‘degree Year 3’ data for years 2011-2013 + 2017-2019. Those years provide a pre-&-post comparative baseline for performance outcomes in students never exposed to this school’s radical PBL experiment. That baseline is then compared to PBL alumni outcomes (2013-2016….including’Student Evaluation of Course Quality’ outcomes…) to clarify ‘radical PBL’ effects.

Keywords: project-based learning, longitudinal mixed-methods, students criticism, effects-on-learning

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Authors: Jaime E. Fernandez, Pablo J. Valverde

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This paper presents a methodological approach that aims to contrast/validate theoretical results from a corruption network game through probabilistic analysis of simulated microdata using Bayesian Networks (BNs). The research develops a public corruption model in a game theory framework. Theoretical results suggest a series of 'optimal settings' of model's exogenous parameters that boost the emergence of corruption. The paper contrasts these outcomes with probabilistic inference results based on BNs adjusted over simulated microdata. Principal findings indicate that probabilistic reasoning based on BNs significantly improves parameter specification and causal analysis in a public corruption game.

Keywords: Bayesian networks, probabilistic reasoning, public corruption, theoretical games

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Authors: I. Inthanongsone, C. Drebenstedt, J. C. Bongaerts, P. Sontamino

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The major concern in evaluating the value of mining projects related to the deficiency of the traditional discounted cash flow (DCF) method. This method does not take uncertainties into account and, hence it does not allow for an economic assessment of managerial flexibility and operational adaptability, which are increasingly determining long-term corporate success. Such an assessment can be performed with the real options valuation (ROV) approach, since it allows for a comparative evaluation of unforeseen uncertainties in a project life cycle. This paper presents an economic evaluation model for open pit mining projects based on real options valuation approach. Uncertainties in the model are caused by metal prices and cost uncertainties and the system dynamics (SD) modeling method is used to structure and solve the real options model. The model is applied to a case study. It can be shown that that managerial flexibility reacting to uncertainties may create additional value to a mining project in comparison to the outcomes of a DCF method. One important insight for management dealing with uncertainty is seen in choosing the optimal time to exercise strategic options.

Keywords: DCF methods, ROV approach, system dynamics modeling methods, uncertainty

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Authors: Angel Champion, Sadia Kanwal, Rafat Siddiqui

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Harnessing phytochemicals from plant sources presents a novel opportunity to prevent or treat malignant diseases, including breast cancer. Chemotherapy lacks precision in targeting cancerous cells while sparing normal cells, but a phytopharmaceutical approach may offer a solution. Dandelion, a common weed plant, is rich in phytochemicals and provides a safer, more cost-effective alternative with lower toxicity than traditional pharmaceuticals for conditions such as breast cancer. In this study, an in-vitro experiment will be conducted using the ethanol extract of Dandelion on triple-negative MDA-231 breast cancer cell lines. The polyphenolic analysis revealed that the Dandelion extract, particularly from the root and leaf (both cut and sifted), had the most potent antioxidant properties and exhibited the most potent antioxidation activity from the powdered leaf extract. The extract exhibits prospective promising effects for inducing cell proliferation and apoptosis in breast cancer cells, highlighting its potential for targeted therapeutic interventions. Standardizing methods for Dandelion use is crucial for future clinical applications in cancer treatment. Combining plant-derived compounds with cancer nanotechnology holds the potential for effective strategies in battling malignant diseases. Utilizing liposomes as carriers for phytoconstituent anti-cancer agents offers improved solubility, bioavailability, immunoregulatory effects, advancing anticancer immune function, and reducing toxicity. This integrated approach of natural products and nanotechnology has significant potential to revolutionize healthcare globally, especially in underserved communities where herbal medicine is prevalent.

