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Authors: Nami Matsumoto

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This study explores the experiences of cross-linguistic medical encounters by patients, and their views of receiving language support therein, with a particular focus on Japanese-English cases. The aim of this study is to investigate the reason for the frequent use of a spouse as a communication mediator from a Japanese perspective, through a comparison with that of English speakers. This study conducts an empirical qualitative analysis of the accounts of informants. A total of 31 informants who have experienced Japanese-English cross-linguistic medical encounters were recruited in Australia and Japan for semi-structured in-depth interviews. A breakdown of informants is 15 English speakers and 16 Japanese speakers. In order to obtain a further insight into collected data, additional interviews were held with 4 Australian doctors who are familiar with using interpreters. This study was approved by the Australian National University Human Research Ethics Committee, and written consent to participate in this study was obtained from all participants. The interviews lasted up to over one hour. They were audio-recorded and subsequently transcribed by the author. Japanese transcriptions were translated into English by the author. An analysis of interview data found that patients value relationship in communication. Particularly, Japanese informants, who have an English-speaking spouse, value trust-based communication interventions by their spouse, regardless of the language proficiency of the spouse. In Australia, health care interpreters are required to abide by the national code of ethics for interpreters. The Code defines the role of an interpreter exclusively to be language rendition and enshrines the tenets of accuracy, confidentiality and professional role boundaries. However, the analysis found that an interpreter who strictly complies with the Code sometimes fails to render the real intentions of the patient and their doctor. Findings from the study suggest that an interpreter should not be detached from the context and should be more engaged in the needs of patients. Their needs are not always communicated by an interpreter when they simply follow a professional code of ethics. The concept of relationship-centred care should be incorporated in the professional practice of health care interpreters.

Keywords: Health care, Japanese-English medical encounters, language barriers, trust.

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Authors: Moatlhodi Wise Letshwenyo, Lesedi Lebogang

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Botswana is an arid country that needs to start reusing wastewater as part of its water security plan. Pilot scale slow sand filtration in combination with roughing filter was investigated for the treatment of effluent from Botswana International University of Science and Technology to meet Botswana irrigation standards. The system was operated at hydraulic loading rates of 0.04 m/hr and 0.12 m/hr. The results show that the system was able to reduce turbidity from 262 Nephelometric Turbidity Units to a range between 18 and 0 Nephelometric Turbidity Units which was below 30 Nephelometric Turbidity Units threshold limit. The overall efficacy ranged between 61% and 100%. Suspended solids, Biochemical Oxygen Demand, and Chemical Oxygen Demand removal efficiency averaged 42.6%, 45.5%, and 77% respectively and all within irrigation standards. Other physio-chemical parameters were within irrigation standards except for bicarbonate ion which averaged 297.7±44 mg L^-1 in the influent and 196.22±50 mg L^-1 in the effluent which was above the limit of 92 mg L^-1, therefore averaging a reduction of 34.1% by the system. Total coliforms, fecal coliforms, and Escherichia coli in the effluent were initially averaging 1.1 log counts, 0.5 log counts, and 1.3 log counts respectively compared to corresponding influent log counts of 3.4, 2.7 and 4.1, respectively. As time passed, it was observed that only roughing filter was able to reach reductions of 97.5%, 86% and 100% respectively for faecal coliforms, Escherichia coli, and total coliforms. These organism numbers were observed to have increased in slow sand filter effluent suggesting multiplication in the tank. Water quality index value of 22.79 for the physio-chemical parameters suggests that the effluent is of excellent quality and can be used for irrigation purposes. However, the water quality index value for the microbial parameters (1820) renders the quality unsuitable for irrigation. It is concluded that slow sand filtration in combination with roughing filter is a viable option for the treatment of secondary effluent for reuse purposes. However, further studies should be conducted especially for the removal of microbial parameters using the system.

Keywords: Irrigation, roughing filter, slow sand filter, turbidity, water quality index.

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity and weight gain are associated with increased risk of developing cardiovascular diseases and the progression of liver fibrosis. Aspartate transaminase–to-platelet count ratio index (APRI) and fibrosis-4 (FIB-4) were primarily considered as the formulas capable of differentiating hepatitis from cirrhosis. However, to the best of our knowledge, their status in children is not clear. The aim of this study is to determine APRI and FIB-4 status in obese (OB) children and compare them with values found in children with normal body mass index (N-BMI). A total of 68 children examined in the outpatient clinics of the Pediatrics Department in Tekirdag Namik Kemal University Medical Faculty were included in the study. Two groups were constituted. In the first group, 35 children with N-BMI, whose age- and sex-dependent BMI indices vary between 15 and 85 percentiles, were evaluated. The second group comprised 33 OB children whose BMI percentile values were between 95 and 99. Anthropometric measurements and routine biochemical tests were performed. Using these parameters, values for the related indices, BMI, APRI, and FIB-4, were calculated. Appropriate statistical tests were used for the evaluation of the study data. The statistical significance degree was accepted as p < 0.05. In the OB group, values found for APRI and FIB-4 were higher than those calculated for the N-BMI group. However, there was no statistically significant difference between the N-BMI and OB groups in terms of APRI and FIB-4. A similar pattern was detected for triglyceride (TRG) values. The correlation coefficient and degree of significance between APRI and FIB-4 were r = 0.336 and p = 0.065 in the N-BMI group. On the other hand, they were r = 0.707 and p = 0.001 in the OB group. Associations of these two indices with TRG have shown that this parameter was strongly correlated (p < 0.001) both with APRI and FIB-4 in the OB group, whereas no correlation was calculated in children with N-BMI. TRG are associated with an increased risk of fatty liver, which can progress to severe clinical problems such as steatohepatitis, which can lead to liver fibrosis. TRG are also independent risk factors for cardiovascular disease. In conclusion, the lack of correlation between TRG and APRI as well as FIB-4 in children with N-BMI, along with the detection of strong correlations of TRG with these indices in OB children, was the indicator of the possible onset of the tendency towards the development of fatty liver in OB children. This finding also pointed out the potential risk for cardiovascular pathologies in OB children. The nature of the difference between APRI vs. FIB-4 correlations in N-BMI and OB groups (no correlation vs. high correlation), respectively, may be the indicator of the importance of involving age and alanine transaminase parameters in addition to AST and PLT in the formula designed for FIB-4.

Keywords: APRI, FIB-4, obesity, triglycerides.

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Authors: Ahmad-Ur-Rahman Saljoqi, Rahib Zada, Imtiaz Ali Khan, Iqbal Munir, Sadur-Rehman, Hazrat Jabir Alam Khan

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Studies regarding the determination of population trend of Lipaphis erysimi (kalt.) and its associated natural enemies in different Brassica lines along with the effect of gamma radiation on their population were conducted at Agricultural Research Farm, Malakandher, Khyber Pakhtunkhwa Agricultural University Peshawar during spring 2006. Three different Brassica lines F6B3, F6B6 and F6B7 were used, which were replicated four times in Randomized Complete Block Design. The data revealed that aphid infestation invariably stated in all three varieties during last week of February 2006 (1st observation). The peak population of 4.39 aphids leaf-1 was s recorded during 2nd week of March and lowest population of 1.02 aphids leaf-1 was recorded during 5th week of March. The species of lady bird beetle (Coccinella septempunctata) and Syrphid fly (Syrphus balteatus) first appeared on 24th February with a mean number of 0.40 lady bird beetle leaf-1 and 0.87 Syrphid fly leaf-1, respectively. At the time when aphid population started to increase the peak population of C. septempunctata (0.70 lady bird beetle leaf- 1) and S. balteatus (1.04 syrphid fly leaf-1) was recorded on the 2nd week of March. Chrysoperla carnea appeared in the 1st week of March and their peak population was recorded during the 3rd week of March with mean population of 1.46 C. carnea leaf-1. Among all the Brassica lines, F6B7 showed comparatively more resistance as compared to F6B3 F6B6. F6B3 showed least resistance against L. erysimi, which was found to be the most susceptible cultivar. F6B7 was also found superior in terms of natural enemies. Maximum number of all natural enemies was recorded on this variety followed by F6B6. Lowest number of natural enemies was recorded in F6B3. No significant effect was recorded for the effect of gamma radiation on the population of aphids, natural enemies and on the varieties.

