Search results for: procedural Law

Authors: V. Durmus, M. Uydaci

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In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.

Keywords: malpractice mediation, medical disputes, reconciliation, health litigation, Turkish health law

Procedia PDF Downloads 284

Authors: Pramote Thangkratok

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The aims of this experimental study were to investigate the effect of Reverse Trendelenburg Position on the Back Pain after Cardiovascular Angiography and Interventions. In addition, to compare bleeding and hematoma occurrences at the Access site between experimental and control groups. The randomized controlled trial (RCT) was conducted in 70 patients who underwent Cardiovascular Angiography and Interventions via the femoral artery and received post procedural care at the intermediate cardiac care unit, Bangkok Heart Hospital. From December 2015 to February 2016. The control group (35 patients) was to get standard care after the intervention, whereas the experimental group (35 patients) was Reverse Trendelenburg Position 30-45 degrees. The groups were not significantly different in terms of demographic characteristics, Age, Gender, BMI, blood pressure, heart rate. While not significantly different from each other, the intensity of back pain control group had a significantly higher pain score than experimental group. Vascular complications in terms of bleeding and hematoma were not significantly different between the control and experimental groups. The findings show that Reverse Trendelenburg Position after Cardiovascular Angiography and Interventions would reduce or prevent the back pain without increasing the chance of bleeding and hematoma.

Keywords: reverse trendelenburg position, back pain, cardiovascular angiography, cardiovascular interventions

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Authors: Sumeyra Karatas, Veysel Karatas, Reyhan Safak, Gamze Bulut-Ozturk, Ozgul Kartal

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Productive struggle entails a student's cognitive exertion to comprehend mathematical concepts and uncover solutions not immediately apparent. The significance of productive struggle in learning mathematics is accentuated by influential educational theorists, emphasizing its necessity for learning mathematics with understanding. Consequently, supporting productive struggle in learning mathematics is recognized as a high-leverage and effective mathematics teaching practice. In this study, the investigation into the role of productive struggle in learning mathematics led to the development of a comprehensive rubric for productive struggle pedagogy through an exhaustive literature review. The rubric consists of eight primary criteria and 37 sub-criteria, providing a detailed description of teacher actions and pedagogical choices that foster students' productive struggles. These criteria encompass various pedagogical aspects, including task design, tool implementation, allowing time for struggle, posing questions, scaffolding, handling mistakes, acknowledging efforts, and facilitating discussion/feedback. Utilizing this rubric, a team of researchers and teachers designed eight 90-minute lesson plans, employing a productive struggle pedagogy, for a two-week unit on solving systems of linear equations. Simultaneously, another set of eight lesson plans on the same topic, featuring identical content and problems but employing a traditional lecture-and-practice model, was designed by the same team. The objective was to assess the impact of supporting productive struggle on students' mathematics learning, defined by the strands of mathematical proficiency. This quasi-experimental study compares the control group, which received traditional lecture- and practice instruction, with the treatment group, which experienced a productive struggle in pedagogy. Sixty-six 10th and 11th-grade students from two algebra classes, taught by the same teacher at a high school, underwent either the productive struggle pedagogy or lecture-and-practice approach over two-week eight 90-minute class sessions. To measure students' learning, an assessment was created and validated by a team of researchers and teachers. It comprised seven open-response problems assessing the strands of mathematical proficiency: procedural and conceptual understanding, strategic competence, and adaptive reasoning on the topic. The test was administered at the beginning and end of the two weeks as pre-and post-test. Students' solutions underwent scoring using an established rubric, subjected to expert validation and an inter-rater reliability process involving multiple criteria for each problem based on their steps and procedures. An analysis of covariance (ANCOVA) was conducted to examine the differences between the control group, which received traditional pedagogy, and the treatment group, exposed to the productive struggle pedagogy, on the post-test scores while controlling for the pre-test. The results indicated a significant effect of treatment on post-test scores for procedural understanding (F(2, 63) = 10.47, p < .001), strategic competence (F(2, 63) = 9.92, p < .001), adaptive reasoning (F(2, 63) = 10.69, p < .001), and conceptual understanding (F(2, 63) = 10.06, p < .001), controlling for pre-test scores. This demonstrates the positive impact of supporting productive struggle in learning mathematics. In conclusion, the results revealed the significance of the role of productive struggle in learning mathematics. The study further explored the practical application of productive struggle through the development of a comprehensive rubric describing the pedagogy of supporting productive struggle.

Keywords: effective mathematics teaching practice, high school algebra, learning mathematics, productive struggle

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Authors: Stephen J Futter, Michael I Okereke

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This paper presents an investigation of the premature in-service failure of the engine mounting towers that form part of the bedframe commonly used for industrial power generation applications. The client during a routine in-service assessment of the generator set observed that the engine mounting towers had cracked. Thus, this study has investigated in detail the origin of the crack and proffered solutions to prevent a re-occurrence. Seven step problem solving methodology was followed during this paper. The study used both experimental and numerical approaches to understand, monitor and evaluate the cause and evolution of the premature failure. Findings from this study indicated that the failure resulted from a combination of varied processes from procurement of material parts, material selection, welding processes and inaptly designed load-bearing mechanics of the generating set and its mounting arrangement. These in-field observations and experimental simulations provided insights to design and validate a numerical finite element sub-model of the cracked bedframe considering thermal cycling: designed as part of these investigations. Resulting findings led to a recommendation of several procedural changes that should be adopted by the manufacturer, in order to prevent the re-occurrence of such pre-mature failure in future industrial applications.