Keywords: apoptosis, antioxidant activity, cancer nanotechnology, phytopharmaceutical

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Authors: Abdul Hafeez, Samiya Shehzadi

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This research paper presents a different approach towards eco-friendly textile design by developing a sustainable composite fabric from orange peel for ladies' undergarments. The research focuses on utilizing orange peel to develop a unique orange leather/composite (fabric) through a process involving heating, extracting, and subsequent sun-drying to obtain the composite. The sustainable composite fabric shows properties that are favorable to the development of environmentally friendly undergarments, which not only offer UV protection but also possess healing properties for the skin. Through comprehensive testing and analysis, it has been determined that the orange peel composite fabric has zero harmful effects on the skin, making it a safe and desirable material for intimate wear. Furthermore, the research suggests that the orange peel composite fabric has the potential to reduce the rate of cancer cell growth. While the exact mechanisms and factors contributing to this effect require further investigation, the initial findings indicate promising aspects of the fabric in terms of potential cancer-preventive properties. Research contribution to the field of sustainable textile design by introducing a usual and eco-friendly approach utilizing orange peel waste. This work opens up avenues for further exploration and development of innovative materials that are both sustainable and beneficial for human health.

Keywords: sustainability, composite textiles, extracting, undergarments, eco-friendly, orange peels

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Authors: Cecilia Moreira, Rita Paiva, Daniela Macedo, Leonor Ribeiro, Isabel Fernandes, Luis Costa

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Background: Head and neck paragangliomas are a rare group of tumors with a large spectrum of clinical manifestations. The approach to evaluate and treat these lesions has evolved over the last years. Surgery was the standard for the approach of these patients, but nowadays new techniques of imaging and radiation therapy changed that paradigm. Despite advances in treating, the growth potential and clinical outcome of individual cases remain largely unpredictable. Objectives: Characterization of our institutional experience with clinical management of these tumors. Methods: This was a cross-sectional study of patients followed in our institution between 01 January and 31 December 2017 with paragangliomas of the head and neck and cranial base. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic workup, treatment modality, tumor control and recurrence, complications of treatment and hereditary status were collected and summarized. Results: A total of four female patients were followed between 01 January and 31 December 2017 in our institution. The mean age of our cohort was 53 (± 16.1) years. The primary locations were at the level of the tympanic jug (n=2, 50%) and carotid body (n=2, 50%), and only one of the tumors of the carotid body presented pulmonary metastasis at the time of diagnosis. None of the lesions were catecholamine-secreting. Two patients underwent genetic testing, with no mutations identified. The initial clinical presentation was variable highlighting the decrease of visual acuity and headache as symptoms present in all patients. In one of the cases, loss of all teeth of the lower jaw was the presenting symptomatology. Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were employed as treatment approaches according to anatomical location and resectability of lesions. As post-therapeutic sequels the persistence of tinnitus and disabling pain stands out, presenting one of the patients neuralgia of the glossopharyngeal. Currently, all patients are under regular surveillance with a median follow up of 10 months. Conclusion: Ultimately, clinical management of these tumors remains challenging owing to heterogeneity in clinical presentation, the existence of multiple treatment alternatives, and potential to cause serious detriment to critical functions and consequently interference with the quality of life of the patients.

Keywords: clinical outcomes, head and neck, management, paragangliomas

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Authors: Chijindu Okpalaoka, Charles Chinedu Onuselogu

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COVID-19, humanity's coronavirus disease caused by SARS-CoV-2, was first detected in late 2019 in Wuhan, China. COVID-19 lacked an established conventional pharmaceutical therapy, and as a result, the outbreak quickly became an epidemic affecting the entire World. Only a qPCR assay is reliable for diagnosing COVID-19. Clustered, regularly interspaced short palindromic repeats (CRISPR) technology is being researched for speedy and specific identification of COVID-19, among other therapeutic techniques. Apart from its therapeutic capabilities, the CRISPR technique is being evaluated to develop antiviral therapies; nevertheless, no CRISPR-based medication has been approved for human use to date. Prophylactic antiviral CRISPR in living being cells, a Cas 13-based approach against coronavirus, has been developed. While this method can be evolved into a treatment approach, it may face substantial obstacles in human clinical trials for licensure. This study discussed the potential applications of CRISPR-based techniques for developing a speedy and accurate feasible treatment alternative for the COVID-19 virus.

Keywords: COVID-19, CRISPR technique, Cas13, SARS-CoV-2, prophylactic antiviral

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Authors: Mingming Jiang

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This literature review aims to offer an overview of existing research on learning analytics and learning design, the alignment between the two, and how learning analytics has been leveraged to inform learning design in higher education. Current research suggests a need to create more alignment and integration between learning analytics and learning design in order to not only ground learning analytics on learning sciences but also enable data-driven decisions in learning design to improve learning outcomes. In addition, multiple conceptual frameworks have been proposed to enhance the synergy and alignment between learning analytics and learning design. Future research should explore this synergy further in the unique context of higher education, identifying learning analytics metrics in higher education that can offer insight into learning processes, evaluating the effect of learning analytics outcomes on learning design decision-making in higher education, and designing learning environments in higher education that make the capturing and deployment of learning analytics outcomes more efficient.

