The Situation of Cost Management in Execution of Building Projects in Syria.

This research aims at studying the situation of cost management in building projects in Syria, evaluating the applied ways of cost management and finding the suitable means to improve it. To achieve that aim, a questionnaire was distributed to a number of workers in the building contraction sector in Syria to collect data and investigate the existing methodology in cost management in the building field. This research shows that cost management methodology is not applied in Syrian building projects and suggests some solutions that contribute in developing the condition of cost management based on universal methodologies in this field

The Effect of the COVID-19 Pandemic on the Social Inequalities of Health Care Use in Hungary: A Nationally Representative Cross-Sectional Study

Background: The social representation of restricted health care use during the COVID-19 pandemic has not been evaluated properly yet in Hungary. Objective: Our study aimed to quantify the effect of COVID-19 pandemic measures on general practitioner (GP) visits, specialist care, hospitalization, and cost-related prescription nonredemption (CRPNR) among adults, and to identify the social strata susceptible to the pandemic effect. Methods: This cross-sectional study was based on nationally representative data of 6611 (Nprepandemic = 5603 and Npandemic = 1008) adults. Multivariable logistic regression models were applied to determine the sociodemographic and clinical factors influencing health care use by odds ratios (ORs) along with the corresponding 95% confidence intervals (CI). To identify the social strata susceptible to the pandemic effect, the interaction of the time of data collection with the level of education, marital status, and Roma ethnicity, was tested and described by iORs. Results: While the CRPNR did not change, the frequency of GP visits, specialist care, and hospitalization rates was remarkably reduced by 22.2%, 26.4%, and 6.7%, respectively, during the pandemic. Roma proved to be not specifically affected by the pandemic in any studied aspect, and the pandemic restructuring of health care impacted the social subgroups evenly with respect to hospital care. However, the pandemic effect was weaker among primary educated adults (iORGP visits, high-school vs. primary-education = 0.434; 95% CI 0.243-0.776, ORspecialist visit, high-school vs. primary-education = 0.598; 95% CI 0.364-0.985), and stronger among married adults (iORGP visit, widowed vs. married = 2.284; 95% CI 1.043-4.998, iORspecialist visit, widowed vs. married = 1.915; 95% CI 1.157-3.168), on the frequency of GP visits and specialist visits. The prepandemic CRPNR inequality by the level of education was increased (iORhigh-school vs. primary-education = 0.236; 95% CI 0.075–0.743). Conclusion: Primary educated and widowed adults did not follow the general trend, and their prepandemic health care use was not reduced during the pandemic. This shows that although the management of pandemic health care use restrictions was implemented by not increasing social inequity, the drug availability for primary educated individuals could require more support

Situated Learning Through Robotics Processes

Technological advances in robotics, digital fabrication, and sensor technologies are changing the landscape of innovation, design, and production. However, integration of these technologies in architecture programs is a challenging task. It requires extensive knowledge of the robotic arm operations, complex computer applications, and developing interdisciplinary skills for producing the end of arm tooling, which makes architectural experimentation and production possible. The following paper describes an informal approach to an interdisciplinary collaboration experiment for initiating operations of a new robotics lab. Leveraging the inaugural event of the lab, students and faculty were invited to design, construct, and participate in exhibiting four projects at the event. The paper explains each project, how student and faculty interacted and learned advanced fabrication techniques, and how their experience contributed to the overall establishment of the lab

Translation, cultural adaptation and linguistic validation of the postgraduate hospital educational environment measure into Arabic

Background: Assessment of the clinical learning environment (CLE) is an essential step that teaching hospitals routinely undertake to ensure the environment is conducive, learning-oriented and supportive of junior doctors’ education. The Postgraduate Hospital Educational Environment Measure (PHEEM) is an internationally recognized tool for assessing the CLE with evidence of high reliability and validity. Translation of PHEEM into other languages such as Spanish, Japanese and Persian enabled wider adoption of the instrument in the world. However, in Syria and other Arabic countries, a validated Arabic translation of PHEEM is still not available, making it difficult to adopt it and use it in Arabic contexts. This study aims to translate and culturally adapt the PHEEM from English into Arabic. Methods: This study followed the structured translation and validation process guideline proposed by Sousa & Rojjanasrirat 2010. First, the PHEEM went through forward translation by three translators, then reconciled with the aid of a fourth translator. Afterwards, two professional bicultural and bilingual translators conducted back translation into English and compared it with the original version. This formed the Pre-final Version (PFV) which was then pretested for clarity on a sample of medical residents in Damascus, Syria. Following appropriate modifications, the PFV was sent to a panel of experts for a comprehensive review of language clarity and to assess content validity. Results: A total of thirty-five medical residents were recruited. Ten items with language clarity issues were identified and modified according to the elicited suggestions. Thereafter, the modified PFV was presented to ten subject experts who identified three items in need of revision. The item-content Validity Index (CVI) was over 0.78 for all of the 40 items; the calculated scale-CVI was 0.945. Discussion: This study provided the first linguistically valid Arabic translation of the widely used PHEEM inventory. The next step is to conduct a full psychometric analysis of the Arabic PHEEM to provide further evidence of validity and reliability

"In general people aren't excited about the vaccine…": Frontline perspectives on COVID-19 vaccine hesitancy across Syria.