Keywords: Engine, Premature Failure, Failure Analysis, Finite Element Model

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Authors: Mohammad Javad Behzadnia, Hamidreza Javadzadeh

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Background: Pain management is essential to surmounting multi-injured people in an overcrowded emergency setting. Its role would be more apparent when the physician encounters a mass casualty in a war zone or even a military prehospital. Having sedative and analgesic properties, rapid onset and offset effects, and maintaining the cardiovascular and respiratory contain are the main reason for selecting Ketamine as a good choice in the war zone. Methods: In a prospective interventional study in a war zone, we have selected and followed two groups of casualties for pain management. All were men with an average age of 26.6±8 y/o and 27.5 ±7 y/o in A and B groups, respectively. Group A received only Ketamine and Group B received Ketamine and diazepam. Results: This study showed that all of the injured patients who received Ketamine had experienced some agitation, and they may finally need benzodiazepines for sedation, but in group B that received benzodiazepine before or simultaneous with Ketamine, the agitation was significantly reduced. (P Value ≤0.05) Conclusion: Various factors may affect pain score and perception; patients' culture, mental health, previous drug usage, and addiction could alter the pain score in similar situations. It seems that the significant agitation is due to catecholamine release in stressful Moments of the battlefield. Accordingly, this situation could be exacerbated due to ketamine properties. Nonetheless, as a good choice in the war zone, Ketamine is now recommended to combine with benzodiazepines for procedural sedation and analgesia (PSA).

Keywords: battlefield, ketamine, benzodiazepine, pain control

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Authors: Rashmi Malik, Videep Mishra

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The practice of generative design has become a transformative approach for an efficient way of generating multiple iterations for any design project. The conventional way of modeling the game elements is very time-consuming and requires skilled artists to design. A 3D modeling tool like 3D S Max, Blender, etc., is used traditionally to create the game library, which will take its stipulated time to model. The study is focused on using the generative design tool to increase the efficiency in game development at the stage of prop and environment generation. This will involve procedural level and customized regulated or randomized assets generation. The paper will present the system design approach using generative tools like Grasshopper (visual scripting) and other scripting tools to automate the process of game library modeling. The script will enable the generation of multiple products from the single script, thus creating a system that lets designers /artists customize props and environments. The main goal is to measure the efficacy of the automated system generated to create a wide variety of game elements, further reducing the need for manual content creation and integrating it into the workflow of AAA and Indie Games.

Keywords: iterative game design, generative design, gaming asset automation, generative game design

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Authors: Funmilayo Abiola Opadoja, Samuel Olukayode Awotona

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Nursing services costing has been a major interest to nurses for a long period of time. Determination of nursing costing is germane in order to show the effectiveness of nursing practice in an improved and affordable health care delivery system. This has been a major concern of managers that have the mind of quality and affordable health services. The treatment or intervention should be considered as ‘product’ of nursing care and should provide an explainable term for billing. The study was non-experimental, descriptive and went about eliciting the views of nurses on costing nursing care at two public hospitals namely: University College Hospital and Adeoyo Maternity Teaching Hospital. The questionnaire was the instrument used in eliciting nurse’s response. It was administered randomly on 300 selected respondents across various wards within the hospitals. The data was collected and analysed using SPSS20.0 to generate frequency, and cross-tabulations to explore the statistical relationship between variables. The result shows that 89.2% of the respondents viewed costing of nursing care as an important issued to be looked into. The study concluded that nursing care costing is germane to enhancing the status and imagery of the nurses, it is essential because it would enhance the performance of nurses in discharging their duties. There is need to have a procedural manual agreed on by nursing practitioner on costing of each care given.

Keywords: costing, health care delivery system, intervention, nursing care, practitioner

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Authors: W. J. Strydom, K. Puren

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Place-making is viewed here as an empowering process in which people represent, improve and maintain their spatial (natural or built) environment. With the above-mentioned in mind, place-making is multi-dimensional and include a spatial dimension (including visual properties or the end product/plan), a procedural dimension during which (negotiation/discussion of ideas with all relevant stakeholders in terms of end product/plan) and a psychological dimension (inclusion of intrinsic values and meanings related to a place in the end product/plan). These three represent dimensions of place-making. The purpose of this paper is to explore these dimensions of place-making in a case study of a local community in Ikageng, Potchefstroom, North-West Province, South Africa. This case study represents an inclusive process that strives to empower a local community (forcefully relocated due to Apartheid legislation in South Africa). This case study focussed on the inclusion of participants in the decision-making process regarding their daily environment. By means of focus group discussions and a collaborative design workshop, data is generated and ultimately creates a linkage with the theoretical dimensions of place-making. This paper contributes to the field of spatial planning due to the exploration of the dimensions of place-making and the relevancy of this process on spatial planning (especially in a South African setting).

Keywords: community engagement, place-making, planning theory, spatial planning

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Authors: Chin Ku, Han liang Lin

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The purpose of this study is to visualize how the rule related to urban design influences the building form by 3D modeling software CityEngine. In order to make the goal of urban design clearly connect to urban form, urban planner or designer should understand how the rule affects the form, especially the building form. In Taiwan, the rule pertained to urban design includes traditional zoning, urban design review and building codes. However, zoning cannot precisely expect the outcome of building form and lack of thinking about public realm and 3D form. In addition to that, urban design review is based on case by case, do not have a comprehensive regulation plan and the building code is just for general regulation. Therefore, rule cannot make the urban form reach the vision or goal of the urban design. Consequently, another kind of zoning called Form-based code (FBC) has arisen. This study uses the component of FBC which pertained to urban fabric such as street width, block and plot size, etc., to be the variants of building form, and find out the relationship between the rule and building form. There are three stages of this research, it will start from a field survey of Taichung City in Taiwan to induce the rule-building form relationship by using cluster analysis and descriptive Statistics. Second, visualize the relationship through the parameterized and codified process in CityEngine which is the procedural modeling, and can analyze, monitor and visualize the 3D world. Last, compare the CityEngine result with real world to examine how extent do this model represent the real world appearance.

