Search results for: LIFE 2013 call

Authors: Dorcas Matowe

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Inequality in health care for racial and ethnic minorities continues to be a growing concern for many Americans. Some of the barriers hindering the elimination of health disparities include lack of insurance, socioeconomic status (SES), and racism. This study will specifically focus on the association between some of these factors- health care access, which includes insurance coverage and frequency of doctor visits, race, ethnicity, and health status. The purpose of this study will be to address the following questions: is having health insurance associated with increased doctor visits? Are racial and ethnic minorities with health insurance more or less likely to see a doctor? Is the association between having health insurance moderated by being an ethnic minority? Given the current implications of the 2010 Affordable Care Act, this study will highlight the need to prioritize health care access for minorities and confront institutional racism. Critical Race Theory (CRT) will demonstrate how racism has reinforced these health disparities. This quantitative study design will analyze secondary data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire, a telephone survey conducted annually in all 50 states and three US territories by state health departments in conjunction with the Center for Disease Control (CDC). Non-identifying health-related data is gathered annually from over 400,000 adults 18 years and above about their health status and use of preventative services. Through Structural Equation Modeling (SEM), the relationship between the predictor variables of health care access, race, and ethnicity, the criterion variable of health status, and the latent variables of emotional support and life satisfaction will be examined. It is hypothesized that there will be an interaction between certain racial and ethnic minorities who went to see a doctor, had insurance coverage, experienced racism, and the quality of their health status, emotional support, and life satisfaction.

Keywords: ethnic minorities, health disparities, health access, racism

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Authors: V. De Sandi

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In this paper, we characterize a class of rank-weighted social welfare orderings that we call ”Excessivist.” The Excessivist Social Welfare Ordering (eSWO) judges incomes above a fixed threshold θ as detrimental to society. To accomplish this, the identification of a richness or affluence line is necessary. We employ a fixed, exogenous line of excess. We define an eSWF in the form of a weighted sum of individual’s income. This requires introducing n+1 vectors of weights, one for all possible numbers of individuals below the threshold. To do this, the paper introduces a slight modification of the class of rank weighted class of social welfare function. Indeed, in our excessivist social welfare ordering, we allow the weights to be both positive (for individuals below the line) and negative (for individuals above). Then, we introduce ethical concerns through an axiomatic approach. The following axioms are required: continuity above and below the threshold (Ca, Cb), anonymity (A), absolute aversion to excessive richness (AER), pigou dalton positive weights preserving transfer (PDwpT), sign rank preserving full comparability (SwpFC) and strong pareto below the threshold (SPb). Ca, Cb requires that small changes in two income distributions above and below θ do not lead to changes in their ordering. AER suggests that if two distributions are identical in any respect but for one individual above the threshold, who is richer in the first, then the second should be preferred by society. This means that we do not care about the waste of resources above the threshold; the priority is the reduction of excessive income. According to PDwpT, a transfer from a better-off individual to a worse-off individual despite their relative position to the threshold, without reversing their ranks, leads to an improved distribution if the number of individuals below the threshold is the same after the transfer or the number of individuals below the threshold has increased. SPb holds only for individuals below the threshold. The weakening of strong pareto and our ethics need to be justified; we support them through the notion of comparative egalitarianism and income as a source of power. SwpFC is necessary to ensure that, following a positive affine transformation, an individual does not become excessively rich in only one distribution, thereby reversing the ordering of the distributions. Given the axioms above, we can characterize the class of the eSWO, getting the following result through a proof by contradiction and exhaustion: Theorem 1. A social welfare ordering satisfies the axioms of continuity above and below the threshold, anonymity, sign rank preserving full comparability, aversion to excessive richness, Pigou Dalton positive weight preserving transfer, and strong pareto below the threshold, if and only if it is an Excessivist-social welfare ordering. A discussion about the implementation of different threshold lines reviewing the primary contributions in this field follows. What the commonly implemented social welfare functions have been overlooking is the concern for extreme richness at the top. The characterization of Excessivist Social Welfare Ordering, given the axioms above, aims to fill this gap.

Keywords: comparative egalitarianism, excess income, inequality aversion, social welfare ordering

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Authors: M. S. Matlala, I. Ignatious

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Environmental sustainability has taken the center stage in human life all over the world. Energy is the most essential component of our life. The conventional sources of energy are non-renewable and have a detrimental environmental impact. Therefore, there is a need to move from conventional to non-conventional renewable energy sources to satisfy the world’s energy demands. The study aimed at screening for microbial cellulolytic enzymes using a proteomic approach. The objectives were to screen for microbial cellulases with high specific activity and separate the cellulolytic enzymes using a combination of zymography and two-dimensional (2-D) gel electrophoresis followed by tryptic digestion, Matrix-assisted Laser Desorption Ionisation-Time of Flight (MALDI-TOF) and bioinformatics analysis. Fungal and bacterial isolates were cultured in M9 minimal and Mandel media for a period of 168 hours at 60°C and 30°C with cellobiose and Avicel as carbon sources. Microbial cells were separated from supernatants through centrifugation, and the crude enzyme from the cultures was used for the determination of cellulase activity, zymography, SDS-PAGE, and two-dimensional gel electrophoresis. Five isolates, with lytic action on carbon sources studied, were a bacterial strain (BARK) and fungal strains (VCFF1, VCFF14, VCFF17, and VCFF18). Peak cellulase production by the selected isolates was found to be 3.8U/ml, 2.09U/ml, 3.38U/ml, 3.18U/ml, and 1.95U/ml, respectively. Two-dimensional gel protein maps resulted in the separation and quantitative expression of different proteins by the microbial isolates. MALDI-TOF analysis and database search showed that the expressed proteins in this study closely relate to different glycoside hydrolases produced by other microbial species with an acceptable confidence level of 100%.

Keywords: cellulases, energy, two-dimensional gel electrophoresis, matrix-assisted laser desorption ionisation-time of flight, MALDI-TOF MS

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Authors: Azadeh Bashiri

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Introduction: In order to better designing of electronic health record system in Iran, integration of health information systems based on a common language must be done to interpret and exchange this information with this system is required. Background: This study, provides a conceptual model of radiology reporting system using unified modeling language. The proposed model can solve the problem of integration this information system with electronic health record system. By using this model and design its service based, easily connect to electronic health record in Iran and facilitate transfer radiology report data. Methods: This is a cross-sectional study that was conducted in 2013. The student community was 22 experts that working at the Imaging Center in Imam Khomeini Hospital in Tehran and the sample was accorded with the community. Research tool was a questionnaire that prepared by the researcher to determine the information requirements. Content validity and test-retest method was used to measure validity and reliability of questioner respectively. Data analyzed with average index, using SPSS. Also, Visual Paradigm software was used to design a conceptual model. Result: Based on the requirements assessment of experts and related texts, administrative, demographic and clinical data and radiological examination results and if the anesthesia procedure performed, anesthesia data suggested as minimum data set for radiology report and based it class diagram designed. Also by identifying radiology reporting system process, use case was drawn. Conclusion: According to the application of radiology reports in electronic health record system for diagnosing and managing of clinical problem of the patient, provide the conceptual Model for radiology reporting system; in order to systematically design it, the problem of data sharing between these systems and electronic health records system would eliminate.

