The Energy Requirements of Pregnant Rural Thai Women

The objective of this study was to investigate the energy requirements of pregnant rural Thai women. Altogether 44 women were followed from about 10 weeks gestation until term. They were all poor farmers who continued their agricultural work until delivery. The theordical calculation of the energy cost of pregnancy by Hytten & Leitch (1964) was based on the needs of nonpregnant women with an added amount estimated for the maternal physiological changes and for the growth and development of the fetus. This estimate of the energy cost of pregnancy has been used as a basis for recommendations during the last few decades. (FAO/WHO/UNU, 1985; FAO/WHO,1973; DHSS, 1969, etc). The calculation of the energy requirements of pregnancy in this study, however, was conducted by measuring the physiological changes in the mother as a whole, i.e. the changes in the maintenance metabolism (BMR); the changes in body composition, particularly the weight and fat gain; the changes in activity pattern of the mother, and the pregnancy outcome. In this study the progressive change in BMR was measured throughout pregnancy. The results showed a different pattern of change in BMR in the Thai women compared to the theoretical value. A slight change in early pregnancy was observed and thereafter a marked increase resulted in a total increment from 10 weeks until term at 24,000kcal. Estimates of the BMR of non-pregnant compared to the pregnant women at 10 weeks gestation provided no evidence to support the marked change in BMR during early pregnancy, as demonstrated by Hytten & Leitch (1964). Weight gain during pregnancy was found to be 8.9+/-2.9kg. Fat gain however was estimated by 3 different approaches 1) the changes of the skinfold thickness (biceps, triceps, subscapular and suprailiac); 2) the factorial method and 3) the changes of maternal body weight The average fat gain by these different methods was found to be 1. 2kg. The energy equivalent of this fat gain and the increment of maintenance energy resulted in 37,200kcal, plus an assumed energy equivalent of about 10,000kcal from fetal fat and fetal and maternal protein tissues. The energy cost of pregnancy was therefore 47,200kcal which was met by the estimated increase of energy intake of 56,900kcal. Energy intake was measured serially using the precise weighing method. The observers recorded the food intake for 5 consecutive days in every 6 weeks. The average energy intake was 1932+/-358kcal/d at about 10 weeks and showed a rise of 56,900kcal until term. Measurements of total daily energy expenditure were also made on these women simultaneously with the food intake. The average energy expenditure at 10 weeks was 1870+/-287kcal and the total increment from 10 weeks until term was 31,600kcal. The difference between the increment of intake and expenditure was found to be similar to the energy needed for the energy deposition in maternal adipose tissue stores and the product of conception. Changes in total energy expenditure resulted from changes in activity pattern and in the energy costs of individual activities. The women tended to spend more time sitting and less time in agricultural activity particularly in the second half of pregnancy. The daily energy expenditure however increased due to the assumption that the energy cost of activity per unit body weight was constant, which was true for BMR, at least until 33 weeks gestation. A significant decrease in energy cost of the weight bearing activities, i.e. walking on the treadmill at a fixed speed was observed during the second half of pregnancy. The results indicated an increased mechanical efficiency of the pregnant women. If this was the case for other activities, this would lower the increment of the calculated energy expenditure in this study. The energy cost of pregnancy in this group of women was 47,200kcal to cover the period of 30 weeks from 10 weeks until term. This was equivalent to an increment of 225kcal daily. The pregnancy outcome of this study was satisfactory taking into account the small stature of the women. These women gave birth to healthy babies with an average birth weight of 2.98+/-0.35kg and birth length of 0.48+/-0.02m. In order to form a basis for recommending the energy requirements for pregnant rural women, more information is needed particularly from conception to 10 weeks of pregnancy