Keywords: Canola aphid, Lipaphis erysimi, natural enemies, brassica lines, gamma radiation.

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Authors: A. Anastasopoulou, A. Kolios, T. Somorin, A. Sowale, Y. Jiang, B. Fidalgo, A. Parker, L. Williams, M. Collins, E. J. McAdam, S. Tyrrel

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Developing countries are nowadays confronted with great challenges related to domestic sanitation services in view of the imminent water scarcity. Contemporary sanitation technologies established in these countries are likely to pose health risks unless waste management standards are followed properly. This paper provides a solution to sustainable sanitation with the development of an innovative toilet system, called Nano Membrane Toilet (NMT), which has been developed by Cranfield University and sponsored by the Bill & Melinda Gates Foundation. The particular technology converts human faeces into energy through gasification and provides treated wastewater from urine through membrane filtration. In order to evaluate the environmental profile of the NMT system, a deterministic life cycle assessment (LCA) has been conducted in SimaPro software employing the Ecoinvent v3.3 database. The particular study has determined the most contributory factors to the environmental footprint of the NMT system. However, as sensitivity analysis has identified certain critical operating parameters for the robustness of the LCA results, adopting a stochastic approach to the Life Cycle Inventory (LCI) will comprehensively capture the input data uncertainty and enhance the credibility of the LCA outcome. For that purpose, Monte Carlo simulations, in combination with an artificial neural network (ANN) model, have been conducted for the input parameters of raw material, produced electricity, NO_X emissions, amount of ash and transportation of fertilizer. The given analysis has provided the distribution and the confidence intervals of the selected impact categories and, in turn, more credible conclusions are drawn on the respective LCIA (Life Cycle Impact Assessment) profile of NMT system. Last but not least, the specific study will also yield essential insights into the methodological framework that can be adopted in the environmental impact assessment of other complex engineering systems subject to a high level of input data uncertainty.

Keywords: Sanitation systems, nano membrane toilet, LCA, stochastic uncertainty analysis, Monte Carlo Simulations, artificial neural network.

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Authors: Ola Elfmark, Lars M. Bardal, Luca Oggiano, H˚avard Myklebust

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Team pursuit is a relatively new event in international long track speed skating. For a single speed skater the aerodynamic drag will account for up to 80% of the braking force, thus reducing the drag can greatly improve the performance. In a team pursuit the interactions between athletes in near proximity will also be essential, but is not well studied. In this study, systematic measurements of the aerodynamic drag, body posture and relative positioning of speed skaters have been performed in the low speed wind tunnel at the Norwegian University of Science and Technology, in order to investigate the aerodynamic interaction between two speed skaters. Drag measurements of static speed skaters drafting, leading, side-by-side, and dynamic drag measurements in a synchronized and unsynchronized movement at different distances, were performed. The projected frontal area was measured for all postures and movements and a blockage correction was performed, as the blockage ratio ranged from 5-15% in the different setups. The static drag measurements where performed on two test subjects in two different postures, a low posture and a high posture, and two different distances between the test subjects 1.5T and 3T where T being the length of the torso (T=0.63m). A drag reduction was observed for all distances and configurations, from 39% to 11.4%, for the drafting test subject. The drag of the leading test subject was only influenced at -1.5T, with the biggest drag reduction of 5.6%. An increase in drag was seen for all side-by-side measurements, the biggest increase was observed to be 25.7%, at the closest distance between the test subjects, and the lowest at 2.7% with ∼ 0.7 m between the test subjects. A clear aerodynamic interaction between the test subjects and their postures was observed for most measurements during static measurements, with results corresponding well to recent studies. For the dynamic measurements, the leading test subject had a drag reduction of 3% even at -3T. The drafting showed a drag reduction of 15% when being in a synchronized (sync) motion with the leading test subject at 4.5T. The maximal drag reduction for both the leading and the drafting test subject were observed when being as close as possible in sync, with a drag reduction of 8.5% and 25.7% respectively. This study emphasize the importance of keeping a synchronized movement by showing that the maximal gain for the leading and drafting dropped to 3.2% and 3.3% respectively when the skaters are in opposite phase. Individual differences in technique also appear to influence the drag of the other test subject.

Keywords: Aerodynamic interaction, drag cycle, drag force, frontal area, speed skating.

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Authors: T Rusu, P I Moraru, I Bogdan, A I Pop, M L Sopterean

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The paper presents the influence of the conventional ploughing tillage technology in comparison with the minimum tillage, upon the soil properties, weed control and yield in the case of maize (Zea mays L.), soya-bean (Glycine hispida L.) and winter wheat (Triticum aestivum L.) in a three years crop rotation. A research has been conducted at the University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Romania. The use of minimum soil tillage systems within a three years rotation: maize, soya-bean, wheat favorites the rise of the aggregates hydro stability with 5.6-7.5% on a 0-20 cm depth and 5-11% on 20-30 cm depth. The minimum soil tillage systems – paraplow, chisel or rotary grape – are polyvalent alternatives for basic preparation, germination bed preparation and sowing, for fields and crops with moderate loose requirements being optimized technologies for: soil natural fertility activation and rationalization, reduction of erosion, increasing the accumulation capacity for water and realization of sowing in the optimal period. The soil tillage system influences the productivity elements of cultivated species and finally the productions thus obtained. Thus, related to conventional working system, the productions registered in minimum tillage working represented 89- 97% in maize, 103-112% in soya-bean, 93-99% in winter-wheat. The results of investigations showed that the yield is a conclusion soil tillage systems influence on soil properties, plant density assurance and on weed control. Under minimum tillage systems in the case of winter weat as an option for replacing classic ploughing, the best results in terms of quality indices were obtained from version worked with paraplow, followed by rotary harrow and chisel. At variants worked with paraplow were obtained quality indices close to those of the variant worked with plow, and protein and gluten content was even higher. At Ariesan variety, highest protein content, 12.50% and gluten, 28.6% was obtained for the variant paraplow.

Keywords: Minimum tillage, soil properties, yields quality.

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Authors: B. B. Rana, M. Yokota, Y. Shimizu, Y. Koide, I. Takamure, T. Kawano, M. Murai

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Various genes which control or affect heading time have been found in rice. Out of them, Se1 and E1 loci play important roles in determining heading time by controlling photosensitivity. An isogenic-line pair of late and early lines were developed from progenies of the F₁ from Suweon 258 × 36U. A lateness gene tentatively designated as “Ex” was found to control the difference in heading time between the early and late lines mentioned above. The present study was conducted to examine the effect of Ex on yield and related traits. Indica-type variety Suweon 258 was crossed with 36U, which is an Ur1 (Undulate rachis-1) isogenic line of IR36. In the F₂ population, comparatively early-heading, late-heading and intermediate-heading plants were segregated. Segregation similar to that by the three types of heading was observed in the F₃ and later generations. A late-heading plant and an early-heading plant were selected in the F₈ population from an intermediate-heading F₇ plant, for developing L and E of the isogenic-line pair, respectively. Experiments for L and E were conducted by randomized block design with three replications. Transplanting was conducted on May 3 at a planting distance of 30 cm × 15 cm with two seedlings per hill to an experimental field of the Faculty of Agriculture, Kochi University. Chemical fertilizers containing N, P₂O₅ and K₂O were applied at the nitrogen levels of 4 g/m², 9 g/m² and 18 g/m² in total being denoted by "N4", "N9" and "N18", respectively. Yield, yield components and other traits were measured. Ex delayed 80%-heading by 17 or 18 days in L as compared with E. In total brown rice yield (g/m²), L was 635, 606 and 590, and E was 577, 548 and 501, respectively, at N18, N9 and N4, indicating that Ex increased this trait by 10% to 18%. Ex increased yield-1.5 mm sieve (g/m²) b 9% to 15% at the three fertilizer levels. Ex increased the spikelet number per panicle by 16% to 22%. As a result, the spikelet number per m² was increased by 11% to 18% at the three fertilizer levels. Ex decreased 1000-grain weight (g) by 2 to 4%. L was not significantly different from E in ripened-grain percentage, fertilized-spikelet percentage and percentage of ripened grains to fertilized spikelets. Hence, it is inferred that Ex increased yield by increasing spikelet number per panicle. Hence, Ex could be utilized to develop high yielding varieties for warmer districts.

