Search results for: patient outcomes

Authors: Karin Hansson, Göran Cars, Mats Danielson, Love Ekenberg, Aron Larsson

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Within the realm of e-government, the development has moved towards testing new means for democratic decisionmaking, like e-panels, electronic discussion forums, and polls. Although such new developments seem promising, they are not problem-free, and the outcomes are seldom used in the subsequent formal political procedures. Nevertheless, process models offer promising potential when it comes to structuring and supporting transparency of decision processes in order to facilitate the integration of the public into decision-making procedures in a reasonable and manageable way. Based on real-life cases of urban planning processes in Sweden, we present an outline for an integrated framework for public decision making to: a) provide tools for citizens to organize discussion and create opinions; b) enable governments, authorities, and institutions to better analyse these opinions; and c) enable governments to account for this information in planning and societal decision making by employing a process model for structured public decision making.

Keywords: Negotiation games, Agenda setting, Multi-criteria decision analysis, Elicitation method.

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Authors: K. Bensafia, A. Mansour, G. Le Maillot, B. Clement, O. Reynet, P. Ariès, S. Haddab

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This paper presents a system designed for wireless acquisition, the recording of electrocardiogram (ECG) signals and the monitoring of the heart’s health during surgery. This wireless recording system allows us to visualize and monitor the state of the heart’s health during a surgery, even if the patient is moved from the operating theater to post anesthesia care unit. The acquired signal is transmitted via a Bluetooth unit to a PC where the data are displayed, stored and processed. To test the reliability of our system, a comparison between ECG signals processed by a conventional ECG monitoring system (Datex-Ohmeda) and by our wireless system is made. The comparison is based on the shape of the ECG signal, the duration of the QRS complex, the P and T waves, as well as the position of the ST segments with respect to the isoelectric line. The proposed system is presented and discussed. The results have confirmed that the use of Bluetooth during surgery does not affect the devices used and vice versa. Pre- and post-processing steps are briefly discussed. Experimental results are also provided.

Keywords: Electrocardiography, monitoring, surgery, wireless system.

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Authors: John Tolentino, Yong Seok Park

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There are currently many people living with limb loss in the USA. The main causes for amputation can range from vascular disease, to trauma, or cancer. This number is expected increase over the next decade. Many patients have a single prosthetic for the first year but end up getting a second one to accommodate their changing physique. Afterwards, the prosthesis gets replaced every three to five years depending on how often it is used. This could cost the patient up to $500,000 throughout their lifetime. Complications do not end there, however. Due to the absence of nerves, it becomes more difficult to traverse terrain with a prosthetic. Moving on an incline or decline becomes difficult, thus curbs and stairs can be a challenge. Certain physical activities, such as cycling, could be even more strenuous. It will need to be relearned to accommodate for the change in weight, center of gravity, and transfer of energy from the leg to the pedal. The purpose of this research project is to develop a new, alternate below-knee cycling prosthetic using Dieter & Schmidt’s design process approach. It will be subjected to fatigue analysis under dynamic loading to observe the limitations as well as the strengths and weaknesses of the prosthetic. Benchmark comparisons will be made between existing prosthetics and the proposed one, examining the benefits and disadvantages. The resulting prosthetic will be 3D printed using acrylonitrile butadiene styrene (ABS) or polycarbonate (PC) plastic.

Keywords: 3D printing, cycling, prosthetic design, synthetic design.

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Authors: Amjad Al Shammari, Ashraf Ibrahim, Laila Seada

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Background and Objectives: Incidence of thyroid carcinoma has been increasing world-wide. In the present study, we evaluated diagnostic accuracy of Fine needle aspiration (FNA) and its efficiency in early detecting neoplastic lesions of thyroid gland over a 3-year period. Methods: Data have been retrieved from pathology files in King Khalid Hospital. For each patient, age, gender, FNA, site & size of nodule and final histopathologic diagnosis were recorded. Results: Study included 490 cases where 419 of them were female and 71 male. Male to female ratio was 1:6. Mean age was 43 years for males and 38 for females. Cases with confirmed histopathology were 131. In 101/131 (77.1%), concordance was found between FNA and histology. In 30/131 (22.9%), there was discrepancy in diagnosis. Total malignant cases were 43, out of which 14 (32.5%) were true positive and 29 (67.44%) were false negative. No false positive cases could be found in our series. Conclusion: FNA could diagnose benign nodules in all cases, however, in malignant cases, ultrasound findings have to be taken into consideration to avoid missing of a microcarcinoma in the contralateral lobe.

