Search results for: Geographical Information System (GIS) for assets management

Authors: Zolani Metu

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The death of more than 140 psychiatric patients who were unethically deinstitutionalized from the Life Esidimeni hospital Johannesburg, in 2016, shined a light on South Africa’s failing public mental healthcare system. Compounded by insufficient research evidence on African deinstitutionalization, this necessitates inquiries into deinstitutionalized mental healthcare, reintegration and community-based mental healthcare within the South African context. This study employed a quantitative research approach which utilized a cross-sectional research design, to investigate experiences with the reintegration of institutionalized forensic mental health service users into communities in the Western Cape, South Africa. A convenience sample of 100 mental health care workers from different occupational and organizational backgrounds in the Western Cape was purposively selected using the Western Cape Health Directorate as a sampling frame. A self-administered questionnaire (SAQ) was used as the data collection instrument. The results of the study indicate that criminogenic factors such as substance use, history of violent behaviour, criminal history and disruptive social behaviour complicate the reintegration of forensic mental health service users into communities. The current extent of reintegration of forensic mental health service users was found to be 'poor' (46%; n= 46); and financial difficulties, criminogenic factors and limited Community-Based Care (CBC) facilities were identified as key barriers to the reintegration process. 56% of all job applications for forensic mental health service users were unsuccessful, and 53% of all applications for their admission into CBC facilities were declined. Although social support (informal) was found to be essential for successful reintegration, institutional support (formal) through assertive community treatment (35%; n= 35) and CBC facilities (21%) and the disability grant (DG=50%) was found to be more important for family coping and reintegration. Moreover, 72% of respondents had positive perceptions about the process of reintegration; no statistically significant relationship was found between years of experience and perceptions about reintegration (P-value = 0.062); and perceptions were not found to be a barrier to reintegration. No statistically significant relationship was found between years of working experience and understanding the legislative framework of deinstitutionalization (P-Value =.0.061). However, using a Chi-square test, a significant relationship (P-value = 0.021) was found between sex and understanding the legal framework involved in the process of reintegration. The study recommends a post-2020 deinstitutionalization agenda that factors-in criminogenic realities associated with forensic mental health service users, and affirms the strengthening of PHC and community based care systems as precedents of successful deinstitutionalization and reintegration of mental health service users.

Keywords: forensic mental health, deinstitutionalization, reintegration, mental health service users

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Authors: Regina Rekuviene, Vykintas Samaitis, Liudas Mažeika, Audrius Jankauskas, Virginija Jankauskaitė, Laura Gegeckienė, Abdolali Sadaghiani, Shaghayegh Saeidiharzand

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Icing brings significant damage to aviation and renewable energy installations. Air-conditioning, refrigeration, wind turbine blades, airplane and helicopter blades often suffer from icing phenomena, which cause severe energy losses and impair aerodynamic performance. The icing process is a complex phenomenon with many different causes and types. Icing mechanisms, distributions, and patterns are still relevant to research topics. The adhesion strength between ice and surfaces differs in different icing environments. This makes the task of anti-icing very challenging. The techniques for various icing environments must satisfy different demands and requirements (e.g., efficient, lightweight, low power consumption, low maintenance and manufacturing costs, reliable operation). It is noticeable that most methods are oriented toward a particular sector and adapting them to or suggesting them for other areas is quite problematic. These methods often use various technologies and have different specifications, sometimes with no clear indication of their efficiency. There are two major groups of anti-icing methods: passive and active. Active techniques have high efficiency but, at the same time, quite high energy consumption and require intervention in the structure’s design. It’s noticeable that vast majority of these methods require specific knowledge and personnel skills. The main effect of passive methods (ice-phobic, superhydrophobic surfaces) is to delay ice formation and growth or reduce the adhesion strength between the ice and the surface. These methods are time-consuming and depend on forecasting. They can be applied on small surfaces only for specific targets, and most are non-biodegradable (except for anti-freezing proteins). There is some quite promising information on ultrasonic ice mitigation methods that employ UGW (Ultrasonic Guided Wave). These methods are have the characteristics of low energy consumption, low cost, lightweight, and easy replacement and maintenance. However, fundamental knowledge of ultrasonic de-icing methodology is still limited. The objective of this work was to identify the ice formation processes and its progress by employing ultrasonic guided wave technique. Throughout this research, the universal set-up for acoustic measurement of ice formation in a real condition (temperature range from +240 C to -230 C) was developed. Ultrasonic measurements were performed by using high frequency 5 MHz transducers in a pitch-catch configuration. The selection of wave modes suitable for detection of ice formation phenomenon on copper metal surface was performed. Interaction between the selected wave modes and ice formation processes was investigated. It was found that selected wave modes are sensitive to temperature changes. It was demonstrated that proposed ultrasonic technique could be successfully used for the detection of ice layer formation on a metal surface.

Keywords: ice formation processes, ultrasonic GW, detection of ice formation, ultrasonic testing

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Authors: John Kosmeh

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Introduction – For years, senior health care and skilled nursing facilities have been plagued with the dilemma of not having the necessary tools and equipment to adequately care for senior residents in their communities. This has led to high transport rates to emergency departments and high 30-day readmission rates, costing billions of unnecessary dollars each year, as well as quality assurance issues. Our Senior care telemedicine program is designed to solve this issue. Methods – We conducted a 1-year pilot program using our technology coupled with our 24/7 telemedicine program with skilled nursing facilities in different parts of the United States. We then compared transports rates and 30-day readmission rates to previous years before the use of our program, as well as transport rates of other communities of similar size not using our program. This data was able to give us a clear and concise look at the success rate of reducing unnecessary transport and readmissions as well as cost savings. Results – A 94% reduction nationally of unnecessary out-of-facility transports, and to date, complete elimination of 30-day readmissions. Our virtual platform allowed us to instruct facility staff on the utilization of our tools and system as well as deliver treatment by our ER-trained providers. Delay waiting for PCP callbacks was eliminated. We were able to obtain lung, heart, and abdominal ultrasound imaging, 12 lead EKG, blood labs, auscultate lung and heart sounds, and collect other diagnostic tests at the bedside within minutes, providing immediate care and allowing us to treat residents within the SNF. Are virtual capabilities allowed for loved ones, family members, and others who had medical power of attorney to virtually connect with us at the time of visit, to speak directly with the medical provider, providing increased confidence in the decision to treat the resident in-house. The decline in transports and readmissions will greatly reduce governmental cost burdens, as well as fines imposed on SNF for high 30-day readmissions, reduce the cost of Medicare A readmissions, and significantly impact the number of patients visiting overcrowded ERs. Discussion – By utilizing our program, SNF can effectively reduce the number of unnecessary transports of residents, as well as create significant savings from loss of day rates, transportation costs, and high CMS fines. The cost saving is in the thousands monthly, but more importantly, these facilities can create a higher quality of life and medical care for residents by providing definitive care instantly with ER-trained personnel.

Keywords: senior care, long term care, telemedicine, technology, senior care communities

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Authors: Nisa Mohan

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Clinical coding is a feasible method for estimating the national prevalence of adverse drug event (ADE) admissions. However, under-coding of ADE admissions is a limitation of this method. Whilst the under-coding will impact the accurate estimation of the actual burden of ADEs, the feasibility of the coded data in estimating the adverse drug event admissions goes much further compared to the other methods. Therefore, it is necessary to know the reasons for the under-coding in order to improve the clinical coding of ADE admissions. The ability to identify the reasons for the under-coding of ADE admissions rests on understanding the decision-making process of coding ADE admissions. Hence, the current study aimed to explore the decision-making process of clinical coders when coding cases of ADE admissions. Clinical coders from different levels of coding job such as trainee, intermediate and advanced level coders were purposefully selected for the interviews. Thirteen clinical coders were recruited from two Auckland region District Health Board hospitals for the interview study. Semi-structured, one-on-one, face-to-face interviews using open-ended questions were conducted with the selected clinical coders. Interviews were about 20 to 30 minutes long and were audio-recorded with the approval of the participants. The interview data were analysed using a general inductive approach. The interviews with the clinical coders revealed that the coders have targets to meet, and they sometimes hesitate to adhere to the coding standards. Coders deviate from the standard coding processes to make a decision. Coders avoid contacting the doctors for clarifying small doubts such as ADEs and the name of the medications because of the delay in getting a reply from the doctors. They prefer to do some research themselves or take help from their seniors and colleagues for making a decision because they can avoid a long wait to get a reply from the doctors. Coders think of ADE as a small thing. Lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing may contribute to the under-coding of the ADE admissions. These findings suggest that further work is needed on interventions to improve the clinical coding of ADE admissions. Providing education to coders about the importance of ADEs, educating clinicians about the importance of clear and confirmed medical records entries, availing pharmacists’ services to improve the detection and clear documentation of ADE admissions, and including a mandatory field in the discharge summary about external causes of diseases may be useful for improving the clinical coding of ADE admissions. The findings of the research will help the policymakers to make informed decisions about the improvements. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. This country-specific research conducted in New Zealand may also benefit other countries by providing insight into the clinical coding of ADE admissions and will offer guidance about where to focus changes and improvement initiatives.

