Search results for: Follow up
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 288

Search results for: Follow up

48 The Pedagogical Integration of Digital Technologies in Initial Teacher Training

Authors: Vânia Graça, Paula Quadros-Flores, Altina Ramos

Abstract:

The use of Digital Technologies in teaching and learning processes is currently a reality, namely in initial teacher training. This study aims at knowing the digital reality of students in initial teacher training in order to improve training in the educational use of ICT and to promote digital technology integration strategies in an educational context. It is part of the IFITIC Project "Innovate with ICT in Initial Teacher Training to Promote Methodological Renewal in Pre-school Education and in the 1st and 2nd Basic Education Cycle" which involves the School of Education, Polytechnic of Porto and Institute of Education, University of Minho. The Project aims at rethinking educational practice with ICT in the initial training of future teachers in order to promote methodological innovation in Pre-school Education and in the 1st and 2nd Cycles of Basic Education. A qualitative methodology was used, in which a questionnaire survey was applied to teachers in initial training. For data analysis, the techniques of content analysis with the support of NVivo software were used. The results point to the following aspects: a) future teachers recognize that they have more technical knowledge about ICT than pedagogical knowledge. This result makes sense if we consider the objective of Basic Education, so that the gaps can be filled in the Master's Course by students who wish to follow the teaching; b) the respondents are aware that the integration of digital resources contributes positively to students' learning and to the life of children and young people, which also promotes preparation in life; c) to be a teacher in the digital age there is a need for the development of digital literacy, lifelong learning and the adoption of new ways of teaching how to learn. Thus, this study aims to contribute to a reflection on the teaching profession in the digital age.

Keywords: Digital technologies, initial teacher training, pedagogical use of ICT, skills.

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47 Ordinal Regression with Fenton-Wilkinson Order Statistics: A Case Study of an Orienteering Race

Authors: Joonas Pääkkönen

Abstract:

In sports, individuals and teams are typically interested in final rankings. Final results, such as times or distances, dictate these rankings, also known as places. Places can be further associated with ordered random variables, commonly referred to as order statistics. In this work, we introduce a simple, yet accurate order statistical ordinal regression function that predicts relay race places with changeover-times. We call this function the Fenton-Wilkinson Order Statistics model. This model is built on the following educated assumption: individual leg-times follow log-normal distributions. Moreover, our key idea is to utilize Fenton-Wilkinson approximations of changeover-times alongside an estimator for the total number of teams as in the notorious German tank problem. This original place regression function is sigmoidal and thus correctly predicts the existence of a small number of elite teams that significantly outperform the rest of the teams. Our model also describes how place increases linearly with changeover-time at the inflection point of the log-normal distribution function. With real-world data from Jukola 2019, a massive orienteering relay race, the model is shown to be highly accurate even when the size of the training set is only 5% of the whole data set. Numerical results also show that our model exhibits smaller place prediction root-mean-square-errors than linear regression, mord regression and Gaussian process regression.

Keywords: Fenton-Wilkinson approximation, German tank problem, log-normal distribution, order statistics, ordinal regression, orienteering, sports analytics, sports modeling.

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46 Varieties of Capitalism and Small Business CSR: A Comparative Overview

Authors: S. Looser, W. Wehrmeyer

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Given the limited research on Small and Mediumsized Enterprises’ (SMEs) contribution to Corporate Social Responsibility (CSR) and even scarcer research on Swiss SMEs, this paper helps to fill these gaps by enabling the identification of supranational SME parameters. Thus, the paper investigates the current state of SME practices in Switzerland and across 15 other countries. Combining the degree to which SMEs demonstrate an explicit (or business case) approach or see CSR as an implicit moral activity with the assessment of their attributes for “variety of capitalism” defines the framework of this comparative analysis. To outline Swiss small business CSR patterns in particular, 40 SME owner-managers were interviewed. A secondary data analysis of studies from different countries laid groundwork for this comparative overview of small business CSR. The paper identifies Swiss small business CSR as driven by norms, values, and by the aspiration to contribute to society, thus, as an implicit part of the day-to-day business. Similar to most Central European, Mediterranean, Nordic, and Asian countries, explicit CSR is still very rare in Swiss SMEs. Astonishingly, also British and American SMEs follow this pattern in spite of their strong and distinctly liberal market economies. Though other findings show that nationality matters this research concludes that SME culture and an informal CSR agenda are strongly formative and superseding even forces of market economies, nationally cultural patterns, and language. Hence, classifications of countries by their market system, as found in the comparative capitalism literature, do not match the CSR practices in SMEs as they do not mirror the peculiarities of their business. This raises questions on the universality and generalisability of unmediated, explicit management concepts, especially in the context of small firms.

Keywords: CSR, comparative study, cultures of capitalism, Small and Medium-sized Enterprises.

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45 Power Factor Correction Based on High Switching Frequency Resonant Power Converter

Authors: B. Sathyanandhi, P. M. Balasubramaniam

Abstract:

This paper presents Buck-Boost converter topology to maintain the input power factor by using the power factor stage control and regulation stage control. Suppose, if we are using the RL load the power factor will be reduced due to the presence of total harmonic distortion in the current wave. To improve the power factor the current waveform should follow the fundamental component of the voltage waveform. These can be achieved by using the high -frequency power converter. Based on the resonant circuit the converter is able to perform the function of Buck, Boost, and buck-boost converter. Here ,we have used Buck-Boost converter, because, the buck-boost converter has more advantages than the boost converter. Here the switching action of the power converter can  take place by using the external zero comparator PFC stage control. The power converter consisting of the resonant  circuit which is used to control the output voltage gain of the converter. The power converter is operated at a very high switching frequency in the range of 400KHz in order to overcome the switching losses of the power converter. Due to  presence of high switching frequency, the power factor will improve. Therefore, the total harmonics distortion present in the current waveform has also reduced. These results has generated in the form of simulation by using MATLAB/SIMULINK software.  Similar to the Buck and Boost converters, the operation of the Buck-Boost has best understood, in terms of the inductor's "reluctance" for allowing rapid change in current, which also reduces the Total Harmonic Distortion (THD) in the input current waveform, which can improve the input Power factor, based on the type of load used.

Keywords: Buck-boost converter, High switching frequency, Power factor correction, power factor correction stage Regulation stage, Total harmonic distortion (THD).