Keywords: FNA, hail, histopathology, thyroid.

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Authors: Mohamed M. Saleh, Khalid S. Al-Hagla

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By taking advantage of computer-s processing power, an unlimited number of variations and parameters in both spatial and environmental can be provided while following the same set of rules and constraints. This paper focuses on using the tools of parametric urbanism towards a more responsive environmental and sustainable urban morphology. It presents an understanding to Parametric Urban Comfort Envelope (PUCE) as an interactive computational assessment urban model. In addition, it investigates the applicability potentials of this model to generate an optimized urban form to Borg El Arab city (a new Egyptian Community) concerning the human comfort values specially wind and solar envelopes. Finally, this paper utilizes its application outcomes -both visual and numerical- to extend the designer-s limitations by decrease the concern of controlling and manipulation of geometry, and increase the designer-s awareness about the various potentials of using the parametric tools to create relationships that generate multiple geometric alternatives.

Keywords: Assessment model, human comfort, parametric urbanism, sustainable urban morphology.

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Authors: Aryana Collins Jackson, Elisabetta Bevacqua, Pierre De Loor, Ronan Querrec

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This paper presents a taxonomy of non-technical skills, communicative intentions, and behavior for an individual acting as a medical coordinator. In medical emergency situations, a leader among the group is imperative to both patient health and team emotional and mental health. Situational Leadership is used to make clear and easy-to-follow guidelines for behavior depending on circumstantial factors. Low-level leadership behaviors belonging to two different styles, directive and supporting, are identified from literature and are included in the proposed taxonomy. The high-level information in the taxonomy consists of the necessary non-technical skills belonging to a medical coordinator: situation awareness, decision making, task management, and teamwork. Finally, communicative intentions, dimensions, and functions are included. Thus this work brings high-level and low-level information - medical non-technical skills, communication capabilities, and leadership behavior - into a single versatile taxonomy of behavior.

Keywords: Medical, leadership styles, taxonomy, human behavior.

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Authors: Lobna Hafez, Eman Elakkad

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Sustainability is no longer a choice for firms. To achieve sustainable supply chain, all three dimensions of sustainability should be considered. Unlike the economic and environmental aspects, social sustainability has been rarely given attention. The problem surrounding social sustainability and employees’ welfare in Egypt is complex and remains unsolved. The aim of this study is to qualitatively assess the current level of application of social sustainability in the retailing sector in Egypt through using the social sustainability indicators identified in the literature. The purpose of this investigation is to gain knowledge about the complexity of the system involved. A case study is conducted on one of the largest retailers in Egypt. Data were collected through semi-structured interviews with managers and employees to determine the level of application and identify the major obstacles affecting the social sustainability in the retailing context. The work developed gives insights about the details and complexities of the application of social sustainability in developing countries, from the retailing perspective. The outcomes of this study will help managers to understand the enablers of social sustainability and will direct them to methods of sound implementation.

Keywords: Egypt, retailing sector, social sustainability, sustainability.

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Authors: B. Bakken, O. Boe

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The Norwegian Military Academy (Army) has initiated a project with the main ambition to explore possible avenues to enhancing operational effectiveness through an increased use of simulation-based training and exercises. Within a cost/benefit framework, we discuss opportunities and limitations of vertical and horizontal integration of the existing tactical training system. Vertical integration implies expanding the existing training system to span the full range of training from tactical level (platoon, company) to command and staff level (battalion, brigade). Horizontal integration means including other domains than army tactics and staff procedures in the training, such as military ethics, foreign languages, leadership and decision making. We discuss each of the integration options with respect to purpose and content of training, "best practice" for organising and conducting simulation-based training, and suggest how to evaluate training procedures and measure learning outcomes. We conclude by giving guidelines towards further explorative work and possible implementation.