Keywords: adverse drug events, clinical coders, decision making, hospital admissions

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Authors: Soraia V. M. de Sá, Miguel A. Faria, José O. Fernandes, Sara C. Cunha

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Cereals play a vital role in fulfilling the nutritional needs of children, supplying essential nutrients crucial for their growth and development. However, concerns arise due to children's heightened vulnerability due to their unique physiology, specific dietary requirements, and relatively higher intake in relation to their body weight. This vulnerability exposes them to harmful food contaminants, particularly mycotoxins, prevalent in cereals. Because of the thermal stability of mycotoxins, conventional industrial food processing often falls short of eliminating them. Children, especially those aged 4 months to 12 years, frequently encounter mycotoxins through the consumption of specialized food products, such as instant foods, breakfast cereals, bars, cookie snacks, fruit puree, and various dairy items. A close monitoring of this demographic group's exposure to mycotoxins is essential, as toxins ingestion may weaken children’s immune systems, reduce their resistance to infectious diseases, and potentially lead to cognitive impairments. The severe toxicity of mycotoxins, some of which are classified as carcinogenic, has spurred the establishment and ongoing revision of legislative limits on mycotoxin levels in food and feed globally. While EU Commission Regulation 1881/2006 addresses well-known mycotoxins in processed cereal-based foods and infant foods, the absence of regulations specifically addressing emerging mycotoxins underscores a glaring gap in the regulatory framework, necessitating immediate attention. Emerging mycotoxins have gained mounting scrutiny in recent years due to their pervasive presence in various foodstuffs, notably cereals and cereal-based products. Alarmingly, exposure to multiple mycotoxins is hypothesized to exhibit higher toxicity than isolated effects, raising particular concerns for products primarily aimed at children. This study scrutinizes the presence of 22 mycotoxins of the diverse range of chemical classes in 148 processed cereal-based foods, including 39 breakfast cereals, 25 infant formulas, 27 snacks, 25 cereal bars, and 32 cookies commercially available in Portugal. The analytical approach employed a modified QuEChERS procedure followed by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) analysis. Given the paucity of information on the risk assessment of children to multiple mycotoxins in cereal and cereal-based products consumed by children of Portugal pioneers the evaluation of this critical aspect. Overall, aflatoxin B1 (AFB1) and aflatoxin G2 (AFG2) emerged as the most prevalent regulated mycotoxins, while enniatin B (ENNB) and sterigmatocystin (STG) were the most frequently detected emerging mycotoxins.

Keywords: cereal-based products, children´s nutrition, food safety, UPLC-MS/MS analysis

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Authors: Nyathi Mpumelelo; Moeng Thabiso Maria

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BACKGROUND AND OBJECTIVES: Radiopharmaceuticals are used for diagnosis, treatment, staging and follow up of various diseases. However, there is concern that the ionizing radiation (gamma rays, α and ß particles) emitted by radiopharmaceuticals may result in exposure of radiographers and nurses with limited knowledge of the principles of radiation protection and safety, raising the risk of cancer induction. This study aimed at investigation radiation safety awareness levels among radiographers and nurses at a small tertiary hospital in South Africa. METHODS: An analytical cross-sectional study. A validated two-part questionnaire was implemented to consenting radiographers and nurses working in a Nuclear Medicine Department. Part 1 gathered demographic information (age, gender, work experience, attendance to/or passing ionizing radiation protection courses). Part 2 covered questions related to knowledge and awareness of radiation protection principles. RESULTS: Six radiographers and five nurses participated (27% males and 73% females). The mean age was 45 years (age range 20-60 years). The study revealed that neither professional development courses nor radiation protection courses are offered at the Nuclear Medicine Department understudy. However, 6/6 (100%) radiographers exhibited a high level of awareness of radiation safety principles on handling and working with radiopharmaceuticals which correlated to their years of experience. As for nurses, 4/5 (80%) showed limited knowledge and awareness of radiation protection principles irrespective of the number of years in the profession. CONCLUSION: Despite their major role of caring for patients undergoing diagnostic and therapeutic treatments, the nurses showed limited knowledge of ionizing radiation and associated side effects. This was not surprising since they never received any formal basic radiation safety course. These findings were not unique to this Centre. A study conducted in a Kuwaiti Radiology Department also established that the vast majority of nurses did not understand the risks of working with ionizing radiation. Similarly, nurses in an Australian hospital exhibited knowledge limitations. However, nursing managers did provide the necessary radiation safety training when requested. In Guatemala and Saudi Arabia, where there was shortage of professional radiographers, nurses underwent radiography training, a course that equipped them with basic radiation safety principles. The radiographers in the Centre understudy unlike others in various parts of the world demonstrated substantial knowledge and awareness on radiation protection. Radiations safety courses attended when an opportunity arose played a critical role in their awareness. The knowledge and awareness levels of these radiographers were comparable to their counterparts in Sudan. However, it was much more above that of their counterparts in Jordan, Nigeria, Nepal and Iran who were found to have limited awareness and inadequate knowledge on radiation dose. Formal radiation safety and awareness courses and workshops can play a crucial role in raising the awareness of nurses and radiographers on radiation safety for their personal benefit and that of their patients.

Keywords: radiation safety, radiation awareness, training, nuclear medicine

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Authors: Marlin Mubarak

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Background: Endometriosis is a complex disabling disease affecting young females in the reproductive period mainly. The aim of this project is to generate a diagnostic model to predict severity and stage of endometriosis prior to Laparoscopic surgery. This will help to improve the pre-operative diagnostic accuracy of stage 3 & 4 endometriosis and as a result, refer relevant women to a specialist centre for complex Laparoscopic surgery. The model is based on the British Society of Gynaecological Endoscopy (BSGE) pain questionnaire, clinical examination and ultrasound scan. Design: This is a prospective, observational, study, in which women completed the BSGE pain questionnaire, a BSGE requirement. Also, as part of the routine preoperative assessment patient had a routine ultrasound scan and when recto-vaginal and deep infiltrating endometriosis was suspected an MRI was performed. Setting: Luton & Dunstable University Hospital. Patients: Symptomatic women (n = 56) scheduled for laparoscopy due to pelvic pain. The age ranged between 17 – 52 years of age (mean 33.8 years, SD 8.7 years). Interventions: None outside the recognised and established endometriosis centre protocol set up by BSGE. Main Outcome Measure(s): Sensitivity and specificity of endometriosis diagnosis predicted by symptoms based on BSGE pain questionnaire, clinical examinations and imaging. Findings: The prevalence of diagnosed endometriosis was calculated to be 76.8% and the prevalence of advanced stage was 55.4%. Deep infiltrating endometriosis in various locations was diagnosed in 32/56 women (57.1%) and some had DIE involving several locations. Logistic regression analysis was performed on 36 clinical variables to create a simple clinical prediction model. After creating the scoring system using variables with P < 0.05, the model was applied to the whole dataset. The sensitivity was 83.87% and specificity 96%. The positive likelihood ratio was 20.97 and the negative likelihood ratio was 0.17, indicating that the model has a good predictive value and could be useful in predicting advanced stage endometriosis. Conclusions: This is a hypothesis-generating project with one operator, but future proposed research would provide validation of the model and establish its usefulness in the general setting. Predictive tools based on such model could help organise the appropriate investigation in clinical practice, reduce risks associated with surgery and improve outcome. It could be of value for future research to standardise the assessment of women presenting with pelvic pain. The model needs further testing in a general setting to assess if the initial results are reproducible.

Keywords: deep endometriosis, endometriosis, minimally invasive, MRI, ultrasound.

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Authors: Prince Amartey

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Bees are clever creatures, thus, capturing bees implies that the hives are intelligent in the sense that they have all of the required circumstances to attract and trap the bees. If the hive goes above and beyond to keep the bees in the hive and to keep the activities of in-hive pests to a minimal in order for the bees to develop to their maximum potential, the hive is becoming or is more 'intelligent'. Some bee pests, such as tiny beehive beetles, are endemic to Africa; however, the way we now extract honey by cutting off the combs and pressing for honey prevents the spread of these bees' insect enemies. However, when we explore entering the commercialization. When freshly collected combs are returned to the hives following the adoption of the frame and other systems, there is a need to consider putting in strategies to manage the accompanying pest concerns that arise with unprotected combs.The techniques for making hives more'intelligent' are thus more important presently, given that the African apicultural business does not wish to encourage the use of pesticides in the hives. This include changing the hive's entrance holes in order to improve the bees' own mechanism for defending the entry sites, as well as collecting pests by setting exterior and in-hive traps to prevent pest infiltration into hives by any means feasible. Material and Methods: The following five (5) mechanisms are proposed to make the hives more 'intelligent.' i. The usage of modified frames with five (5) beetle traps positioned horizontally on the vertical 'legs' to catch the beetle along the combs' surfaces-multiple bee ii. Baited bioelectric frame traps, which has both vertical sections of frame covered with a 3mm mesh that allows pest entry but not bees. The pest is attracted by strips of combs of honey, open brood, pollen on metal plates inserted horizontally on the vertical ‘legs’ of the frames. An electrical ‘mine’ system in place that electrocutes the pests as they step on the wires in the trap to enter the frame trap iii. The ten rounded hive entry holes are adapted as the bees are able to police the entrance to prevent entry of pest. The holes are arranged in two rows, with one on top of the other What Are the Main Contributions of Your Research?-Results Discussions and Conclusions The techniques implemented decrease pest ingress, while in-hive traps capture those that escape entry into the hives. Furthermore, the stand alteration traps larvae and stops their growth into adults. As beekeeping commercialization grows throughout Africa, these initiatives will minimize insect infestation in hives and necessarily enhance honey output.