Keywords: Heading time, lateness gene, photosensitivity, rice, yield, yield components.

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Authors: Lucie Côté, Martin Lauzier, Guy Beauchamp, France Guertin

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Stress causes deleterious effects to the physical, psychological and organizational levels, which highlight the need to use effective coping strategies to deal with it. Several coping models exist, but they don’t integrate the different strategies in a coherent way nor do they take into account the new research on the emotional coping and acceptance of the stressful situation. To fill these gaps, an integrative model incorporating the main coping strategies was developed. This model arises from the review of the scientific literature on coping and from a qualitative study carried out among workers with low or high levels of stress, as well as from an analysis of clinical cases. The model allows one to understand under what circumstances the strategies are effective or ineffective and to learn how one might use them more wisely. It includes Specific Strategies in controllable situations (the Modification of the Situation and the Resignation-Disempowerment), Specific Strategies in non-controllable situations (Acceptance and Stubborn Relentlessness) as well as so-called General Strategies (Wellbeing and Avoidance). This study is intended to undertake and present the process of development and validation of an instrument to measure coping strategies based on this model. An initial pool of items has been generated from the conceptual definitions and three expert judges have validated the content. Of these, 18 items have been selected for a short form questionnaire. A sample of 300 students and employees from a Quebec university was used for the validation of the questionnaire. Concerning the reliability of the instrument, the indices observed following the inter-rater agreement (Krippendorff’s alpha) and the calculation of the coefficients for internal consistency (Cronbach's alpha) are satisfactory. To evaluate the construct validity, a confirmatory factor analysis using MPlus supports the existence of a model with six factors. The results of this analysis suggest also that this configuration is superior to other alternative models. The correlations show that the factors are only loosely related to each other. Overall, the analyses carried out suggest that the instrument has good psychometric qualities and demonstrates the relevance of further work to establish predictive validity and reconfirm its structure. This instrument will help researchers and clinicians better understand and assess coping strategies to cope with stress and thus prevent mental health issues.

Keywords: Acceptance, coping strategies, measurement instrument, questionnaire, stress, validation process.

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Authors: Mustafa M. Donma, Orkide Donma

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Anthropometric measurements are essential for obesity studies. Waist circumference (WC) is the most frequently used measure and along with hip circumference (HC), it is used in most equations derived for the evaluation of obese individuals. Morbid obesity (MO) is the most severe clinical form of obesity and such individuals may also exhibit some clinical findings leading to metabolic syndrome (MetS). Then, it becomes a requirement to discriminate MO children with MetS (MOMetS+) from MO children without MetS (MOMetS-). Almost all obesity indices can differentiate obese (OB) children from children with normal body mass index (N-BMI). However, not all of them are capable of making this distinction. The aim of this study was to find out the clinical availability of (waist circumference + hip circumference)/2 ((WC+HC)/2) for the differential diagnosis of MOMetS+ and MOMetS- and to compare the possible preponderance of it over some other anthropometric or fat-based obesity indices. 45 MOMetS+ and 45 MOMetS- children were included in the study. Participants have submitted informed consent forms. The study protocol was approved by the Non-interventional Clinical Studies Ethics Committee of Tekirdag Namik Kemal University. Anthropometric measurements were performed. BMI, waist-to-hip circumference (WHR), (WC+HC)/2, trunk-to-leg fat ratio (TLFR), trunk-to-appendicular fat ratio (TAFR), trunk fat+leg fat/2 ((trunk+leg fat)/2), diagnostic obesity notation model assessment index-2 (D2I) and fat mass index (FMI) were calculated for both groups. Study data were analyzed statistically and 0.05 for p value was accepted as the statistical significance degree. Statistically higher BMI, WC, (WC+HC)/2, (trunk+leg fat)/2 values were found in MOMetS+ children than MOMetS- children. No statistically significant difference was detected for WHR, TLFR, TAFR, D2I and FMI between two groups. The lack of difference between the groups in terms of FMI and D2I pointed out the fact that the recently developed fat-based index; (trunk+leg fat)/2 gives much more valuable information during the evaluation of MOMetS+ and MOMetS- children. Upon evaluation of the correlations, (WC+HC)/2 was strongly correlated with D2I and FMI in both MOMetS+ and MOMetS- groups. Neither D2I nor FMI was correlated with W/H. Strong correlations were calculated between (WC+HC)/2 and (trunk+leg fat)/2 in both MOMetS- (r = 0.961; p < 0.001) and MOMetS+ (r = 0.936; p < 0.001) groups. Partial correlations between (WC+HC)/2 and (trunk+leg fat)/2 after controlling the effect of basal metabolic rate were r = 0.726; p < 0.001 in MOMetS- group and r = 0.932; p < 0.001 in MOMetS+ group. The correlation in the latter group was higher than the first group. In conclusion, recently developed anthropometric obesity index (WC+HC)/2 and fat-based obesity index (trunk+leg fat)/2 were of preponderance over the previously introduced classical obesity indices such as WHR, D2I and FMI during the differential diagnosis of MOMetS+ and MOMetS- children.

Keywords: Hip circumference, metabolic syndrome, morbid obesity, waist circumference.

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Authors: Lorenzo Casagrande, Antonio Bonati, Ferdinando Auricchio, Antonio Occhiuzzi

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This paper summarizes the results of a survey on smart non-structural element dynamic dissipation when installed in modern high-rise mega-frame prototypes. An innovative glazed curtain wall was designed using Shape Memory Alloy (SMA) joints in order to increase the energy dissipation and enhance the seismic/wind response of the structures. The studied buildings consisted of thirty- and sixty-storey planar frames, extracted from reference three-dimensional steel Moment Resisting Frame (MRF) with outriggers and belt trusses. The internal core was composed of a CBF system, whilst outriggers were placed every fifteen stories to limit second order effects and inter-storey drifts. These structural systems were designed in accordance with European rules and numerical FE models were developed with an open-source code, able to account for geometric and material nonlinearities. With regard to the characterization of non-structural building components, full-scale crescendo tests were performed on aluminium/glass curtain wall units at the laboratory of the Construction Technologies Institute (ITC) of the Italian National Research Council (CNR), deriving force-displacement curves. Three-dimensional brick-based inelastic FE models were calibrated according to experimental results, simulating the fac¸ade response. Since recent seismic events and extreme dynamic wind loads have generated the large occurrence of non-structural components failure, which causes sensitive economic losses and represents a hazard for pedestrians safety, a more dissipative glazed curtain wall was studied. Taking advantage of the mechanical properties of SMA, advanced smart joints were designed with the aim to enhance both the dynamic performance of the single non-structural unit and the global behavior. Thus, three-dimensional brick-based plastic FE models were produced, based on the innovated non-structural system, simulating the evolution of mechanical degradation in aluminium-to-glass and SMA-to-glass connections when high deformations occurred. Consequently, equivalent nonlinear links were calibrated to reproduce the behavior of both tested and smart designed units, and implemented on the thirty- and sixty-storey structural planar frame FE models. Nonlinear time history analyses (NLTHAs) were performed to quantify the potential of the new system, when considered in the lateral resisting frame system (LRFS) of modern high-rise MRFs. Sensitivity to the structure height was explored comparing the responses of the two prototypes. Trends in global and local performance were discussed to show that, if accurately designed, advanced materials in non-structural elements provide new sources of energy dissipation.

Keywords: Advanced technologies, glazed curtain walls, non-structural elements, seismic-action reduction, shape memory alloy.