Keywords: 3D visualization, CityEngine, form-based code, urban form

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Authors: Rezvan Ravanfar Haghighi, S. Chatterjee, Pratik Kumar, V. C. Vani, Priya Jagia, Sanjiv Sharma, Susama Rani Mandal, R. Lakshmy

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The dual energy computed tomography (DECT) aims at noting the HU(V) values for the sample at two different voltages V=V1, V2 and thus obtain the electron densities (ρe) and effective atomic number (Zeff) of the substance. In the present paper, we aim to obtain a numerical algorithm by which (ρe, Zeff) can be obtained from the HU(100) and HU(140) data, where V=100, 140 kVp. The idea is to use this inversion method to characterize and distinguish between the lipid and fibrous coronary artery plaques.With the idea to develop the inversion algorithm for low Zeff materials, as is the case with non calcified coronary artery plaque, we prepare aqueous samples whose calculated values of (ρe, Zeff) lie in the range (2.65×1023≤ ρe≤ 3.64×1023 per cc ) and (6.80≤ Zeff ≤ 8.90). We fill the phantom with these known samples and experimentally determine HU(100) and HU(140) for the same pixels. Knowing that the HU(V) values are related to the attenuation coefficient of the system, we present an algorithm by which the (ρe, Zeff) is calibrated with respect to (HU(100), HU(140)). The calibration is done with a known set of 20 samples; its accuracy is checked with a different set of 23 known samples. We find that the calibration gives the ρe with an accuracy of ± 4% while Zeff is found within ±1% of the actual value, the confidence being 95%.In this inversion method (ρe, Zeff) of the scanned sample can be found by eliminating the effects of the CT machine and also by ensuring that the determination of the two unknowns (ρe, Zeff) does not interfere with each other. It is found that this algorithm can be used for prediction of chemical characteristic (ρe, Zeff) of unknown scanned materials with 95% confidence level, by inversion of the DECT data.

Keywords: chemical composition, dual-energy computed tomography, inversion algorithm

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Authors: Shivaram P. Arunachalam, Mustafa Y. Sir, Andy Boggust, David M. Nestler, Thomas R. Hellmich, Kalyan S. Pasupathy

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Emergency departments (EDs) provide urgent care to patients throughout the day in a complex and chaotic environment. Real-time location systems (RTLS) are increasingly being utilized in healthcare settings, and have shown to improve safety, reduce cost, and increase patient satisfaction. Radio Frequency Identification Device (RFID) data in an ED has been shown to compute variables such as patient-provider contact time, which is associated with patient outcomes such as 30-day hospitalization. These variables can provide avenues for improving ED operational efficiency. A major challenge with ED financial operations is under-coding of critical care services due to physicians’ difficulty reporting accurate times for critical care provided under Current Procedural Terminology (CPT) codes 99291 and 99292. In this work, the authors propose a framework to optimize ED critical care billing using RFID data. RFID estimated physician-patient contact times could accurately quantify direct critical care services which will help model a data-driven approach for ED critical care billing. This paper will describe the framework and provide insights into opportunities to prevent under coding as well as over coding to avoid insurance audits. Future work will focus on data analytics to demonstrate the feasibility of the framework described.

Keywords: critical care billing, CPT codes, emergency department, RFID

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Authors: Sheikh Shams Azam, Manoj Raju, Venkatesh Pagidimarri, Vamsi Kasivajjala

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Over the past decade, there has been a steep rise in the data-driven analysis in major areas of medicine, such as clinical decision support system, survival analysis, patient similarity analysis, image analytics etc. Most of the data in the field are well-structured and available in numerical or categorical formats which can be used for experiments directly. But on the opposite end of the spectrum, there exists a wide expanse of data that is intractable for direct analysis owing to its unstructured nature which can be found in the form of discharge summaries, clinical notes, procedural notes which are in human written narrative format and neither have any relational model nor any standard grammatical structure. An important step in the utilization of these texts for such studies is to transform and process the data to retrieve structured information from the haystack of irrelevant data using information retrieval and data mining techniques. To address this problem, the authors present Q-Map in this paper, which is a simple yet robust system that can sift through massive datasets with unregulated formats to retrieve structured information aggressively and efficiently. It is backed by an effective mining technique which is based on a string matching algorithm that is indexed on curated knowledge sources, that is both fast and configurable. The authors also briefly examine its comparative performance with MetaMap, one of the most reputed tools for medical concepts retrieval and present the advantages the former displays over the latter.