Keywords: bee pests, modified frames, multiple beetle trap, Baited bioelectric frame traps

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Authors: Chiao-Cheng Huang, Pei-Te Chiueh, Ya-Hsuan Liou

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Chromium-contaminated wastewater from electroplating industrial activity has been a long-standing environmental issue, as it can degrade surface water quality and is harmful to soil ecosystems. The traditional method of treating chromium-contaminated wastewater has been to use chemical coagulation processes. However, this method consumes large amounts of chemicals such as sulfuric acid, sodium hydroxide, and sodium bicarbonate in order to remove chromium. However, a series of new methods for treating chromium-containing wastewater have been developed. This study aimed to compare the environmental impact of four different lab scale chromium removal processes: 1.) chemical coagulation process (the most common and traditional method), in which sodium metabisulfite was used as reductant, 2.) electrochemical process using two steel sheets as electrodes, 3.) reduction by iron-copper bimetallic powder, and 4.) photocatalysis process by TiO2. Each process was run in the lab, and was able to achieve 100% removal of chromium in solution. Then a Life Cycle Assessment (LCA) study was conducted based on the experimental data obtained from four different case studies to identify the environmentally preferable alternative to treat chromium wastewater. The model used for calculating the environmental impact was TRACi, and the system scope includes the production phase and use phase of chemicals and electricity consumed by the chromium removal processes, as well as the final disposal of chromium containing sludge. The functional unit chosen in this study was the removal of 1 mg of chromium. Solution volume of each case study was adjusted to 1 L in advance and the chemicals and energy consumed were proportionally adjusted. The emissions and resources consumed were identified and characterized into 15 categories of midpoint impacts. The impact assessment results show that the human ecotoxicity category accounts for 55 % of environmental impact in Case 1, which can be attributed to the sulfuric acid used for pH adjustment. In Case 2, production of steel sheet electrodes is an energy-intensive process, thus contributed to 20 % of environmental impact. In Case 3, sodium bicarbonate is used as an anti-corrosion additive, which results mainly in 1.02E-05 Comparative Toxicity Unit (CTU) in the human toxicity category and 0.54E-05 (CTU) in acidification of air. In Case 4, electricity consumption for power supply of UV lamp gives 5.25E-05 (CTU) in human toxicity category, 1.15E-05 (kg Neq) in eutrophication. In conclusion, Case 3 and Case 4 have higher environmental impacts than Case 1 and Case 2, which can be attributed mostly to higher energy and chemical consumption, leading to high impacts in the global warming and ecotoxicity categories.

Keywords: chromium, lab scale, life cycle assessment, wastewater

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Authors: Cecile Garry, Katia Rovira, Julie Brisson

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Autism Spectrum Disorder (ASD) is defined by a qualitative and quantitative impairment of social interaction. Indeed early intervention programs, such as the Early Start Denver Model (ESDM), aimed at encouraging the development of social skills. In classroom, the children need to be socially engaged to learn. Early intervention programs can thus be implemented in kindergarten schools. In these schools, ASD children have more opportunities to interact with their peers or adults than in elementary schools. However, the preschool children with ASD are less socially engaged than their typically developing peers in the classroom. They initiate, respond and maintain less the social interactions. In addition, they produce more responses than initiations. When they interact, the non verbal communication is more used than verbal or symbolic communication forms and they are more engaged with adults than with peers. Nevertheless, communicative patterns may vary according to the clinical profiles of ASD children. Indeed, the ASD children with better cognitive skills interact more with their peers and use more symbolic communication than the ASD children with a low cognitive level. ASD children with the less severe symptoms use more the verbal communication than ASD children with the more severe symptoms. Small groups and structured activities encourage coordinated joint engagement episodes in ASD children. Our goal is to evaluate ASD children’s social engagement development in class, with their peers or adults, during dyadic or group activities. Participants were 19 preschool children with ASD aged from 3 to 6 years old that benefited of an early intervention in special kindergarten schools. Severity of ASD symptoms was measured with the CARS at the beginning of the follow-up. Classroom situations of interaction were recorded during 10 minutes (5 minutes of dyadic interaction and 5 minutes of a group activity), every 2 months, during 10 months. Social engagement behaviors of children, including initiations, responses and imitation, directed to a peer or an adult, were then coded. The Observer software (Noldus) that allows to annotate behaviors was the coding system used. A double coding was conducted and revealed a good inter judges fidelity. Results show that ASD children were more often and longer socially engaged in dyadic than in groups situations. They were also more engaged with adults than with peers. Children with the less severe symptoms of ASD were more socially engaged in groups situations than children with the more severe symptoms of ASD. Then, ASD children with the less severe symptoms of ASD were more engaged with their peers than ASD children with the more severe symptoms of ASD. However, the engagement frequency increased during the 10 month of follow-up but only for ASD children with the more severe symptoms at the beginning. To conclude, these results highlighted the necessity of individualizing early intervention programs according to the clinical profile of the child.

Keywords: autism spectrum disorder, preschool children, developmental psychology, early interventions, social interactions

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Authors: S. Fata, M. A. Tokat, N. Bagardi, B. Yilmaz

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Nowadays, various traditional practices are used throughout the world with aim to improve fertility. Various traditional remedies, acupuncture, religious practices such as sacrifice are frequently used. Studies often evaluate the traditional practices used by the women. But the use of this non-medical practice by couples and specific application reasons of this methods has been less investigated. The aim of this study was to evaluate the common used non-medical practices and determine perceived benefits by couples with fertility problems in Turkey. This is a descriptive study. Research data were collected between May-July 2016, in Izmir Ege Birth Education and Research Hospital Assisted Reproduction Clinic, from 151 couples with fertility problem. Personal Information Form and Non-Medical Practices Used for Fertility Evaluation Form was used. Number 'GOA 2649' permission letter from Dokuz Eylul University Non-Invasive Research Ethics Board, permission letter from the institution and the written consent from participants has been received to carry out the study. In the evaluation of the data, frequencies and proportions analysis were used. The average age of women participating in the study was 32.87, the 35.8% were high school graduates, 60.3% were housewife and the 58.9% lived in city. The 30.5% of husbands were high school graduates, the 96.7% were employed and the 60.9% lived in city. The 78.1% of couples lived as a nuclear family, the average marriage year was 7.58, in 33.8% the fertility problem stems from women, 42.4% of them received a diagnosis for 1-2 years, 35.1% were being treated for 1-2 years. The 35.8% of women reported use of non-medical applications. The 24.4% of women used figs, onion cure, hacemat, locust, bee-pollen milk, the 18.2% used herbs, the 13.1% vowed, the 12.1% went to the tomb, the 10.1% did not bath a few days after the embryo transfer, the 9.1% used thermal water baths, the 5.0% manually corrected the womb, the 5.0% printed amulets by Hodja, the 3.0% went to the Hodja/pilgrims. Among the perceived benefits of using non-medical practices; facilitate pregnancy and implantation, improve oocyte quality were the most recently expressed. Women said that they often used herbs to develop follicles, did not bath after embryo transfer with aim to provide implantation, and used thermal waters to get rid of the infection. Compared to women, only the 25.8% of men used the non-medical practice. The 52.1% reported that they used peanuts, hacemat, locust, bee-pollen milk, the 14.9% used herbs, the 12.8% vowed, the 10.1% went to the tomb, the 10.1% used thermal water baths. Improve sperm number, motility and quality were the most expected benefits. Men said that they often used herbs to improve sperm number, used peanuts, hacemat, locust, bee-pollen milk to improve sperm motility and quality. Couples in Turkey often use non-medical practices to deal with fertility problems. Some of the practices considered as useful can adversely affect health. Healthcare providers should evaluate the use of non-medical practices and should inform if the application is known adverse effects on health.