COVID-19 vaccine hesitancy is a new phenomenon in Syria, about which relatively little is known. We aimed to explore this, drawing from 37 semi-structured interviews with frontline health-workers and service-users across Syria's major military areas-of-control. We found COVID-19 vaccine hesitancy was common and increasing among service-users and less common, but still present, among health-workers in all areas. Interrelated reasons included pragmatic fears of novel vaccine risks, unreliable information, and conflict-related hesitancies as a form of resistance or reasserting some perceived control, particularly outside Al-Assad government-controlled areas. Vaccine hesitancy has thus become a socio-political issue, requiring macro-level responses, across Syria

AB024. “COVID-19 is just another way to die...”: a qualitative longitudinal study of frontline COVID-19 response governance across Syria

Background: Governance of coronavirus disease 2019 (COVID-19) responses has been challenging for all countries. Syria has been particularly challenged, due to protracted multi-party conflict and debilitated health systems fragmented across several governance areas. To improve response governance, we need a better understanding of frontline response policy implementation across the country. This study explored perspectives of COVID-19 response governance among frontline healthcare providers over time and across all areas of Syria. Methods: We used a qualitative longitudinal study design, conducting five rounds of remote semi-structured key informant interviews in Arabic (i.e., approximately 8 interviews each in March 2020, July 2020, September 2020, December 2020, and September 2021) with 14 purposively sampled public and private healthcare providers in the three main areas-of-control [i.e., opposition-controlled area (OCA), autonomous administration-controlled area (AACA), al-Assad government-controlled area (GCA)]. We conducted integrative thematic analysis in Arabic, within and across geography and time, as described by Neale [2021]. Results: Almost all participants across all areas and rounds expressed distrust of local health authorities and dissatisfaction with COVID-19 response governance. This was most apparent in initial rounds and in GCA. Response planning was identified as insufficient, non-participatory, and non-transparent, with limited infrastructure and resources as the main challenges across time. Anticipated rapid virus spread and health systems collapse did not occur. Community adherence to prevention measures varied, starting weakly due to public skepticism, increasing immediately after first cases were confirmed and then fluctuating with case numbers and challenges of insecurity and misinformation. Perceptions of COVID-19 vaccination were positive, while low uptake and hesitancy were attributed to misinformation, disinformation, and disinterest. Participant optimism increased over time. Suggested improvements to COVID-19 response governance focused on strengthening current health systems’ capacity and improving coordination. Conclusions: Addressing transparency and misinformation should be a first step to improving public engagement and trust and thus response governance for COVID-19 and future health emergencies

'We need someone to deliver our voices': reflections from conducting remote qualitative research in Syria.

The need to generate evidence in spaces considered insecure and inhabited by potentially extremely vulnerable individuals (e.g. conflict-affected people who may not have means to move) has led researchers to study conflict-affected settings remotely. Increased attention to remote research approaches from social scientists, due to COVID-19-related travel restrictions, is sparking interest on appropriate methods and tools. Drawing on several years' experience of remotely conducting qualitative research in Syria, we discuss challenges and approaches to conducting more inclusive, participatory, and meaningful research from a distance. The logistics, ethics, and politics of conducting research remotely are symptomatic of broader challenges in relation to the decolonisation of global and humanitarian health research. Key to the success of remote approaches is the quality of the relationships researchers need to be able to develop with study participants without face-to-face interactions and with limited engagement 'in the field'. Particularly given overdue efforts to decolonise research institutions and methods, lead researchers should have a meaningful connection with the area in which they are conducting research. This is critical both to reduce chances that it will be extractive and exploitative and additionally for the quality of interpretation

Whose voices should shape global health education? Curriculum codesign and codelivery by people with direct expertise and lived experience