Keywords: information retrieval, unified medical language system, syntax based analysis, natural language processing, medical informatics

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Authors: Rubaiyat Jahan

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This paper reports some findings of a study on the issues related to teacher autonomy in the Bangladeshi school contexts, and data of this research was collected from fourteen practicing English teachers of Bangladesh through semi structured interviews. The theoretical underpinning of teacher autonomy, on an apparent note, focuses on the behavioral aspects of teacher autonomy hence emphasizing mostly on the teachers’ capacity for self-directed acts of teaching and self-directed acts of professional development. Yet, a contemporary literature survey of teacher autonomy seems to be concerned more on the political interpretations of teacher autonomy. Thus, autonomous teachers are expected to generate their personal theories of teaching from their practices. The idea of personal theories of practice upholds the view that along with the teaching, teachers need to engage themselves in various classroom based research with a view to theorising from their practices. The findings of this research indicate enormous evidence of behavioral aspects of teacher autonomy. As the data of this research suggests, the participant teachers’ understanding of classroom situations, their reflections on the situational realities and opting for classroom decisions on the basis of those realizations are some good examples of teacher autonomy. Also, a few teachers’ stated teaching practices seem to reflect, though in a subtle way, their effort of outlining context embedded personal theories of teaching. This paper has got one significant pedagogical implication for the teacher education. Any teacher education must promote the conditions and capabilities for the present and prospective teachers for the role of theorisers in addition to develop their professional, procedural, and personal knowledge base.

Keywords: personal theories of practice, self-directed acts of professional development, self-directed acts of teaching, teacher autonomy

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Authors: Raneem Osama Salem, Ayesha Nuzhat, Fatimah Nasser Al Shehri, Nasser Al Hamdan

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Background: Recently, most medical schools around the globe are using simulation for teaching and assessing students’ clinical skills and competence. There are many obstacles that could face students and faculty when simulation sessions are introduced into undergraduate curriculum. Objective: The aim of this study is to obtain the opinion of undergraduate medical students and our faculty regarding the role of simulation in undergraduate curriculum, the simulation modalities used, and perceived barriers in implementing stimulation sessions. Methods: To address the role of simulation, modalities used, and perceived challenges to implementation of simulation sessions, a self-administered pilot tested questionnaire with 18 items using a 5 point Likert scale was distributed. Participants included undergraduate male medical students (n=125) and female students (n=70) as well as the faculty members (n=14). Result: Various learning outcomes are achieved and improved through the technology enhanced simulation sessions such as communication skills, diagnostic skills, procedural skills, self-confidence, and integration of basic and clinical sciences. The use of high fidelity simulators, simulated patients and task trainers was more desirable by our students and faculty for teaching and learning as well as an evaluation tool. According to most of the students,' institutional support in terms of resources, staff and duration of sessions was adequate. However, motivation to participate in the sessions and provision of adequate feedback by the staff was a constraint. Conclusion: The use of simulation laboratory is of great benefit to the students and a great teaching tool for the staff to ensure students learning of the various skills.

Keywords: simulators, medical students, skills, simulated patients, performance, challenges, skill laboratory

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Authors: Danzhao Cheng, Eugene Ch'ng

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Virtual Reality technologies can reconstruct cultural heritage objects and sites to a level of realism. Concentrating mostly on documenting authentic data and accurate representations of tangible contents, current virtual heritage is limited to accumulating visually presented objects. Such constructions, however, are fragmentary and may not convey the inherent significance of heritage in a meaningful way. In order to contextualise fragmentary historical contents where history can be told, a strategy is to create a guided narrative via role-playing. Such an approach can strengthen the logical connections of cultural elements and facilitate creative synthesis within the virtual world. This project successfully reconstructed the Ningbo Sanjiangkou VR site in Yuan Dynasty combining VR technology and role-play game approach. The results with 80 pairs of participants suggest that VR role-playing can be beneficial in a number of ways. Firstly, it creates thematic interactivity which encourages users to explore the virtual heritage in a more entertaining way with task-oriented goals. Secondly, the experience becomes highly engaging since users can interpret a historical context through the perspective of specific roles that exist in past societies. Thirdly, personalisation allows open-ended sequences of the expedition, reinforcing user’s acquisition of procedural knowledge relative to the cultural domain. To sum up, role-playing in VR poses great potential for experiential learning as it allows users to interpret a historical context in a more entertaining way.

Keywords: experiential learning, maritime silk road, role-playing, virtual heritage, virtual reality

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Authors: Tapiwa Shumba, Nyaradzo D. T. Karubwa

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Dispute resolution is the plinth of regional integration initiatives anchored on the rule of law and compliance with obligations. Without effective and reliable despite resolution mechanisms, it may be difficult to foster deeper integration. Within the Southern African Development Community (SADC) legal and institutional framework exists an apparent recognition that dispute resolution is an integral part of the regional integration. Almost all legal instruments of SADC include some provision for dispute resolution. Institutionally, the somewhat now defunct SADC Tribunal is meant to be the fulcrum for resolving disputes that arise under SADC instruments. However, after a closer analysis of the substance of these legal provisions and the attendant procedural mechanisms for addressing disputes, an argument can be made that dispute resolution in SADC is somewhat scant, fragmented and neglected. In most instruments, the common provision on dispute resolution appears to be a ‘mid-night clause’. In other instruments which have specialised provisions and procedures, questions of practicality and genius cannot be avoided. Worse still there now appears to be a lack of magnanimity between the substantive provisions in various instruments and the role of the transformed Tribunal. This scant, fragmented and neglected dispute resolution system may have an impact on the observance of the rule of law and compliance with obligations in the rules-based SADC system. This all, in turn, has an effect on the common agenda for deeper regional integration. This article seeks to expose this scant, fragmented and neglected SADC dispute resolution system and to propose a harmonised system that addresses these challenges. A ‘one stop shop’ system under a strengthened SADC tribunal is proposed as a responsive solution.