Keywords: structured radiology report, information needs, minimum data set, electronic health record system in Iran

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Authors: Shazia Almas, Jaffar Iqbal, Nazia Almas

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In most of the South Asian countries like Pakistan medical profession is one the most valued and respectful professions yet being a medical professional requires an enormous amount of responsibilities and work overload at the same time which possibly can be in contrast with family role of a doctor. Job and family are two primary spheres of a person's life no matter whatever the profession one adopts and the type of family one is running. There is a bi-directional relationship between job and family. The type and nature of work, time schedules, working shifts in medical profession are very demanding in the countries like Pakistan where number of patients is far more higher than the number of doctors available. The work life also have significant impact on family life and vice versa. Because of the sensitivity and interdependency of these relations, today’s overarching and competing demands remain dissatisfactory. The main objective of the current research is to investigate how interpersonal relationships affect work and work affects interpersonal relationships of medical professionals. In line with identifying these facts, the current study aimed to examine the predictive role of psychological capital (self-efficacy, hope, optimism, and resilience), in organizational outcome (job satisfaction) and personal outcome (family satisfaction) amongst male and medical professionals. A total of 350 participants from public and private sector hospitals of Pakistan were recruited through simple random and stratified sampling techniques, with age ranges from 26-50 years. The questionnaire including established and certified self-report measures of Psychological Capital Questionnaire, Job Satisfaction, and Family Satisfaction were adopted to collect the data. The reliability and validity of mentioned instruments were established through Cronbach’s alpha and factor analyses (exploratory and confirmatory) respectively using Structural Equation Modeling (SEM) by AMOS. The proposed hypotheses were tested using Pearson’s Correlation and Regression analyses for predicting effect whereas, t-Test was deployed to verify the difference between male and female health professionals. The results revealed that self-efficacy and optimism predicted job satisfaction while, self-efficacy, hope, and resilience predicted family satisfaction. Moreover, the results depicted significant gender differences in job satisfaction where females were higher on job satisfaction as compared to male medical professionals but no significant differences were observed in levels of family satisfaction between both genders. The study has implications for social, organizational and work policy designers. The study also paves for more researches with positive psychological approach to promote work-family harmony.

Keywords: family satisfaction, job satisfaction, medical professionals, psychological capital

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Authors: Maryam Ghavam Sadri, Maryam Shahrooz

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Background: Nowadays the prevalence of metabolic syndrome (Mets) has taken on a growing trend. Studies have shown the relationship between vitamin D deficiency (VDD) status and Mets in children. Also studies have recorded that exerting strategies for vitamin D status improvement can help prevent Mets in children. This study investigated multiple strategies of prevention of Mets resulting from VDD in children. Methods: This review study has been done by using keywords related to the topic and 54 articles were found (2000-2015) that 25 were selected according to the indicators of Mets, supplementation and fortification of foods with vitamin D and attention to children environment and life style. Results: Studies have suggested the correlation between serum levels of vitamin D with waist circumference (p < 0.0001), systolic blood pressure (p=0.01), HOMA-IR (p=0.001) and HDL cholesterol (p < 0.0001). An inverse correlation between serum 25 (OH) D and HOMA-IR (p = 0.006) and insulin (P = 0.002) has been proved in overweight group. Higher HOMASDS and triglycerides found in vitamin D deficient obese children compared to control group without VDD (p=0.04). After supplementation with vitamin D, serum TG concentration decreases significantly (p=0.04), and improves insulin resistance (p=0.02). The prevalence of VDD is associated with time of watching TV (P < 0.01), hours of physical activity per week (P = 0.01), skipping breakfast (P < 0.001) soda intake (P < 0.001), and milk intake per day (P < 0.01). Conclusion: According to the beneficial role of vitamin D in prevention of Mets and proven relationship between serum levels of vitamin D and Mets indicators, we can prevent childhood Mets through the application of appropriate strategies such as supplementation and food fortification with vitamin D and positive changes in children life style with especial attention to physical activity in exposure of sunlight and their environment condition.

Keywords: children, metabolic syndrome, prevention strategies, vitamin D

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Authors: Andrew Fox, Qingping Yang, Yuanhong Zhao, Tao Zhang

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Furniture is a very significant subdivision of architecture and its inherent interior design activities. The furniture industry has developed from an artisan-driven craft industry, whose forerunners saw themselves manifested in their crafts and treasured a sense of pride in the creativity of their designs, these days largely reduced to an anonymous collective mass-produced output. Although a very conservative industry, there is great potential for the implementation of collaborative digital technologies allowing a reconfigured artisan experience to be reawakened in a new and exciting form. The furniture manufacturing industry, in general, has been slow to adopt new methodologies for a design using artificial and rule-based generative design. This tardiness has meant the loss of potential to enhance its capabilities in producing sustainable, flexible, and mass customizable ‘right first-time’ designs. This paper aims to demonstrate the concept methodology for the creation of alternative and inspiring aesthetic structures for robot-based additive manufacturing (RBAM). These technologies can enable the economic creation of previously unachievable structures, which traditionally would not have been commercially economic to manufacture. The integration of these technologies with the computing power of generative design provides the tools for practitioners to create concepts which are well beyond the insight of even the most accomplished traditional design teams. This paper aims to address the problem by introducing generative design methodologies employing the Autodesk Fusion 360 platform. Examination of the alternative methods for its use has the potential to significantly reduce the estimated 80% contribution to environmental impact at the initial design phase. Though predominantly a design methodology, generative design combined with RBAM has the potential to leverage many lean manufacturing and quality assurance benefits, enhancing the efficiency and agility of modern furniture manufacturing. Through a case study examination of a furniture artifact, the results will be compared to a traditionally designed and manufactured product employing the Ecochain Mobius product life cycle analysis (LCA) platform. This will highlight the benefits of both generative design and robot-based additive manufacturing from an environmental impact and manufacturing efficiency standpoint. These step changes in design methodology and environmental assessment have the potential to revolutionise the design to manufacturing workflow, giving momentum to the concept of conceiving a pre-industrial model of manufacturing, with the global demand for a circular economy and bespoke sustainable design at its heart.