Keywords: learning analytics, learning design, big data in higher education, online learning environments

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Authors: Sharon Millen, Sarah Miller, Laura Dunne, Clare McGeady, Laura Neeson

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This paper presents the findings from a randomised controlled trial (RCT) and process evaluation of the Lifestart parenting programme. Lifestart is a structured child-centred programme of information and practical activity for parents of children aged from birth to five years of age. It is delivered to parents in their own homes by trained, paid family visitors and it is offered to parents regardless of their social, economic or other circumstances. The RCT evaluated the effectiveness of the programme and the process evaluation documented programme delivery and included a qualitative exploration of parent and child outcomes. 424 parents and children participated in the RCT: 216 in the intervention group and 208 in the control group across the island of Ireland. Parent outcomes included: parental knowledge of child development, parental efficacy, stress, social support, parenting skills and embeddedness in the community. Child outcomes included cognitive, language and motor development and social-emotional and behavioural development. Both groups were tested at baseline (when children were less than 1 year old), mid-point (aged 3) and at post-test (aged 5). Data were collected during a home visit, which took two hours. The process evaluation consisted of interviews with parents (n=16 at baseline and end-point), and focus groups with Lifestart Coordinators (n=9) and Family Visitors (n=24). Quantitative findings from the RCT indicated that, compared to the control group, parents who received the Lifestart programme reported reduced parenting-related stress, increased knowledge of their child’s development, and improved confidence in their parenting role. These changes were statistically significant and consistent with the hypothesised pathway of change depicted in the logic model. There was no evidence of any change in parents’ embeddedness in the community. Although four of the five child outcomes showed small positive change for children who took part in the programme, these were not statistically significant and there is no evidence that the programme improves child cognitive and non-cognitive skills by immediate post-test. The qualitative process evaluation highlighted important challenges related to conducting trials of this magnitude and design in the general population. Parents reported that a key incentive to take part in study was receiving feedback from the developmental assessment, which formed part of the data collection. This highlights the potential importance of appropriate incentives in relation to recruitment and retention of participants. The interviews with intervention parents indicated that one of the first changes they experienced as a result of the Lifestart programme was increased knowledge and confidence in their parenting ability. The outcomes and pathways perceived by parents and described in the interviews are also consistent with the findings of the RCT and the theory of change underpinning the programme. This hypothesises that improvement in parental outcomes, arising as a consequence of the programme, mediate the change in child outcomes. Parents receiving the Lifestart programme reported great satisfaction with and commitment to the programme, with the role of the Family Visitor being identified as one of the key components of the programme.

Keywords: parent-child relationship, parental self-efficacy, parental stress, school readiness

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Authors: Lubica Hikkerova, Jean-Michel Sahut

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This article aims to better understand how a natural park, with a touristic vocation, can benefit from its sustainable development approach to enhance the customer experience. For this aim, we analyze, on the one hand, the interactions between the different stakeholders in this sustainable tourism offer, their ways of cooperating to build this offer and, on the other hand, the perceptions of customers. To serve this purpose, two complementary qualitative methodologies have been conducted. As part of a systemic approach, a first study, through group discussions, was conducted with three categories of participants: (I) customers, (II) representatives of the park, communities, tourism offices and associations and 3-service providers in the park. For the second study, semi-directive interviews were realized with park managers and customers. Two levels of contributions have been found. First, we have demonstrated the value of a systemic approach to understanding sustainable tourism. Then, we developed, in the empirical part, a model of causal loops that allowed us to identify the various factors of the offer that decided potential tourists to visit the park and their impact on customer experience. The complementarity of this approach with semi-directive interviews with all the stakeholders enabled us to issue recommendations to improve the customer experience.