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44 Designing a Fuzzy Logic Controller to Enhance Directional Stability of Vehicles under Difficult Maneuvers

Authors: Mehrdad N. Khajavi , Golamhassan Paygane, Ali Hakima

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Vehicle which are turning or maneuvering at high speeds are susceptible to sliding and subsequently deviate from desired path. In this paper the dynamics governing the Yaw/Roll behavior of a vehicle has been simulated. Two different simulations have been used one for the real vehicle, for which a fuzzy controller is designed to increase its directional stability property. The other simulation is for a hypothetical vehicle with much higher tire cornering stiffness which is capable of developing the required lateral forces at the tire-ground patch contact to attain the desired lateral acceleration for the vehicle to follow the desired path without slippage. This simulation model is our reference model. The logic for keeping the vehicle on the desired track in the cornering or maneuvering state is to have some braking forces on the inner or outer tires based on the direction of vehicle deviation from the desired path. The inputs to our vehicle simulation model is steer angle δ and vehicle velocity V , and the outputs can be any kinematical parameters like yaw rate, yaw acceleration, side slip angle, rate of side slip angle and so on. The proposed fuzzy controller is a feed forward controller. This controller has two inputs which are steer angle δ and vehicle velocity V, and the output of the controller is the correcting moment M, which guides the vehicle back to the desired track. To develop the membership functions for the controller inputs and output and the fuzzy rules, the vehicle simulation has been run for 1000 times and the correcting moment have been determined by trial and error. Results of the vehicle simulation with fuzzy controller are very promising and show the vehicle performance is enhanced greatly over the vehicle without the controller. In fact the vehicle performance with the controller is very near the performance of the reference ideal model.

Keywords: Vehicle, Directional Stability, Fuzzy Logic Controller, ANFIS..

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43 Training Undergraduate Engineering Students in Robotics and Automation through Model-Based Design Training: A Case Study at Assumption University of Thailand

Authors: Sajed A. Habib

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Problem-based learning (PBL) is a student-centered pedagogy that originated in the medical field and has also been used extensively in other knowledge disciplines with recognized advantages and limitations. PBL has been used in various undergraduate engineering programs with mixed outcomes. The current fourth industrial revolution (digital era or Industry 4.0) has made it essential for many science and engineering students to receive effective training in advanced courses such as industrial automation and robotics. This paper presents a case study at Assumption University of Thailand, where a PBL-like approach was used to teach some aspects of automation and robotics to selected groups of undergraduate engineering students. These students were given some basic level training in automation prior to participating in a subsequent training session in order to solve technical problems with increased complexity. The participating students’ evaluation of the training sessions in terms of learning effectiveness, skills enhancement, and incremental knowledge following the problem-solving session was captured through a follow-up survey consisting of 14 questions and a 5-point scoring system. From the most recent training event, an overall 70% of the respondents indicated that their skill levels were enhanced to a much greater level than they had had before the training, whereas 60.4% of the respondents from the same event indicated that their incremental knowledge following the session was much greater than what they had prior to the training. The instructor-facilitator involved in the training events suggested that this method of learning was more suitable for senior/advanced level students than those at the freshmen level as certain skills to effectively participate in such problem-solving sessions are acquired over a period of time, and not instantly.

Keywords: Automation, industry 4.0, model-based design training, problem-based learning.

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42 Massive Open Online Course about Content Language Integrated Learning: A Methodological Approach for Content Language Integrated Learning Teachers

Authors: M. Zezou

Abstract:

This paper focuses on the design of a Massive Open Online Course (MOOC) about Content Language Integrated Learning (CLIL) and more specifically about how teachers can use CLIL as an educational approach incorporating technology in their teaching as well. All the four weeks of the MOOC will be presented and a step-by-step analysis of each lesson will be offered. Additionally, the paper includes detailed lesson plans about CLIL lessons with proposed CLIL activities and games in which technology plays a central part. The MOOC is structured based on certain criteria, in order to ensure success, as well as a positive experience that the learners need to have after completing this MOOC. It addresses to all language teachers who would like to implement CLIL into their teaching. In other words, it presents the methodology that needs to be followed so as to successfully carry out a CLIL lesson and achieve the learning objectives set at the beginning of the course. Firstly, in this paper, it is very important to give the definitions of MOOCs and LMOOCs, as well as to explore the difference between a structure-based MOOC (xMOOC) and a connectivist MOOC (cMOOC) and present the criteria of a successful MOOC. Moreover, the notion of CLIL will be explored, as it is necessary to fully understand this concept before moving on to the design of the MOOC. Onwards, the four weeks of the MOOC will be introduced as well as lesson plans will be presented: The type of the activities, the aims of each activity and the methodology that teachers have to follow. Emphasis will be placed on the role of technology in foreign language learning and on the ways in which we can involve technology in teaching a foreign language. Final remarks will be made and a summary of the main points will be offered at the end.

Keywords: Content language integrated learning, connectivist massive open online course, lesson plan, language MOOC, massive open online course criteria, massive open online course, technology, structure-based massive open online course.

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41 The Project Evaluation to Develop the Competencies, Capabilities, and Skills in Repairing Computers of People in Jompluak Local Municipality, Bang Khonthi District, Samut Songkram Province

Authors: Wilailuk Meepracha

Abstract:

The results of the study on the project evaluation to  develop the competencies, capabilities, and skills in repairing  computers of people in Jompluak Local Municipality, Bang Khonthi  District, Samut Songkram Province showed that the overall result  was good (4.33). When considering on each aspect, it was found that  the highest one was on process evaluation (4.60) followed by product  evaluation (4.50) and the least one was on feeding factor (3.97).  When considering in details, it was found that: 1) the context aspect  was high (4.23) with the highest item on the arrangement of the  training situation (4.67) followed by the appropriateness of the target  (4.30) and the least aspect was on the project cooperation (3.73). 2)  The evaluation of average overall primary factor or feeding factor  showed high value (4.23) while the highest aspect was on the  capability of the trainers (4.47) followed by the suitable venue (4.33)  while the least aspect was on the insufficient budget (3.47). 3) The  average result of process evaluation was very high (4.60). The  highest aspect was on the follow-op supervision (4.70) followed by  responsibility of each project staffs (4.50) while the least aspect was  on the present situation and the problems of the community (4.40). 4)  The overall result of the product evaluation was very high (4.50). The  highest aspect was on the diversity of the activities and the  community integration (4.67) followed by project target achievement  (4.63) while the least aspect was on continuation and regularity of the  activities (4.33). The trainees reported high satisfaction on the project  management at very high level (43.33%) while 40% reported high  level and 16.67% reported moderate level. Suggestions for the project  were on the additional number of the computer sets (37.78%)  followed by longer training period especially on computer skills  (43.48%).