Keywords: robot, manufacturing, generative design, sustainability, circular econonmy, product life cycle assessment, furniture

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Authors: Ali A Alshraifeen, Josie Evans, Kathleen Stoddart

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End-stage renal disease (ESRD) introduces physical, psychological, social, emotional and spiritual challenges into patients’ lives. Spirituality has been found to contribute to improved health outcomes, mainly in the areas of quality of life (QOL) and well-being. No studies exist to explore the influence of spirituality on the health outcomes and general well-being in patients with end-stage renal disease receiving hemodialysis (HD) treatment in Scotland. This study was conducted to explore spirituality in the daily lives of among these patients and how it may influence their QOL and general well-being. The study employed a qualitative method. Data were collected using semi-structured interviews with a sample of 21 patients. A thematic approach using Framework Analysis informed the qualitative data analysis. Participants were recruited from 11 dialysis units across four Health Boards in Scotland. The participants were regular patients attending the dialysis units three times per week. Four main themes emerged from the qualitative interviews: ‘Emotional and Psychological Turmoil’, ‘Life is Restricted’, ‘Spirituality’ and ‘Other Coping Strategies’. The findings suggest that patients’ QOL might be affected because of the physical challenges such as unremitting fatigue, disease unpredictability and being tied down to a dialysis machine, or the emotional and psychological challenges imposed by the disease into their lives such as wholesale changes, dialysis as a forced choice and having a sense of indebtedness. The findings also revealed that spirituality was an important coping strategy for the majority of participants who took part in the qualitative component (n=16). Different meanings of spirituality were identified including connection with God or Supernatural Being, connection with the self, others and nature/environment. Spirituality encouraged participants to accept their disease and offered them a sense of protection, instilled hope in them and helped them to maintain a positive attitude to carry on with their daily lives, which may have had a positive influence on their health outcomes and general well-being. The findings also revealed that humor was another coping strategy that helped to diffuse stress and anxiety for some participants and encouraged them to carry on with their lives. The findings from this study provide a significant contribution to a very limited body of work. The study contributes to our understanding of spirituality and how people receiving dialysis treatment use it to manage their daily lives. Spirituality is of particular interest due to its connection with health outcomes in patients with chronic illnesses. The link between spirituality and many chronic illnesses has gained some recognition, yet the identification of its influence on the health outcomes and well-being in patients with ESRD is still evolving. There is a need to understand patients’ experiences and examine the factors that influence their QOL and well-being to ensure that the services available are adequately tailored to them. Hence, further research is required to obtain a better understanding of the influence of spirituality on the health outcomes and general well-being of patients with ESRD.

Keywords: end-stage renal disease, general well-being, quality of life, spirituality

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Authors: Valentina Piric, Maja Martinovic, Zoran Barac

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The application of marketing to the domain of politics has become relevant in recent times. With this article the authors wanted to explore the issue of the current political engagement among young people in Croatia. The question is what makes young people (age 18-30) politically active in young democracies such as that of the Republic of Croatia. Therefore, the objective of this study was to discover the real or hidden motivations behind the decision to actively participate in politics among young members of the two largest political parties in the country – the Croatian Democratic Union and the Social Democratic Party of Croatia. The study expected to find that the motivation for political engagement of young people is often connected with a possible achievement of individual goals and egoistic needs such as: self-acceptance, social success, financial success, prestige, reputation, status, recognition from the others etc. It was also expected that, due to the poor economic and social situation in the country, young people feel an increasing disconnection from politics. Additionally, the authors expected to find that there is a huge potential to engage young people in the political life of the country through a proper and more interactive use of marketing communication campaigns and social media platforms, with an emphasis on highly ethical motives of political activity and their benefits to society. All respondents included in the quantitative survey (sample size [N=100]) are active in one of the two largest political parties in Croatia. The sampling and distribution of the survey occurred in the field in September 2016. The results of the survey demonstrate that in Croatia, the way young people feel about politics and act accordingly, are in fact similar to what the theory describes. The research findings reveal that young people are politically active; however, the challenge is to find a way to motivate even more young people in Croatia to actively participate in the political and democratic processes in the country and to encourage them to see additional benefits out of this practice, not only related to their individual motives, but related more to the well-being of Croatia as a country and of every member of society. The research also discovered a huge potential for political marketing communication possibilities, especially related to interactive social media. It is possible that the social media channels have a stronger influence on the decision-making process among young people when compared to groups of reference. The level of interest in politics among young Croatians varies; some of them are almost indifferent, whilst others express a serious interest in different ways to actively contribute to the political life of the country, defining a participation in the political life of their country almost as their moral obligation. However, additional observations and further research need to be conducted to get a clearer and more precise picture about the interest in politics among young people in Croatia and their social potential.

Keywords: Croatia, marketing communication, motivation, politics, young people

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Authors: Vaso K. Kapnopoulou, Piero Caridis

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The fatigue of ship structural details is of major concern in the maritime industry as it can generate fracture issues that may compromise structural integrity. In the present study, a fatigue analysis of the lower hopper knuckle connection of a bulk carrier was conducted using the Finite Element Method by means of ABAQUS/CAE software. The fatigue life was calculated using Miner’s Rule and the long-term distribution of stress range by the use of the two-parameter Weibull distribution. The cumulative damage ratio was estimated using the fatigue damage resulting from the stress range occurring at each load condition. For this purpose, a cargo hold model was first generated, which extends over the length of two holds (the mid-hold and half of each of the adjacent holds) and transversely over the full breadth of the hull girder. Following that, a submodel of the area of interest was extracted in order to calculate the hot spot stress of the connection and to estimate the fatigue life of the structural detail. Two hot spot locations were identified; one at the top layer of the inner bottom plate and one at the top layer of the hopper plate. The IACS Common Structural Rules (CSR) require that specific dynamic load cases for each loading condition are assessed. Following this, the dynamic load case that causes the highest stress range at each loading condition should be used in the fatigue analysis for the calculation of the cumulative fatigue damage ratio. Each load case has a different effect on ship hull response. Of main concern, when assessing the fatigue strength of the lower hopper knuckle connection, was the determination of the maximum, i.e. the critical value of the stress range, which acts in a direction normal to the weld toe line. This acts in the transverse direction, that is, perpendicularly to the ship's centerline axis. The load cases were explored both theoretically and numerically in order to establish the one that causes the highest damage to the location examined. The most severe one was identified to be the load case induced by beam sea condition where the encountered wave comes from the starboard. At the level of the cargo hold model, the model was assumed to be simply supported at its ends. A coarse mesh was generated in order to represent the overall stiffness of the structure. The elements employed were quadrilateral shell elements, each having four integration points. A linear elastic analysis was performed because linear elastic material behavior can be presumed, since only localized yielding is allowed by most design codes. At the submodel level, the displacements of the analysis of the cargo hold model to the outer region nodes of the submodel acted as boundary conditions and applied loading for the submodel. In order to calculate the hot spot stress at the hot spot locations, a very fine mesh zone was generated and used. The fatigue life of the detail was found to be 16.4 years which is lower than the design fatigue life of the structure (25 years), making this location vulnerable to fatigue fracture issues. Moreover, the loading conditions that induce the most damage to the location were found to be the various ballasting conditions.