Keywords: Effectiveness, integration, simulation, training.

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Authors: Kasra Afsahi, Maryam Soheilifar, Noureddin Nakhostin Ansari

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COVID-19 has been associated with stroke and neurological complications. The patient was a 59-year-old male presented with sudden left hemiparesis and diplopia due to cavernous sinus thrombosis (CST) on 28/03/2020. The COVID-19 test was positive. Multislice computerized tomography (MSCT) showed ischemic infarction. He underwent surgical sinectomy 9 days after admission. Physiotherapy began for him on August 2020. Our game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and function for stroke. After 6 weeks of VR therapy plus conventional physiotherapy exercises (18 sessions, three times per week, 60 minutes each session), there were significant improvements in Brunnstrom Motor Recovery Stage (from “4” to “5”), Fugl-Meyer Scale score of upper extremity section (from 49 to 54), and Modified Barthel Index (from 15 to 18). There were no adverse effects. This case with stroke post COVID-19 due to the CST showed the usefulness of VR therapy used as an adjunct to conventional physiotherapy in improving affected upper extremity.

Keywords: COVID-19, stroke, virtual reality, rehabilitation.

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Authors: Sivapalan, S., Subramaniam, G., Clifford, M.J., Balbir Singh, M.S., Abdullah, A

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Higher education has an important role to play in advocating environmentalism. Given this responsibility, the goal of higher education should therefore be to develop graduates with the knowledge, skills and values related to environmentalism. However, research indicates that there is a lack of consciousness amongst graduates on the need to be more environmentally aware, especially when it comes to applying the appropriate knowledge and skills related to environmentalism. Although institutions of higher learning do include environmental parameters within their undergraduate and postgraduate academic programme structures, the environmental boundaries are usually confined to specific engineering majors within an engineering programme. This makes environmental knowledge, skills and values exclusive to certain quarters of the higher education system. The incorporation of environmental literacy within higher education institutions as a whole is of utmost pertinence if a nation-s human capital is to be nurtured to become change agents for the preservation of environment. This paper discusses approaches that can be adapted by institutions of higher learning to include environmental literacy within the graduate-s higher learning experience.

Keywords: Higher education, engineering education, environmental literacy, Malaysia.

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Authors: Naima Nur, Safa Islam, Saeema Islam, Md. Faridul Alam

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The study addresses the increasing challenge of pediatric presumptive tuberculosis, emphasizing the need to understand the factors associated with it. The research aims to determine the proportion of presumptive TB and factors associated with it among suspected pediatric tuberculosis patients. A cross-sectional study was conducted at ICDDR-Bangladesh, collecting specimens from suspected pediatric patients and using logistic regression for data analysis. The study found a high proportion of presumptive TB (85.7%) but no statistically significant differences between presumptive and non-presumptive TB. Theoretical importance of the study highlights the importance of identifying factors associated with presumptive TB for better control and management strategies. Specimens were collected from 84 suspected pediatric patients diagnosed with TB based on clinical symptoms/radiological findings. Microbiological tests like smear-microscopy, culture, and GeneXpert were used to isolate presumptive TB and confirmed TB. The proportion of presumptive TB was 85.7% among suspected pediatric TB patients. Among various factors that were not found to be associated with the presumptive TB. The study concludes that despite a high proportion of presumptive TB, no significant differences were found between presumptive and non-presumptive TB cases.

Keywords: Presumptive tuberculosis, confirmed tuberculosis, patient's characteristics, diagnosis.

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Authors: Aaron Aboshio, Jianqioa Ye

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In this study, static and dynamic responses of a typical reinforced concrete solid slab, designed to British Standard (BS 8110: 1997) and under self and live loadings for dance halls are reported. Linear perturbation analysis using finite element method was employed for modal, impulse loading and frequency response analyses of the slab under the aforementioned loading condition. Results from the static and dynamic analyses, comprising of the slab fundamental frequencies and mode shapes, dynamic amplification factor, maximum deflection, stress distributions among other valuable outcomes are presented and discussed. These were gauged with the limiting provisions in the design code with a view of justifying valid optimization objective function for the structure that can ensure both adequate strength and economical section for large clear span slabs. This is necessary owing to the continued increase in cost of erecting building structures and the squeeze on public finance globally.