 

Keywords: Project evaluation, competency development, the capability on computer repairing and computer skills.

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40 Adapting Tools for Text Monitoring and for Scenario Analysis Related to the Field of Social Disasters

Authors: Svetlana Cojocaru, Mircea Petic, Inga Titchiev

Abstract:

Humanity faces more and more often with different social disasters, which in turn can generate new accidents and catastrophes. To mitigate their consequences, it is important to obtain early possible signals about the events which are or can occur and to prepare the corresponding scenarios that could be applied. Our research is focused on solving two problems in this domain: identifying signals related that an accident occurred or may occur and mitigation of some consequences of disasters. To solve the first problem, methods of selecting and processing texts from global network Internet are developed. Information in Romanian is of special interest for us. In order to obtain the mentioned tools, we should follow several steps, divided into preparatory stage and processing stage. Throughout the first stage, we manually collected over 724 news articles and classified them into 10 categories of social disasters. It constitutes more than 150 thousand words. Using this information, a controlled vocabulary of more than 300 keywords was elaborated, that will help in the process of classification and identification of the texts related to the field of social disasters. To solve the second problem, the formalism of Petri net has been used. We deal with the problem of inhabitants’ evacuation in useful time. The analysis methods such as reachability or coverability tree and invariants technique to determine dynamic properties of the modeled systems will be used. To perform a case study of properties of extended evacuation system by adding time, the analysis modules of PIPE such as Generalized Stochastic Petri Nets (GSPN) Analysis, Simulation, State Space Analysis, and Invariant Analysis have been used. These modules helped us to obtain the average number of persons situated in the rooms and the other quantitative properties and characteristics related to its dynamics.

Keywords: Lexicon of disasters, modelling, Petri nets, text annotation, social disasters.

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39 Analytical Slope Stability Analysis Based on the Statistical Characterization of Soil Shear Strength

Authors: Bernardo C. P. Albuquerque, Darym J. F. Campos

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Increasing our ability to solve complex engineering problems is directly related to the processing capacity of computers. By means of such equipments, one is able to fast and accurately run numerical algorithms. Besides the increasing interest in numerical simulations, probabilistic approaches are also of great importance. This way, statistical tools have shown their relevance to the modelling of practical engineering problems. In general, statistical approaches to such problems consider that the random variables involved follow a normal distribution. This assumption tends to provide incorrect results when skew data is present since normal distributions are symmetric about their means. Thus, in order to visualize and quantify this aspect, 9 statistical distributions (symmetric and skew) have been considered to model a hypothetical slope stability problem. The data modeled is the friction angle of a superficial soil in Brasilia, Brazil. Despite the apparent universality, the normal distribution did not qualify as the best fit. In the present effort, data obtained in consolidated-drained triaxial tests and saturated direct shear tests have been modeled and used to analytically derive the probability density function (PDF) of the safety factor of a hypothetical slope based on Mohr-Coulomb rupture criterion. Therefore, based on this analysis, it is possible to explicitly derive the failure probability considering the friction angle as a random variable. Furthermore, it is possible to compare the stability analysis when the friction angle is modelled as a Dagum distribution (distribution that presented the best fit to the histogram) and as a Normal distribution. This comparison leads to relevant differences when analyzed in light of the risk management.

Keywords: Statistical slope stability analysis, Skew distributions, Probability of failure, Functions of random variables.

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38 Vancomycin and Rifaximin Combination Therapy for Diarrhoea Predominant Irritable Bowel Syndrome: An Observational Study

Authors: P. Murphy, D. Vasic, A. W. Gunaratne, T. Tugonon, M. Ison, C. Pagonis, E. T. Sitchon, A. Le Busque, T. J. Borody

Abstract:

Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by an alteration in bowel movements. There are three different types of IBS: diarrhea-predominant IBS (IBS-D), constipation-predominant IBS (IBS-C) and IBS with mixed bowel habit (IBS-M). Antimicrobials are increasingly being used as treatment for all types of IBS. Due to this increased use and subsequent success, the gut microbiome as a factor in the etiology of IBS is becoming more apparent. Accepted standard treatment has focused on IBS-C and involves either vancomycin or rifaximin. Here, we report on a cohort of 18 patients treated with both vancomycin and rifaximin for IBS-D. These patients’ records were reviewed retrospectively. In this cohort, patients were aged between 24-74 years (mean 44 years) and nine were female. At baseline all patients had diarrhea, four with mucus and one with blood. Other reported symptoms include abdominal pain (n = 11) bloating (n = 9), flatulence (n = 7), fatigue (n = 4) and nausea (n = 3). Patient’s treatments were personalized according to their symptom severity and tolerability and were treated with a combination of rifaximin (500-3000 mg/d) and vancomycin (500 mg-1500 mg/d) for an ongoing period. Follow-ups were conducted between 2-32 weeks. Of all patients, 89% reported improvement of at least 1 symptom, one reported no change and one patient’s symptoms got worse. The success of this combination treatment could be due to the different mechanisms of action undertaken by each medication. Vancomycin works by inhibiting the cell wall of the bacteria and rifaximin by inhibiting protein synthesis. This success in treatment validates the idea that IBS-D may be driven by a bacterial infection of the gastrointestinal microbiome. As IBS-D presents similarly to Clostridium difficile and symptom improvement can occur with the same treatment as Clostridium difficile of rifaximin and vancomycin, there is reason to suggest that the infectious agent could be an unidentified strain of Clostridium. Although these results offer some validity to the theory, more research is required.

Keywords: Clostridium difficile infection, diarrhea predominant irritable bowel syndrome, microbiome, vancomycin/rifaximin combination.

