A HOLISTIC APPROACH TO DEVELOP ENGINEERING PROGRAMME OUTCOMES: A CASE STUDY OF TAYLOR'S UNIVERSITY

Part fulfilment of providing an engineering programme which implements outcome based education includes various outcomes that are tied to what the graduate should achieve after, during and before graduation. The programme outcomes are specifically crafted to encapsulate attributes that must be attained by a student upon graduation. The following paper details the principles used to craft the programme outcomes of an engineering undergraduate degree programme. The principles used were chosen based its importance and innovative content as well as being aligned to the purpose of the university which is running the degree programme. Upon crafting the prescribed outcomes, the paper will also detail how stakeholders were engaged and how their opinion was accounted for in the final crafting of the new set of programme outcomes. The paper also highlights how a gap analysis was performed to capture areas which were not covered by the previous programme outcomes

A 50-Year-Old Woman with Recurrent Generalised Seizures

Ronald Ma and colleagues discuss the differential diagnosis, investigation, and management of this patient

Capacity building for dementia care in community care services: a mixed methods approach

Background The prevalence of dementia is surging that results in huge service demand in the community care services. Dementia care competence of staff working in these settings is fundamental of the care quality. This project aims to examine the effects of staff training on their competence for the anticipated challenges in dementia care and explore how the training influence their care practices. Methods This study adopted a mixed methods triangulation design, including a prospective multi-center study with pre-test post-test evaluations and a narrative analysis of the participants’ reflective essays. Seventeen experienced health and social care professionals were trained as trainers at the Dementia Services Development Centre of the University of Stirling, UK. The trainers provided local facilitator training to staff members by using training materials that were culturally adapted to the local context. The facilitators were required to deliver 12 two-hour in-service training sessions for 6 months to their colleagues in a small group format in their respective workplace. Eventually a total of 1347 staff members from community care centers, day care centers, outreach teams and care homes of 70 non-government organizations in Hong Kong participated in the study between April 2017 and December 2018. Validated instruments were used to measure knowledge, attitude, sense of competence in dementia care and job satisfaction at the baseline and at 12-month follow-up. All participants were required to write a reflective essay to describe their experiences in dementia care by the end of the training. Results A total of 1264 participants, including 195 facilitators and 1069 learners, completed all assessment were included for analysis. Significant improvements were observed in all outcomes at the 12-month follow-up assessment (Ps ≤ .001). The magnitude of improvements in attitudes was the largest. The findings also showed that the effects of the training program significantly varied across different groups of learners in terms of age, occupation, work and training experience. Conclusions This community-wide large-scale project provided evidence that the train-the-trainer model and reflective learning are effective means to facilitate situated learning that promote awareness and understanding of dementia, and consequently enhance sustainability of changes in care practices

24 hour movement behaviours and the health and development of pre-school children from Zimbabwean settings: the SUNRISE pilot study

Background: In 2019, the World Health Organization (WHO) released global guidelines for physical activity, sedentary behaviour and sleep for the early years. The International Study of Movement Behaviours in the Early Years, SUNRISE, aimed to assess the extent to which children aged three and four years meet the WHO global guidelines and its association with health and development. Objectives: To assess movement behaviours in pre-school children from low-income settings in Zimbabwe and to establish associations between these movement behaviours and adiposity, motor skills and executive function.Methods: Pre-school children/caregivers were recruited from two urban and two rural public schools respectively in Zimbabwe. The caregivers answered questions on the children’s physical activity, screen time, sedentary behaviour and sleep patterns. Children’s movement behaviours were objectively measured using accelerometers. Gross and fine motor skills and executive function were assessed using the Ages and Stages Questionnaire-3 and Early Years Toolbox, respectively. Focus group discussions were carried out with caregivers and teachers on the acceptability and feasibility of the study. Results: Eighty-one children participated in the study. The proportions of children meeting the guidelines were physical activity 92%, sedentary behaviour 70%, and sleep 86%, and all guidelines combined 24%. Boys and girls were similar (p>0.05 for all variables) for all executive function variables, but rural children had significantly lower inhibition scores (p=0.026) than urban children. Conclusion: The study adds to the growing literature on movement behaviours and associated risk factors in low-resourced settings. Further investigations of movement behaviours in this age group in Zimbabwe are recommended