Keywords: dynamic load cases, finite element method, high cycle fatigue, lower hopper knuckle

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Authors: Juyeon Lee, Sungeun You

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Experiential avoidance is one’s tendency to avoid painful internal experience, unwanted adverse thoughts, emotions, and physical sensations. The Multidimensional Experiential Avoidance Questionnaire (MEAQ) is a measure of experiential avoidance, and the original scale consisted of 62 items with six subfactors including behavioral avoidance, distress aversion, procrastination, distraction/suppression, repression/denial, and distress endurance. The purpose of this study was to examine the factor structure of the MEAQ in a Korean sample. Three hundred community adults and university students aged 18 to 35 participated in an online survey assessing experiential avoidance (MEAQ and Acceptance and Action Questionnaire-II; AAQ-II), depression (Patient Health Questionnaire-9; PHQ-9), anxiety (Generalized Anxiety Disoder-7; GAD-7), negative affect (Positive and Negative Affect Scale; PANAS), neuroticism (Big Five Inventory; BFI), and quality of life (Satisfaction with Life Scale; SWLS). Factor analysis with principal axis with direct oblimin rotation was conducted to examine subfactors of the MEAQ. Results indicated that the six-factor structure of the original scale was adequate. Eight items out of 62 items were removed due to insufficient factor loading. These items included 3 items of behavior avoidance (e.g., “When I am hurting, I would do anything to feel better”), 2 items of repression/denial (e.g., “I work hard to keep out upsetting feelings”), and 3 items of distress aversion (e.g., “I prefer to stick to what I am comfortable with, rather than try new activities”). The MEAQ was positively associated with the AAQ-II (r = .47, p < .001), PHQ-9 (r = .37, p < .001), GAD-7 (r = .34, p < .001), PANAS (r = .35, p < .001), and neuroticism (r = .24, p < .001), and negatively correlated with the SWLS (r = -.38, p < .001). Internal consistency was good for the MEAQ total (Cronbach’s α = .90) as well as all six subfactors (Cronbach’s α = .83 to .87). The findings of the study support the multidimensional feature of experiential avoidance and validity of the MEAQ in a sample of Korean adults.

Keywords: avoidance, experiential avoidance, factor structure, MEAQ

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Authors: Paula Higa

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This paper briefly examines age and its impact on a dancer’s performance career. An investigation into the possible reasons why audiences don’t regularly see veteran dancers on stage (termed as the Gray Dancer) supports the research. This analysis reflects some of the social dynamics that shape perceptions of the aging body in the U.S., as well as the correlation between the meaning of old and decay in Western culture. The primary question addressed in this research asks, who has the prerogative to determine when a dancer should stop dancing - society or the dancer themselves The aging process can significantly shorten a performer's professional career. The body has less endurance and is more susceptible to injuries, fatigue, etc. It also becomes less flexible and loses muscular strength and tone. A reduction in physical skills may usher gray dancers to embrace an ideology of shorter careers. However, in today’s age of diversity, equity, and inclusion, the realm of dance performance should reflect the times in which it is rooted; a multi-generational environment where people interact and participate in all of life's events. Overall, this study champions the inclusion of gray dancers as representations of mastery and wisdom akin to those traits associated with age and experience across various professions. Dance is an art form that transcends the assumptions of youthful beauty and physical ability. It serves as a conduit for conveying a lifetime of experiences, emotions, and ideas through the expressive vehicle of the body. Furthermore, it presents audiences with a medium to perceive and comprehend both themselves and life itself, echoing Noverre's insightful contemplation. The essay underscores the importance of valuing, sensing, and appreciating the richness that gray dancers bring to the stage by delving into segments of dance history and analyzing the possible influence of curators, directors, audiences, and society in general on ageism in dance.

Keywords: dance, ageism, politics in dance, curatorial process

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Authors: Shamila Manie, Soraya Maart, Ayesha Osman

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Introduction: People diagnosed with multidrug resistant pulmonary tuberculosis (MDR-PTB) is subjected to prolonged hospitalization in South Africa. It has thus become essential for research to shift its focus from a purely medical approach, but to include social and environmental factors when looking at the impact of the disease on those affected. Aim: To explore the factors affecting individuals with multi-drug resistant pulmonary tuberculosis during long-term hospitalization using the comprehensive ICF core-sets for obstructive pulmonary disease (OPD) and cardiopulmonary (CPR) conditions at Brooklyn Chest Hospital (BCH). Methods: A quantitative descriptive, cross-sectional study design was utilized. A convenient sample of 19 adults at Brooklyn Chest Hospital were interviewed. Results: Most participants reported a decrease in exercise tolerance levels (b455: n=11). However it did not limit participation. Participants reported that a lack of privacy in the environment (e155) was a barrier to health. The presence of health professionals (e355) and the provision of skills development services (e585) are facilitators to health and well-being. No differences exist in the functional ability of HIV positive and negative participants in this sample. Conclusion: The ICF Core Sets appeared valid in identifying the barriers and facilitators experienced by individuals with MDR-PTB admitted to BCH. The hospital environment must be improved to add to the QoL of those admitted, especially improving privacy within the wards. Although the social grant is seen as a facilitator, greater emphasis must be placed on preparing individuals to be economically active in the labour for when they are discharged.

Keywords: multidrug resistant tuberculosis, MDR ICF core sets, health-related quality of life (HRQoL), hospitalization

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Authors: Samane Maroufi, Rasoul Khayyam Nekouei, Sajjad Sefimofarah, Veena Sahajwalla

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The present work details a three-stage strategy based on selective purification of rare earth oxide (REOs) isolated from end-of-life nickel-metal hydride (Ni-MH) batteries leading to high-yield fabrication of defect-rich Mn1-x-y(CeₓLaᵧ)O2-δ film. In step one, major impurities (Fe and Al) were removed from a REE-rich solution. In step two, the resulting solution with trace content of Mn was further purified through electrodeposition which resulted in the synthesis of a non-stoichiometric Mn₋₁₋ₓ₋ᵧ(CeₓLaₓᵧ)O2-δ ultra-thin film, with controllable thicknesses (5-650 nm) and transmittance (~29-100%)in which Ce4+/3+ and La3+ ions were dissolved in MnO2-x lattice. Due to percolation impacts on the optoelectronic properties of ultrathin films, a representative Mn1-x-y(CexLay)O2-δ film with 86% transmittance exhibited an outstanding areal capacitance of 3.4 mF•cm-2, mainly attributed to the intercalation/de-intercalation of anionic O2- charge carriers through the atomic tunnels of the stratified Mn1-x-y(CexLay)O2-δ crystallites. Furthermore, the Mn1-x-y(CexLay)O2-δ exhibited excellent capacitance retention of ~90% after 16,000 cycles. Such stability was shown to be associated with intervalence charge transfers occurring among interstitial Ce/La cations and Mn oxidation states within the Mn₋₁₋ₓ₋ᵧ(CexLay)O2-δ structure. The energy and power densities of the transparent flexible Mn₋₁₋ₓ₋ᵧ(CexLay)O2-δ full-cell pseudocapacitor device with a solid-state electrolyte was measured to be 0.088 µWh.cm-2 and 843 µW.cm-2, respectively. These values showed insignificant changes under vigorous twisting and bending to 45-180˚, confirming these materials are intriguing alternatives for size-sensitive energy storage devices. In step three, the remaining solution purified further, that led to the formation of REOs (La, Ce, and Nd) nanospheres with ~40-50 nm diameter.