Strategies for effective virtual education delivery in Thailand

An increasing number of Thai universities arc using information and communication technologies to support virtual education delivery (VED). The main purpose of this study was to examine the strategies used by Thai universities to adopt the concept of \u27\u27virtual education delivery as an education tool. The study attempted to determine the critical factors that influence success in implementing Thai VEDs, and identified the ways to facilitate such adoption. These factors were synthesised with Thai environmental and cultural factors to develop a strategic framework which can be used to assist universities in Thailand to achieve more effective implementation of VEDs. The conceptual research framework was derived from knowledge gleaned from a review of previous research studies. The literature suggested some understanding of the what and how factors influencing VEDs, but contributed generally rather than specifically to the Thai cultural environment. This framework enabled the researcher to contextualise issues and to determine factors influencing Thai VEDs. This was used to develop the domains of the research questions which were examined through case study analysis of four Thai universities. A multi-method research approach including quantitative and qualitative methods was chosen because of its suitability to this problem. Tho contexts in determining critical factors influencing the success of Thai VEDs were examined through a survey and case studies. The questionnaire survey was developed from relevant research and based on the theoretical framework. This was administered to 240 students in four Rajabhat Institutes. 167 valid responses were received which was a response rate of 69.5 percent. Multiple regression analysis was used to test the relationships between the dependent variable and the independent variables. The dependent variable was the success of VED interpreted in terms of the effectiveness of quality, productivity and the student perception of their VED courses. The independent variables were resources, computer literacy, perceived value of computer-based information, culture and information culture. It was discovered that resources, perceived value of computer-based information, culture and information culture were significant influences on the success of Thai VED. In order to identify recurring themes that could enable the interpretation of another setting, multiple case studies through structured interviews were utilised. This was examined through analysis of four Rajabhat Institutes utilising VEDs. The results from interviewing instructors and administrators who were involved in VED were analysed by using a conceptual cluster matrix and cross case analysis to address the similarities and differences across cases. The results of this stage of analysis concluded that poor computer literacy, negative perceived value of computer-based information and information culture (of both students and instructors) were inhibitors to the success of VED. Further, some characteristics of Thai culture: high power distance, high uncertainty avoidance, and collectivism were founded to be critical barriers to knowledge sharing, essential for collaborative: learning in VEDs. Finally, the results have significant implications for administering and implementing VED. These suggested that there are four coping strategies to enhance VED implementation: I) improving technologies and providing technical support; 2) increasing IT/IS competency and skills of students and instructors; 3) changing students and instructors\u27 attitude to accept usefulness of VED; and 4) enhancing the members\u27 cooperation and commitment. In order to apply these findings in a practical setting an Audit instrument has been developed to allow continuous self-evaluation of the effectiveness of VED in Thai institutions

The Industrial Engineer and Energy and Environment

Industries have always been a major consumer of energy and a major source of greenhouse gas emissions, causing environmental problems. Concerns about the impact of industries on the environment have led industries to change or adapt their methodologies to be more efficient and environmentally responsible. This article explains the impact that has on the industrial engineer

THE ROLE OF SOCIAL NETWORKING ON POLITICAL CONSIOUSNESS OF UNIVERSITY STUDENTS IN LOWER NORTHEASTERN REGION, THAILAND

This research aims to investigate the behavior of social networking in receiving political information and involving in politics of the university students in lower northeastern region and to examine the relationship of the reflection after receiving information through the social networking and the democratic and power-oriented consciousness of the respondents. The effect of the political consciousness on political involvement and monitoring of politician’s work through the social networking are also the focus of the study. The research used a mixed-method of quantitative and qualitative approaches. A focus group was employed in the qualitative data collection from which 21 samples including chairman of the student were selected. The qualitative collected data were analyzed in order to that the results could be used to base the survey questionnaire. The questionnaire was then utilized to collect the quantitative data from 427 sampled students in eight universities. The statistics including frequency, percentage, mean, standard deviation, Pearson’s product moment correlation, and multiple regressions analysis were employed in data analysis. Receiving political information three to four times a week is found in mean frequency of the respondents. The behavior of the information recipients found not to voice their opinions and not to pass on the received information to other people on Facebook or other social networking is very close in proportion to those sharing their views and passing on the information to friends on the social networking. Only getting interested but not wanting to get involved in politics is the main reason of the samples. The reflection after receiving information results in most respondents saying they are able to understand, analyze, and identify facts of the received messages. And the ability in identifying of facts is related to the respondent’s democratic consciousness while the inability in identifying of facts is relevant to the power-orientation. Hypothesis test indicates the democratic consciousness having relationship with the positive effect of political involvement and monitoring of politician’s work whereas the power-oriented consciousness is found to be opposite in thatthe more the consciousness found to be power-oriented the less tendency to get involved in politics and monitoring of politician’s work of the respondents exists

New Product Development Processes for IOT-Enabled Home Use Medical Devices: A Systematic Review

Background: In the new forefront of healthcare at patients’ homes, medical devices developed to use at home setting by lay users are essential. The adoption of home-use medical devices will benefit both patients and public healthcare services in terms of quality of life, enhanced outcomes, and reduced cost of care. Home use medical devices associated with Internet-Of-Things (IOT) technology assists patients in performing self-care as well as providing health information remotely to health care professionals. However, adopting technology requires understanding the nature of the medical device and medical device development (MDD). Existing studies concerning the new product development (NPD) processes or design processes were systematically reviewed to explore knowledge and expertise to provide a framework for IOT engineers or designers to adopt IOT technology to home use medical devices. Objective: This study aimed to review the published literature to explore the current studies in the field of the NPD process, design process, design methodology, and outcome of the device affecting user acceptance. Methods: A systematic review following PRISMA guidelines of the English language literature from four electronic databases and academic search engines published from 2007 to 2018 was conducted. The papers were screened and assessed following predefined inclusive and exclusive criteria. The results were analyzed according to the research questions. Results: The findings revealed state-of-the-art in the NPD process and design process (n=4), the design methodology (n=23), and the resultant outcomes of empirical or clinical research in the validation stage (n=14) of medical device development (MDD). The findings also delineated existing studies in NPD, design process, and design methodologies aimed to ensure that medical devices would be effective and safe. Human factor engineering (HFE), cognitive method, ethnographic, and other methodologies were proposed to understand users, uses and context of use. Barriers, constraints, and multidisciplinary communication were addressed. Tools, processes, and methodologies were proposed to overcome the barriers. Conclusion: As home-use medical device development (MDD) and the adoption of IOT technology is now at a crossroads. This study addresses the necessity for future academic studies related to IOT adoption to MDD, including unique risks, multidisciplinary problems, emerging from IOT technology. Finally, future studies aimed at fabricating the NPD process or design process for IOT home-use medical devices to gain user acceptance were outlined