Keywords: fertility, couples, non-medical practice, perceived benefit

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Authors: Marsha D. Loda

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College enrollment is declining and generation Z, today’s college students, are struggling. Before the pandemic, researchers characterized this generational cohort as unique. Gen Z has been called the most achievement-oriented generation, as they enjoy greater economic status, are more racially and ethnically diverse, and better educated than any other generation. However, they are also the most likely generation to suffer from depression and anxiety. Gen Z has grown up largely with usually well-intentioned but overprotective parents who inadvertently kept them from learning life skills, likely impacting their ability to cope with and to effectively manage challenges. The unprecedented challenges resulting from the pandemic up ended their world and left them emotionally reeling. One of the ramifications of this for higher education is how to reengage current Gen Z students in the classroom. This research presents qualitative findings from 24 single-spaced pages of verbatim comments from college students. Research questions concerned what helps them learn and what they abhor, as well as how to engage them with the university outside of the classroom to aid in retention. Students leave little doubt about what they want to experience in the classroom. In order of mention, students want discussion, to engage with questions, to hear how a topic relates to real life and the real world, to feel connections with the professor and fellow students, and to have an opportunity to give their opinions. They prefer a classroom that involves conversation, with interesting topics and active learning. “professor talks instead of lecturing” “professor builds a connection with the classroom” “I am engaged because it feels like a respectful conversation” Similarly, students are direct about what they dislike in a classroom. In order of frequency, students dislike teachers unenthusiastically reading word or word from notes or presentations, repeating the text without adding examples, or addressing how to apply the information. “All lecture. I can read the book myself” “Not taught how to apply the skill or lesson” “Lectures the entire time. Lesson goes in one ear and out the other.” Pertaining to engagement outside the classroom, Gen Z challenges higher education to step outside the box. They don’t want to just hear from professionals in their field, they want to meet and interact with them. Perhaps because of their dependence on technology and pandemic isolation, they seem to reach out for assistance in forming social bonds. “I believe fun and social events are the best way to connect with students and get them involved. Cookouts, raffles, socials, or networking events would all most likely appeal to many students”. “Events… even if they aren’t directly related to learning. Maybe like movie nights… doing meet ups at restaurants”. Qualitative research suggests strategy. This research is rife with strategic implications to improve learning, increase engagement and reduce drop-out rates among Generation Z higher education students. It also compliments existing research on student engagement. With college enrollment declining by some 1.3 million students over the last two years, this research is both timely and important.

Keywords: college enrollment, generation Z, higher education, pandemic, student engagement

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Authors: D. O. Miranda, L. R. Azevedo, J. F. C. Cordeiro, A. H. Dos Santos, S. F. Lisboa, F. S. Guimarães, G. S. Bisson

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Background: The Colorectal cancer (CRC) is one of the most common cancers and the fourth leading cause of cancer death in the world. The prevalence of psychiatric-disorders among CRC patients, mainly depression, is high, resulting in impaired quality of life and side effects of primary treatment. High levels of proinflammatory cytokines at tumor microenvironment is a feature of CRC and the literature suggests that those mediators could contribute to the development of psychiatric disorders. Nevertheless, the ability of tumor-associated biological processes to affect the central nervous system (CNS) has only recently been explored in the context of symptoms of depression and is still not well understood. Therefore, the aim of the present study was to test the hypothesis that depressive-like behavior in an experimental model of CCR induced by N-methyl-N-nitro-N-nitrosoguanidine (MNNG) was correlated to proinflammatory profile in the periphery and in the brain. Methods: Colorectal carcinogenesis was induced in adult C57BL/6 mice (n=12) by administration of MNNG (5mg/kg, 0.1ml/intrarectal instillation) 2 times a week, for 2 week. Control group (n=12) received saline (0.1ml/intrarectal instillation). Eight weeks after beginning of MNNG administration animals were submitted to the forced swim test (FST) and the sucrose preference test for evaluation, respectively, of depressive- and anhedonia-like behaviors. After behavioral evaluation, the colon was collected and brain regions dissected (cortex-C, striatum-ST and hippocampus-HIP) for posterior evaluation of cytokine levels (IL-1β, IL-10, IL-17, and CX3CL1) by ELISA. Results: MNNG induced depressive-like behavior, represented by increased immobility time in the FST (Student t test, p < 0.05) and lower sucrose preference (Student t test, p < 0.05). Moreover, there were increased levels of IL-1β, IL-17 and CX3CL1 in the colonic tissue (Student t test, p < 0.05) and in the brain (IL-1 β in the ST and HIP, Student t test, p < 0.05; IL-17 and CX3CL1 in the C and HIP, p < 0.05). IL-10 levels, in contrast, were decreased in both the colon (p < 0.05) and the brain (C and HIP, p < 0.05). Conclusions: The results obtained in the present work support the notion that tumor growth induces neuroinflammation in stress-related brain regions and depressive-like behavior, which could be related to the high incidence of depression in colorectal carcinogenesis. This work have important clinical and research implications, taken into account that cytokine levels may be a marker promissory for the developing depression in CRC patients. New therapeutic strategies to assist in alleviating mental suffering in cancer patients might result from a better understanding of the role of cytokines in the pathophysiology of depression in these subjects.

Keywords: cytokines, brain, depression, colorectal cancer

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Authors: Brad Stappenbelt

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The phenomenon of vortex-induced vibration (VIV) for elastically restrained cylindrical structures in cross-flows is relatively well investigated. The utility of this mechanism in harvesting energy from marine current and tidal flows is however arguably still in its infancy. With relatively few moving components, a flow-induced vibration-based energy conversion device augers low complexity compared to the commonly employed turbine design. Despite the interest in this concept, a practical device has yet to emerge. It is desirable for optimal system performance to design for a very low mass or mass moment of inertia ratio. The device operating range, in particular, is maximized below the vortex-induced vibration critical point where an infinite resonant response region is realized. An unfortunate consequence of this requirement is large buoyancy forces that need to be mitigated by gravity-based, suction-caisson or anchor mooring systems. The focus of this paper is the testing of a novel VIV marine current energy harvesting configuration that utilizes a symmetrical and balanced pair of horizontal pivoted cylinders. The results of several years of experimental investigation, utilizing the University of Wollongong fluid mechanics laboratory towing tank, are analyzed and presented. A reduced velocity test range of 0 to 60 was covered across a large array of device configurations. In particular, power take-off damping ratios spanning from 0.044 to critical damping were examined in order to determine the optimal conditions and hence the maximum device energy conversion efficiency. The experiments conducted revealed acceptable energy conversion efficiencies of around 16% and desirable low flow-speed operating ranges when compared to traditional turbine technology. The potentially out-of-phase spanwise VIV cells on each arm of the device synchronized naturally as no decrease in amplitude response and comparable energy conversion efficiencies to the single cylinder arrangement were observed. In addition to the spatial design benefits related to the horizontal device orientation, the main advantage demonstrated by the current symmetrical horizontal configuration is to allow large velocity range resonant response conditions without the excessive buoyancy. The novel configuration proposed shows clear promise in overcoming many of the practical implementation issues related to flow-induced vibration marine current energy harvesting.

Keywords: flow-induced vibration, vortex-induced vibration, energy harvesting, tidal energy

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Authors: Andres Mejia-Ortiz, Catalina Lozada, German R. Santos, Rafael Angulo-Jaramillo, Bernardo Caicedo

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The interaction between atmospheric variables and soil properties is a determining factor when evaluating the flow of water through the soil. This interaction situation directly determines the behavior of the soil and greatly influences the changes that occur in it. The atmospheric variations such as changes in the relative humidity, air temperature, wind velocity and precipitation, are the external variables that reflect a greater incidence in the changes that are generated in the subsoil, as a consequence of the water flow in descending and ascending conditions. These environmental variations have a major importance in the study of the soil because the conditions of humidity and temperature in the soil surface depend on them. In addition, these variations control the thickness of the unsaturated zone and the position of the water table with respect to the surface. However, understanding the relationship between the atmosphere and the soil is a somewhat complex aspect. This is mainly due to the difficulty involved in estimating the changes that occur in the soil from climate changes; since this is a coupled process where act processes of mass transfer and heat. In this research, an experimental field was implemented to study in-situ the interaction between the atmosphere and the soft soils of the city of Bogota, Colombia. The soil under study consists of a 60 cm layer composed of two silts of similar characteristics at the surface and a deep soft clay deposit located under the silky material. It should be noted that the vegetal layer and organic matter were removed to avoid the evapotranspiration phenomenon. Instrumentation was carried on in situ through a field disposal of many measuring devices such as soil moisture sensors, thermocouples, relative humidity sensors, wind velocity sensor, among others; which allow registering the variations of both the atmospheric variables and the properties of the soil. With the information collected through field monitoring, the water balances were made using the Hydrus-1D software to determine the flow conditions that developed in the soil during the study. Also, the moisture profile for different periods and time intervals was determined by the balance supplied by Hydrus 1D; this profile was validated by experimental measurements. As a boundary condition, the actual evaporation rate was included using the semi-empirical equations proposed by different authors. In this study, it was obtained for the rainy periods a descending flow that was governed by the infiltration capacity of the soil. On the other hand, during dry periods. An increase in the actual evaporation of the soil induces an upward flow of water, increasing suction due to the decrease in moisture content. Also, cracks were developed accelerating the evaporation process. This work concerns to the study of soil-atmosphere interaction through the experimental field and it is a very useful tool since it allows considering all the factors and parameters of the soil in its natural state and real values of the different environmental conditions.