Keywords: regional integration, harmonisation, SADC tribunal, dispute resolution

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Authors: Dina Tareq Ismail, Alexandria A. Proff

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The United Arab Emirates (UAE) is a nation seeking to advance in all fields, particularly education. One area of focus for UAE 2021 agenda is to restructure UAE schools and universities by equipping them with highly developed technology. The agenda also advises educational institutions to prepare students with applicable and transferrable Information and Communication Technology (ICT) skills. Despite the emphasis on ICT and computer literacy skills, there exists limited empirical data on the use of M-Learning in the literature. This qualitative study explores the motivation of higher primary Arabic teachers in private schools toward implementing and integrating M-Learning apps in their classrooms. This research employs a phenomenological approach through the use of semistructured interviews with nine purposefully selected Arabic teachers. The data were analyzed using a content analysis via multiple stages of coding: open, axial, and thematic. Findings reveal three primary themes: (1) Arabic teachers with high levels of procedural knowledge in ICT are more motivated to implement M-Learning; (2) Arabic teachers' perceptions of self-efficacy influence their motivation toward implementation of M-Learning; (3) Arabic teachers implement M-Learning when they possess high utility and/or intrinsic value in these applications. These findings indicate a strong need for further training, equipping, and creating buy-in among Arabic teachers to enhance their ICT skills in implementing M-Learning. Further, given the limited availability of M-Learning apps designed for use in the Arabic language on the market, it is imperative that developers consider designing M-Learning tools that Arabic teachers, and Arabic-speaking students, can use and access more readily. This study contributes to closing the knowledge gap on teacher-motivation for implementing M-Learning in their classrooms in the UAE.

Keywords: ICT skills, m-learning, self-efficacy, teacher-motivation

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Authors: Sevgi Karaca

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Since December 6, 2018, mediation has become mandatory for commercial disputes under the Turkish Commercial Code. Mandatory mediation became one of the “causes of action”, and being compulsory means starting the mediation process before going to court. As it contemplates looking at “the causes of the action”, the terminology may lead to misinterpretation of the core of the phrases. However, the terms pertain to a prerequisite for starting the lawsuit. The court will examine failure to comply with such requirements, and the case will be dismissed without further action. Türkiye’s use of obligatory mediation is highly unusual. It is neither judge-led nor judge-assisted mediation but rather a mediation conducted outside of court with the participation of a third party (mediators). What distinguishes it is the incorporation of obligatory mediation into the causes of actions listed in the Code of Civil Procedure. Being one of the causes of action in a legal case implies that the absence of any of them may result in the procedural dismissal of the case without any further action. The case must be presented to the mediator first, and if the parties are unable to reach an agreement, they must deliver the results of the mediation session. Other than submitting the minutes, parties are ineligible to file a lawsuit. However, despite a lengthy history of use in England and Wales, there are considerable reservations about making mediation mandatory. The Civil Procedure Code does not explicitly mention making mediation mandatory. For the time being, there is no Mediation Code, and case law limits the growth of obligatory mediation. Some renowned judges voiced their desire to re-evaluate the notion of required mediation, prompting the Civil Justice Council to release a study in 2021 on the significance of amending case law and the high value of mandatory mediation. By contrasting the approaches to mandatory mediation in England and Wales, the study will investigate the method of controlled mandatory mediation and its effects on the success of mediation in Türkiye.

Keywords: alternative dispute resolution, case law, cause of action, litigation process, mandatory mediation

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Authors: Yan Li, Qi-Fan Jia, Jie Zhou

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In today’s China, primary and secondary teachers are living a hard life with high pressure but low payment, which results in a sense of unfair and less satisfaction of life. However, teachers’ life satisfaction is a significant factor of their mental health and plays an important role in the development and progress of the society. This study was aimed to explore the effect of teachers’ perception of social justice on life satisfaction. 450 primary and secondary teachers from China were measured with life satisfaction scales, social justice scales, income satisfaction scale, job satisfaction scale, pressure condition scale, and major life event scale. Results showed their pressure is significantly higher than average, while life satisfaction, job satisfaction, income satisfaction and perceived social justice are lower. Hierarchical regression analysis showed that demographic variables, i.e., gender, age, education level and matric status, and factors related to occupation, i.e., professional title, school type and working hours per day cannot predict teachers’ life satisfaction. Teachers who had worked for 11-20 years had a lower life satisfaction compared to those with 1-5 years working experience. However, social status, monthly household income, income satisfaction, as well as job satisfaction were positively related to life satisfaction, whereas pressure condition was negatively related to it. After controlling for demographic factors and individual attitudes, social justice still had a positive effect on life satisfaction, among which distributive justice played a more important role than procedural justice. The suggestions on teachers’ condition in China and the implications for education reform to improve teachers’ mental health are discussed.

Keywords: life satisfaction, mental health, primary and secondary teachers, social justice

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Authors: Harshadkumar Rajgor, Jeff Butterworth

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Background: Barretts oesophagus increases the risk of developing oesophageal adenocarcinoma. Over the last 40 years, there has been a 6 fold increase in the incidence of oesophageal adenocarcinoma in the western world and the incidence rates are increasing at a greater rate than cancers of the colon, breast and lung. Endoscopic mucosal resection (EMR) is a relatively new technique being used by 2 centres in the greater midlands cancer network. EMR can be used for curative or staging purposes, for high-grade dysplasia’s and T1 tumours of the oesophagus. EMR is also suitable for those who are deemed high risk for oesophagectomy. EMR has a recurrence rate of 21% according to the Wiesbaden data. Method: A retrospective study of prospectively collected data was carried out involving 24 patients who had EMR for curative or staging purposes. Complications of residual or recurrent disease following EMR that required further treatment were investigated. Results: In 54% of cases residual or recurrent disease was suspected. 96% of patients were given clear and concise information regarding their diagnosis of high-grade dysplasia or T1 tumours. All 24 patients consulted the same specialist healthcare team. Conclusion: EMR is a safe and effective treatment for patients who have high-grade dysplasia and T1NO tumours. In 54% of cases residual or recurrent disease was suspected. Initially, only single resections were undertaken. Multiple resections are now being carried out to reduce the risk of recurrence. Complications from EMR remain low in this series and consisted of a single episode of post procedural bleeding.