Keywords: spent Ni-MH batteries, green energy, flexible pseudocapacitor, rare earth elements

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Authors: Jeries Khoury

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The use of legendary, folkloric and religious symbols is one of the most important phenomena in modern Arabic poetry. Interestingly enough, most of the modern Arabic poetry’s pioneers were so fascinated by the biblical symbols and they managed to use many modern techniques to make these symbols adequate for their personal life from one side and fit to their Islamic beliefs from the other. One of the most famous poets to do so was al-Sayya:b. The way he employed one of these symbols ‘job’, the new features he adds to this character and the link between this character and his personal life will be discussed in this study. Besides, the study will examine the influence of al-Sayya:b on another modern poet Saadi Yusuf, who, following al-Sayya:b, used the character of Job in a special way, by mixing its features with al-Sayya:b’s personal features and in this way creating a new mixed character. A semantic, cultural and comparative analysis of the poems written by al-Sayya:b himself and the other poets who evoked the mixed image of al-Sayya:b-Job, can reveal the changes Arab poets made to the original biblical figure of Job to bring it closer to Islamic culture. The paper will make an intensive use of intertextuality idioms in order to shed light on the network of relations between three kinds of texts (indeed three ‘palimpsests’: 1- biblical- the primary text; 2- poetic- al-Syya:b’s secondary version; 3- re-poetic- Sa’di Yusuf’s tertiary version). The bottom line in this paper is that that al-Sayya:b was directly influenced by the dramatic biblical story of Job more than the brief Quranic version of the story. In fact, the ‘new’ character of Job designed by al-Sayya:b himself differs from the original one in many aspects that we can safely say it is the Sayyabian-Job that cannot be found in the poems of any other poets, unless they are evoking the own tragedy of al-Sayya:b himself, like what Saadi Yusuf did.

Keywords: Arabic poetry, intertextuality, job, meter, modernism, symbolism

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Authors: Abdullah Alhaqbani

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Purpose: Implementing continuous improvement is a challenge that public sector organisations face in becoming successful. Many obstacles hinder public organisations from successfully implementing continuous improvement. This paper aims to highlight the key core obstacles that face public organisations to implement continuous improvement programmes. Approach: Based on the literature, this paper reviews 66 papers that were published between 2000 and 2013 and that focused on the concept of continuous improvement and improvement methodologies in the context of public sector organisations. The methodologies for continuous improvement covered in these papers include Total Quality Management, Six Sigma, process re-engineering, lean thinking and Kaizen. Findings: Of the 24 obstacles found in the literature, 11 barriers were seen as core barriers that frequently occurred in public sector organisations. The findings indicate that lack of top management commitment; organisational culture and political issues and resistance to change are significant obstacles for improvement programmes. Moreover, this review found that improvement methodologies share some core barriers to successful implementation within public organisations. These barriers as well are common in the different geographic area. For instance lack of top management commitment and training that found in the education sector in Albanian are common barriers of improvement studies in Kuwait, Saudi Arabia, Spain, UK and US. Practical implications: Understanding these core issues and barriers will help managers of public organisations to improve their strategies with respect to continuous improvement. Thus, this review highlights the core issues that prevent a successful continuous improvement journey within the public sector. Value: Identifying and understanding the common obstacles to successfully implementing continuous improvement in the public sector will help public organisations to learn how to improve in launching and successfully sustaining such programmes. However, this is not the end; rather, it is just the beginning of a longer improvement journey. Thus, it is intended that this review will identify key learning opportunities for public sector organisations in developing nations which will then be tested via further research.

Keywords: continuous improvement, total quality management, obstacles, public sector

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Authors: Camila Plaza, Stefan Felder

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In October 2014, the TARMED reform was implemented in Switzerland. In an effort to even out the financial standing of general practitioners (including pediatricians) relative to that of specialists in the outpatient sector, the reform tackled two aspects: on the one hand, GPs would be able to bill an additional 9 CHF per patient, once per consult per day. This is referred to as the surcharge position. As a second measure, it reduced the fees for certain technical services targeted to specialists (e.g., imaging, surgical technical procedures, etc.). Given the fee-for-service reimbursement system in Switzerland, we predict that physicians reacted to the economic incentives of the reform by increasing the consults per patient and decreasing the average amount of time per consult. Within this framework, our treatment group is formed by GPs and our control group by those specialists who were not affected by the reform. Using monthly insurance claims panel data aggregated at the physician praxis level (provided by SASIS AG), for the period of January 2013-December 2015, we run difference in difference panel data models with physician and time fixed effects in order to test for the causal effects of the reform. We account for seasonality, and control for physician characteristics such as age, gender, specialty, and physician experience. Furthermore, we run the models on subgroups of physicians within our sample so as to account for heterogeneity and treatment intensities. Preliminary results support our hypothesis. We find evidence of an increase in consults per patients and a decrease in time per consult. Robustness checks do not significantly alter the results for our outcome variable of consults per patient. However, we do find a smaller effect of the reform for time per consult. Thus, the results of this paper could provide policymakers a better understanding of physician behavior and their sensitivity to financial incentives of reforms (both past and future) under the current reimbursement system.

Keywords: difference in differences, financial incentives, health reform, physician behavior

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Authors: Ibitoye Olabode Clement

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The huge amount of grants for infrastructures development in Tertiary Institutions in Nigeria calls for transparency and accountability in the procurement process. However, questions have been raised concerning the judicious and appropriate use of the funds, and it was doubtful if the institutions complied with due process. This paper examined the causes of non-compliance with the Public Procurement Act (2007) in the procurement of Goods, Works, and Services through either direct or indirect processes of procurement, mostly in Tertiary Institutions of State government subvention institutions in Nigeria. Nigeria has over 120 public universities, polytechnics, and colleges of Education. This paper will take samples of some selected Institutions in southwest Nigeria. The institutions comprise 5 Universities, 5 Polytechnics, and 5 Colleges of Education / Health and Technology. The opinions of the institutions’ Procurement Officers on the tremendous investment through grants and interventions for infrastructure development in Tertiary Education Institutions (TEI) in Nigeria call for transparency and accountability in the procurement process. However, there are a lot of questions have been raised as to the judicious use of the funds, and it was doubtful if the institutions complied with due process. This study examined the causes of non-compliance with the Public Procurement Act (2007) in the procurement of Goods, Works, and Services in most State Government Public Institutions in Southwest Nigeria. Over, 120 public institutions comprising 5 Universities, 5 Polytechnics, and 5 Colleges of Education / Health and Technology were used for the study. The opinions of the institutions’ Procurement Officers on the causes of non-compliance with the Act in their procurement process were sought using a structured questionnaire. The results revealed that non-independent of Procurement Officers, non-compliance with the Act by some at the managerial level, claiming inadequate knowledge of the Act, non-employment of qualified and experienced Procurement officers, insufficient publicity of the Act, and non-existence of corporate governance led to poor management of procurement record and non-provision of incentive, Inability to separate the duties of Internal Auditors and Procurement Officers, Inability to translate procurement entity at large which makes nearly all at departmental level believe they procurement officers. Conclusively, on taking the Procurement Officers through interviewing having it that: the right educational and professional qualifications, understanding of the Act, sufficient cognate working experience, recruiting most professionals needed if not all, and occupying management position will enhance compliance. Hence, in addition, adopting an external empowered department from the Bureau should raise for monitoring the compliance mostly in State Government Tertiary Education Institution. Also, an organizational culture with a corporate governance structure that supports the engagement of the right and qualified personnel to handle procurement, encourages them to perform at their best and rewards excellent service by giving incentives, and operates within an administrative environment devoid of corruption.