Phytotoxic metabolites from Neofusicoccum parvum, a pathogen of Botryosphaeria dieback of grapevine

Liquid chromatography-diode array screening of the organic extract of the cultures of 13 isolates of the fungus Neofusicoccum parvum, the main causal agent of botryosphaeria dieback of grapevine, showed similar metabolites. One strain was selected for further chemical studies and led to the isolation and characterisation of 13 metabolites. Structures were elucidated through spectroscopic analyses, including one- and two-dimensional NMR and mass spectrometry, and through comparison to literature data. The isolated compounds belong to four different chemical families: five metabolites, namely, ( )-terremutin (1), (+)-terremutin hydrate (2), (+)-epi-sphaeropsidone (3) ( )-4-chloro-terremutin hydrate (4) and(+)-4- hydroxysuccinate-terremutin hydrate (5), belong to the family of dihydrotoluquinones; two metabolites, namely, (6S,7R) asperlin (6) and (6R,7S)-dia-asperlin (7), belong to the family of epoxylactones; four metabolites, namely, (R)-( )-mellein (8), (3R,4R)-4-hydroxymellein (9), (3R,4S)-4-hydroxymellein (10) (R)( )-3-hydroxymellein (11), belong to the family of dihydroisocoumarins; and two of the metabolites, namely, 6-methyl-salicylic acid (12) and 2-hydroxypropyl salicylic acid (13), belong to the family of hydroxybenzoic acids. We determined the phytotoxic activity of the isolated metabolites through a leaf disc assay and the expression of defence-related genes in Vitis vinifera cells cv. Chardonnay cultured with ( )-terremutin (1), the most abundant metabolite. Finally, analysis of the brown stripes of grapevine wood from plants showing botryosphaeria dieback symptoms revealed the presence of two of the isolated phytotoxinsinfo:eu-repo/semantics/publishedVersio

Quinone compounds regulate the level of ROS production by the NADPH oxidase Nox4

NADPH oxidase Nox4 is expressed in a wide range of tissues and plays a role in cellular signaling by providing reactive oxygen species (ROS) as intracellular messengers. Nox4 oxidase activity is thought to be constitutive and regulated at the transcriptional level; however, we challenge this point of view and suggest that specific quinone derivatives could modulate this activity. In fact, we demonstrated a significant stimulation of Nox4 activity by 4 quinone derivatives (AA-861, tBuBHQ, tBuBQ, and duroquinone) observed in 3 different cellular models, HEK293E, T-REx™, and chondrocyte cell lines. Our results indicate that the effect is specific toward Nox4 versus Nox2. Furthermore, we showed that NAD(P)H:quinone oxidoreductase (NQO1) may participate in this stimulation. Interestingly, Nox4 activity is also stimulated by reducing agents that possibly act by reducing the disulfide bridge (Cys226, Cys270) located in the extracellular E-loop of Nox4. Such model of Nox4 activity regulation could provide new insight into the understanding of the molecular mechanism of the electron transfer through the enzyme, i.e., its potential redox regulation, and could also define new therapeutic targets in diseases in which quinones and Nox4 are implicated. © 2013 Elsevier Inc. All rights reserved

Temperature correction of spectra to improve solute concentration monitoring by in situ ultraviolet and mid-infrared spectrometries towards isothermal local model performance