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37 Kinetic, Thermodynamic and Process Modeling of Synthesis of UV Curable Glyceryl and Neopentyl Glycol Acrylates

Authors: R. D. Kulkarni, Mayur Chaudhari, S. Mishra

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Curing of paints by exposure to UV radiations is emerging as one of the best film forming technique as an alternative to traditional solvent borne oxidative and thermal curing coatings. The composition and chemistry of UV curable coatings and role of multifunctional and monofunctional monomers, oligomers, and photoinitiators have been discussed. The limitations imposed by thermodynamic equilibrium and tendency for acrylic double bond polymerizations during synthesis of multifunctional acrylates have been presented. Aim of present investigation was thus to explore the reaction variables associated with synthesis of multifunctional acrylates. Zirconium oxychloride was evaluated as catalyst against regular acid functional catalyst. The catalyzed synthesis of glyceryl acrylate and neopentyl glycol acrylate was conducted by variation of following reaction parameters: two different reactant molar ratios- 1:4 and 1:6; catalyst usage in % by moles on polyol- 2.5, 5.0 and 7.5 and two different reaction temperatures- 45 and 75 0C. The reaction was monitored by determination of acid value and hydroxy value at regular intervals, besides TLC, HPLC, and FTIR analysis of intermediates and products. On the basis of determination of reaction progress over 1-60 hrs, the esterification reaction was observed to follow 2nd order kinetics with rate constant varying from 1*10-4 to 7*10-4. The thermal and catalytic components of second order rate constant and energy of activation were also determined. Uses of these kinetic and thermodynamic parameters in design of reactor for manufacture of multifunctional acrylate ester have been presented. The synthesized multifunctional acrylates were used to formulate and apply UV curable clear coat followed by determination of curing characteristics and mechanical properties of cured film. The overall curing rates less than 05 min. were easily attained indicating economical viability of radiation curable system due to faster production schedules

Keywords: glyceryl acrylate, neopentyl glycol acrylate, kinetic modeling, zirconium oxychloride.

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36 Fuzzy Power Controller Design for Purdue University Research Reactor-1

Authors: Oktavian Muhammad Rizki, Appiah Rita, Lastres Oscar, Miller True, Chapman Alec, Tsoukalas Lefteri H.

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The Purdue University Research Reactor-1 (PUR-1) is a 10 kWth pool-type research reactor located at Purdue University’s West Lafayette campus. The reactor was recently upgraded to use entirely digital instrumentation and control systems. However, currently, there is no automated control system to regulate the power in the reactor. We propose a fuzzy logic controller as a form of digital twin to complement the existing digital instrumentation system to monitor and stabilize power control using existing experimental data. This work assesses the feasibility of a power controller based on a Fuzzy Rule-Based System (FRBS) by modelling and simulation with a MATLAB algorithm. The controller uses power error and reactor period as inputs and generates reactivity insertion as output. The reactivity insertion is then converted to control rod height using a logistic function based on information from the recorded experimental reactor control rod data. To test the capability of the proposed fuzzy controller, a point-kinetic reactor model is utilized based on the actual PUR-1 operation conditions and a Monte Carlo N-Particle simulation result of the core to numerically compute the neutronics parameters of reactor behavior. The Point Kinetic Equation (PKE) was employed to model dynamic characteristics of the research reactor since it explains the interactions between the spatial and time varying input and output variables efficiently. The controller is demonstrated computationally using various cases: startup, power maneuver, and shutdown. From the test results, it can be proved that the implemented fuzzy controller can satisfactorily regulate the reactor power to follow demand power without compromising nuclear safety measures.

Keywords: Fuzzy logic controller, power controller, reactivity, research reactor.

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35 Save Lives: The Application of Geolocation-Awareness Service in Iranian Pre-Hospital EMS Information Management System

Authors: Somayeh Abedian, Pirhossein Kolivand, Hamid Reza Lornejad, Amin Karampour, Ebrahim Keshavarz Safari

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For emergency and relief service providers such as pre-hospital emergencies, quick arrival at the scene of an accident or any EMS mission is one of the most important requirements of effective service delivery. EMS Response time (the interval between the time of the call and the time of arrival on scene) is a critical factor in determining the quality of pre-hospital Emergency Medical Services (EMS). This is especially important for heart attack, stroke, or accident patients that seconds are vital in saving their lives. Location-based e-services can be broadly defined as any service that provides information pertinent to the current location of an active mobile handset or precise address of landline phone call at a specific time window, regardless of the underlying delivery technology used to convey the information. According to research, one of the effective methods of meeting this goal is determining the location of the caller via the cooperation of landline and mobile phone operators in the country. The follow-up of the Communications Regulatory Authority (CRA) organization has resulted in the receipt of two separate secured electronic web services. Thus, to ensure human privacy, a secure technical architecture was required for launching the services in the pre-hospital EMS information management system. In addition, to quicken medics’ arrival at the patient's bedside, rescue vehicles should make use of an intelligent transportation system to estimate road traffic using a GPS-based mobile navigation system independent of the Internet. This paper seeks to illustrate the architecture of the practical national model used by the Iranian EMS organization.

Keywords: response time, geographic location inquiry service, location-based services, emergency medical services information system

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34 Safety Study of Intravenously Administered Human Cord Blood Stem Cells in the Treatment of Symptoms Related to Chronic Inflammation

Authors: Brian M. Mehling, Louis Quartararo, Marine Manvelyan, Paul Wang, Dong-Cheng Wu

Abstract:

Numerous investigations suggest that Mesenchymal Stem Cells (MSCs) in general represent a valuable tool for therapy of symptoms related to chronic inflammatory diseases. Blue Horizon Stem Cell Therapy Program is a leading provider of adult and children’s stem cell therapies. Uniquely we have safely and efficiently treated more than 600 patients with documenting each procedure. The purpose of our study is primarily to monitor the immune response in order to validate the safety of intravenous infusion of human umbilical cord blood derived MSCs (UC-MSCs), and secondly, to evaluate effects on biomarkers associated with chronic inflammation. Nine patients were treated for conditions associated with chronic inflammation and for the purpose of antiaging. They have been given one intravenous infusion of UCMSCs. Our study of blood test markers of 9 patients with chronic inflammation before and within three months after MSCs treatment demonstrates that there is no significant changes and MSCs treatment was safe for the patients. Analysis of different indicators of chronic inflammation and aging included in initial, 24-hours, two weeks and three months protocols showed that stem cell treatment was safe for the patients; there were no adverse reactions. Moreover data from follow up protocols demonstrates significant improvement in energy level, hair, nails growth and skin conditions. Intravenously administered UC-MSCs were safe and effective in the improvement of symptoms related to chronic inflammation. Further close monitoring and inclusion of more patients are necessary to fully characterize the advantages of UC-MSCs application in treatment of symptoms related to chronic inflammation.