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Authors: Igbakura I. Luga, Alex A. Adikwu

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A comparison of resistance to quinolones was carried out on isolates of Shiga toxin-producing Escherichia coliO157:H7 from cattle and mecA and nuc genes harbouring Staphylococcus aureus from pigs. The isolates were separately tested in the first and current decades of the 21^st century. The objective was to demonstrate the dissemination of resistance to this frontline class of antibiotic by bacteria from food animals and bring to the limelight the spread of antibiotic resistance in Nigeria. A total of 10 isolates of the E. coli O157:H7 and 9 of mecA and nuc genes harbouring S. aureus were obtained following isolation, biochemical testing, and serological identification using the Remel Wellcolex E. coli O157:H7 test. Shiga toxin-production screening in the E. coli O157:H7 using the verotoxin E. coli reverse passive latex agglutination (VTEC-RPLA) test; and molecular identification of the mecA and nuc genes in S. aureus. Detection of the mecA and nuc genes were carried out using the protocol by the Danish Technical University (DTU) using the following primers mecA-1:5'-GGGATCATAGCGTCATTATTC-3', mecA-2: 5'-AACGATTGTGACACGATAGCC-3', nuc-1: 5'-TCAGCAAATGCATCACAAACAG-3', nuc-2: 5'-CGTAAATGCACTTGCTTCAGG-3' for the mecA and nuc genes, respectively. The nuc genes confirm the S. aureus isolates and the mecA genes as being methicillin-resistant and so pathogenic to man. The fluoroquinolones used in the antibiotic resistance testing were norfloxacin (10 µg) and ciprofloxacin (5 µg) in the E. coli O157:H7 isolates and ciprofloxacin (5 µg) in the S. aureus isolates. Susceptibility was tested using the disk diffusion method on Muller-Hinton agar. Fluoroquinolone resistance was not detected from isolates of E. coli O157:H7 from cattle. However, 44% (4/9) of the S. aureus were resistant to ciprofloxacin. Resistance of up to 44% in isolates of mecA and nuc genes harbouring S. aureus is a compelling evidence for the rapid spread of antibiotic resistance from bacteria in food animals from Nigeria. Ciprofloxacin is the drug of choice for the treatment of Typhoid fever, therefore widespread resistance to it in pathogenic bacteria is of great public health significance. The study concludes that antibiotic resistance in bacteria from food animals is on the increase in Nigeria. The National Food and Drug Administration and Control (NAFDAC) agency in Nigeria should implement the World Health Organization (WHO) global action plan on antimicrobial resistance. A good starting point can be coordinating the WHO, Office of International Epizootics (OIE), Food and Agricultural Organization (FAO) tripartite draft antimicrobial resistance monitoring and evaluation (M&E) framework in Nigeria.

Keywords: Fluoroquinolone, Nigeria, resistance, Staphylococcus aureus.

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Authors: Maciej Zasuwa, Grzegorz Ptasinski, Antoni Kopyt

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Nowadays flight simulators offer tremendous possibilities for safe and cost-effective pilot training, by utilization of powerful, computational tools. Due to technology outpacing methodology, vast majority of training related work is done by human instructors. It makes assessment not efficient, and vulnerable to instructors’ subjectivity. The research presents an Objective Assessment Tool (gOAT) developed at the Warsaw University of Technology, and tested on SW-4 helicopter flight simulator. The tool uses database of the predefined manoeuvres, defined and integrated to the virtual environment. These were implemented, basing on Aeronautical Design Standard Performance Specification Handling Qualities Requirements for Military Rotorcraft (ADS-33), with predefined Mission-Task-Elements (MTEs). The core element of the gOAT enhanced algorithm that provides instructor a new set of information. In details, a set of objective flight parameters fused with report about psychophysical state of the pilot. While the pilot performs the task, the gOAT system automatically calculates performance using the embedded algorithms, data registered by the simulator software (position, orientation, velocity, etc.), as well as measurements of physiological changes of pilot’s psychophysiological state (temperature, sweating, heart rate). Complete set of measurements is presented on-line to instructor’s station and shown in dedicated graphical interface. The presented tool is based on open source solutions, and flexible for editing. Additional manoeuvres can be easily added using guide developed by authors, and MTEs can be changed by instructor even during an exercise. Algorithm and measurements used allow not only to implement basic stress level measurements, but also to reduce instructor’s workload significantly. Tool developed can be used for training purpose, as well as periodical checks of the aircrew. Flexibility and ease of modifications allow the further development to be wide ranged, and the tool to be customized. Depending on simulation purpose, gOAT can be adjusted to support simulator of aircraft, helicopter, or unmanned aerial vehicle (UAV).

Keywords: Automated assessment, flight simulator, human factors, pilot training.

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Authors: Essam Abd-Elrazek

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With the rapid growth in business size, today-s businesses orient Throughout thirty years local, national and international experience in medicine as a medical student, junior doctor and eventually Consultant and Professor in Anaesthesia, Intensive Care and Pain Management, I note significant generalised dissatisfaction among medical students and doctors regarding their medical education and practice. We repeatedly hear complaints from patients about the dysfunctional health care system they are dealing with and subsequently the poor medical service that they are receiving. Medical students are bombarded with lectures, tutorials, clinical rounds and various exams. Clinicians are weighed down with a never-ending array of competing duties. Patients are extremely unhappy about the long waiting lists, loss of their records and the continuous deterioration of the health care service. This problem has been reported in different countries by several authors [1,2,3]. In a trial to solve this dilemma, a genuine idea has been suggested implementing computer technology in medicine [2,3]. Computers in medicine are a medium of international communication of the revolutionary advances being made in the application of the computer to the fields of bioscience and medicine [4,5]. The awareness about using computers in medicine has recently increased all over the world. In Misr University for Science & Technology (MUST), Egypt, medical students are now given hand-held computers (Laptop) with Internet facility making their medical education accessible, convenient and up to date. However, this trial still needs to be validated. Helping the readers to catch up with the on going fast development in this interesting field, the author has decided to continue reviewing the literature, exploring the state-of-art in computer based medicine and up dating the medical professionals especially the local trainee Doctors in Egypt. In part I of this review article we will give a general background discussing the potential use of computer technology in the various aspects of the medical field including education, research, clinical practice and the health care service given to patients. Hope this will help starting changing the culture, promoting the awareness about the importance of implementing information technology (IT) in medicine, which is a field in which such help is needed. An international collaboration is recommended supporting the emerging countries achieving this target.

Keywords: Medical Informatics, telemedicine, e-health systems.

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Authors: Mustafa M. Donma, Orkide Donma

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Zinc (Zn) is a vital element required for growth and development particularly in children. It exhibits some protective effects against cardiovascular diseases (CVDs). Zn may be a potential biomarker of cardiovascular health. High sensitive cardiac troponin T (hs-cTnT) and cardiac myosin binding protein C (cMyBP-C) are new generation markers used for prediagnosis, diagnosis and prognosis of CVDs. The aim of this study is to determine Zn as well as new generation cardiac markers’ profiles in children with normal body mass index (N-BMI), obese (OB), morbid obese (MO) children and children with metabolic syndrome (MetS) findings. The association among them will also be investigated. Four study groups were constituted. The study protocol was approved by the institutional Ethics Committee of Tekirdag Namik Kemal University. Parents of the participants filled informed consent forms to participate in the study. Group 1 is composed of 44 children with N-BMI. Group 2 and Group 3 comprised 43 OB and 45 MO children, respectively. 45 MO children with MetS findings were included in Group 4. World Health Organization age- and sex-adjusted BMI percentile tables were used to constitute groups. These values were 15-85, 95-99 and above 99 for N-BMI, OB and MO, respectively. Criteria for MetS findings were determined. Routine biochemical analyses including Zn were performed. hs-cTnT and cMyBP-C concentrations were measured by enzyme-linked immunosorbent assay. Data were analyzed by using SPSS software. p < 0.05 was accepted as significant. Four groups were matched for age and gender. Decreased Zn concentrations were measured in Groups 2, 3 and 4 compared to Group 1. Groups did not differ from one another in terms of hs-cTnT. There were statistically significant differences between cMyBP-C levels of MetS group and N-BMI as well as OB groups. There was an increasing trend going from N-BMI group to MetS group. There were statistically significant negative correlations between Zn and hs-cTnT as well as cMyBP-C concentrations in MetS group. In conclusion, inverse correlations detected between Zn and new generation cardiac markers (hs-TnT and cMyBP-C) have pointed out that decreased levels of Zn accompany increased levels of hs-cTnT as well as cMyBP-C in children with MetS. This finding emphasizes that both Zn and these new generation cardiac markers may be evaluated as biomarkers of cardiovascular health during severe childhood obesity precipitated with MetS findings and also suggested as the messengers of the future risk in the adulthood periods of children with MetS.

Keywords: Cardiac myosin binding protein-C, cardiovascular diseases, children, high sensitive cardiac troponin T, obesity.