Changes in temperature can significantly affect spectroscopic-based methods for in situ monitoring of processes. As varying temperature is inherent to many processes, associated temperature effects on spectra are unavoidable, which can hinder solute concentration determination. Ultraviolet (UV) and mid-infrared (IR) data were acquired for l-ascorbic acid (LAA) in MeCN/H2O (80:20 w/w) at different concentrations and temperatures. For both techniques, global partial least squares (PLS) models for prediction of LAA concentration constructed without preprocessing of the spectra required a high number of latent variables to account for the effects of temperature on the spectra (root mean square error of cross validation (RMSECV) of 0.18 and 0.16 g/100 g solvent, for UV and IR datasets, respectively). The PLS models constructed on the first derivative spectra required fewer latent variables, yielding variable results in accuracy (RMSECV of 0.23 and 0.06 g/100 g solvent, respectively). Corresponding isothermal local models constructed indicated improved model performance that required fewer latent variables in the absence of temperature effects (RMSECV of 0.01 and 0.04 g/100 g solvent, respectively). Temperature correction of the spectral data via loading space standardization (LSS) enabled the construction of global models using the same number of latent variables as the corresponding local model, which exhibited comparable model performance (RMSECV of 0.06 and 0.04 g/100 g solvent, respectively). The additional chemometric effort required for LSS is justified if prediction of solute concentration is required for in situ monitoring and control of cooling crystallization with an accuracy and precision approaching that attainable using an isothermal local model. However, the model performance with minimal preprocessing may be sufficient, for example, in the early phase development of a cooling crystallization process, where high accuracy is not always required. UV and IR spectrometries were used to determine solubility diagrams for LAA in MeCN/H2O (80:20 w/w), which were found to be accurate compared to those obtained using the traditional techniques of transmittance and gravimetric measurement. For both UV and IR spectrometries, solubility values obtained from models with LSS temperature correction were in better agreement with those determined gravimetrically. In this first example of the application of LSS to UV spectra, significant improvement in the predicted solute concentration is achieved with the additional chemometric effort. There is no extra experimental burden associated with the use of LSS if a structured approach is employed to acquire calibration data that account for both temperature and concentration

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Perceived status towards COVID-19 mitigation measures among medical students in Malaysian Borneo

Introduction: Mitigation measures are important in curbing COVID-19 infection. However, people’s adherence to the control measures is depending upon their knowledge, attitudes and practices (KAP) towards the disease. This study aims to determine the KAP on COVID-19 and its associated factors among medical students in Malaysian Borneo during the period of the pandemic. Methods: A cross-sectional online survey of 248 medical students from University Malaysia Sabah was conducted from August to September 2020. The survey instrument was adapted from a previously validated questionnaire on COVID-19. Descriptive statistics and simple logistic regression were conducted. Results: The mean age of respondents was 22.0 (SD 1.4) years. Majority (65.7%, n= 163) were clinical students, female gender (70.6%, n= 175), and Bumiputera ethnic (46.8%, n= 116). 211 (85.1%), 191 (77.0%) and 163 (65.7%) of the respondents have good level of knowledge, positive attitude and good practice respectively. Conclusion: The medical students are updated with the current health issues especially on COVID-19. They are aware of the attributes of the disease and have concerns in taking good care of themselves. Further study needs to be implemented among the groups of non-medical student of the same institution to compare their KAP on COVID-19

Effects of 12-Week Rowing Training on Resting Cardiac Output, Stroke Volume, and Heart Rate of Stroke Survivors

Rowing exercise is one of the cardiorespiratory exercises that induce higher aerobic capacity. Cardiorespiratory parameters, cardiac output (CO), stroke volume (SV), and heart rate (HR) are indicators to measure one’s cardiorespiratory fitness. The aim was to study the effects of 12-week rowing training on resting cardiac output (RCO), resting stroke volume (RSV), and resting heart rate (RHR) of stroke survivors. Ten stroke survivors (6 males; 4 females), mean age of 43.6 ± 16.15 years, were subjected to a 12-week rowing training (Concept II Rowing Ergometer, Model C, USA). An individualised programme was prescribed based on %HRR for each of stroke individual. Rowing training was conductedtwice per week (12 HIIT; 12 MR). Paired t-test and repeated measures ANOVA (RPM ANOVA) were used for statistical analyses using IBM® SPSS® Statistics 20 software. RPM ANOVA analysis showed no significant effect on RCO [F (5, 45) = 1.066, p = 0.392, RSV [F (2.188, 19.693) = 0.677, p = 0.532)], and RHR [F (5, 45) = 0.856, p = 0.518]. Paired t-test showed no significant difference between pre- and post-test despite the improved values of Mean ± Standard Deviation (RCO: 8129.50 ± 3916.31 to 8494.18 ± 6248.86 mL/min; RSV: 99.27 ± 33.98 to 121.84 ± 66.24 mL; RHR: 78.02 ± 17.39 to 77.17 ± 11.98 bpm) for all respective parameters. Twelve weeks rowing training did not improve resting cardiorespiratory parameters of stroke survivors statistically. Future studies are suggested to include gender difference and medication effect variables