Keywords: sustainable tourism, systematic approach, price, park

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Authors: Hong Zeng

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In the process of popularization of higher education, it is necessary to innovate teaching methods in order to make the students cultivated suitable for the needs of social development. This paper discusses the limitations and shortcomings of the traditional teaching method of teaching approach to a person's aptitude, personality, and interest and introduces the new teaching method of teaching approach to a person's personality. The teaching approach to a person's personality is a target teaching method that aims to develop students' potential and cultivate professional talents. Therefore, teachers should be professional and can adopt modern teaching methods from the Internet so that students can clearly understand the course and the knowledge structure. Finally, the students using new teaching methods can enhance their motivation to study and quickly acquire professional skills.

Keywords: higher education, personality, target education, student-centered

Procedia PDF Downloads 83

Authors: Thanom Kaeniam

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ST-Elevation Myocardial Infarction (STEMI) is a state of sudden death of the heart muscle due to sudden blockage of the artery. STEMI patients are usually in critical condition and with a potential opportunity for sudden death. Therefore, management guidelines for safety in caring and referring STEMI patients are needed. The objective of this developmental research was to assess the effectiveness of using the guidelines for caring and referring STEMI patients at the Accident and Emergency Department of Songkhla Hospital. The subjects of the study were 22 nurses in the emergency room, and doctors on duty in the accident and emergency room selected using purposive sampling with inclusion criteria. The research instruments were the guidelines for caring and referring STEMI patients, and record forms for the effectiveness of using the guidelines for caring and referring STEMI patients (a general record form for STEMI patients, a record form for SK administering, a referring record form for PCI, and a record form for dead patient in the accident and emergency room and during referring). The instruments were tested for content validity by three experts, and the reliability was tested using Kuder-Richardson 20 (KR20). The descriptive statistic employed was the percentage. The outcomes of using the guidelines for caring and referring ST Elevation Myocardial Infarction (STEMI) Patients at the Accident and Emergency Department revealed that before using the guidelines in 2009, 2010, and 2011, there were 84, 73, and 138 STEMI patients receiving services at the accident and emergency room, of which, only 9, 32, and 48 patients were referred for PCI/SK medications, or 10.74; 43.84; and 34.78 percent, and the death rates were 10.71; 10.95; and 11.59 percent, respectively. However, after the use of the guidelines in 2012, 2013, and 2014, there were 97, 77, and 57 patients, of which, the increases to 77, 72, and 55 patients were referred for PCI /SK medications or 79.37; 93.51; and 96.49 percent, and the death rates were reduced to 10.30; 6.49; and 1.76 percent, respectively. The results of the study revealed that the use of the guidelines for caring and referring STEMI patients at the Accident and Emergency Department increased the effectiveness and quality of nursing, especially in terms of SK medication, caring and referring patients for PCI to reduce the death rate.

Keywords: outcomes, guidelines for caring, referring, myocardial infarction, STEMI

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Authors: Andrey Boyko

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Nowadays, there is no consensus about the influence of urethral plate (UP) width on the surgical outcomes after distal hypospadias repair. The purpose of the research was to study the association between UP width and surgical outcomes after distal hypospadias repair in children. Materials and methods: The study included 138 patients with distal hypospadias. The mean age at the time of surgery was 4.6 years (6 months – 16 years). We measured UP width at the “midpoint within the glans” and used the HOSE scale to assess postoperative outcomes. The patients were divided into 2 groups: group 1 – the patients (107) with UP < 8mm, group 2 – patients (31) with UP > 8mm. All boys underwent TIP repair. Preincision means UP width after incision means UP width, and the UP ratio was analyzed. Statistical data were obtained using Statistica 10. Results: The findings were preincision mean UP width - 5.4 mm and 9.4 mm; after incision mean UP width - 13mm and 17.5 mm; UP ratio - 0.41 and 0.53 in group 1 and group 2, respectively. Most postoperative complications (fistula, meatal stenosis, and stricture) happened in patients with UP width < 8 mm versus ≥ 8 mm (7/107 versus 2/31, respectively). HOSE results were 15.77 (group 1), 15.65 (group 2). The follow up lasted up to 12 months. Statistical analysis proved the absence of correlation between UP width and postoperative complications. Conclusions: In conclusion, it should be noted that the success of surgical repair mostly depended on the surgical technique.