Keywords: non compliance of procurement act, tertiary education institution, university, polytechnic and college of education/ health science and technology, Nigeria

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Authors: Carolina Brandão Piva

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In our visual culture, images play a newly significant role in the basis of a complex dialogue between imagination, creativity, and social practice. Insofar as imagination has broken out of the 'special expressive space of art' to become a part of the quotidian mental work of ordinary people, it is pertinent to recognize that visual representation can no longer be assumed as if in a domain detached from everyday life or exclusively 'centered' within the limited frame of 'art history.' The approach of Visual Culture as a field of study is, in this sense, indispensable to comprehend that not only 'the image,' but also 'the imagined' and 'the imaginary' are produced in the plurality of social interactions; crucial enough, this assertion directs us to something new in contemporary cultural processes, namely both imagination and image production constitute a social practice. This paper starts off with this approach and seeks to examine the artistic practice of two women from the State of Goiás, Brazil, who are ordinary citizens with their daily activities and narratives but also dedicated to visuality production. With no formal training from art schools, branded or otherwise, Maria Aparecida de Souza Pires deploys 'waste disposal' of daily life—from car tires to old work clothes—as a trampoline for art; also adept at sourcing raw materials collected from her surroundings, she manipulates raw hewn wood, tree trunks, plant life, and various other pieces she collects from nature giving them new meaning and possibility. Hilda Freire works with sculptures in clay using different scales and styles; her art focuses on representations of women and pays homage to unprivileged groups such as the practitioners of African-Brazilian religions, blue-collar workers, poor live-in housekeepers, and so forth. Although they have never been acknowledged by any mainstream art institution in Brazil, whose 'criterion of value' still favors formally trained artists, Maria Aparecida de Souza Pires, and Hilda Freire have produced visualities that instigate 'new ways of seeing,' meriting cultural significance in many ways. Their artworks neither descend from a 'traditional' medium nor depend on 'canonical viewing settings' of visual representation; rather, they consist in producing relationships with the world which do not result in 'seeing more,' but 'at least differently.' From this perspective, the paper finally demonstrates that grouping this kind of artistic production under the label of 'mere craft' has much more to do with who is privileged within the fields of power in art system, who we see and who we do not see, and whose imagination of what is fed by which visual images in Brazilian contemporary society.

Keywords: visual culture, artistic practice, women's art in the Brazilian State of Goiás, Maria Aparecida de Souza Pires, Hilda Freire

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Authors: Yuta Nakano, Kozo Kajiwara, Atsushi Hori, Takeshi Fujita

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In association with the wave of electric vehicles (EV), low energy consumption systems have become more and more important. One of the key technologies to realize low energy consumption is a dynamic vision sensor (DVS), or we can call it an event sensor, neuromorphic vision sensor and so on. This sensor has several features, such as high temporal resolution, which can achieve 1 Mframe/s, and a high dynamic range (120 DB). However, the point that can contribute to low energy consumption the most is its sparsity; to be more specific, this sensor only captures the pixels that have intensity change. In other words, there is no signal in the area that does not have any intensity change. That is to say, this sensor is more energy efficient than conventional sensors such as RGB cameras because we can remove redundant data. On the other side of the advantages, it is difficult to handle the data because the data format is completely different from RGB image; for example, acquired signals are asynchronous and sparse, and each signal is composed of x-y coordinate, polarity (two values: +1 or -1) and time stamp, it does not include intensity such as RGB values. Therefore, as we cannot use existing algorithms straightforwardly, we have to design a new processing algorithm to cope with DVS data. In order to solve difficulties caused by data format differences, most of the prior arts make a frame data and feed it to deep learning such as Convolutional Neural Networks (CNN) for object detection and recognition purposes. However, even though we can feed the data, it is still difficult to achieve good performance due to a lack of intensity information. Although polarity is often used as intensity instead of RGB pixel value, it is apparent that polarity information is not rich enough. Considering this context, we proposed to use the timestamp information as a data representation that is fed to deep learning. Concretely, at first, we also make frame data divided by a certain time period, then give intensity value in response to the timestamp in each frame; for example, a high value is given on a recent signal. We expected that this data representation could capture the features, especially of moving objects, because timestamp represents the movement direction and speed. By using this proposal method, we made our own dataset by DVS fixed on a parked car to develop an application for a surveillance system that can detect persons around the car. We think DVS is one of the ideal sensors for surveillance purposes because this sensor can run for a long time with low energy consumption in a NOT dynamic situation. For comparison purposes, we reproduced state of the art method as a benchmark, which makes frames the same as us and feeds polarity information to CNN. Then, we measured the object detection performances of the benchmark and ours on the same dataset. As a result, our method achieved a maximum of 7 points greater than the benchmark in the F1 score.

Keywords: event camera, dynamic vision sensor, deep learning, data representation, object recognition, low energy consumption

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Authors: Fundime Miri, Emanuela Sulaj

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Benthic ecosystems constitute important ecological habitats, providing fundamental services for spawning, foraging, and sheltering aquatic organisms. Benthic faunal communities are characterized by a large biological diversity, supported by a great physical variety of benthic habitats. Until late, the study of meiobenthic communities in Albania has been neglectedthus excluding an important component of benthos. The present study aims to bring characteristics of distribution pattern of meiofaunal communities with further focus on nematode genus-based diversity from different intertidal habitats along Albanian Adriatic Sea Coast. The investigation area is extended from Shkodra to Vlora District, including six sandy sampling sites in beaches and areas near river estuaries. Sediment samples were collected manually in low intertidal zone by using a cylindrical corer, with an internal diameter of 5 cm. The richness onmeiofaunalmajor taxon level did not show any significant change between different sampling sites compare to significant changes in nematode diversity at genus level, with distinct nematode assemblages per sampling sites and presence of exclusive genera. All meiofaunal communities under study were dominated by nematodes. Further assessment of functional diversity on nematode assemblages exhibited changes as well on trophic groups and life strategies due to diverse feeding behaviors and c-p values of nematode genera. This study emphasize the need for lower level taxonomic identification of meiofaunal organisms and extending of ecological assessments on trophic diversity and life strategies to understanding functional consequences.