Keywords: endoscopic mucosal resection, oesophageal dysplasia, T1 tumours, cancer network

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Authors: Zuzana Durajova, Natasa Diatkova, Shreya Bhardwaj

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This paper introduces the project START, its activities, goals, evaluation and final results. Over the past few decades, the legal discourse surrounding mental health has resulted in improvement in patient rights (in Netherlands, etc.), the appointment of Ombudspersons for psychiatric patients (in Austria, Sweden) and facilitating the participation of patients in decision-making processes. Czech legislation already recognizes the position of “patient’s advocate” as a person of trust. However, this instrument is not very widely known and rarely used in practice. In the pilot study of the project, legal training for patient advocacy is provided to persons with experience with mental health problems/psychiatric hospitalization chosen from a Czech-based NGO. These persons (patient advocates) visit patients in involuntary hospitalization in one closed ward in the chosen psychiatric institution. During visits, the patient advocates inform patients about their legal standing, their procedural rights and also offer them individual support in contacting their counsel, family members etc. To understand the effect of the intervention, qualitative interviews and participant observations are conducted with the patients, advocates, the hospital management and staff and other identifiable stakeholders, such as government officials responsible for mental health care reform. The interviews are held before, during and after the intervention (support from patient advocates in hospitals). Given the ethical quandaries arising from using psychiatric wards as a field setting, we assume a participatory approach to ensure respect for patient boundaries and dignity. Through this project, we seek to establish a profession of patient advocates based on professional standards.

Keywords: patient advocacy, involuntary hospitalization, Czech Republic, patient Rights, professionalization

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Authors: Rizky Oktaviana

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The main purpose of studying lies in improving students’ understanding. Teachers usually use written test to measure students’ understanding about learning material especially mathematical learning material. This common method actually has a lack point, such that in mathematics content, written test only show procedural steps to solve mathematical problems. Therefore, teachers unable to see whether students actually understand about mathematical concepts and the relation between concepts or not. One of the best tools to observe students’ understanding about the mathematical concepts is concept map. The goal of this research is to describe junior high school students understanding about mathematical concepts through Concept Maps based on the difference of mathematical ability. There were three steps in this research; the first step was choosing the research subjects by giving mathematical ability test to students. The subjects of this research are three students with difference mathematical ability, high, intermediate and low mathematical ability. The second step was giving concept mapping training to the chosen subjects. The last step was giving concept mapping task about the function to the subjects. Nodes which are the representation of concepts of function were provided in concept mapping task. The subjects had to use the nodes in concept mapping. Based on data analysis, the result of this research shows that subject with high mathematical ability has formal understanding, due to that subject could see the connection between concepts of function and arranged the concepts become concept map with valid hierarchy. Subject with intermediate mathematical ability has relational understanding, because subject could arranged all the given concepts and gave appropriate label between concepts though it did not represent the connection specifically yet. Whereas subject with low mathematical ability has poor understanding about function, it can be seen from the concept map which is only used few of the given concepts because subject could not see the connection between concepts. All subjects have instrumental understanding for the relation between linear function concept, quadratic function concept and domain, co domain, range.

Keywords: concept map, concept mapping, mathematical concepts, understanding

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Authors: Mitchell Stanton

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Background: Endovascular management is well established as a mainstay treatment option for cerebral aneurysms. It is also well established that immediate post procedural imaging can be difficult to interpret due to the presence of contrast material. However, through the use of Dual-Energy computed tomography, it has become possible to differentiate contrast extravasation and intracranial haemorrhage. This case illustrates the importance of this technology following endovascular treatment of an unruptured cerebral aneurysm. Case Presentation: A 79-year-old female was found to have an unruptured large intracavernous ICA fusiform aneurysm on CT Brain Angiogram after presenting with acute ophthalmoplegia. This ophthalmoplegia was caused by mass effect from the aneurysm and subsequently the aneurysm was treated with an endovascular flow diverting stent. CT brain was performed post operatively due to a reduced level of consciousness and this showed diffuse subarachnoid hyperdensity of the left hemisphere. The use of Dual-Energy CT allowed accurate differentiation and illustrated diffuse contrast material extravasation, allowing patient to continue on dual-antiplatelets and therapeutic anticoagulation to reduce the risk of ischaemic injury post endovascular stent. Conclusion: Endovascular treatment options for management of intracranial aneurysms are constantly evolving. The use of Dual-Energy CT therefore has an integral role in accurately diagnosing any post-operative complications. Specifically, differentiating between subarachnoid haemorrhage and contrast extravasation is vital in these patients due to the significant consequences to their ongoing management in regards to continuation or cessation of antiplatelets or anticoagulation. With increasing access to this technology, its use should become standard practice in the post-operative investigation of these patients undergoing endovascular treatment.