Keywords: Chronic inflammatory diseases, intravenous infusion, mesenchymal stem cells (MSCs), umbilical cord blood.

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33 Botswana and Nation-Building Theory

Authors: Rowland M. Brucken

Abstract:

This paper argues nation-building theories that prioritize democratic governance best explain the successful postindependence development of Botswana. Three main competing schools of thought exist regarding the sequencing of policies that should occur to re-build weakened or failed states. The first posits that economic development should receive foremost attention, while democratization and a binding sense of nationalism can wait. A second group of experts identified constructing a sense of nationalism among a populace is necessary first, so that the state receives popular legitimacy and obedience that are prerequisites for development. Botswana, though, transitioned into a multi-party democracy and prosperous open economy due to the utilization of traditional democratic structures, enlightened and accountable leadership, and an educated technocratic civil service. With these political foundations already in place when the discovery of diamonds occurred, the resulting revenues were spent wisely on projects that grew the economy, improved basic living standards, and attracted foreign investment. Thus democratization preceded, and therefore provided an accountable basis for, economic development that might otherwise have been squandered by greedy and isolated elites to the detriment of the greater population. Botswana was one of the poorest nations in the world at the time of its independence in 1966, with little infrastructure, a dependence on apartheid South Africa for trade, and a largely subsistence economy. Over the next thirty years, though, its economy grew the fastest of any nation in the world. The transparent and judicious use of diamond returns is only a partial explanation, as the government also pursued economic diversification, mass education, and rural development in response to public needs. As nation-building has become a project undertaken by nations and multilateral agencies such as the United Nations and the North Atlantic Treaty Organization, Botswana may provide best practices that others should follow in attempting to reconstruct economically and politically unstable states.

Keywords: Botswana, democratization, economic development, nation-building.

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32 Use of Hair as an Indicator of Environmental Lead Pollution: Characteristics and Seasonal Variation of Lead Pollution in Egypt

Authors: A. A. K. Abou-Arab, M. A. Abou Donia, Nevin E. Sharaf, Sherif R. Mohamed, A. K. Enab

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Lead being a toxic heavy metal that mankind is exposed to the highest levels of this metal from environmental pollutants. A total of 180 Male scalp hair samples were collected from different environments in Greater Cairo (GC), i.e. industrial, heavy traffic and rural areas (60 samples from each) having different activities during the period of, 1/5/2010 to 1/11/2012. Hair samples were collected during five stages. Data proved that the concentration of lead in male industrial areas of Cairo ranged between 6.2847 to 19.0432 μg/g, with mean value of 12.3288 μg/g. On the other hand, lead content of hair samples of residential-traffic areas ranged between 2.8634 to 16.3311 μg/g with mean value of 9.7552 μg/g. While lead concentration on the hair of the male residents living in rural area ranged between 1.0499-9.0402μg/g with mean value of 4.7327 μg/g. The Pb concentration in scalp hair of Cairo residents of residential-traffic and rural traffic areas was observed to follow the same pattern. The pattern was that of decrease concentration of summer and its increase in winter. Then, there was a marked increase in Pb concentration of summer 2012, and this increase was significant. These were obviously seen for the residential-traffic and rural areas residents. Pb pollution in residents of industrial areas showed the same seasonal pattern, but there was marked to decrease in Pb concentration of summer 2012, and this decrease was significant. Lead pollution in residents of GC was serious. It is worth noting that the atmosphere is still contaminated by lead despite a decade of using unleaded gasoline. Strong seasonal variation in higher Pb concentration on winter than in summer was found. Major contributions to the pollution with Pb could include industry emissions, motor vehicle emissions and long transported dust from outside Cairo. More attention should be paid to the reduction of Pb content of the urban aerosol and to the Pb pollution health.

Keywords: Hair, lead, environmental exposure, seasonal variations, Egypt.

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31 The Journey from Lean Manufacturing to Industry 4.0: The Rail Manufacturing Process in Mexico

Authors: Diana Flores Galindo, Richard Gil Herrera

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Nowadays, Lean Manufacturing and Industry 4.0 are very important in every country. One of the main benefits is continued market presence. It has been identified that there is a need to change existing educational programs, as well as update the knowledge and skills of existing employees. It should be borne in mind that behind each technological improvement, there is a human being. Human talent cannot be neglected. The main objectives of this article are to review the link between Lean Manufacturing, the incorporation of Industry 4.0 and the steps to follow to implement it; analyze the current situation and study the implications and benefits of this new trend, with a particular focus on Mexico. Lean Manufacturing and Industry 4.0 implementation waves must always take care of the most important capital – intellectual capital. The methodology used in this article comprised the following steps: reviewing the reality of the fourth industrial revolution, reviewing employees’ skills on the journey to become world-class, and analyzing the situation in Mexico. Lean Manufacturing and Industry 4.0 were studied not as exclusive concepts, but as complementary ones. The methodological framework used is focused on motivating companies’ collaborators to guarantee common results, innovate, and remain in the market in the face of new requirements from company stakeholders. The key findings were that both trends emphasize the need to improve communication across the entire company and incorporate new technologies into everyday work, from the shop floor to administrative staff, to help improve processes. Taking care of people, activities and processes will bring a company success. In the specific case of Mexico, companies in all sectors need to be aware of and implement technological improvements according to their specific needs. Low-cost labor represents one of the most typical barriers. In conclusion, companies must build a roadmap according to their strategy and needs to achieve their short, medium- and long-term goals.

Keywords: Lean management, lean manufacturing, industry 4.0, motivation, SWOT analysis, Hoshin Kanri.