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Authors: U. K. Hulihalli, Shantveerayya

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Buckwheat (Fagopyrum esculentum Moench) is an annual crop belongs to family Poligonaceae. The cultivated buckwheat species are notable for their exceptional nutritive values. It is an important source of carbohydrates, fibre, macro, and microelements such as K, Ca, Mg, Na and Mn, Zn, Se, and Cu. It also contains rutin, flavonoids, riboflavin, pyridoxine and many amino acids which have beneficial effects on human health, including lowering both blood lipid and sugar levels. Rutin, quercetin and some other polyphenols are potent carcinogens against colon and other cancers. Buckwheat has significant nutritive value and plenty of uses. Cultivation of buckwheat in Sothern part of India is very meager. Hence, a study was planned with an objective to know the performance of buckwheat genotypes to different planting geometries and fertility levels. The field experiment was conducted at Main Agriculture Research Station, University of Agriculture Sciences, Dharwad, India, during 2017 Kharif. The experiment was laid-out in split-plot design with three replications having three planting geometries as main plots, two genotypes as sub plots and three fertility levels as sub-sub plot treatments. The soil of the experimental site was vertisol. The standard procedures are followed to record the observations. The planting geometry of 30*10 cm was recorded significantly higher seed yield (893 kg/ha⁻¹), stover yield (1507 kg ha⁻¹), clusters plant⁻¹ (7.4), seeds clusters⁻¹ (7.9) and 1000 seed weight (26.1 g) as compared to 40*10 cm and 20*10 cm planting geometries. Between the genotypes, significantly higher seed yield (943 kg ha⁻¹) and harvest index (45.1) was observed with genotype IC-79147 as compared to PRB-1 genotype (687 kg ha⁻¹ and 34.2, respectively). However, the genotype PRB-1 recorded significantly higher stover yield (1344 kg ha⁻¹) as compared to genotype IC-79147 (1173 kg ha⁻¹). The genotype IC-79147 was recorded significantly higher clusters plant⁻¹ (7.1), seeds clusters⁻¹ (7.9) and 1000 seed weight (24.5 g) as compared PRB-1 (5.4, 5.8 and 22.3 g, respectively). Among the fertility levels tried, the fertility level of 60:30 NP kg ha⁻¹ recorded significantly higher seed yield (845 kg ha^-1) and stover yield (1359 kg ha⁻¹) as compared to 40:20 NP kg ha^-1 (808 and 1259 kg ha⁻¹ respectively) and 20:10 NP kg ha^-1 (793 and 1144 kg ha⁻¹ respectively). Within the treatment combinations, IC 79147 genotype having 30*10 cm planting geometry with 60:30 NP kg ha⁻¹ recorded significantly higher seed yield (1070 kg ha⁻¹), clusters plant⁻¹ (10.3), seeds clusters⁻¹ (9.9) and 1000 seed weight (27.3 g) compared to other treatment combinations.

Keywords: Buckwheat, fertility levels, genotypes, geometry, polyphenols, rutin.

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Authors: Mihriban Korukluoglu, Goksen Arik, Cagla Erdogan, Selen Kocakoglu

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Kefir is a traditional fermented refreshing beverage which is known for its valuable and beneficial properties for human health. Mainly yeast species, lactic acid bacteria (LAB) strains and fewer acetic acid bacteria strains live together in a natural matrix named “kefir grain”, which is formed from various proteins and polysaccharides. Different microbial species live together in slimy kefir grain and it has been thought that synergetic effect could take place between microorganisms, which belong to different genera and species. In this research, yeast and LAB were isolated from kefir samples obtained from Uludag University Food Engineering Department. The cell morphology of isolates was screened by microscopic examination. Gram reactions of bacteria isolates were determined by Gram staining method, and as well catalase activity was examined. After observing the microscopic/morphological and physical, enzymatic properties of all isolates, they were divided into the groups as LAB and/or yeast according to their physicochemical responses to the applied examinations. As part of this research, the antagonistic/synergistic efficacy of the identified five LAB and five yeast strains to each other were determined individually by disk diffusion method. The antagonistic or synergistic effect is one of the most important properties in a co-culture system that different microorganisms are living together. The synergistic effect should be promoted, whereas the antagonistic effect is prevented to provide effective culture for fermentation of kefir. The aim of this study was to determine microbial interactions between identified yeast and LAB strains, and whether their effect is antagonistic or synergistic. Thus, if there is a strain which inhibits or retards the growth of other strains found in Kefir microflora, this circumstance shows the presence of antagonistic effect in the medium. Such negative influence should be prevented, whereas the microorganisms which have synergistic effect on each other should be promoted by combining them in kefir grain. Standardisation is the most desired property for industrial production. Each microorganism found in the microbial flora of a kefir grain should be identified individually. The members of the microbial community found in the glue-like kefir grain may be redesigned as a starter culture regarding efficacy of each microorganism to another in kefir processing. The main aim of this research was to shed light on more effective production of kefir grain and to contribute a standardisation of kefir processing in the food industry.

Keywords: Antagonistic effect, kefir, lactic acid bacteria (LAB), synergistic, yeast.

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Authors: Chrysoula Karathanasi, Senad Karavdic, Angela Odero, Michèle Baumann

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It is not only the economic determinants that impact on life conditions, but maintaining a good level of life satisfaction (LS) may also be an important challenge currently. In Luxembourg, university students receive financial aid from the government. They are then registered at the Centre for Documentation and Information on Higher Education (CEDIES). Luxembourg is built on migration with almost half its population consisting of foreigners. It is upon this basis that our research aims to analyze the associations with mental health factors (health satisfaction, psychological quality of life, worry), perceived financial situation, career attitudes (adaptability, optimism, knowledge, planning) and LS, for non-Luxembourgish and native postgraduate students. Between 2012 and 2013, postgraduates registered at CEDIES were contacted by post and asked to participate in an online survey with either the option of English or French. The study population comprised of 644 respondents. Our statistical analysis excluded: those born abroad who had Luxembourgish citizenship, or those born in Luxembourg who did not have citizenship. Two groups were formed one consisting 147 non-Luxembourgish and the other 284 natives. A single item measured LS (1=not at all satisfied to 10=very satisfied). Bivariate tests, correlations and multiple linear regression models were used in which only significant relationships (p<0.05) were integrated. Among the two groups no differences were found between LS indicators (7.8/10 non-Luxembourgish; 8.0/10 natives) as both were higher than the European indicator of 7.2/10 (for 25-34 years). In the case of non-Luxembourgish students, they were older than natives (29.3 years vs. 26.3 years) perceived their financial situation as more difficult, and a higher percentage of their parents had an education level higher than a Bachelor's degree (father 59.2% vs 44.6% for natives; mother 51.4% vs 33.7% for natives). In addition, the father’s education was related to the LS of postgraduates and the higher was the score, the greater was the contribution to LS. Whereas for native students, when their scores of health satisfaction and career optimism were higher, their LS’ score was higher. For both groups their LS was linked to mental health-related factors, perception of their financial situation, career optimism, adaptability and planning. The higher the psychological quality of life score was, the greater the LS of postgraduates’ was. Good health and positive attitudes related to the job market enhanced their LS indicator.

Keywords: Career attitudes, fathers’ education level, life satisfaction, mental health.

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Authors: Mohammad K. Abedin, Mohammad Shahjahan, Zeenat Sultana, Tawfique Jahan, Jesmin Akter

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To strengthen social and behavior change communication (SBCC) capacity of Ministry of Health and Family Welfare (MoHFW) of the Government of Bangladesh, BCCP/BKMI developed two eLearning courses providing opportunities for professional development of SBCC Program Managers who have no access to training or refreshers training. The two eLearning courses – Message and Material Development (MMD) and Monitoring and Evaluation (MandE) of SBCC programs – went online in September 2015, where all users could register their participation so results could be monitored. Methodology: To assess the uses of these courses a randomly selected sample was collected to run a pre and post-test analyses and a phone survey were conducted. Systematic random sampling was used to select a sample of 75 MandE and 25 MMD course participants from a sampling frame of 179 and 51 respectively. Results: As of September 2016, more than 179 learners have completed the MandE course, and 49 learners have completed the MMD course. The users of these courses are program managers, university faculty members, and students. Encouraging results were revealed from the analysis of pre and post-test scores and a phone survey three months after course completion. Test scores suggested a substantial increase in knowledge. The pre-test scores findings suggested that about 19% learners scored high on the MandE. The post-test scores finding indicated a high score (92%) of the sample across 4 modules of MandE. For MMD course in pre-test scoring, 30% of the learners scored high, and 100% scored high at the post-test. It was found that all the learners in the phone survey have discussed the courses. Most of the sharing occurred with colleagues and friends, usually through face to face (70%) interaction. The learners reported that they did recommend the two courses to concerned people. About 67% MandE and 76% MMD learners stated that the concepts that they had to learn during the course were put into practice in their work settings. The respondents for both MandE and MMD courses have provided a valuable set of suggestions that would further strengthen the courses. Conclusions: The study showed that the initiative offered ample opportunities to build capacity in various ways in which the eLearning courses were used. It also highlighted the importance of scaling up these efforts to further strengthen the outcomes.