Keywords: Economical design, Finite element method, Modal dynamics, Reinforced concrete, Slab.

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Authors: L. Salhi, M. Talbi, A. Cherif

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This paper presents a new strategy of identification and classification of pathological voices using the hybrid method based on wavelet transform and neural networks. After speech acquisition from a patient, the speech signal is analysed in order to extract the acoustic parameters such as the pitch, the formants, Jitter, and shimmer. Obtained results will be compared to those normal and standard values thanks to a programmable database. Sounds are collected from normal people and patients, and then classified into two different categories. Speech data base is consists of several pathological and normal voices collected from the national hospital “Rabta-Tunis". Speech processing algorithm is conducted in a supervised mode for discrimination of normal and pathology voices and then for classification between neural and vocal pathologies (Parkinson, Alzheimer, laryngeal, dyslexia...). Several simulation results will be presented in function of the disease and will be compared with the clinical diagnosis in order to have an objective evaluation of the developed tool.

Keywords: Formants, Neural Networks, Pathological Voices, Pitch, Wavelet Transform.

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Authors: Aliza Lee, Mark Wilt, John Bonk, Scott Floyd, Bradley Hoffman, Karen Uchmanowicz

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Bipartite medial cuneiforms are relatively rare but may play a significant role in biomechanical and gait abnormalities. It is believed that a bipartite medial cuneiform may alter the available range of motion due to its larger morphological variant, thus limiting the metatarsal plantarflexion needed to achieve adequate hallux dorsiflexion for normal gait. Radiographic and clinical assessment were performed on two patients who reported with foot pain along the first ray. Both patients had visible bipartite medial cuneiforms on MRI. Using gait plate and Metascan ™ analysis, both were noted to have four measurements far beyond the expected range. Medial and lateral heel peak pressure, hallux peak pressure, and 1st metatarsal peak pressure were all noted to be increased. These measurements are believed to be increased due to the hindrance placed on the available ROM of the first ray by the increased size of the medial cuneiform. A larger patient population would be needed to fully understand this developmental anomaly.

Keywords: Bipartite medial cuneiforms, cuneiform, developmental anomaly, gait abnormality.

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Authors: Zia Abbas, Giuseppe Scotti, Mauro Olivieri

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Current mode circuits like current conveyors are getting significant attention in current analog ICs design due to their higher band-width, greater linearity, larger dynamic range, simpler circuitry, lower power consumption and less chip area. The second generation current controlled conveyor (CCCII) has the advantage of electronic adjustability over the CCII i.e. in CCCII; adjustment of the X-terminal intrinsic resistance via a bias current is possible. The presented approach is based on the CMOS implementation of second generation positive (CCCII+), negative (CCCII-) and dual Output Current Controlled Conveyor (DOCCCII) and its application as Universal filter. All the circuits have been designed and simulated using 65nm CMOS technology model parameters on Cadence Virtuoso / Spectre using 1V supply voltage. Various simulations have been carried out to verify the linearity between output and input ports, range of operation frequency, etc. The outcomes show good agreement between expected and experimental results.

Keywords: CCCII+, CCCII-, DOCCCII, Electronic tunability, Universal filter

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Authors: Muhammad Zeeshan UlHaque, Peng Du, Leo K. Cheng, Marc D. Jacobs

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Sensory nerves in the foot play an important part in the diagnosis of various neuropathydisorders, especially in diabetes mellitus.However, a detailed description of the anatomical distribution of the nerves is currently lacking. A computationalmodel of the afferent nerves inthe foot may bea useful tool for the study of diabetic neuropathy. In this study, we present the development of an anatomically-based model of various major sensory nerves of the sole and dorsal sidesof the foot. In addition, we presentan algorithm for generating synthetic somatosensory nerve networks in the big-toe region of a right foot model. The algorithm was based on a modified version of the Monte Carlo algorithm, with the capability of being able to vary the intra-epidermal nerve fiber density in differentregionsof the foot model. Preliminary results from the combinedmodel show the realistic anatomical structure of the major nerves as well as the smaller somatosensory nerves of the foot. The model may now be developed to investigate the functional outcomes of structural neuropathyindiabetic patients.