Keywords: field monitoring, soil-atmosphere, soft soils, soil-water balance

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Authors: Ronald Croce, Timothy Quinn, John Miller

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Incomplete activation, or activation failure, of motor units during maximal voluntary contractions is often referred to as muscle inhibition (MI), and is defined as the inability of the central nervous system to maximally drive a muscle during a voluntary contraction. The purpose of the present study was to assess the interrelationship amongst peak torque (PT), muscle inhibition (MI; incomplete activation of motor units), and voluntary muscle activation (VMA) of the quadriceps’ muscle group as a function of knee angle and muscle length during maximal voluntary isometric contractions (MVICs). Nine young adult males (mean + standard deviation: age: 21.58 + 1.30 years; height: 180.07 + 4.99 cm; weight: 89.07 + 7.55 kg) performed MVICs in random order with the knee at 15, 55, and 95° flexion. MI was assessed using the interpolated twitch technique and was estimated by the amount of additional knee extensor PT evoked by the superimposed twitch during MVICs. Voluntary muscle activation was estimated by root mean square amplitude electromyography (EMGrms) and mechanomyography (MMGrms) of agonist (vastus medialis [VM], vastus lateralis [VL], and rectus femoris [RF]) and antagonist (biceps femoris ([BF]) muscles during MVICs. Data were analyzed using separate repeated measures analysis of variance. Results revealed a strong dependency of quadriceps’ PT (p < 0.001), MI (p < 0.001) and MA (p < 0.01) on knee joint position: PT was smallest at the most shortened muscle position (15°) and greatest at mid-position (55°); MI and MA were smallest at the most shortened muscle position (15°) and greatest at the most lengthened position (95°), with the RF showing the greatest change in MA. It is hypothesized that the ability to more fully activate the quadriceps at short compared to longer muscle lengths (96% contracted at 15°; 91% at 55°; 90% at 95°) might partly compensate for the unfavorable force-length mechanics at the more extended position and consequent declines in VMA (decreases in EMGrms and MMGrms muscle amplitude during MVICs) and force production (PT = 111-Nm at 15°, 217-NM at 55°, 199-Nm at 95°). Biceps femoris EMG and MMG data showed no statistical differences (p = 0.11 and 0.12, respectively) at joint angles tested, although there were greater values at the extended position. Increased BF muscle amplitude at this position could be a mechanism by which anterior shear and tibial rotation induced by high quadriceps’ activity are countered. Measuring and understanding the degree to which one sees MI and VMA in the QF muscle has particular clinical relevance because different knee-joint disorders, such ligament injuries or osteoarthritis, increase levels of MI observed and markedly reduced the capability of full VMA.

Keywords: electromyography, interpolated twitch technique, mechanomyography, muscle activation, muscle inhibition

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Authors: Mary A. Lindell

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Adults with intellectual disabilities (ID) are increasingly attending postsecondary institutions, including inclusive residential programs at four-year universities. The legislation, national organizations, and researchers support developing postsecondary education (PSE) options for this historically underserved population. Simultaneously, researchers are assessing the quality of life indicators (QOL) for people with ID. This study explores the quality of life characteristics for individuals with ID entering a two-year PSE program. A survey aligned with the PSE program was developed and administered to participants before they began their college program (in future studies, the same survey will be administered 6 months and 1 year after graduating). Employment, income, and housing are frequently cited QOL measures. People with disabilities, and especially people with ID, are more likely to experience unemployment and low wages than people without disabilities. PSE improves adult outcomes (e.g., employment, income, housing) for people with and without disabilities. Similarly, adults with ID who attend PSE are more likely to be employed than their peers who do not attend PSE; however, adults with ID are least likely among their typical peers and other students with disabilities to attend PSE. There is increased attention to providing individuals with ID access to PSE and more research is needed regarding the characteristics of students attending PSE. This study focuses on the participants of a fully residential two-year program for individuals with ID. Students earn an Applied Skills Certificate while focusing on five benchmarks: self-care, home care, relationships, academics, and employment. To create a QOL measure, the goals of the PSE program were identified, and possible assessment items were initially selected from the National Core Indicators (NCI) and the National Transition Longitudinal Survey 2 (NTLS2) that aligned with the five program goals. Program staff and advisory committee members offered input on potential item alignment with program goals and expected value to students with ID in the program. National experts in researching QOL outcomes of people with ID were consulted and concurred that the items selected would be useful in measuring the outcomes of postsecondary students with ID. The measure was piloted, modified, and administered to incoming students with ID. Research questions: (1) In what ways are students with ID entering a two-year PSE program similar to individuals with ID who complete the NCI and NTLS2 surveys? (2) In what ways are students with ID entering a two-year PSE program different than individuals with ID who completed the NCI and NTLS2 surveys? The process of developing a QOL measure specific to a PSE program for individuals with ID revealed that many of the items in comprehensive national QOL measures are not relevant to stake-holders of this two-year residential inclusive PSE program. Specific responses of students with ID entering an inclusive PSE program will be presented as well as a comparison to similar items on national QOL measures. This study explores the characteristics of students with ID entering a residential, inclusive PSE program. This information is valuable for, researchers, educators, and policy makers as PSE programs become more accessible for individuals with ID.

Keywords: intellectual disabilities, inclusion, post-secondary education, quality of life

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Authors: Camila Lee Park, Mauro Fracarolli Nunes

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Understood as the preference for products and services that do not involve moral dilemmas, ethical consumption has been increasingly discussed by scholars, practitioners, and consumers. Among its diverse trends, the defense of animal rights and welfare seems to have gained particular momentum in past decades. Not surprisingly, companies, governments, ideologues, and virtually any institution or group interested in (re)shaping society invest in the building of narratives oriented to influence consumption behavior. The animal rights movement, for example, is devoted to the elimination of the use of animals in science, as well as of commercial animal agriculture and hunting activities. Although advances in ethical consumption may be observed in practice, it still seems more popular as rhetoric. Diverse scholars have addressed the disparities between self-professed ethical consumers and their actual purchase patterns, with differences being attributed to factors such as price sensitivity, lack of information, quality, cynicism, and limited availability. The gap is also linked to the 'consumer sovereignty myth', according to which consumers are only able to choose from a pre-determined range of choices made before products reach them. On the other hand, academics also debate ethical consumption behavior as more likely to occur when it assumes compliance with social norms. As sustainability becomes a permanent issue, customers may tend to adhere to ethical consumption, either because of an individual value or due to a social one. Regardless of these efforts, the actual value attributed to ethical businesses remains unclear. Likewise, the power of stakeholders’ initiatives to influence corporate strategies is dubious. In search to offer new perspectives on these matters, the present study concentrates on the following research questions: Do customers value products/companies that respect animal rights? If so, does such enhanced value convert into actions from the part of the companies? Broadly, we aim to understand if customers’ perception holds performative traits (i.e., are capable of either trigger or contribute to changes in organizational behaviour around the respect for animal rights). In addressing these issues, two preliminary behavioral vignette-based experiments were conducted, with the perspectives of 307 participants being assessed. Building on a case of the cosmetics industry, social, emotional, and functional values were hypothesized as directly impacting positive word-of-mouth, which, in turn, would carry direct effects on purchase intention. A first structural equation model was analyzed with the combined samples of studies I and II. Results suggest that emotional value strongly impacts both positive word-of-mouth and purchase intention. Data confirms initial expectations on customers valuing products and companies that comply with ethical postures concerning animals, especially if social-oriented practices are also present.