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30 Grade and Maximum Tumor Dimension as Determinants of Lymphadenectomy in Patients with Endometrioid Endometrial Cancer (EEC)

Authors: Ali A. Bazzi, Ameer Hamza, Riley O’Hara, Kimberly Kado, Karen H. Hagglund, Lamia Fathallah, Robert T. Morris

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Introduction: Endometrial Cancer is a common gynecologic malignancy primarily treated with complete surgical staging, which may include complete pelvic and para-aortic lymphadenectomy. The role of lymphadenectomy is controversial, especially the intraoperative indications for the procedure. Three factors are important in decision to proceed with lymphadenectomy: Myometrial invasion, maximum tumor dimension, and histology. Many institutions incorporate these criteria in varying degrees in the decision to proceed with lymphadenectomy. This investigation assesses the use of intraoperatively measured MTD with and without pre-operative histologic grade. Methods: This study compared retrospectively EEC patients with intraoperatively measured MTD ≤2 cm to those with MTD >2 cm from January 1, 2002 to August 31, 2017. This assessment compared those with MTD ≤ 2cm with endometrial biopsy (EB) grade 1-2 to patients with MTD > 2cm with EB grade 3. Lymph node metastasis (LNM), recurrence, and survival were compared in these groups. Results: This study reviewed 222 patient cases. In tumors > 2 cm, LNM occurred in 20% cases while in tumors ≤ 2 cm, LNM was found in 6% cases (p=0.04). Recurrence and mean survival based on last follow up visit in these two groups were not statistically different (p=0.78 and 0.36 respectively). Data demonstrated a trend that when combined with preoperative EB International Federation of Gynecology and Obstetrics (FIGO) grade, a higher proportion of patients with EB FIGO Grade 3 and MTD > 2 cm had LNM compared to those with EB FIGO Grade 1-2 and MTD ≤ 2 cm (43% vs, 11%, p=0.06). LNM was found in 15% of cases in which lymphadenectomy was performed based on current practices, whereas if the criteria of EB FIGO 3 and MTD > 2 cm were used the incidence of LNM would have been 44% cases. However, using this criterion, two patients would not have had their nodal metastases detected. Compared to the current practice, the sensitivity and specificity of the proposed criteria would be 60% and 81%, respectively. The PPV and NPV would be 43% and 90%, respectively. Conclusion: The results indicate that MTD combined with EB FIGO grade can detect LNM in a higher proportion of cases when compared to current practice. MTD combined with EB FIGO grade may eliminate the need of frozen section sampling in a substantial number of cases.

Keywords: Endometrial cancer, FIGO grade, lymphadenectomy, tumor size.

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29 Similarity Solutions of Nonlinear Stretched Biomagnetic Flow and Heat Transfer with Signum Function and Temperature Power Law Geometries

Authors: M. G. Murtaza, E. E. Tzirtzilakis, M. Ferdows

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Biomagnetic fluid dynamics is an interdisciplinary field comprising engineering, medicine, and biology. Bio fluid dynamics is directed towards finding and developing the solutions to some of the human body related diseases and disorders. This article describes the flow and heat transfer of two dimensional, steady, laminar, viscous and incompressible biomagnetic fluid over a non-linear stretching sheet in the presence of magnetic dipole. Our model is consistent with blood fluid namely biomagnetic fluid dynamics (BFD). This model based on the principles of ferrohydrodynamic (FHD). The temperature at the stretching surface is assumed to follow a power law variation, and stretching velocity is assumed to have a nonlinear form with signum function or sign function. The governing boundary layer equations with boundary conditions are simplified to couple higher order equations using usual transformations. Numerical solutions for the governing momentum and energy equations are obtained by efficient numerical techniques based on the common finite difference method with central differencing, on a tridiagonal matrix manipulation and on an iterative procedure. Computations are performed for a wide range of the governing parameters such as magnetic field parameter, power law exponent temperature parameter, and other involved parameters and the effect of these parameters on the velocity and temperature field is presented. It is observed that for different values of the magnetic parameter, the velocity distribution decreases while temperature distribution increases. Besides, the finite difference solutions results for skin-friction coefficient and rate of heat transfer are discussed. This study will have an important bearing on a high targeting efficiency, a high magnetic field is required in the targeted body compartment.

Keywords: Biomagnetic fluid, FHD, nonlinear stretching sheet, slip parameter.

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28 Applying Participatory Design for the Reuse of Deserted Community Spaces

Authors: Wei-Chieh Yeh, Yung-Tang Shen

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The concept of community building started in 1994 in Taiwan. After years of development, it fostered the notion of active local resident participation in community issues as co-operators, instead of minions. Participatory design gives participants more control in the decision-making process, helps to reduce the friction caused by arguments and assists in bringing different parties to consensus. This results in an increase in the efficiency of projects run in the community. Therefore, the participation of local residents is key to the success of community building. This study applied participatory design to develop plans for the reuse of deserted spaces in the community from the first stage of brainstorming for design ideas, making creative models to be employed later, through to the final stage of construction. After conducting a series of participatory designed activities, it aimed to integrate the different opinions of residents, develop a sense of belonging and reach a consensus. Besides this, it also aimed at building the residents’ awareness of their responsibilities for the environment and related issues of sustainable development. By reviewing relevant literature and understanding the history of related studies, the study formulated a theory. It took the “2012-2014 Changhua County Community Planner Counseling Program” as a case study to investigate the implementation process of participatory design. Research data are collected by document analysis, participants’ observation and in-depth interviews. After examining the three elements of “Design Participation”, “Construction Participation”, and” Follow–up Maintenance Participation” in the case, the study emerged with a promising conclusion: Maintenance works were carried out better compared to common public works. Besides this, maintenance costs were lower. Moreover, the works that residents were involved in were more creative. Most importantly, the community characteristics could be easy be recognized.

Keywords: Participatory design, Deserted spaces, Community building, Reuse.

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27 An Analysis of the Performances of Various Buoys as the Floats of Wave Energy Converters

Authors: İlkay Özer Erselcan, Abdi Kükner, Gökhan Ceylan

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The power generated by eight point absorber type wave energy converters each having a different buoy are calculated in order to investigate the performances of buoys in this study. The calculations are carried out by modeling three different sea states observed in two different locations in the Black Sea. The floats analyzed in this study have two basic geometries and four different draft/radius (d/r) ratios. The buoys possess the shapes of a semi-ellipsoid and a semi-elliptic paraboloid. Additionally, the draft/radius ratios range from 0.25 to 1 by an increment of 0.25. The radiation forces acting on the buoys due to the oscillatory motions of these bodies are evaluated by employing a 3D panel method along with a distribution of 3D pulsating sources in frequency domain. On the other hand, the wave forces acting on the buoys which are taken as the sum of Froude-Krylov forces and diffraction forces are calculated by using linear wave theory. Furthermore, the wave energy converters are assumed to be taut-moored to the seabed so that the secondary body which houses a power take-off system oscillates with much smaller amplitudes compared to the buoy. As a result, it is assumed that there is not any significant contribution to the power generation from the motions of the housing body and the only contribution to power generation comes from the buoy. The power take-off systems of the wave energy converters are high pressure oil hydraulic systems which are identical in terms of their characteristic parameters. The results show that the power generated by wave energy converters which have semi-ellipsoid floats is higher than that of those which have semi elliptic paraboloid floats in both locations and in all sea states. It is also determined that the power generated by the wave energy converters follow an unsteady pattern such that they do not decrease or increase with changing draft/radius ratios of the floats. Although the highest power level is obtained with a semi-ellipsoid float which has a draft/radius ratio equal to 1, other floats of which the draft/radius ratio is 0.25 delivered higher power that the floats with a draft/radius ratio equal to 1 in some cases.