Keywords: Diabetic neuropathy, Finite element modeling, Monte Carlo Algorithm, Somatosensory nerve networks

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Authors: B. Thanasansomboon, S. Choemprayong, N. Parinyanitikul, U. Tanlamai

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Being diagnosed with metastatic breast cancer, the patients as well as their caretakers are affected physically and mentally. Although the medical systems in Thailand have been attempting to improve the quality and effectiveness of the treatment of the disease in terms of physical illness, the success of the treatment also depends on the quality of mental health. Metastatic breast cancer patients have found that social support is a key factor that helps them through this difficult time. It is recognized that social support in different dimensions, including emotional support, social network support, informational support, instrumental support and appraisal support, are contributing factors that positively affect the quality of life of patients in general, and it is undeniable that social support in various forms is important in promoting the quality of life of metastatic breast patients. However, previous studies have not been dedicated to investigating their quality of life concerning affective, cognitive, and behavioral outcomes. Therefore, this study aims to develop integrated social support through social networks to improve the quality of life of metastatic breast cancer patients in Thailand.

Keywords: Social support, metastatic breast cancer, quality of life, social network.

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Authors: Kari Björn

Abstract:

Introduction of games has expanded the application area of computer-aided learning tools to wide variety of age groups of learners. Serious games engage the learners into a real-world -type of simulation and potentially enrich the learning experience. Institutional background of a Bachelor’s level engineering program in Information and Communication Technology is introduced, with detailed focus on one of its majors, Health Technology. As part of a Customer Oriented Software Application thematic semester, one particular course of “eHealth Business and Solutions” is described and reflected in a gamified framework. Learning a consistent view into vast literature of business management, strategies, marketing and finance in a very limited time enforces selection of topics relevant to the industry. Health Technology is a novel and growing industry with a growing sector in consumer wearable devices and homecare applications. The business sector is attracting new entrepreneurs and impatient investor funds. From engineering education point of view the sector is driven by miniaturizing electronics, sensors and wireless applications. However, the market is highly consumer-driven and usability, safety and data integrity requirements are extremely high. When the same technology is used in analysis or treatment of patients, very strict regulatory measures are enforced. The paper introduces a course structure using gamification as a tool to learn the most essential in a new market: customer value proposition design, followed by a market entry game. Students analyze the existing market size and pricing structure of eHealth web-service market and enter the market as a steering group of their company, competing against the legacy players and with each other. The market is growing but has its rules of demand and supply balance. New products can be developed with an R&D-investment, and targeted to market with unique quality- and price-combinations. Product cost structure can be improved by investing to enhanced production capacity. Investments can be funded optionally by foreign capital. Students make management decisions and face the dynamics of the market competition in form of income statement and balance sheet after each decision cycle. The focus of the learning outcome is to understand customer value creation to be the source of cash flow. The benefit of gamification is to enrich the learning experience on structure and meaning of financial statements. The paper describes the gamification approach and discusses outcomes after two course implementations. Along the case description of learning challenges, some unexpected misconceptions are noted. Improvements of the game or the semi-gamified teaching pedagogy are discussed. The case description serves as an additional support to new game coordinator, as well as helps to improve the method. Overall, the gamified approach has helped to engage engineering student to business studies in an energizing way.

Keywords: Engineering education, integrated curriculum, learning experience, learning outcomes.