Keywords: animal rights, business ethics, emotional value, ethical consumption

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Authors: Mustafa M. Donma, Orkide Donma

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Metabolisms of macrominerals, those of calcium, phosphorus and magnesium, are closely associated with the metabolism of vitamin D. Particularly magnesium, the second most abundant intracellular cation, is related to biochemical and metabolic processes in the body, such as those of carbohydrates, proteins and lipids. The status of each mineral was investigated in obesity to some extent. Their products and ratios may possibly give much more detailed information about the matter. The aim of this study is to investigate possible relations between each macromineral and some obesity-related parameters. This study was performed on 235 children, whose ages were between 06-18 years. Aside from anthropometric measurements, hematological analyses were performed. TANITA body composition monitor using bioelectrical impedance analysis technology was used to establish some obesity-related parameters including basal metabolic rate (BMR), total fat, mineral and muscle masses. World Health Organization body mass index (BMI) percentiles for age and sex were used to constitute the groups. The values above 99^th percentile were defined as morbid obesity. Those between 95^th and 99^th percentiles were included into the obese group. The overweight group comprised of children whose percentiles were between 95 and 85. Children between the 85^th and 15^th percentiles were defined as normal. Metabolic syndrome (MetS) components (waist circumference, fasting blood glucose, triacylglycerol, high density lipoprotein cholesterol, systolic pressure, diastolic pressure) were determined. High performance liquid chromatography was used to determine Vitamin D status by measuring 25-hydroxy cholecalciferol (25-hydroxy vitamin D₃, 25(OH)D). Vitamin D values above 30.0 ng/ml were accepted as sufficient. SPSS statistical package program was used for the evaluation of data. The statistical significance degree was accepted as p < 0.05. The important points were the correlations found between vitamin D and magnesium as well as phosphorus (p < 0.05) that existed in the group with normal BMI values. These correlations were lost in the other groups. The ratio of phosphorus to magnesium was even much more highly correlated with vitamin D (p < 0.001). The negative correlation between magnesium and total fat mass (p < 0.01) was confined to the MetS group showing the inverse relationship between magnesium levels and obesity degree. In this group, calcium*magnesium product exhibited the highest correlation with total fat mass (p < 0.001) among all groups. Only in the MetS group was a negative correlation found between BMR and calcium*magnesium product (p < 0.05). In conclusion, magnesium is located at the center of attraction concerning its relationships with vitamin D, fat mass and MetS. The ratios and products derived from macrominerals including magnesium have pointed out stronger associations other than each element alone. Final considerations have shown that unique correlations of magnesium as well as calcium*magnesium product with total fat mass have drawn attention particularly in the MetS group, possibly due to the derangements in some basic elements of carbohydrate as well as lipid metabolism.

Keywords: macrominerals, metabolic syndrome, pediatric obesity, vitamin D

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Authors: Malahat Rezaee, Mahiran Basri, Raja Noor Zaliha Raja Abdul Rahman, Abu Bakar Salleh

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Sodium diclofenac is one of the most commonly used drugs of nonsteroidal anti-inflammatory drugs (NSAIDs). It is especially effective in the controlling the severe conditions of inflammation and pain, musculoskeletal disorders, arthritis, and dysmenorrhea. Formulation as nanoemulsions is one of the nanoscience approaches that have been progressively considered in pharmaceutical science for transdermal delivery of drug. Nanoemulsions are a type of emulsion with particle sizes ranging from 20 nm to 200 nm. An emulsion is formed by the dispersion of one liquid, usually the oil phase in another immiscible liquid, water phase that is stabilized using surfactant. Palm kernel oil esters (PKOEs), in comparison to other oils; contain higher amounts of shorter chain esters, which suitable to be applied in micro and nanoemulsion systems as a carrier for actives, with excellent wetting behavior without the oily feeling. This research was aimed to study the effect of O/S ratio on stability and rheological behavior of sodium diclofenac loaded and unloaded palm kernel oil esters nanoemulsion systems. The effect of different O/S ratio of 0.25, 0.50, 0.75, 1.00 and 1.25 on stability of the drug-loaded and unloaded nanoemulsion formulations was evaluated by centrifugation, freeze-thaw cycle and storage stability tests. Lecithin and cremophor EL were used as surfactant. The stability of the prepared nanoemulsion formulations was assessed based on the change in zeta potential and droplet size as a function of time. Instability mechanisms including coalescence and Ostwald ripening for the nanoemulsion system were discussed. In comparison between drug-loaded and unloaded nanoemulsion formulations, drug-loaded formulations represented smaller particle size and higher stability. In addition, the O/S ratio of 0.5 was found to be the best ratio of oil and surfactant for production of a nanoemulsion with the highest stability. The effect of O/S ratio on rheological properties of drug-loaded and unloaded nanoemulsion systems was studied by plotting the flow curves of shear stress (τ) and viscosity (η) as a function of shear rate (γ). The data were fitted to the Power Law model. The results showed that all nanoemulsion formulations exhibited non-Newtonian flow behaviour by displaying shear thinning behaviour. Viscosity and yield stress were also evaluated. The nanoemulsion formulation with the O/S ratio of 0.5 represented higher viscosity and K values. In addition, the sodium diclofenac loaded formulations had more viscosity and higher yield stress than drug-unloaded formulations.

Keywords: nanoemulsions, palm kernel oil esters, sodium diclofenac, rheoligy, stability

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Authors: Kevin Kok-Yew Tan, Caleb Chu

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In the context of globalization and increasing interdependence among nations, the dynamics of cross-national conflict shifting have become a critical area of study in international relations and communication research. While previous studies have explored the impact of cultural tightness-looseness (TL) on various societal outcomes, there has been limited research on how this cultural construct influences the framing of conflicts in international media. This study seeks to address this gap by investigating the potential correlation between TL and the way countries frame cross-national conflicts, particularly in news coverage. The significance of this research lies in its potential to reveal how cultural norms and societal pressures shape international narratives, potentially influencing public perception and policy responses. The methodology of this study involves a comparative content analysis of news coverage from 10 sets of two independent countries on a third-party country’s conflict. The countries selected represent a spectrum of TL, which characterizes the strength of a culture’s norms and the degree to which those norms are sanctioned. By analyzing news articles from major media outlets, this study will assess the framing of the conflict, with particular attention to the themes, tone, and rhetorical strategies employed. Content analysis will be complemented by quantitative measures of cultural tightness and looseness, allowing for a systematic comparison of how tight versus loose societies frame the same conflict. Preliminary findings suggest a significant correlation between cultural tightness and the framing of cross-national conflicts. In tighter cultures, news coverage tends to be more homogenous, with a strong emphasis on conformity to national narratives and a lower tolerance for alternative viewpoints. This contrasts with the more diverse and pluralistic framing observed in news coverage from looser cultures, where there is greater openness to multiple perspectives and less alignment with government or institutional narratives. These findings are consistent with the theoretical underpinnings of TL, which emphasize the role of strong norms and social regulation in shaping collective responses to external threats. Moreover, the study highlights the role of third-party countries in amplifying or mitigating the effects of TL on international conflict narratives. In conclusion, this research contributes to the growing body of literature on TL and cross-national conflict shifting by providing empirical evidence of how cultural norms influence media framing in international contexts. The findings underscore the importance of considering cultural factors in the analysis of global media and international relations, particularly in an era where information flows across borders more freely than ever before. Future research could extend this analysis to other forms of cross-national interactions, including economic and diplomatic relations, to further understand the role of TL in shaping global conflict dynamics.

Keywords: cultural tightness, conflict-shifting, communication, media framing

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Authors: Federica Marangio

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This study looks at the triangle of knowledge: research-education-innovation as growth engine of an inclusive and sustainable society, where the research is the strategic process which allows the acquisition of knowledge, innovation appraises the knowledge acquired and the education is the enabling factor of the human capital to create entrepreneurial capital. Where does Italy and China stand in the global geography of innovation? Europe is calling on a smart, inclusive and sustainable growth through a specializing process that looks at the social and economic challenges, able to understand the characteristics of specific geographic areas. It is easily questionable why it is not as simple as it looks to come up with entrepreneurial ideas in all the geographic areas. Seen that the technology plus the human capital should be the means through which is possible to innovate and contribute to the boost of innovation culture, then the young educated people can be seen as the society changing agents and it becomes clear the importance of investigating the skills and competencies that lead to innovation. By starting innovation-based activities, other countries on an international level, are able now to be part of an healthy innovative ecosystem which is the result of a strong growth policy which enables innovation. Analyzing the geography of the innovation on a global scale, comes to light that the innovative entrepreneurship is the process which portrays the competitiveness of the regions in the knowledge-based economy as strategic process able to match intellectual capital and market opportunities. The level of innovative entrepreneurship is not only the result of the endogenous growth ability of the enterprises, but also by significant relations with other enterprises, universities, other centers of education and institutions. To obtain more innovative entrepreneurship is necessary to stimulate more synergy between all these territory actors in order to create, access and value existing and new knowledge ready to be disseminate. This study focuses on individual’s lived experience and the researcher believed that she can’t understand the human actions without understanding the meaning that they attribute to their thoughts, feelings, beliefs and so given she needed to understand the deeper perspectives captured through face-to face interaction. A case study approach will contribute to the betterment of knowledge in this field. This case study will represent a picture of the innovative ecosystem and the entrepreneurial mindset as a key ingredient of endogenous growth and a must for sustainable local and regional development and social cohesion. The case study will be realized analyzing two Chinese companies. A structured set of questions will be asked in order to gain details on what generated success or failure in the different situations with the past and at the moment of the research. Everything will be recorded not to lose important information during the transcription phase. While this work is not geared toward testing a priori hypotheses, it is nevertheless useful to examine whether the projects undertaken by the companies, were stimulated by enabling factors that, as result, enhanced or hampered the local innovation culture.

Keywords: Entrepreneurship, education, geography of innovation, education.