Keywords: E-learning course, message and material development, monitoring and evaluation, social and behavior change communication.

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Authors: Mustafa M. Donma

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Metabolic syndrome (MetS) components are noteworthy among children with obesity and morbid obesity, because they point out the cases with MetS, which have the great tendency to severe health problems such as cardiovascular diseases both in childhood and adulthood. In clinical practice, considerable efforts are being observed to bring into the open the striking differences between morbid obese cases and those with MetS findings. The most privileged aspect is concerning cardiometabolic features. The aim of this study was to derive an index, which behaves different in children with and without MetS from the cardiac point of view. For the purpose, aspartate transaminase (AST), a cardiac enzyme still being used independently to predict cardiac-related problems was used. 124 children were recruited from the outpatient clinic of Department of Pediatrics in Tekirdag Namik Kemal University, Faculty of Medicine. 43 children with normal body mass index, 41 and 40 morbid obese (MO) children with MetS and without the characteristic features of MetS, respectively, were included in the study. Weight, height, waist circumference (WC), hip circumference (HC), head circumference (HdC), neck circumference (NC), systolic and diastolic blood pressure values were measured and recorded. Body mass index and anthropometric ratios were calculated. Fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein cholesterol (HDL-C) analyses were performed. The values for AST, alanine transaminase (ALT) and AST/ALT were obtained. Advanced Donma cardiac index (ADCI) values were calculated. Statistical evaluations including correlation analysis were done by a statistical package program. The statistical significance degree was accepted as p < 0.05. The index, ADCI, was developed from both anthropometric and biochemical parameters. All anthropometric measurements except weight were included in the equation. Besides all biochemical parameters concerning MetS components were also added. This index was tested in each of three groups. Its performance was compared with the performance of cardiometabolic index (CMI). It was also checked whether it was compatible with AST activity. The performance of ADCI was better than that of CMI. Instead of double increase, the increase of three times was observed in children with MetS compared to MO children. The index was correlated with AST in MO group and with AST/ALT in MetS group. In conclusion, this index was superior in discovering cardiac problems in MO and in diagnosing MetS in MetS groups. It was also arbiter to point out cardiovascular and MetS aspects among the groups.

Keywords: Aspartate transaminase, cardiac index, metabolic syndrome, obesity.

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Authors: É. Vincze

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Demand on plant oils has increased to an enormous extent that is due to the change of human nutrition habits on the one hand, while on the other hand to the increase of raw material demand of some industrial sectors, just as to the increase of biofuel production. Besides the determining importance of sunflower in Hungary the production area, just as in part the average yield amount of rapeseed has increased among the produced oil crops. The variety/hybrid palette has changed significantly during the past decade. The available varieties’/hybrids’ palette has been extended to a significant extent. It is agreed that rapeseed production demands professionalism and local experience. Technological elements are successive; high yield amounts cannot be produced without system-based approach. The aim of the present work was to execute the complex study of one of the most critical production technology element of rapeseed production, that was sowing technology. Several sowing technology elements are studied in this research project that are the following: biological basis (the hybrid Arkaso is studied in this regard), sowing time (sowing time treatments were set so that they represent the wide period used in industrial practice: early, optimal and late sowing time) plant density (in this regard reaction of rare, optimal and too dense populations) were modelled. The multifactorial experimental system enables the single and complex evaluation of rapeseed sowing technology elements, just as their modelling using experimental result data. Yield quality and quantity have been determined as well in the present experiment, just as the interactions between these factors. The experiment was set up in four replications at the Látókép Plant Production Research Site of the University of Debrecen. Two different sowing times were sown in the first experimental year (2014), while three in the second (2015). Three different plant densities were set in both years: 200, 350 and 500 thousand plants ha-1. Uniform nutrient supply and a row spacing of 45 cm were applied. Winter wheat was used as pre-crop. Plant physiological measurements were executed in the populations of the Arkaso rapeseed hybrid that were: relative chlorophyll content analysis (SPAD) and leaf area index (LAI) measurement. Relative chlorophyll content (SPAD) and leaf area index (LAI) were monitored in 7 different measurement times.

Keywords: Inner quality, plant density, rapeseed, sowing time.

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Authors: Mustafa M. Donma, Orkide Donma

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Alterations in lipid parameters as well as in the fat distribution of the body are noteworthy during the evaluation of obesity stages. Total cholesterol (TC), triglycerides (TRG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C) are basic lipid fractions. Fat deposited in trunk and extremities may give considerable amount of information. Ratios such as trunk-to-leg fat ratio (TLFR) and trunk-to-appendicular fat ratio (TAFR) are derived from distinct fat distribution in these areas. In this study, lipid fractions and TLFR as well as TAFR were evaluated and the distinctions among healthy, obese (OB) and morbid obese (MO) groups were investigated. Three groups [normal body mass index (N-BMI), OB, MO] were constituted. Ages and sexes of the groups were matched. The study protocol was approved by the Non-interventional Ethics Committee of Tekirdag Namik Kemal University. Written informed consent forms were obtained from the parents of the participants. Anthropometric measurements (height, weight, waist circumference, hip circumference, head circumference, neck circumference) were recorded during the physical examination. BMI values were calculated. Total, trunk, leg and arm fat mass values were obtained by TANITA Bioelectrical Impedance Analysis. These values were used to calculate TLFR and TAFR. Systolic (SBP) and diastolic blood pressures (DBP) were measured. Routine biochemical tests including lipid fractions were performed. Data were evaluated using SPSS software. p value smaller than 0.05 was accepted as significant. There was no difference among the age values and gender ratios of the groups. Any statistically significant difference was not observed in terms of DBP, TLFR as well as serum lipid fractions. Higher SBP values were measured both in OB and MO children than those with N-BMI. TAFR showed a significant difference between N-BMI and OB groups. Statistically significant increases were detected between insulin values of N-BMI group and OB as well as MO groups. There were bivariate correlations between LDL and TLFR as well as TAFR values in MO group. When adjusted for SBP and DBP, partial correlations were calculated for LDL-TLFR as well as LDL-TAFR. Much stronger partial correlations were obtained for the same couples upon controlling for TRG and HDL-C. Much stronger partial correlations observed in MO children emphasize the potential transition from morbid obesity to metabolic syndrome. These findings have concluded that LDL-C may be suggested as a discriminating parameter between OB and MO children.

Keywords: Children, lipid parameters, obesity, trunk-to-leg fat ratio, trunk-to-appendicular fat ratio.