Keywords: aneurysm, computed tomography, contrast extravasation, dual-energy CT, endovascular, subarachnoid haemorrhage

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Authors: Rohtash

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Academically, the concept of Justice in the literature is vast, and theories are voluminous and definitions are numerous but it is very difficult to define. Through the ages, justice has been evolving and developing reasoning that how individuals and communities do the right thing that is just and fair to all in that society. Justice is a relative and dynamic concept, not absolute one. It is different in different societies based on their morality and ethics. The idea of justice cannot arise from a single morality but interaction of competing moralities and contending perspectives. Justice is the conditional and circumstantial term. Therefore, justice takes different meanings in different contexts. Justice is the application of the Laws. It is a values-based concept in order to protect the rights and liberties of the people. It is a socially created concept that has no physical reality. It exists in society on the basis of the spirit of sharing by the communities and members of society. The conception of justice in society or among communities and individuals is based on their social coordination. It can be effective only when people’s judgments are based on collective reasoning. Their behavior is shaped by social values, norms and laws. People must accept, share and respect the set of principles for delivering justice. Thus justice can be a reasonable solution to conflicts and to coordinate behavior in society. The subject matter of distributive justice is the Public Good and societal resources that should be evenly distributed among the different sections of society on the principles developed and established by the State through legislation, public policy and Executive orders. The Socioeconomic transformation of the society is adopted by the constitution within the limit of its morality and gives a new dimension to transformative justice. Therefore, both Procedural and Transformative justice is part of Distributive justice. Distributive justice is purely an economic phenomenon. It concerns the allocation of resources among the communities and individuals. The subject matter of distributive justice is the distribution of rights, responsibilities, burdens and benefits in society on the basis of the capacity and capability of individuals.

Keywords: distributive justice, constitutionalism, institutionalism, constitutional morality

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Authors: K. N. Dinesh Babu

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In this paper, the protection of a complicated bus arrangement with a dual bus coupler and bus sectionalizer using low impedance differential protection applicable for very high voltages like 220kV and 400kV is discussed. In many power generation stations, several operational procedures are implemented to utilize the transfer bus as the main bus and to facilitate the maintenance of circuit breakers and current transformers (in each section) without shutting down the bay(s). Owing to this fact, the complications in operational philosophy have thrown challenges for the bus bar protection implementation. Many bus topologies allow any one of the main buses available in the station to be used as an auxiliary bus. In such a system, pre-defined precautions and procedures are made as guidelines, which are followed before assigning any bus as an auxiliary bus. The procedure involves shifting of links, changing rotary switches, insertion of test block, and so on, thereby causing unreliable operation. This kind of unreliable operation or inadvertent procedural lapse may result in the isolation of the bus bar from the grid due to the unpredictable operation of the bus bar protection relay, which is a commonly occurring phenomenon due to manual mistakes. With the sophisticated configuration and implementation of logic in modern intelligent electronic devices, the operator is free to select the transfer arrangement without sacrificing the protection required by a bus differential system for a reliable operation, and labor-intensive processes are completely eliminated. This paper deals with the procedure to test the security logic for such special scenarios using Megger make SMRT, bus bar protection relay to assure system stability and get rid of all the specific operational precautions/procedure.

Keywords: bus bar protection, by-pass isolator, blind spot, breaker failure, intelligent electronic device, end fault, bus unification, directional principle, zones of protection, breaker re-trip, under voltage security, smart megger relay tester

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Authors: Umporn Wutchana

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An open ended problem and unstructured interview had been used to explore students’ conceptual and procedural understanding of vector components. The open ended problem had been designed based on research instrument used in previous physics education research. Without physical context, we asked students to find out magnitude and draw graphical form of vector components. The open ended problem was given to 211 first year students of faculty of science during the third (summer) semester in 2014 academic year. The students spent approximately 15 minutes of their second time of the General Physics I course to complete the open ended problem after they had failed. Consequently, their responses were classified based on the similarity of errors performed in the responses. Then, an unstructured interview was conducted. 7 students were randomly selected and asked to reason and explain their answers. The study results showed that 53% of 211 students provided correct numerical magnitude of vector components while 10.9% of them confused and punctuated the magnitude of vectors in x- with y-components. Others 20.4% provided just symbols and the last 15.6% gave no answer. When asking to draw graphical form of vector components, only 10% of 211 students made corrections. A majority of them produced errors and revealed alternative conceptions. 46.5% drew longer and/or shorter magnitude of vector components. 43.1% drew vectors in different forms or wrote down other symbols. Results from the unstructured interview indicated that some students just memorized the method to get numerical magnitude of x- and y-components. About graphical form of component vectors, some students though that the length of component vectors should be shorter than those of the given one. So then, it could be combined to be equal length of the given vectors while others though that component vectors should has the same length as the given vectors. It was likely to be that many students did not develop a strong foundation of understanding in vector components but just learn by memorizing its solution or the way to compute its magnitude and attribute little meaning to such concept.