Keywords: Black Sea, Buoys, Hydraulic Power Take-Off System, Wave Energy Converters.

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26 Fault-Tolerant Control Study and Classification: Case Study of a Hydraulic-Press Model Simulated in Real-Time

Authors: Jorge Rodriguez-Guerra, Carlos Calleja, Aron Pujana, Iker Elorza, Ana Maria Macarulla

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Society demands more reliable manufacturing processes capable of producing high quality products in shorter production cycles. New control algorithms have been studied to satisfy this paradigm, in which Fault-Tolerant Control (FTC) plays a significant role. It is suitable to detect, isolate and adapt a system when a harmful or faulty situation appears. In this paper, a general overview about FTC characteristics are exposed; highlighting the properties a system must ensure to be considered faultless. In addition, a research to identify which are the main FTC techniques and a classification based on their characteristics is presented in two main groups: Active Fault-Tolerant Controllers (AFTCs) and Passive Fault-Tolerant Controllers (PFTCs). AFTC encompasses the techniques capable of re-configuring the process control algorithm after the fault has been detected, while PFTC comprehends the algorithms robust enough to bypass the fault without further modifications. The mentioned re-configuration requires two stages, one focused on detection, isolation and identification of the fault source and the other one in charge of re-designing the control algorithm by two approaches: fault accommodation and control re-design. From the algorithms studied, one has been selected and applied to a case study based on an industrial hydraulic-press. The developed model has been embedded under a real-time validation platform, which allows testing the FTC algorithms and analyse how the system will respond when a fault arises in similar conditions as a machine will have on factory. One AFTC approach has been picked up as the methodology the system will follow in the fault recovery process. In a first instance, the fault will be detected, isolated and identified by means of a neural network. In a second instance, the control algorithm will be re-configured to overcome the fault and continue working without human interaction.

Keywords: Fault-tolerant control, electro-hydraulic actuator, fault detection and isolation, control re-design, real-time.

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25 A Six-Year Case Study Evaluating the Stakeholders’ Requirements and Satisfaction in Higher Educational Establishments

Authors: Ioannis I. Αngeli

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Worldwide and mainly in the European Union, many standards, regulations, models and systems exists for the evaluation and identification of stakeholders’ requirements of individual universities and higher education (HE) in general. All systems are targeting to measure or evaluate the Universities’ Quality Assurance Systems and the services offered to the recipients of HE, mainly the students. Numerous surveys were conducted in the past either by each university or by organized bodies to identify the students’ satisfaction or to evaluate to what extent these requirements are fulfilled. In this paper, the main results of an ongoing 6-year joint research will be presented very briefly. This research deals with an in depth investigation of student’s satisfaction, students personal requirements, a cup analysis among these two parameters and compares different universities. Through this research an attempt will be made to address four very important questions in higher education establishments (HEE): (1) Are there any common requirements, parameters, good practices or questions that apply to a large number of universities that will assure that students’ requirements are fulfilled? (2) Up to what extent the individual programs of HEE fulfil the requirements of the stakeholders? (3) Are there any similarities on specific programs among European HEE? (4) To what extent the knowledge acquired in a specific course program is utilized or used in a specific country? For the execution of the research an internationally accepted questionnaire(s) was used to evaluate up to what extent the students’ requirements and satisfaction were fulfilled in 2012 and five years later (2017). Samples of students and or universities were taken from many European Universities. The questionnaires used, the sampling method and methodology adopted, as well as the comparison tables and results will be very valuable to any university that is willing to follow the same route and methodology or compare the results with their own HHE. Apart from the unique methodology, valuable results are demonstrated from the four case studies. There is a great difference between the student’s expectations or importance from what they are getting from their universities (in all parameters they are getting less). When there is a crisis or budget cut in HEE there is a direct impact to students. There are many differences on subjects taught in European universities.

Keywords: Quality in higher education, students’ requirements, education standards, student’s survey, stakeholder’s requirements, Mechanical Engineering courses.

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24 Stakeholder Analysis: Who are the Key Actorsin Establishing and Developing Thai Independent Consumer Organizations?

Authors: P. Ondee, S. Pannarunothai

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In Thailand, both the 1997 and the current 2007 Thai Constitutions have mentioned the establishment of independent organizations as a new mechanism to play a key role in proposing policy recommendations to national decision-makers in the interest of collective consumers. Over the last ten years, no independent organizations have yet been set up. Evidently, nobody could point out who should be key players in establishing provincial independent consumer bodies. The purpose of this study was to find definitive stakeholders in establishing and developing independent consumer bodies in a Thai context. This was a cross-sectional study between August and September 2007, using a postal questionnaire with telephone follow-up. The questionnaire was designed and used to obtain multiple stakeholder assessment of three key attributes (power, interest and influence). Study population was 153 stakeholders associated with policy decision-making, formulation and implementation processes of civil-based consumer protection in pilot provinces. The population covered key representatives from five sectors (academics, government officers, business traders, mass media and consumer networks) who participated in the deliberative forums at 10 provinces. A 49.7% response rate was achieved. Data were analyzed, comparing means of three stakeholder attributes and classification of stakeholder typology. The results showed that the provincial health officers were the definitive stakeholders as they had legal power, influence and interest in establishing and sustaining the independent consumer bodies. However, only a few key representatives of the provincial health officers expressed their own paradigm on the civil-based consumer protection. Most provincial health officers put their own standpoint of building civic participation at only a plan-implementation level. For effective policy implementation by the independent consumer bodies, the Thai government should provide budgetary support for the operation of the provincial health officers with their paradigm shift as well as their own clarified standpoint on corporate governance.

Keywords: Civic participation, civil society, consumerprotection, independent organization, policy decision-making, stakeholder analysis.