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Authors: Orkide Donma, Mustafa M. Donma

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Basal metabolic rate (BMR) is widely used and an accepted measure of energy expenditure. Its principal determinant is body mass. However, this parameter is also correlated with a variety of other factors. The objective of this study is to measure BMR and compare it with the values obtained from predictive equations in adults classified according to their body mass index (BMI) values. 276 adults were included into the scope of this study. Their age, height and weight values were recorded. Five groups were designed based on their BMI values. First group (n = 85) was composed of individuals with BMI values varying between 18.5 and 24.9 kg/m². Those with BMI values varying from 25.0 to 29.9 kg/m² constituted Group 2 (n = 90). Individuals with 30.0-34.9 kg/m², 35.0-39.9 kg/m², > 40.0 kg/m² were included in Group 3 (n = 53), 4 (n = 28) and 5 (n = 20), respectively. The most commonly used equations to be compared with the measured BMR values were selected. For this purpose, the values were calculated by the use of four equations to predict BMR values, by name, introduced by Food and Agriculture Organization (FAO)/World Health Organization (WHO)/United Nations University (UNU), Harris and Benedict, Owen and Mifflin. Descriptive statistics, ANOVA, post-Hoc Tukey and Pearson’s correlation tests were performed by a statistical program designed for Windows (SPSS, version 16.0). p values smaller than 0.05 were accepted as statistically significant. Mean ± SD of groups 1, 2, 3, 4 and 5 for measured BMR in kcal were 1440.3 ± 210.0, 1618.8 ± 268.6, 1741.1 ± 345.2, 1853.1 ± 351.2 and 2028.0 ± 412.1, respectively. Upon evaluation of the comparison of means among groups, differences were highly significant between Group 1 and each of the remaining four groups. The values were increasing from Group 2 to Group 5. However, differences between Group 2 and Group 3, Group 3 and Group 4, Group 4 and Group 5 were not statistically significant. These insignificances were lost in predictive equations proposed by Harris and Benedict, FAO/WHO/UNU and Owen. For Mifflin, the insignificance was limited only to Group 4 and Group 5. Upon evaluation of the correlations of measured BMR and the estimated values computed from prediction equations, the lowest correlations between measured BMR and estimated BMR values were observed among the individuals within normal BMI range. The highest correlations were detected in individuals with BMI values varying between 30.0 and 34.9 kg/m². Correlations between measured BMR values and BMR values calculated by FAO/WHO/UNU as well as Owen were the same and the highest. In all groups, the highest correlations were observed between BMR values calculated from Mifflin and Harris and Benedict equations using age as an additional parameter. In conclusion, the unique resemblance of the FAO/WHO/UNU and Owen equations were pointed out. However, mean values obtained from FAO/WHO/UNU were much closer to the measured BMR values. Besides, the highest correlations were found between BMR calculated from FAO/WHO/UNU and measured BMR. These findings suggested that FAO/WHO/UNU was the most reliable equation, which may be used in conditions when the measured BMR values are not available.

Keywords: Adult, basal metabolic rate, FAO/WHO/UNU, obesity, prediction equations.

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Authors: R. Clancy, M. Ahern, D. O’Sullivan, K. Bruton

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The manufacturing industry is currently undergoing a digital transformation as part of the mega-trend Industry 4.0. As part of this phase of the industrial revolution, traditional manufacturing processes are being combined with digital technologies to achieve smarter and more efficient production. To successfully digitally transform a manufacturing facility, the processes must first be digitized. This is the conversion of information from an analogue format to a digital format. The objective of this study was to explore the research area of digitizing manufacturing data as part of the worldwide paradigm, Industry 4.0. The formal methodology of a systematic mapping study was utilized to capture a representative sample of the research area and assess its current state. Specific research questions were defined to assess the key benefits and limitations associated with the digitization of manufacturing data. Research papers were classified according to the type of research and type of contribution to the research area. Upon analyzing 54 papers identified in this area, it was noted that 23 of the papers originated in Germany. This is an unsurprising finding as Industry 4.0 is originally a German strategy with supporting strong policy instruments being utilized in Germany to support its implementation. It was also found that the Fraunhofer Institute for Mechatronic Systems Design, in collaboration with the University of Paderborn in Germany, was the most frequent contributing Institution of the research papers with three papers published. The literature suggested future research directions and highlighted one specific gap in the area. There exists an unresolved gap between the data science experts and the manufacturing process experts in the industry. The data analytics expertise is not useful unless the manufacturing process information is utilized. A legitimate understanding of the data is crucial to perform accurate analytics and gain true, valuable insights into the manufacturing process. There lies a gap between the manufacturing operations and the information technology/data analytics departments within enterprises, which was borne out by the results of many of the case studies reviewed as part of this work. To test the concept of this gap existing, the researcher initiated an industrial case study in which they embedded themselves between the subject matter expert of the manufacturing process and the data scientist. Of the papers resulting from the systematic mapping study, 12 of the papers contributed a framework, another 12 of the papers were based on a case study, and 11 of the papers focused on theory. However, there were only three papers that contributed a methodology. This provides further evidence for the need for an industry-focused methodology for digitizing and analyzing manufacturing data, which will be developed in future research.

Keywords: Analytics, digitization, industry 4.0, manufacturing.

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Authors: Niwatchai Namwichisirikul

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Due to the emergence of “Humanized Healthcare" introduced by Professor Dr. Prawase Wasi in 2003[1], the development of this paradigm tends to be widely implemented. The organizations included Healthcare Accreditation Institute (public organization), National Health Foundation, Mahidol University in cooperation with Thai Health Promotion Foundation, and National Health Security Office (Thailand) have selected the hospitals or infirmaries that are qualified for humanized healthcare since 2008- 2010 and 35 of them are chosen to be the outstandingly navigating organizations for the development of humanized healthcare, humanized healthcare award [2]. The research aims to study the current issue, characteristics and patterns of hospital administration contributing to humanized healthcare system in Thailand. The selected case studies are from four hospitals including Dansai Crown Prince Hospital, Leoi; Ubolrattana Hospital, Khon Kaen; Kapho Hospital, Pattani; and Prathai Hospital, Nakhonrachasima. The methodology is in-depth interviewing with 10 staffs working as hospital executive directors, and representatives from leader groups including directors, multidisciplinary hospital committees, personnel development committees, physicians and nurses in each hospital. (Total=40) In addition, focus group discussions between hospital staffs and general people (including patients and their relatives, the community leader, and other people) are held by means of setting 4 groups including 8 people within each group. (Total=128) The observation on the working in each hospital is also implemented. The findings of the study reveal that there are five important aspects found in each hospital including (1) the quality improvement under the mental and spiritual development policy from the chief executives and lead teams, leaders as Role model and they have visionary leadership; (2) the participation hospital administration system focusing on learning process and stakeholder- needs, spiritual human resource management and development; (3) the relationship among people especially staffs, team work skills, mutual understanding, effective communication and personal inner-development; (4) organization culture relevant to the awareness of patients- rights as well as the participation policy including spiritual growth achieving to the same goals, sharing vision, developing public mind, and caring; and (5) healing structures or environment providing warmth and convenience for hospital staffs, patients and their relatives and visitors.

Keywords: Hospital administration, Humanized healthcare.

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Authors: Jacqueline M. Dias, Amina A Khowaja

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Clinical education is one of the most important components of a nursing curriculum as it develops the students’ cognitive, psychomotor and affective skills. Clinical teaching ensures the integration of knowledge into practice. As the numbers of students increase in the field of nursing coupled with the faculty shortage, clinical preceptors are the best choice to ensure student learning in the clinical settings. The clinical preceptor role has been introduced in the undergraduate nursing programme. In Pakistan, this role emerged due to a faculty shortage. Initially, two clinical preceptors were hired. This study will explore clinical preceptors views and experiences of precepting Bachelor of Science in Nursing (BScN) students in an undergraduate program. A case study design was used. As case studies explore a single unit of study such as a person or very small number of subjects; the two clinical preceptors were fundamental to the study and served as a single case. Qualitative data were obtained through an iterative process using in depth interviews and written accounts from reflective journals that were kept by the clinical preceptors. The findings revealed that the clinical preceptors were dedicated to their roles and responsibilities. Another, key finding was that clinical preceptors’ prior knowledge and clinical experience were valuable assets to perform their role effectively. The clinical preceptors found their new role innovative and challenging; it was stressful at the same time. Findings also revealed that in the clinical agencies there were unclear expectations and role ambiguity. Furthermore, clinical preceptors had difficulty integrating theory into practice in the clinical area and they had difficulty in giving feedback to the students. Although this study is localized to one university, generalizations can be drawn from the results. The key findings indicate that the role of a clinical preceptor is demanding and stressful. Clinical preceptors need preparation prior to precepting students on clinicals. Also, institutional support is fundamental for their acceptance. This paper focuses on the views and experiences of clinical preceptors undertaking a newly established role and resonates with the literature. The following recommendations are drawn to strengthen the role of the clinical preceptors: A structured program for clinical preceptors is needed along with mentorship. Clinical preceptors should be provided with formal training in teaching and learning with emphasis on clinical teaching and giving feedback to students. Additionally, for improving integration of theory into practice, clinical modules should be provided ahead of the clinical. In spite of all the challenges, ten more clinical preceptors have been hired as the faculty shortage continues to persist.