Keywords: benthos, meiofauna, nematode genus-based diversity, functional diversity, intertidal, albanian adriatic coast

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Authors: Elvira Lumi, Hans Jazxhi

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In the works of the writer Flutura Açka, the play with these questions is acute, and in almost each of them, the act of loneliness and isolation builds in a completely involuntary way unique and frequent conceptual spaces. Because the object of study is too broad to grasp all the works, this study lays out a rapid paradox of our access to three of the novels in the line of numerous authorial works. The novel "Woman Loneliness" (2001), also marked as the first work in prose by the author, declares in the title the paradigm of what she has decided to confess. The gender segregation proclaimed in the title will be revealed step by step in the work as conventional human segregation without gender. In this novel, the analysis of the state of "loneliness" will require a contemplation beyond man, when the role of the environment and the distance from the center of the narrative base will be extremely visible in the work. The novel "Cross of Oblivion" (2004) has another form of perception of loneliness, which, unlike the one built by the characters themselves in the novel "Woman Loneliness," is imposed and obligatory to live by the circumstances. Its characters are trapped in loneliness, as loneliness that comes from impossibility, from the past, from dependence on fate, from fear of change, and from the obligation to accept it. At the heart of the novel, the plot of the novel game is dictated by the Kanun and its rules and the loneliness of the basis of life in unbroken waves towards the periphery of the event, a periphery that has very large geography and is played in today's Europe. The novel "Where are you?" (2009) has a completely different form of constructing the concept of loneliness and isolation that comes under conditions of repression and political pressure. The loneliness in this novel takes the form of the protective element from the circumstances that actually require a social inclusion; it is personal loneliness that ensures relative mental health of the characters, up to a new trap created by the circumstances, thus building life fragmentary “healthy” in the order of a mentally ill and socially ill society.

Keywords: loneliness, existential, isolation, woman, prose

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Authors: Vasiliki Markantoni, Eftychia Platsidaki, Georgios Chaidemenos, Georgios Kontochristopoulos

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Introduction: Bromhidrosis, also known as osmidrosis, is a common distressing condition with a significant negative effect on patient’s quality of life. Its etiology is multifactorial. It usually affects axilla, genital skin, breasts and soles, areas where apocrine glands are mostly distributed. Therapeutic treatments include topical antibacterial agents, antiperspirants and neuromuscular blocker agents-toxins. In this study, we aimed to evaluate the efficacy and possible complications of topical glycopyrrolate, an anticholinergic agent, for treatment of bromhidrosis. Glycopyrrolate, applied topically as a cream, solution or spray at concentrations between 0,5% and 4%, has been successfully used to treat different forms of focal hyperhidrosis. Materials and Methods: Twenty patients, six males and fourteen females, meeting the criteria for bromhidrosis were treated with topical glycopyrrolate for two months. The average age was 36. Eleven patients had bromhidrosis located to the axillae, four to the soles, four to both axillae and soles and one to the genital folds. Glycopyrrolate was applied topically as a cream at concentration 2%, formulated in Fitalite. During the first month, patients were using the cream every night and thereafter twice daily. The degree of malodor was assessed subjectively by patients and scaled averagely as ‘none’, ‘mild’, ‘moderate’, and ‘severe’ with corresponding scores of 0, 1, 2, and 3, respectively. The modified Dermatology Life Quality Index (DLQI) was used to assess the quality of life. The clinical efficacy was graded by the patient scale of excellent, good, fair and poor. In the end, patients were given the power to evaluate whether they were totally satisfied with, partially satisfied or unsatisfied and possible side effects during the treatment were recorded. Results: All patients were satisfied at the end of the treatment. No patient defined the response as no improvement. The subjectively assessed score level of bromhidrosis was remarkably improved after the first month of treatment and improved slightly more after the second month. DLQI score was also improved to all patients. Adverse effects were reported in 2 patients. In the first case, topical irritation was reported. This was classed as mild (erythema and desquamation), appeared during the second month of treatment and was treated with low-potency topical corticosteroids. In the second case, mydriasis was reported, that recovered without specific treatment, as soon as we insisted to the importance of careful hygiene after cream application so as not to contaminate the periocular skin or ocular surface. Conclusions: Dermatologists often encounter patients with bromhidrosis, therefore should be aware of treatment options. To the best of our knowledge, this is the first study to evaluate the use of topical glycopyrrolate as a therapeutic approach for bromhidrosis. Our findings suggest that topical glycopyrrolate has an excellent safety profile and demonstrate encouraging results for the management of this distressful condition.

Keywords: Bromhidrosis, glycopyrrolate, topical treatment, osmidrosis

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Authors: Tadesse Menjetta, Daniel Dana, Serkadis Debalke

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Schistosomiasis/Bilharziasis is one of the neglected tropical parasitic diseases caused by different species of genus Schistosoma. Among the species, S. mansoni (causative agents of intestinal schistosomiasis) is one of the causes of severe intestinal parasitic infections with high public and medical importance in Ethiopia. There is a scarcity of information about the status of S. mansoni infection among the fisherman in our study area and in the country at large. Therefore, this study was designed to determine the prevalence and risk factors of S.mansoni infection among fishermen at Lake Hawassa, southern Ethiopia. A cross-sectional study was conducted among the fishermen from April to June 2013 in Hawassa, Southern Ethiopia. A total of 243 fishermen were included by systematic sampling from the lists of the fishermen members in the registration book of fishermen associations in the Hawassa Town. Data on socio-demographic features and risk factors were collected by using semi-structured questionnaires. Stool samples were collected and processed using Kato-Katz thick smear techniques and examined between 30- 40 minute for hookworm and after 24 hours for S. mansoni and other soil-transmitted helminths (STHs). The overall prevalence of S.mansoni among the fishermen was 29.21% (71/243), and the mean intensity of infection was 158.88 egg per gram (EPG). The prevalence of intestinal helminths including S. mansoni was 69.54% (169/243). Moreover, the prevalence of soil-transmitted helminths (STHs) was 40.74% (99/243), 35.80% (87/243) and 5.76% (14/243) for A. lumbricoides, T. trichiura and hookworm species, respectively. Almost similar prevalence of S.mansoni, 31.82%, 31.75%, 31.94% were recorded in age groups of 15-19, 20-24 and 25-29 years, respectively. Fishermen who are swimming always were 2.92 times [95% CI: 1.554, 5.502] more likely to acquire S. mansoni infection than other water contacting habit of the study participants. The results of the current investigation indicated the moderate endemicity of S. mansoni among the fishermen at Lake Hawassa, southern Ethiopia. Fishermen could be the potential risk group for S. mansoni infection and might be responsible for the transmission of S. mansoni to other segments of the communities. Since the high prevalence of STH was recorded among the fishermen, integrated prevention and control strategies from different sectors might be important to tackle the problem.

Keywords: S. mansoni, soil transmitted helminths, fishermen, Lake Hawassa, Ethiopia

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Authors: Hadjer Messabih

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The M’zab architecture has preserved its identity that was able to endure for centuries conserving practically the same way of life and the same building techniques since the 11th century. Even more, the newly built ksar Tafilelt is also designed to meet the local tradition. In 1996, a community led project was initiated to build a “new ksar” named Tafilelt based on a traditional form of community-led cooperative housing. It is a unique experience in the field of community housing that reproduces traditional architectural patterns while addressing contemporary ways of life with their expected modern comfort. This research is based on the hypothesis that the process of producing ksar Tafilelt is culturally responsive to a conservative community that was characterized by certain values which were transmitted to this ksar manifesting as cultural continuity. It aims at investigating what type of cultural continuity manifests itself in the co-production of ksar Tafilelt and the way the settlement and its houses are produced and inhabited, as well as the new emerging values and adaptive transition in social relations. The research methodology is based on a combination of questionnaires, in depth interviews, photography, and site visit to record and demonstrate how these buildings respond to peoples’ needs. Post Occupancy Evaluation (POE) is also employed in order to understand the lessons that can be learned from this project. Finally, this study proves that the cultural continuity that was transmitted from the Ibadi community is sill manifested in ksar Tafilelt, which provided strong religious bonds and a strong sense of community. The research findings have resulted in a number of lessons and principles that can be learnt from the project of ksar Tafilelt which can inform future practices of housing provision and design in Algeria and other countries.