There are contrasting opinions of what Global Health (GH) curricula should contain and limited discussion on whose voices should shape it. In GH education, those with first-hand expertise of living and working in the contexts discussed in GH classrooms are often absent when designing curricula. To address this, we developed a new model of curriculum co-design called Virtual Roundtable for Collaborative Education Design (ViRCoED). This paper describes the rationale and outputs of the ViRCoED approach in designing a new section of the Global Health BSc curriculum at Imperial College London, with a focus on healthcare in the Syrian conflict. The team, importantly, involved partners with lived and/or professional experience of the conflict as well as alumni of the course, and educators in all stages of design and delivery through to marking and project evaluation. The project experimented with disrupting power dynamics and extending ownership of the curriculum beyond traditional faculty by co-designing and co-delivering module contents together with colleagues with direct expertise and experience of the Syrian context. An authentic approach was applied to assessment design using real-time syndromic healthcare data from the Aleppo and Idlib Governorates. We discuss the challenges involved in our collaborative partnership and describe how it may have enhanced the validity of our curriculum with students engaging in a richer representation of key health issues in the conflict. We observed an enhanced self-reflexivity in the students’ approach to quantitative data and its complex interpretation. The dialogic nature of this collaborative design was also a formative process for partners and an opportunity for GH educators to reflect on their own positionality. The project aims to challenge current standards and structures in GH curriculum development and gesture towards a GH education sector eventually led by those with lived experience and expertise to significantly enhance the validity of GH education

'COVID-19 is just another way to die…': a qualitative longitudinal study of frontline COVID-19 response governance across Syria

INTRODUCTION: Governance of COVID-19 responses has been challenging for all countries. Syria has been particularly challenged due to protracted multiparty conflict and debilitated health systems fragmented across different areas of control. To improve response governance, better understanding of frontline response policy implementation across the country is needed. This study thus explored perspectives of COVID-19 response governance among frontline healthcare providers over time and across major areas of control. METHODS: We used a qualitative longitudinal study design, conducting five rounds of remote semistructured interviews in Arabic (ie, approximately eight interviews each in March 2020, July 2020, September 2020, December 2020 and September 2021) with 14 purposively sampled public and private healthcare providers in the three main areas of control (ie, opposition-controlled area, Autonomous Administration-controlled area and al-Assad government-controlled area (GCA)). We conducted integrative thematic analysis in Arabic within and across geography and time. RESULTS: Almost all participants across all areas and rounds expressed distrust of local health authorities and dissatisfaction with COVID-19 response governance. This was most apparent in initial rounds and in GCA. Response planning was identified as insufficient, non-participatory and non-transparent. Limited infrastructure and resources were the main challenges across time, though anticipated rapid virus spread and health systems' collapse did not occur and participant optimism increased over time. Public adherence to prevention measures varied-initially weak due to general scepticism, increasing after first cases were confirmed and then fluctuating with case numbers and challenges of insecurity and misinformation. Perceptions of COVID-19 vaccination varied, with low uptake and hesitancy attributed to misinformation, disinformation and disinterest. Suggested improvements to COVID-19 response governance focused on strengthening health systems' capacity and coordination. CONCLUSION: This is a unique longitudinal study of COVID-19 responses. Addressing transparency and misinformation should be a first step to improving public engagement and trust and thus response governance for health emergencies in Syria

Studies of the anticorrosion property of a newly synthesized Green isoxazolidine for API 5L X60 steel in acid environment

tThe potential of an environmentally friendly novel synthesized and characterized isoxazoli-dine derivative namely 5-(4-dodecyloxy-3-methoxybenzyl)-2-methylisoxazolidine (DMBMI)as anticorrosion agent for carbon steel in 1 mol/L HCl solution was investigated using gravi-metric and electrochemical techniques. Kinetics parameters of the corrosion process andthe thermodynamic data of adsorption of the organic molecule on the carbon steel surfacewas also assessed in order to characterize the performance of the studied compound as acorrosion inhibitor. The solubility, toxicity and the state of the molecule at the acidic pH(1 mol/L HCl) was predicted. It was found that the synthesized compound is green (envi-ronmentally friendly) with an optimum solubility of 23.8 mg/L. Also the molecule exists100 percent in protonated form in 1 mol/L HCl (pH = 0). The molecule possesses anticorro-sion property against steel corrosion in acid environment. Corrosion retardation efficacy isdependent on concentration and temperature. DMBMI exhibited concentration dependentcorrosion inhibition ability influencing mainly anodic metal dissolution based on potentio-dynamic polarization data. Addition of KI through the mechanism of competitive adsorptionenhanced the inhibition efficiency considerably. The active sites for the interaction of DMBMIwith steel surface was calculated using quantum chemical method while the adsorptionenergy between the inhibitor and steel surface was derived via Monte Carlo simulations.Results from theoretical studies and surface analysis are in conformity and reveal that theO and N heteroatoms in the synthesized molecule are the interaction centers