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Authors: S. Sudhakar, Geetha Manjunath, Siva Teja Kakileti, Himanshu Madhu

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Diagnosis of breast cancer at early stages has seen better clinical and survival outcomes. Survival rates in developing countries like India are very low due to accessibility and affordability issues of screening tests such as Mammography. In addition, Mammography is not much effective in younger women with dense breasts. This leaves a gap in current screening methods. Thermalytix is a new technique for detecting breast abnormality in a non-contact, non-invasive way. It is an AI-enabled computer-aided diagnosis solution that automates interpretation of high resolution thermal images and identifies potential malignant lesions. The solution is low cost, easy to use, portable and is effective in all age groups.  This paper presents the results of a retrospective comparative analysis of Thermalytix over Mammography and Clinical Breast Examination for breast cancer screening. Thermalytix was found to have better sensitivity than both the tests, with good specificity as well. In addition, Thermalytix identified all malignant patients without palpable lumps.

Keywords: Breast Cancer Screening, Radiology, Thermalytix, Artificial Intelligence, Thermography.

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Authors: Ali Zifan, Panos Liatsis, Panagiotis Kantartzis, Manolis Gavaises, Nicos Karcanias, Demosthenes Katritsis

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We present a new method for the fully automatic 3D reconstruction of the coronary artery centerlines, using two X-ray angiogram projection images from a single rotating monoplane acquisition system. During the first stage, the input images are smoothed using curve evolution techniques. Next, a simple yet efficient multiscale method, based on the information of the Hessian matrix, for the enhancement of the vascular structure is introduced. Hysteresis thresholding using different image quantiles, is used to threshold the arteries. This stage is followed by a thinning procedure to extract the centerlines. The resulting skeleton image is then pruned using morphological and pattern recognition techniques to remove non-vessel like structures. Finally, edge-based stereo correspondence is solved using a parallel evolutionary optimization method based on f symbiosis. The detected 2D centerlines combined with disparity map information allow the reconstruction of the 3D vessel centerlines. The proposed method has been evaluated on patient data sets for evaluation purposes.

Keywords: Vessel enhancement, centerline extraction, symbiotic reconstruction.

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Authors: Sara Blanc, José V. Benlloch-Dualde, Laura Grindei, Ana C. Torres, Angélica Monteiro

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This paper presents a study that leads an experience by introducing digital learning applied to a case study focused on primary and secondary school garden-based education. The approach represents an example for interaction among different education and research agents at different countries and levels, such as universities, public and private researches and schools, to get involved in the implementation of education for sustainable development that will make students become more sensible to natural environment, more responsible for their consumption, more aware about waste reduction and recycling, more conscious of the sustainable use of natural resources and, at the same time, more ‘digitally competent’. The experience was designed attending to the European digital education context and OECD (Organization for Economic Co-operation and Development) directives in transversal skills education. The paper presents the methodology carried out in the study as well as outcomes obtained from the experience.

Keywords: School gardens, primary education, secondary education, science technology and innovation in education, digital learning, sustainable development goals, university, knowledge transference.

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Authors: N. Khomarloo, F. Mousazadegan, M. Latifi, N. Hemmatinejad

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Recently, the utilization of reusable surgical gowns in order to decrease costs, environmental protection and enhance surgeon’s comfort is considered. One of the concerns in applying this kind of medical protective clothing is reduction of their resistance to bacterial penetration especially in wet state, after repeated laundering and sterilizing process. The purpose of this study is to investigate the effect of the laundering and sterilizing process on the reusable surgical gown’s resistance against bacterial wet penetration. To this end, penetration of Staphylococcus aureus bacteria in wet state after 70 washing and sterilizing cycles was evaluated on the two single-layer and three-layer reusable gowns. The outcomes reveal that up to 20 laundering and sterilizing cycles, protective property of samples improves due to fabric shrinkage, after that because of the fabric’s construction opening, the bacterial penetration increase. However, the three-layer gown presents higher protective performance comparing to the single-layer one.

Keywords: Reusable surgical gown, laundry, sterilization, wet bacterial penetration.