Identifying Strategies For Effective Virtual Education Delivery In Thailand

Increasingly, universities in Thailand are shifting towards virtual education delivery (VED) using information and communication technology to facilitate knowledge sharing and to gain competitive advantage. Little however is known about the way in which Thai society will adapt to the use of online instruction both from the teaching and learning communities. This study was designed to examine the critical success factors for implementing VEDs in Thailand, and to identify ways to facilitate such adoption and lead to effective outcomes. The study incorporated an analysis of three specific factors related to Thai culture: high power distance Bhun Khun , uncertainty avoidance Kreng Jai and, collectivism Kam Lang Jai . This paper reviews the development of the research model, describes the conceptual underpinning of the cultural model and presents the preliminary findings of the study

Cross-Cultural Perspectives of Knowledge Sharing for Different Virtual Classroom Environments: A Case Study of Thai Students in Thai and Australian Universities

Collaborative learning has been accepted as an effective learning style that can enhance students‘ and instructors‘ ability to create knowledge and develop understanding. To enhance an effective collaboration learning environment needs the sharing of similar knowledge, background and experience through information communication technologies (ICT). There are a number of ways in which culture influences the use of these information technologies. The cultural characteristics, which can be viewed as the influencing factors on knowledge sharing in a virtual classroom, are power distance, uncertainty avoidance, individualism and collectivism. The main purpose of this study was to investigate how the differences in cultural values affect the way Thai students in both Thailand and Australia access and share knowledge in a virtual classroom. According to Hofstede, the national culture between Thais and Australians are different in the degree of power distance, uncertainty avoidance and individualism/collectivism. Thais are likely to have high power distance, high uncertainty avoidance and collectivism while Australians have low power distance, low uncertainty avoidance and individualism. A qualitative method using t-test and Multiple Regression analysis was chosen to test the research hypotheses that Thai students in Thai universities have greater difficulty in knowledge sharing than Thai students in Australian universities. A questionnaire survey designed to identify cultural differences was administrated to 100 students in Thai universities and 100 students in Australian universities who used ICT for sharing knowledge in their virtual classroom. The findings of the study and recommendations will be outlined. The research outcome of the study can assist project managers in implementing effective open-wide knowledge exchange systems

Update on Anti-EGFR Therapy

Editoria

Tumor marker analyses from the phase III, placebo-controlled, FASTACT-2 study of intercalated erlotinib with gemcitabine/platinum in the first-line treatment of advanced non-small-cell lung cancer

AbstractObjectivesThe FASTACT-2 study of intercalated erlotinib with chemotherapy in Asian patients found that EGFR mutations were the main driver behind the significant progression-free survival (PFS) benefit noted in the overall population. Further exploratory biomarker analyses were conducted to provide additional insight.Materials and methodsThis multicenter, randomized, placebo-controlled, double-blind, phase III study investigated intercalated first-line erlotinib or placebo with gemcitabine/platinum, followed by maintenance erlotinib or placebo, for patients with stage IIIB/IV non-small cell lung cancer (NSCLC). Provision of samples for biomarker analysis was encouraged but not mandatory. The following biomarkers were analyzed (in order of priority): EGFR mutation by cobas® test, KRAS mutation by cobas® KRAS test, HER2 by immunohistochemistry (IHC), HER3 by IHC, ERCC1 by IHC, EGFR gene copy number by fluorescence in-situ hybridization (FISH) and EGFR by IHC. All subgroups were assessed for PFS (primary endpoint), overall survival (OS), non-progression rate and objective response rate.ResultsOverall, 256 patients provided samples for analysis. Considerable overlap was noted among biomarkers, except for EGFR and KRAS mutations, which are mutually exclusive. Other than EGFR mutations (p<0.0001), no other biomarkers were significantly predictive of outcomes in a treatment-by-biomarker interaction test, although ERCC1 IHC-positive status was predictive of improved OS for the erlotinib arm versus placebo in EGFR wild-type patients (median 18.4 vs 9.5 months; hazard ratio [HR] HR=0.32, 95% confidence intervals [CI]: 0.14–0.69, p=0.0024).ConclusionActivating EGFR mutations were predictive for improved treatment outcomes with a first-line intercalated regimen of chemotherapy and erlotinib in NSCLC. ERCC1 status may have some predictive value in EGFR wild-type disease, but requires further investigation