Keywords: graphical vectors, vectors, vector components, misconceptions, alternative conceptions

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Authors: Alex Knighton, Roba Khundkar, Michael Dunn

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Neo-colonialism is defined as the use of economic, political, cultural, or other pressures to control or influence other countries, especially former dependencies, and concerns have been raised about its presence in surgical missions. Surgical missions aim to rectify the huge disparity in surgical access worldwide, but their ethics must be carefully considered. This is especially in light of colonial history which affects international relations and global health today, to ensure that colonial attitudes are not influencing efforts to promote equity. This review examines the history of colonial global health, demonstrating that global health initiatives have consistently been used to benefit those providing them, and then asks whether elements of colonialism are still pervasive in surgical missions today. Data was collected from the literature using specified search terms and snowball searching, as well as from international expert web-based conferences on global surgery ethics. A thematic analysis was then conducted on this data, resulting in the identification of six themes which are identifiable in both past and present global health initiatives. These six themes are power, lack of understanding or respect, feelings of superiority, exploitation, enabling of dependency, and acceptance of poorer standards of care. An ethical analysis follows, concluding that the concerns of power and neo-colonialism in global surgery would be addressed by adopting a framework of procedural justice that promotes a refined governance process in which stakeholders are able to propose and reject decisions that affect them. The paper argues that adopting this model would address concerns of the power disparity in the field directly, as well as promoting an ethical framework to enable the other concerns of power disparity and neo-colonialism identified in the present analysis to be addressed.

Keywords: medical ethics, global surgery, global health, neocolonialism, surgical missions

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Authors: Eric Lai, Sarah Lorger, David Eisinger, Richard Waugh

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Introduction: Percutaneous embolization of varicoceles has shown similar outcomes to surgery. However, there are advantages of radiological intervention as patients are not exposed to general anaesthesia, experience a quicker recovery and face a lower risk of major complications. Radiological interventions are also preferable after a failed surgical approach. We evaluate clinical outcomes of percutaneous embolization at a tertiary hospital in Sydney, Australia. Methods: Retrospective case series without a control group from a single site (Royal Prince Alfred Hospital, Sydney, Australia). A data search was performed on the interventional radiology database with the word “varicocele” between February 2017 and March 2022. 62 patients were identified. Each patient file was reviewed and included in the study if they met the inclusion criteria. Results: A total of 56 patients were included. 6 patients were excluded as they did not receive intervention after the initial diagnostic venography. Technical success was 100%. Complications were seen in 3 patients (5.3%). The complications included post-procedural pain and fever, venous perforation with no clinical adverse outcome, and a mild allergic reaction to contrast. Recurrence occurred in 3 patients (5.6%), all of whom received a successful second procedure. DISCUSSION: This study demonstrates comparable rates of technical success, complication rate and recurrence to other studies in the literature. When compared to surgical outcomes, the results were also similar. The main limitation is multiple patients lack long-term follow-up beyond 1 year, resulting in potential underestimation of the recurrence rate. Conclusion: Percutaneous embolization of varicocele is a safe alternative to surgical intervention.

Keywords: varicocele, interventional radiology, urology, radiology

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Authors: Dilliram Paudyal

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The history of taxation in Nepal dates back to antiquity. However, the modern tax system gained its momentum after the establishment of democracy in 1951, which initially focused only land tax and tariff on foreign trade. In the due time, several taxes were introduced, such as direct taxes, indirect taxes, and non-taxes. However, the tax structure in Nepal is heavily dominated by indirect taxes that contribute more than 60 % of the total revenue. The government has been mobilizing revenues through a series of tax reforms during the Tenth Five-year Plan (2002 – 2007) and successive Three-year Interim Development Plans by introducing several tax measures. However, these reforms are regressive in nature, which does not lead the overall economy towards short-run stability as well as in the long run development. Based on the literature review and discussion among government officials and few taxpayers individually and groups, this paper aims to major issues and challenges that hinder the tax reform effective in Nepal. Additionally, this paper identifies potential way and process of tax reform in Nepal. The results of the study indicate that transparency in a major problem in Nepalese tax system in Nepal, where serious structural constraints with administrative and procedural complexities envisaged in the Income Tax Act and taxpayers are often unaware of the specific size of tax which is to comply them. Some other issues include high tax rate, limited tax base, leakages in tax collection, rigid and complex Income Tax Act, inefficient and corrupt tax administration, limited potentialities of direct taxes and negative responsiveness of land tax with higher administrative costs. In the context, modality of tax structure and mobilize additional resources is to be rectified on a greater quantum by establishing an effective, dynamic and highly power driven Autonomous Revenue Board.

Keywords: corrupt, development, inefficient, taxation

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Authors: Naz Najma, Grace T. M. Dal Sasso, Maria de Lourdes de Souza

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The development of information and communication technologies and the accessibility of mobile devices has increased the possibilities of the teaching and learning process anywhere and anytime. Mobile and web application allows the production of constructive teaching and learning models in various educational settings, showing the potential for active learning in nursing. The objective of this study was to present the development of an educational technology (Savinglife®, an app) for learning cardiopulmonary resuscitation and advanced cardiovascular life support training. Savinglife® is a technological production, based on the concept of virtual learning and problem-based learning approach. The study was developed from January 2016 to November 2016, using five phases (analyze, design, develop, implement, evaluate) of the instructional systems development process. The technology presented 10 scenarios and 12 simulations, covering different aspects of basic and advanced cardiac life support. The contents can be accessed in a non-linear way leaving the students free to build their knowledge based on their previous experience. Each scenario is presented through interactive tools such as scenario description, assessment, diagnose, intervention and reevaluation. Animated ECG rhythms, text documents, images and videos are provided to support procedural and active learning considering real life situation. Accessible equally on small to large devices with or without an internet connection, Savinglife® offers a dynamic, interactive and flexible tool, placing students at the center of the learning process. Savinglife® can contribute to the student’s learning in the assessment and management of basic and advanced cardiac life support in a safe and ethical way.

Keywords: problem-based learning, cardiopulmonary resuscitation, nursing education, advanced cardiac life support, educational technology

Procedia PDF Downloads 280