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23 Client Satisfaction: Does Private or Public Health Sector Make a Difference? Results from Secondary Data Analysis in Sindh, Pakistan

Authors: Wajiha Javed, Arsalan Jabbar, Nelofer Mehboob, Muhammad Tafseer, Zahid Memon

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Introduction: Researchers globally have strived to explore diverse factors that augment the continuation and uptake of family planning methods. Clients’ satisfaction is one of the core determinants facilitating continuation of family planning methods. There is a major debate yet scanty evidence to contrast public and private sectors with respect to client satisfaction. The objective of this study is to compare quality-of-care provided by public and private sectors of Pakistan through a client satisfaction lens. Methods: We used Pakistan Demographic Heath Survey 2012-13 dataset on 3133 women. Ten different multivariate models were made. to explore the relationship between client satisfaction and dependent outcome after adjusting for all known confounding factors and results are presented as OR and AOR (95% CI). Results: Multivariate analyses showed that clients were less satisfied in contraceptive provision from private sector as compared to public sector (AOR 0.92, 95% CI 0.63-1.68) even though the result was not statistically significant. Clients were more satisfied from private sector as compared to the public sector with respect to other determinants of quality-of-care follow-up care (AOR 3.29, 95% CI 1.95-5.55), infection prevention (AOR 2.41, 95% CI 1.60-3.62), counseling services (AOR 2.01, 95% CI 1.27-3.18, timely treatment (AOR 3.37, 95% CI 2.20-5.15), attitude of staff (AOR 2.23, 95% CI 1.50-3.33), punctuality of staff (AOR 2.28, 95% CI 1.92-4.13), timely referring (AOR 2.34, 95% CI 1.63-3.35), staff cooperation (AOR 1.75, 95% CI 1.22-2.51) and complications handling (AOR 2.27, 95% CI 1.56-3.29). Discussion: Public sector has successfully attained substantial satisfaction levels with respect to provision of contraceptives, but it contrasts previous literature from a multi country studies. Our study though in is concordance with a study from Tanzania where public sector was more likely to offer family planning services to clients as compared to private facilities. Conclusion: In majority of the developing countries, public sector is more involved in FP service provision; however, in Pakistan clients’ satisfaction in private sector is more, which opens doors for public-private partnerships and collaboration in the near future. 

Keywords: Client satisfaction, Family Planning, Public private partnership, Quality of care

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22 Innovation in “Low-Tech” Industries: Portuguese Footwear Industry

Authors: António Marques, Graça Guedes

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The Portuguese footwear industry had in the last five years a remarkable performance in the exportation values, the trade balance and others economic indicators. After a long period of difficulties and with a strong reduction of companies and employees since 1994 until 2009, the Portuguese footwear industry changed the strategy and is now a success case between the international players of footwear. Only the Italian industry sells footwear with a higher value than the Portuguese and the distance between them is decreasing year by year. This paper analyses how the Portuguese footwear companies innovate and make innovation, according the classification proposed by the Oslo Manual. Also, analyses the strategy follow in the innovation process and shows the linkage between the type of innovation and the strategy of innovation. The research methodology was qualitative and the strategy for data collection was the case study. The qualitative data will be analyzed with the MAXQDA software. The economic results of the footwear companies studied shows differences between all of them and these differences are related with the innovation strategy adopted. The companies focused in product and marketing innovation, oriented to their target market, have higher ratios “turnover per worker” than the companies focused in process innovation. However, all the footwear companies in this “low-tech” industry create value and contribute to a positive foreign trade of 1.310 million euros in 2013. The growth strategies implemented has the participation of the sectorial organizations in several innovative projects. And it’s obvious that cooperation between all of them is a critical element to the performance achieved by the companies and the innovation observed. The Portuguese footwear sector has in the last years an excellent performance (economic results, exportation values, trade balance, brands and international image) and his performance is strongly related with the strategy in innovation followed, the type of innovation and the networks in the cluster. A simplified model, called “Ace of Diamonds”, is proposed by the authors and explains the way how this performance was reached by the seven companies that participate in the study (two of them are the leaders in the setor), and if this model can be used in others traditional and “low-tech” industries.

Keywords: Footwear industry, innovation strategy, low-tech industry, Oslo Manual.

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21 Socio-Spatial Resilience Strategic Planning Through Understanding Strategic Perspectives on Tehran and Bath

Authors: Aynaz Lotfata

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Planning community has been long discussing emerging paradigms within the planning theory in the face of the changing conditions of the world order. The paradigm shift concept was introduced by Thomas Kuhn, in 1960, who claimed the necessity of shifting within scientific knowledge boundaries; and following him in 1970 Imre Loktas also gave priority to the emergence of multi-paradigm societies [24]. Multi-paradigm is changing our predetermined lifeworld through uncertainties. Those uncertainties are reflected in two sides, the first one is uncertainty as a concept of possibility and creativity in public sphere and the second one is uncertainty as a risk. Therefore, it is necessary to apply a resilience planning approach to be more dynamic in controlling uncertainties which have the potential to transfigure present time and space definitions. In this way, stability of system can be achieved. Uncertainty is not only an outcome of worldwide changes but also a place-specific issue, i.e. it changes from continent to continent, a country to country; a region to region. Therefore, applying strategic spatial planning with respect to resilience principle contributes to: control, grasp and internalize uncertainties through place-specific strategies. In today-s fast changing world, planning system should follow strategic spatial projects to control multi-paradigm societies with adaptability capacities. Here, we have selected two alternatives to demonstrate; these are; 1.Tehran (Iran) from the Middle East 2.Bath (United Kingdom) from Europe. The study elaborates uncertainties and particularities in their strategic spatial planning processes in a comparative manner. Through the comparison, the study aims at assessing place-specific priorities in strategic planning. The approach is to a two-way stream, where the case cities from the extreme end of the spectrum can learn from each other. The structure of this paper is to firstly compare semi-periphery (Tehran) and coreperiphery (Bath) cities, with the focus to reveal how they equip to face with uncertainties according to their geographical locations and local particularities. Secondly, the key message to address is “Each locality requires its own strategic planning approach to be resilient.--

Keywords: Adaptation, Relational Network, Socio-Spatial Strategic Resiliency, Uncertainty.

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20 Relationship-Centred Care in Cross-Linguistic Medical Encounters

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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19 A Retrospective Study of Vaginal Stenosis Following Treatment of Cervical Cancers and the Effectiveness of Rehabilitation Interventions

Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk

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Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.

Keywords: Dilator, sexually active, vaginal dilation, vaginal stenosis.

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