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Authors: Helena Costa Oliveira, Carmem Oliveira, Rita Moutinho

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The Balanced Scorecard (BSC) is a continuous strategic monitoring model focused not only on financial issues but also on internal processes, patients/users, and learning and growth. Initially dedicated to business management, it currently serves organizations of other natures - such as hospitals. This paper presents a BSC designed for a Portuguese Acute Pain Unit (APU). This study is qualitative and based on the experience of collaborators at the APU. The management of APU is based on four perspectives – users, internal processes, learning and growth, and financial and legal. For each perspective, there were identified strategic objectives, critical factors, lead indicators and initiatives. The strategic map of the APU outlining sustained strategic relations among strategic objectives. This study contributes to the development of research in the health management area as it explores how organizational insufficiencies and inconsistencies in this particular case can be addressed, through the identification of critical factors, to clearly establish core outcomes and initiatives to set up.

Keywords: Acute pain unit, balanced scorecard, hospital management, organizational performance, Portugal.

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Authors: D. O. Omondi, M. K. Walingo, G. M. Mbagaya, L. O. A. Othuon

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Understanding patient factors related to physical activity behavior is important in the management of Type 2 Diabetes. This study applied the Theory of Planned Behavior model to understand physical activity behavior among sampled Type 2 diabetics in Kenya. The study was conducted within the diabetic clinic at Kisii Level 5 Hospital and adopted sequential mixed methods design beginning with qualitative phase and ending with quantitative phase. Qualitative data was analyzed using grounded theory analysis method. Structural equation modeling using maximum likelihood was used to analyze quantitative data. The common fit indices revealed that the theory of planned behavior fitted the data acceptably well among the Type 2 diabetes and within physical activity behavior {¤ç2 = 213, df = 84, n=230, p = .061, ¤ç2/df = 2.53; TLI = .97; CFI =.96; RMSEA (90CI) = .073(.029, .08)}. This theory proved to be useful in understanding physical activity behavior among Type 2 diabetics.

Keywords: Physical activity, Theory of Planned Behavior, Type2 diabetes, Kenya.

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Authors: Thitaporn Thoopputra, Tipaporn Pongmesa, Shuchuen Li

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Aims: To evaluate the application of non-invasive diabetes risk assessment tool in community pharmacy setting. Methods: Thai diabetes risk score was applied to assess individuals at risk of developing type 2 diabetes. Interactive computer-based risk screening (IT) and paper-based risk screening (PT) tools were applied. Participants aged over 25 years with no known diabetes were recruited in six participating pharmacies. Results: A total of 187 clients, mean aged (+SD) was 48.6 (+10.9) years. 35% were at high risk. The mean value of willingness-to-pay for the service fee in IT group was significantly higher than PT group (p=0.013). No significant difference observed for the satisfaction between groups. Conclusions: Non-invasive risk assessment tool, whether paper-based or computerized-based can be applied in community pharmacy to support the enhancing role of pharmacists in chronic disease management. Long term follow up is needed to determine the impact of its application in clinical, humanistic and economic outcomes.

Keywords: Community pharmacy, intervention, prevention, risk assessment, type 2 diabetes.

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Authors: Aki Sugano, Mika Ohta, Mineko Ikegami, Kenji Miura, Sayo Tsukamoto, Akihiro Ichinose, Toshiko Ohshima, Eiichi Maeda, Masako Matsuura, Yutaka Takao

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Along with the advances in medicine, providing medical information to individual patient is becoming more important. In Japan such information via Braille is hardly provided to blind and partially sighted people. Thus we are researching and developing a Web-based automatic translation program “eBraille" to translate Japanese text into Japanese Braille. First we analyzed the Japanese transcription rules to implement them on our program. We then added medical words to the dictionary of the program to improve its translation accuracy for medical text. Finally we examined the efficacy of statistical learning models (SLMs) for further increase of word segmentation accuracy in braille translation. As a result, eBraille had the highest translation accuracy in the comparison with other translation programs, improved the accuracy for medical text and is utilized to make hospital brochures in braille for outpatients and inpatients.

Keywords: Automatic Braille translation, Medical text, Partially sighted people.