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Authors: Scott Snyder

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Grading approaches in higher education have not changed meaningfully in over 100 years. While there is variation in the types of grades assigned across countries, most use approaches based on simple ordinal scales (e.g, letter grades). While grades are generally viewed as an indication of a student's performance, challenges arise regarding the clarity, validity, and reliability of letter grades. Research about grading in higher education has primarily focused on grade inflation, student attitudes toward grading, impacts of grades, and benefits of plus-minus letter grade systems. Little research is available about alternative approaches to grading, varying approaches used by faculty within and across colleges, and faculty attitudes toward grades and alternative approaches to grading. To begin to address these gaps, a survey was conducted of faculty in a sample of departments at three diverse colleges in a southeastern state in the US. The survey focused on faculty experiences with and attitudes toward grading, the degree to which faculty innovate in teaching and grading practices, and faculty interest in alternatives to the point system approach to grading. Responses were received from 104 instructors (21% response rate). The majority reported that teaching accounted for 50% or more of their academic duties. Almost all (92%) of respondents reported using point and percentage systems for their grading. While all respondents agreed that grades should reflect the degree to which objectives were mastered, half indicated that grades should also reflect effort or improvement. Over 60% felt that grades should be predictive of success in subsequent courses or real life applications. Most respondents disagreed that grades should compare students to other students. About 42% worried about their own grade inflation and grade inflation in their college. Only 17% disagreed that grades mean different things based on the instructor while 75% thought it would be good if there was agreement. Less than 50% of respondents felt that grades were directly useful for identifying students who should/should not continue, identify strengths/weaknesses, predict which students will be most successful, or contribute to program monitoring of student progress. Instructors were less willing to modify assessment than they were to modify instruction and curriculum. Most respondents (76%) were interested in learning about alternative approaches to grading (e.g., specifications grading). The factors that were most associated with willingness to adopt a new grading approach were clarity to students and simplicity of adoption of the approach. Follow-up studies are underway to investigate implementations of alternative grading approaches, expand the study to universities and departments not involved in the initial study, examine student attitudes about alternative approaches, and refine the measure of attitude toward adoption of alternative grading practices within the survey. Workshops about challenges of using percentage and point systems for determining grades and workshops regarding alternative approaches to grading are being offered.

Keywords: alternative approaches to grading, grades, higher education, letter grades

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Authors: Haiyan Huang, Jan Blommaert, Ellen Van Praet

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The embrace of neoliberal economic system in China has engendered the entry of global commodity capitalism into domestic Chinese market and ushered in the post-feminism that is closely associated with consumerism from western culture. Chinese women are instilled and thus hold the belief of empowering themselves and expressing their individualism through consumption. To unravel the consumerist ideologies embedded in Li’s discursive practices, we rely on critical discourse analysis (CDA) as our research framework. The data analyses suggest that cosmopolitanism and class are two repeating themes when Li engages in persuading consumerist behaviors from the female audience. Through hints and cues such as “going on business trips”, “traveling abroad”, “international brands” and among others, Li provides the access to and possibility of imagining cosmopolitan and middle class identity for his audience. Such yearning for western culture and global citizen identity also implicates the aspiration for a well-off socioeconomic status, proving that post-feminism in China not only embodies western consumerism but also implicates the struggle of class movement. These defining elements of choice and freedom are well-situated in contemporary Chinese society where women are enjoying more educational and economic independence than before. However a closer examination reveals conflicts between hegemonic discourse of post-feminism and the status quo. First, propagating women’s power through consumption obscure the entrenched gender inequality in China. Philosophies such as employment discrimination, equal payment, education right, etc., the cornerstones of feminism did not exist in China, leading to historical gender issues unsolved. Second, the lengthy broadcastings (which normally last more than 2 hours) featured with big discounts on products beg the question who are the real audience of ecommerce livestreaming. Seemingly addressing to young well-off Chinese females, Li’s discursive practice can be targeting at young but not wealthy girls who aspire to mimic the lifestyle of middle class women. By selling the idea of empowering and constructing identity through consuming beauty products (e.g., lipsticks), capitalists are endeavoring to create the post-feminism illusion and cause anxieties among Chinese females. Through in-depth analyses of hegemonic discourse on ecommerce livestreaming of lipsticks, the paper contributes to a better understanding of post-feminism in contemporary China and meanwhile illustrates the problems Chinese women face in securing power and equality.

Keywords: Chinese women, critical discourse analysis, ecommerce livestreaming, post-feminism

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Authors: George Kassar, Phillip A. Cartwright

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Based on data collected from The Jones Learning Center (JLC), University of the Ozarks, Arkansas, U.S., this study explores the impact of inclusive classroom practices on neuro-diverse college students’ and their consequent academic performance having participated in integrative therapies designed to support students who are intellectually capable of obtaining a college degree, but who require support for learning challenges owing to disabilities, AD/HD, or ASD. The purpose of this study is two-fold. The first objective is to explore the general process, special techniques, and practices of the (JLC) inclusive program. The second objective is to identify and analyze the effectiveness of the processes, techniques, and practices in supporting the academic performance of enrolled college students with learning disabilities following integration into mainstream university learning. Integrity, transparency, and confidentiality are vital in the research. All questions were shared in advance and confirmed by the concerned management at the JLC. While administering the questionnaire as well as conducted the interviews, the purpose of the study, its scope, aims, and objectives were clearly explained to all participants prior starting the questionnaire / interview. Confidentiality of all participants assured and guaranteed by using encrypted identification of individuals, thus limiting access to data to only the researcher, and storing data in a secure location. Respondents were also informed that their participation in this research is voluntary, and they may withdraw from it at any time prior to submission if they wish. Ethical consent was obtained from the participants before proceeding with videorecording of the interviews. This research uses a mixed methods approach. The research design involves collecting, analyzing, and “mixing” quantitative and qualitative methods and data to enable a research inquiry. The research process is organized based on a five-pillar approach. The first three pillars are focused on testing the first hypothesis (H1) directed toward determining the extent to the academic performance of JLC students did improve after involvement with comprehensive JLC special program. The other two pillars relate to the second hypothesis (H2), which is directed toward determining the extent to which collective and applied knowledge at JLC is distinctive from typical practices in the field. The data collected for research were obtained from three sources: 1) a set of secondary data in the form of Grade Point Average (GPA) received from the registrar, 2) a set of primary data collected throughout structured questionnaire administered to students and alumni at JLC, and 3) another set of primary data collected throughout interviews conducted with staff and educators at JLC. The significance of this study is two folds. First, it validates the effectiveness of the special program at JLC for college-level students who learn differently. Second, it identifies the distinctiveness of the mix of techniques, methods, and practices, including the special individualized and personalized one-on-one approach at JLC.

Keywords: education, neuro-diverse students, program effectiveness, Jones learning center

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Authors: Jami Wang, Brian Kao, Davin Agustines

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COVID-19 highlighted the active discrimination against the Asian American population easily seen through media, social tension, and increased crimes against the specific population. It is well known that long-term racism can also have a large impact on both emotional and psychological well-being. However, the healthcare disparity during this time also revealed how the Asian American community lacked the research data, political support, and medical infrastructure for this particular population. During a time when Asian American fear for safety with decreasing mental health, telepsychiatry is particularly promising. COVID-19 demonstrated how well psychiatry could integrate with telemedicine, with psychiatry being the second most utilized telemedicine visits. However, the Asian American community did not utilize the telepsychiatry resources as much as other groups. Because of this, we wanted to understand why the patient population who was affected the most by COVID-19 mentally did not seek out care. To do this, we decided to study the top top telepsychiatry platforms. The current top telepsychiatry companies in the United States include Teladoc and BetterHelp. In the Teladoc mental health sector, they only had 4 available languages (English, Spanish, French, and Danis,) with none of them being an Asian language. In a similar manner, Teladoc’s top competitor in the telepsychiatry space, BetterHelp, only listed a total of 3 Asian languages, including Mandarin, Japanese, and Malaysian. However, this is still a short list considering they have over 20 languages available. The shortage of available physicians that speak multiple languages is concerning, as it could be difficult for the Asian American community to relate with. There are limited mental health resources that cater to their likely cultural needs, further exacerbating the structural racism and institutional barriers to appropriate care. It is important to note that these companies do provide interpreters to comply with the nondiscrimination and language assistance federal law. However, interactions with an interpreter are not only more time-consuming but also less personal than talking directly with a physician. Psychiatry is the field that emphasizes interpersonal relationships. The trust between a physician and the patient is critical in developing patient rapport to guide in better understanding the clinical picture and treating the patient appropriately. The language barrier creates an additional barrier between the physician and patient. Because Asian Americans are one of the largest growing patient population bases, these telehealth companies have much to gain by catering to the Asian American market. Without providing adequate access to bilingual and bicultural physicians, the current system will only further exacerbate the growing disparity. The healthcare community and telehealth companies need to recognize that the Asian American population is a severely underserved population in mental health and has much to gain from telepsychiatry. The lack of language is one of many reasons why there is a disparity for Asian Americans in the mental health space.