Keywords: children, distal hypospadias, tip repair, urethral plate width

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Authors: Rammah Abdlbagi, Similoluwa Biyi, Aakash Pai

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Introduction: Short-term ureteric stents are commonly placed after ureteroscopy procedures. The removal usually entails having a flexible cystoscopy, which entails a further invasive procedure. There are often delays in removing the stent as departments have limited cystoscopy availability. However, if stents with extraction strings are used, the patient or a clinician can remove them. The aim of the study is to assess the safety and effectiveness of the use of a stent with a string. Method: A retrospective, single-institution study was conducted over a three-month period. Twenty consecutive patients had ureteric stents with string insertion. Ten of the patients had a stent removal procedure previously with flexible cystoscopy. A validated questionnaire was used to assess outcomes. Primary outcomes included: dysuria, hematuria, urinary frequency, and disturbance of the patient’s daily activities. Secondary outcomes included pain experience during the stent removal. Result: Fifteen patients (75%) experienced hematuria and frequency. Two patients experienced pain and discomfort during the stent removal (10%). Two patients had experienced a disturbance in their daily activity (10%). All patients who had stent removal before using flexible cystoscopy preferred the removal of the stent using a string. None of the patients had stent displacement. The median stent dwell time was five days. Conclusion: Patient reported outcomes measures for the indwelling period of a stent with extraction string are equivalent to the published data on stents. Extraction strings mean that the stent dwell time can be reduced. The removal of the stent on extraction strings is more tolerable than the conventional stent.

Keywords: ureteric stent, string flexible cystoscopy, stent symptoms, validated questionnaire

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Authors: Risikat Oladoyin S. Dauda, Onyebuchi Iwegbu

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This study investigates the response of human development outcomes to selected macroeconomic indicators in Nigeria. Human development outcomes is measured by human development index while the selected macroeconomic variables are inflation rate, real interest rate, government capital expenditure, real exchange rate, current account balance, and savings. Structural Vector Autoregression (SVAR) technique is employed in examining the response of human development index to the macroeconomic shocks. The result from the forecast error variance decomposition and Impulse-Response analysis reveals that fiscal policy (government capital expenditure) shock is the greatest determinant of human development outcomes. This result reiterates the role which the government plays in improving the welfare of the citizenry. The fiscal policy tool is pivotal in human development which comes in the form of investment in education, health, housing, and infrastructure. Further conclusion drawn from this study is that human development outcome positively and significantly responds to shocks from real interest rate, a monetary policy transmission variable and is felt greatly in the short run period. The policy implication of this study is that if capital budget implementation falls below expectations, human development will be engendered. Hence, efforts should be made to ensure that full implementation and appraisal of government capital expenditure is taken sacrosanct as any shock from such plan, engenders human development outcome.

Keywords: human development outcome, macroeconomic outcomes, structural vector autoregression, SVAR

Procedia PDF Downloads 132

Authors: Samira Ali

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Aim: The purpose of this study was to describe nurses’ potential use of power levels to influence the standardization of nursing terminology (SNT) in electronic health records. Also, to examine the relationship between nurses’ use of power levels and variables such as position, communication and the potential goal of achieving SNT in electronic health records. Background: In an era of evidence-based nursing care, with an emphasis on nursing’s ability to measure the care rendered and improve outcomes of care, little is known about the nurse’s potential use of their power to SNT in electronic health records and lack of use of an SNT in electronic health records. Method: This descriptive, correlational, and cross-sectional study was conducted using survey methodology to assess the nurse’s use of power to influence the SNT in electronic health records. The Theory of Group Power within Organizations (TGPO) provided the conceptual framework for this study. A total of (n=232) nurses responded to the survey, posted on three nursing organizations’ websites. Results revealed the mean Cronbach’s alpha of the subscales was .94, suggesting high internal consistency. The mean power capability score was moderately high, at 134.22 (SD = 18.49). Power Capacity was significantly correlated with Power Capability (r = .96, p < .001). Power Capacity subscales were significantly correlated with Power Capacity and Power Capability. Conclusion: The mean Cronbach’s alpha of the subscales was .94 suggestive of reliability of the instrument. Nurses could potentially use power to achieve their goals, such as the implementation of SNT in electronic health records.

Keywords: nurses, power, actualized power, nursing terminology, electronic health records

Procedia PDF Downloads 217