Keywords: Baccalaureate nursing education, clinical education, clinical preceptors, nursing curriculum.

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Authors: Ivana Scidà, Francesco Alotto, Anna Osello

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Due to the importance given today to innovation, the education sector is evolving thanks digital technologies. Virtual Reality (VR) can be a potential teaching tool offering many advantages in the field of training and education, as it allows to acquire theoretical knowledge and practical skills using an immersive experience in less time than the traditional educational process. These assumptions allow to lay the foundations for a new educational environment, involving and stimulating for students. Starting from the objective of strengthening the innovative teaching offer and the learning processes, the case study of the research concerns the digitalization of MastrLAB, High Quality Laboratory (HQL) belonging to the Department of Structural, Building and Geotechnical Engineering (DISEG) of the Polytechnic of Turin, a center specialized in experimental mechanical tests on traditional and innovative building materials and on the structures made with them. The MastrLAB-VR has been developed, a revolutionary innovative training tool designed with the aim of educating the class in total safety on the techniques of use of machinery, thus reducing the dangers arising from the performance of potentially dangerous activities. The virtual laboratory, dedicated to the students of the Building and Civil Engineering Courses of the Polytechnic of Turin, has been projected to simulate in an absolutely realistic way the experimental approach to the structural tests foreseen in their courses of study: from the tensile tests to the relaxation tests, from the steel qualification tests to the resilience tests on elements at environmental conditions or at characterizing temperatures. The research work proposes a methodology for the virtualization of technical laboratories through the application of Building Information Modelling (BIM), starting from the creation of a digital model. The process includes the creation of an independent application, which with Oculus Rift technology will allow the user to explore the environment and interact with objects through the use of joypads. The application has been tested in prototype way on volunteers, obtaining results related to the acquisition of the educational notions exposed in the experience through a virtual quiz with multiple answers, achieving an overall evaluation report. The results have shown that MastrLAB-VR is suitable for both beginners and experts and will be adopted experimentally for other laboratories of the University departments.

Keywords: Building Information Modelling, digital learning, education, virtual laboratory, virtual reality.

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Authors: Kari Björn, Mikael Soini

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Higher Education system reforms, especially Finnish system of Universities of Applied Sciences in 2014 are discussed. The new steering model is based on major legislative changes, output-oriented funding and open information. The governmental steering reform, especially the financial model and the resulting institutional level responses, such as a curriculum reforms are discussed, focusing especially in engineering programs. The paper is motivated by management need to establish objective steering-related performance indicators and to apply them consistently across all educational programs. The close relationship to governmental steering and funding model imply that internally derived indicators can be directly applied. Metropolia University of Applied Sciences (MUAS) as a case institution is briefly introduced, focusing on engineering education in Information and Communications Technology (ICT), and its related programs. The reform forced consolidation of previously separate smaller programs into fewer units of student application. New curriculum ICT students have a common first year before they apply for a Major. A framework of parallel and longitudinal comparisons is introduced and used across Majors in two campuses. The new externally introduced performance criteria are applied internally on ICT Majors using data ex-ante and ex-post of program merger.  A comparative performance of the Majors after completion of joint first year is established, focusing on previously omitted Majors for completeness of analysis. Some new research questions resulting from transfer of Majors between campuses and quota setting are discussed. Practical orientation identifies best practices to share or targets needing most attention for improvement. This level of analysis is directly applicable at student group and teaching team level, where corrective actions are possible, when identified. The analysis is quantitative and the nature of the corrective actions are not discussed. Causal relationships and factor analysis are omitted, because campuses, their staff and various pedagogical implementation details contain still too many undetermined factors for our limited data. Such qualitative analysis is left for further research. Further study must, however, be guided by the relevance of the observations.

Keywords: Engineering education, integrated curriculum, learning outcomes, performance measurement.

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Authors: Peter Boyes, Sarah Sharples, Paul Tennent, Gary Priestnall, Jeremy Morley

Abstract:

Significant long-term investment projects can involve complex decisions. These are often described as capital projects and the factors that contribute to their complexity include budgets, motivating reasons for investment, stakeholder involvement, interdependent projects, and the delivery phases required. The complexity of these projects often requires management groups to be established involving stakeholder representatives, these teams are inherently multidisciplinary. This study uses two university campus capital projects as case studies for this type of management group. Due to the interaction of projects with wider campus infrastructure and users, decisions are made at varying spatial granularity throughout the project lifespan. This spatial-related context brings complexity to the group decisions. Sensemaking is the process used to achieve group situational awareness of a complex situation, enabling the team to arrive at a consensus and make a decision. The purpose of this study is to understand the role of people and data in complex spatial related long-term decision and sensemaking processes. The paper aims to identify and present issues experienced in practical settings of these types of decision. A series of exploratory semi-structured interviews with members of the two projects elicit an understanding of their operation. From two stages of thematic analysis, inductive and deductive, emergent themes are identified around the group structure, the data usage, and the decision making within these groups. When data were made available to the group, there were commonly issues with perception of veracity and validity of the data presented; this impacted the ability of the group to reach consensus and therefore for decision to be made. Similarly, there were different responses to forecasted or modelled data, shaped by the experience and occupation of the individuals within the multidisciplinary management group. This paper provides an understanding of further support required for team sensemaking and decision making in complex capital projects. The paper also discusses the barriers found to effective decision making in this setting and suggests opportunities to develop decision support systems in this team strategic decision-making process. Recommendations are made for further research into the sensemaking and decision-making process of this complex spatial-related setting.

Keywords: decision making, decisions under uncertainty, real decisions, sensemaking, spatial, team decision making

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Authors: Mustafa M. Donma, Orkide Donma

Abstract:

The number of indices developed for the evaluation of obesity and metabolic syndrome (MetS) both in adults and pediatric population is ever increasing. These indices can be weight-dependent or weight–independent. Some are extremely sophisticated equations and their clinical utility is questionable in routine clinical practice. The aim of this study was to compare presently available obesity indices and find the most practical one. Their associations with MetS components were also investigated to determine their capacities in differential diagnosis of morbid obesity with and without MetS. Children with normal body mass index (N-BMI) and morbid obesity were recruited for this study. Three groups were constituted. Age- and sex-dependent BMI percentiles for morbid obese (MO) children were above 99 according to World Health Organization tables. Of them, those with MetS findings were evaluated as MetS group. Children, whose values were between 85 and 15, were included in N-BMI group. The study protocol was approved by the Ethics Committee of Tekirdag Namik Kemal University, Faculty of Medicine. Parents filled out informed consent forms to participate in the study. Anthropometric measurements and blood pressure values were recorded. BMI, hip index (HI), conicity index (CI), triponderal mass index (TPMI), body adiposity index (BAI), body shape index (BSI), body roundness index (BRI), abdominal volume index (AVI), waist-to-hip ratio (WHR) and [waist circumference (WC) + hip circumference (HC)]/2 were the formulas examined in this study. Routine biochemical tests including fasting blood glucose (FBG), insulin (INS), blood lipids were performed. Statistical program SPSS was used for the evaluation of study data; p < 0.05 was accepted as the statistical significance degree. HI did not differ among the groups. A statistically significant difference was noted between N-BMI and MetS groups in terms of ABSI. All the other indices were capable of making discrimination between N-BMI-MO, N-BMI- MetS and MO-MetS groups. No correlation was found between FBG and any obesity indices in any groups. The same was true for INS in N-BMI group. Insulin was correlated with BAI, TPMI, CI, BRI, AVI and (WC+HC)/2 in MO group without MetS findings. In the MetS group, the only index, which was correlated with INS, was (WC+HC)/2. These findings have pointed out that complicated formulas may not be required for the evaluation of the alterations among N-BMI and various obesity groups including MetS. The simple easily computable weight-independent index, (WC+HC)/2, was unique, because it was the only index, which exhibits a valuable association with INS in MetS group. It did not exhibit any correlation with other obesity indices showing associations with INS in MO group. It was concluded that (WC+HC)/2 was pretty valuable practicable index for the discrimination of MO children with and without MetS findings.

Keywords: Fasting blood glucose, insulin, metabolic syndrome, obesity indices.

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