Keywords: telemedicine, psychiatry, Asian American, disparity

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Authors: Jiayue Guo, Lili You

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Background: Children and adolescent health are crucial for both personal well-being and the nation's future health landscape. Health Literacy (HL) is important in enabling adolescents to self-manage their health, a fundamental step towards health empowerment. However, there are limited tools for assessing HL among elementary and junior high school students. This study aims to construct and validate a test-based HL scale for Chinese students, offering a scientific reference for cross-cultural HL tool development. Methods: We conducted a cross-sectional online survey. Participants were recruited from a stratified cluster random sampling method, a total of 4189 Chinese in-school primary and secondary students. The development of the scale was completed by defining the concept of HL, establishing the item indicator system, screening items (7 health content dimensions), and evaluating reliability and validity. Delphi method expert consultation was used to screen items, the Rasch model was conducted for quality analysis, and Cronbach’s alpha coefficient was used to examine the internal consistency. Results: We developed four versions of the HL scale, each with a total score of 100, encompassing seven key health areas: hygiene, nutrition, physical activity, mental health, disease prevention, safety awareness, and digital health literacy. Each version measures four dimensions of health competencies: knowledge, skills, motivation, and behavior. After the second round of expert consultation, the average importance score of each item by experts is 4.5–5.0, and the coefficient of variation is 0.000–0.174. The knowledge and skills dimensions are judgment-based and multiple-choice questions, with the Rasch model confirming unidimensionality at a 5.7% residual variance. The behavioral and motivational dimensions, measured with scale-type items, demonstrated internal consistency via Cronbach's alpha and strong inter-item correlation with KMO values of 0.924 and 0.787, respectively. Bartlett's test of sphericity, with p-values <0.001, further substantiates the scale's reliability. Conclusions: The new test-based scale, designed to evaluate competencies within a multifaceted framework, aligns with current international adolescent literacy theories and China's health education policies, focusing not only on knowledge acquisition but also on the application of health-related thinking and behaviors. The scale can be used as a comprehensive tool for HL evaluation and a reference for other countries.

Keywords: adolescent health, Chinese, health literacy, rasch model, scale development

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Authors: Anne Giles

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Humans naturally wish they could forget traumatic experiences. To help prevent future harm, however, the human brain has evolved to retain data about experiences of threat, alarm, or violation. When given compassionate support and assistance with thinking helpfully and realistically about traumatic events, most people can adjust to experiencing hardships, albeit with residual sad, unfortunate memories. Persistent, recurrent, intrusive memories, difficulty sleeping, emotion dysregulation, and avoidance of reminders, however, may be symptoms of Post-traumatic Stress Disorder (PTSD). Brain scans show that PTSD affects brain functioning. We currently have no physical means of restoring the system of brain structures and functions involved with PTSD. Medications may ease some symptoms but not others. However, forms of "talk therapy" with cognitive components have been found by researchers to reduce, even resolve, a broad spectrum of trauma symptoms. Many cultures have taboos against talking about hardships. Individuals may present themselves to mental health care professionals with severe, disabling trauma symptoms but, because of cultural norms, be unable to speak about them. In China, for example, relationship expectations may include the belief, "Bad things happening in the family should stay in the family (jiāchǒu bùkě wàiyán 家丑不可外扬)." The concept of "family (jiā 家)" may include partnerships, close and extended families, communities, companies, and the nation itself. In contrast to many trauma therapies, Cognitive Processing Therapy (CPT) for Post-traumatic Stress Disorder asks its participants to focus not on "what" happened but on "why" they think the trauma(s) occurred. The question "why" activates and exercises cognitive functioning. Brain scans of individuals with PTSD reveal executive functioning portions of the brain inadequately active, with emotion centers overly active. CPT conceptualizes PTSD as a network of cognitive distortions that keep an individual "stuck" in this under-functioning and over-functioning dynamic. Through asking participants forms of the question "why," plus offering a protocol for examining answers and relinquishing unhelpful beliefs, CPT assists individuals in consciously reactivating the cognitive, executive functions of their brains, thus restoring normal functioning and reducing distressing trauma symptoms. The culturally sensitive components of CPT that allow people to "talk about it without talking about it" may offer the possibility for worldwide relief from symptoms of trauma.

Keywords: cognitive processing therapy (CPT), cultural norms, post-traumatic stress disorder (PTSD), trauma recovery

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Authors: Jack Nash, Chris Simpson, Holly Hurn, Ronel Terblanche, Alan Mistlin

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There is an increasing incidence of mild traumatic brain injury (mTBI) cases throughout sport and with this, a growing interest from governing bodies to ensure these are managed appropriately and player welfare is prioritised. The Berlin consensus statement on concussion in sport recommends a multidisciplinary approach when managing those patients who do not have full resolution of mTBI symptoms. There are as of yet no standardised guideline to follow in the treatment of complex cases mTBI in athletes. The aim of this project was to analyse the outcomes, both clinical and vocational, of all patients admitted to the mild Traumatic Brain Injury (mTBI) service at the UK’s Defence Military Rehabilitation Centre Headley Court between 1st June 2008 and 1st February 2017, as a result of a sport induced injury, and evaluate potential predictive indicators of outcome. Patients were identified from a database maintained by the mTBI service. Clinical and occupational outcomes were ascertained from medical and occupational employment records, recorded prospectively, at time of discharge from the mTBI service. Outcomes were graded based on the vocational independence scale (VIS) and clinical documentation at discharge. Predictive indicators including referral time, age at time of injury, previous mental health diagnosis and a financial claim in place at time of entry to service were assessed using logistic regression. 45 Patients were treated for sport-related mTBI during this time frame. Clinically 96% of patients had full resolution of their mTBI symptoms after input from the mTBI service. 51% of patients returned to work at their previous vocational level, 4% had ongoing mTBI symptoms, 22% had ongoing physical rehabilitation needs, 11% required mental health input and 11% required further vestibular rehabilitation. Neither age, time to referral, pre-existing mental health condition nor compensation seeking had a significant impact on either vocational or clinical outcome in this population. The vast majority of patients reviewed in the mTBI clinic had persistent symptoms which could not be managed in primary care. A consultant-led, multidisciplinary approach to the diagnosis and management of mTBI has resulted in excellent clinical outcomes in these complex cases. High levels of symptom resolution suggest that this referral and treatment pathway is successful and is a model which could be replicated in other organisations with consultant led input. Further understanding of both predictive and individual factors would allow clinicians to focus treatments on those who are most likely to develop long-term complications following mTBI. A consultant-led, multidisciplinary service ensures a large number of patients will have complete resolution of mTBI symptoms after sport-related mTBI. Further research is now required to ascertain the key predictive indicators of outcome following sport-related mTBI.

Keywords: brain injury, concussion, neurology, rehabilitation, sports injury

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Authors: Anette Alén

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Intellectual property (IP) regimes have traditionally been designed to integrate various conflicting elements stemming from private entitlement and the public good. In IP laws and regulations, this design takes the form of specific uses of protected subject-matter without the right-holder’s consent, or exhaustion of exclusive rights upon market release, and the like. More recently, the pursuit of ‘balance’ has gained ground in the conceptualization of these conflicting elements both in terms of IP law and related policy. This can be seen, for example, in European Union (EU) copyright regime, where ‘balance’ has become a key element in argumentation, backed up by fundamental rights reasoning. This development also entails an ever-expanding dialogue between the IP regime and the constitutional safeguards for property, free speech, and privacy, among others. This study analyses the concept of ‘balance’ in EU copyright law: the research task is to examine the contents of the concept of ‘balance’ and the way it is operationalized and pursued, thereby producing new knowledge on the role and manifestations of ‘balance’ in recent copyright case law and regulatory instruments in the EU. The study discusses two particular pieces of legislation, the EU Digital Single Market (DSM) Copyright Directive (EU) 2019/790 and the finalized EU Artificial Intelligence (AI) Act, including some of the key preparatory materials, as well as EU Court of Justice (CJEU) case law pertaining to copyright in the digital era. The material is examined by means of document analysis, mapping the ways ‘balance’ is approached and conceptualized in the documents. Similarly, the interaction of fundamental rights as part of the balancing act is also analyzed. Doctrinal study of law is also employed in the analysis of legal sources. This study suggests that the pursuit of balance is, for its part, conducive to new battles, largely due to the advancement of digitalization and more recent developments in artificial intelligence. Indeed, the ‘balancing act’ rather presents itself as a way to bypass or even solidify some of the conflicting interests in a complex global digital economy. Indeed, such a conceptualization, especially when accompanied by non-critical or strategically driven fundamental rights argumentation, runs counter to the genuine acknowledgment of new types of conflicting interests in the copyright regime. Therefore, a more radical approach, including critical analysis of the normative basis and fundamental rights implications of the concept of ‘balance’, is required to readjust copyright law and regulations for the digital era. Notwithstanding the focus on executing the study in the context of the EU copyright regime, the results bear wider significance for the digital economy, especially due to the platform liability regime in the DSM Directive and with the AI Act including objectives of a ‘level playing field’ whereby compliance with EU copyright rules seems to be expected among system providers.

Keywords: balance, copyright, fundamental rights, platform liability, artificial intelligence

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