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Authors: Shaival Dalal, Nilesh Shah, Dinshaw Pardiwala, David Rajan, Satyen Sanghavi, Charul Bhanji

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Autologous Chondrocyte Implantation (ACI) is used worldwide since 1998 to treat cartilage defect. GEL based ACI is a new tissue-engineering technique to treat full thickness cartilage defect with fibrin and thrombin as scaffold for chondrocytes. Purpose of this study is to see safety and efficacy of gel based ACI for knee cartilage defect in multiple centres with different surgeons. Gel-based Autologous Chondrocyte Implantation (GACI) has shown effectiveness in treating isolated cartilage defect of knee joint. Long term results are still needed to be studied. This study was followed-up up to two years and showed benefit to patients. All enrolled patients with a mean age of 28.5 years had an average defect size of3 square centimeters, and were grade IV as per ICRS grading. All patients were followed up several times and at several intervals at 6th week, 8th week, 11th week, 17th week, 29th week, 57th week after surgery. The outcomes were measured based on the IKDC (subjective and objective) and MOCART scores.

Keywords: Knee, chondrocyte, autologous chondrocyte implantation, gel.

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Authors: Cenk Akbiyik, Gonul Altin Akbiyik

Abstract:

The main purpose of the study was to determine whether students- interpretation achievement differed with the use of various multimedia presentation types. Four groups of students, text only (T), audio only (A), text and audio (TA), text and image (TI), were arranged and they were presented the same story via different types of multimedia presentations. Inference achievement was measured by a critical thinking inference test. Higher mean scores for the TA group compared to the other three groups were found. Also when compared pairwise, interpretation achievement of the TA group differed significantly from scores of the T and TI groups. These differences were interpreted with the increased cognitive load. Increased cognitive load for the TA group may have invited students to put more effort into comprehending the text, thus resulting in better test scores. Findings of the study can be seen as a sign of the importance of learning situations and learning outcomes in multimedia-supported learning environments and may have practical benefits for instructional designers.

Keywords: Multimedia, cognitive multimedia, dual coding, cognitive load, critical thinking.

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Authors: Zhao Jing, Bai Yongqing, Shi Qiaofang, Zang Yang, Zhang Huaihao

Abstract:

Advances in software technology enable the computational chemistry to be commonly applied in various research fields, especially in pedagogy. Thus, in order to expand and improve experimental instructions of computational chemistry for undergraduates, we designed an introductory experiment—research on acrylamide molecular structure and physicochemical properties. Initially, students construct molecular models of acrylamide and polyacrylamide in Gaussian and Materials Studio software respectively. Then, the infrared spectral data, atomic charge and molecular orbitals of acrylamide as well as solvation effect of polyacrylamide are calculated to predict their physicochemical performance. At last, rheological experiments are used to validate these predictions. Through the combination of molecular simulation (performed on Gaussian, Materials Studio) with experimental verification (rheology experiment), learners have deeply comprehended the chemical nature of acrylamide and polyacrylamide, achieving good learning outcomes.

Keywords: Upper-division undergraduate, computer-based learning, laboratory instruction, amides, molecular modeling, spectroscopy.

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Authors: Mohd Zahari, M. S, Salleh, N. K., Kamaruddin, M. S. Y, Kutut, M. Z.

Abstract:

Service quality has become a centerpiece for airline companies in vying with one another and keeps their image in the minds of passengers. Many airlines have pushed service quality through service personalization which includes both ground and on board especially from the viewpoint of retaining satisfied passengers and attracting new ones. Besides those, in-flight meals/food service is another important aspect of the airline operation. The in flight meals/food services now are seen as part of marketing strategies in attracting business or leisure travelers. This study reports the outcomes of the investigation on in-flight meals/food attributes toward passengers- level of satisfaction and re-flying intention. Taste, freshness, appearance of in-flight meals/food served and menu choices are important to the airlines passengers especially for the long haul flight. Food not only contributes to the prediction of the airline passengers- levels of satisfaction but besides other factors slightly influence passengers- re- flying intention. Airline companies therefore should not ignore this element but take the opportunity to create more attractive and acceptable in-flight meals/food along with other matter as marketing tools in attracting passengers to re-flying with them.

Keywords: In-flight meal, passengers, satisfaction, re-flying and intention

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