Keywords: community-led cooperative housing, conservative community, cultural continuity, post occupancy evaluation

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Authors: Jane E. Hill

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Quality of life is an important component for many. With that in mind, everyone will experience some type of loss within his or her lifetime. A person can experience loss due to break up, separation, divorce, estrangement, or death. An individual may experience loss of a job, loss of capacity, or loss caused by human or natural-caused disasters. An individual’s response to such a loss is unique to them, and not everyone will seek services to assist them with their grief due to loss. Counseling can promote positive outcomes for clients that are grieving by addressing the client’s personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as poor health, psychological distress, or an increased risk of depression. Education and training in grief counseling can improve counselors’ problem recognition and skills in treatment planning. The purpose of this study was to examine whether the Council for Accreditation of Counseling and Related Educational Programs (CACREP) master’s degree counseling students view themselves as having been adequately trained in grief theories and skills. Many people deal with grief issues that prevent them from having joy or purpose in their lives and that leaves them unable to engage in positive opportunities or relationships. This study examined CACREP-accredited master’s counseling students’ self-reported competency, training, and education in providing grief counseling. The implications for positive social change arising from the research may be to incorporate and promote education and training in grief theories and skills in a majority of counseling programs and to provide motivation to incorporate professional standards for grief training and practice in the mental health counseling field. The theoretical foundation used was modern grief theory based on John Bowlby’s work on Attachment Theory. The overall research question was how competent do master’s-level counselors view themselves regarding the education or training they received in grief theories or counseling skills in their CACREP-accredited studies. The author used a non-experimental, one shot survey comparative quantitative research design. Cicchetti’s Grief Counseling Competency Scale (GCCS) was administered to CACREP master’s-level counseling students enrolled in their practicum or internship experience, which resulted in 153 participants. Using a MANCOVA, there was significance found for relationships between coursework taken and (a) perceived assessment skills (p = .029), (b) perceived treatment skills (p = .025), and (c) perceived conceptual skills and knowledge (p = .003). Results of this study provided insight for CACREP master’s-level counseling programs to explore and discuss curriculum coursework inclusion of education and training in grief theories and skills.

Keywords: counselor education and training, grief education and training, grief and loss, quality of life

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Authors: Elsher Lawson-Boyd

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In the wake of the Human Genome Project, the life sciences have undergone some fascinating changes. In particular, conventional beliefs relating to gene expression are being challenged by advances in postgenomic sciences, especially by the field of epigenetics. Epigenetics is the modification of gene expression without changes in the DNA sequence. In other words, epigenetics dictates that gene expression, the process by which the instructions in DNA are converted into products like proteins, is not solely controlled by DNA itself. Unlike gene-centric theories of heredity that characterized much of the 20th Century (where the genes were considered as having almost god-like power to create life), gene expression in epigenetics insists on environmental ‘signals’ or ‘exposures’, a point that radically deviates from gene-centric thinking. Science and Technology Studies (STS) scholars have shown that epigenetic research is having vast implications for the ways in which chronic, non-communicable diseases are conceptualized, treated, and governed. However, to the author’s knowledge, there have not yet been any in-depth sociological engagements with neuroepigenetics that examine how the field is affecting mental health and trauma discourse. In this paper, the author discusses preliminary findings from a doctoral ethnographic study on neuroepigenetics, trauma, and embodiment. Specifically, this study investigates the kinds of causal relations neuroepigenetic researchers are making between experiences of trauma and the development of mental illnesses like complex post-traumatic stress disorder (PTSD), both throughout a human’s lifetime and across generations. Using qualitative interviews and nonparticipant observation, the author focuses on two public-facing research centers based in Melbourne: Florey Institute of Neuroscience and Mental Health (FNMH), and Murdoch Children’s Research Institute (MCRI). Preliminary findings indicate that a great deal of ambiguity characterizes this infant field, particularly when animal-model experiments are employed and the results are translated into human frameworks. Nevertheless, researchers at the FNMH and MCRI strongly suggest that adverse and traumatic life events have a significant effect on gene expression, especially when experienced during early development. Furthermore, they predict that neuroepigenetic research will have substantial implications for the ways in which mental illnesses like complex PTSD are diagnosed and treated. These preliminary findings shed light on why medical and health sociologists have good reason to be chiming in, engaging with and de-black-boxing ideations emerging from postgenomic sciences, as they may indeed have significant effects for vulnerable populations not only in Australia but other developing countries in the Global South.

Keywords: genetics, mental illness, neuroepigenetics, trauma

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Authors: Kanchan Mondal, Dasharath Koulage, Dattatray Manerikar, Asmita Ghate

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This paper presents an additive reliability model using warranty data and Finite Element Analysis (FEA) data. Warranty data for any product gives insight to its underlying issues. This is often used by Reliability Engineers to build prediction model to forecast failure rate of parts. But there is one major limitation in using warranty data for prediction. Warranty periods constitute only a small fraction of total lifetime of a product, most of the time it covers only the infant mortality and useful life zone of a bathtub curve. Predicting with warranty data alone in these cases is not generally provide results with desired accuracy. Failure rate of a mechanical part is driven by random issues initially and wear-out or usage related issues at later stages of the lifetime. For better predictability of failure rate, one need to explore the failure rate behavior at wear out zone of a bathtub curve. Due to cost and time constraints, it is not always possible to test samples till failure, but FEA-Fatigue analysis can provide the failure rate behavior of a part much beyond warranty period in a quicker time and at lesser cost. In this work, the authors proposed an Additive Weibull Model, which make use of both warranty and FEA fatigue analysis data for predicting failure rates. It involves modeling of two data sets of a part, one with existing warranty claims and other with fatigue life data. Hazard rate base Weibull estimation has been used for the modeling the warranty data whereas S-N curved based Weibull parameter estimation is used for FEA data. Two separate Weibull models’ parameters are estimated and combined to form the proposed Additive Weibull Model for prediction.

Keywords: bathtub curve, fatigue, FEA, reliability, warranty, Weibull

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Authors: Sameer A. Pathan, Biswadev Mitra, Zain A. Bhutta, Isma Qureshi, Elle Spencer, Asmaa A. Hameed, Sana Nadeem, Ramsha Tahir, Shahzad Anjum, Peter A. Cameron

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Background: This study aimed to compare epidemiology, clinical presentations, management and outcomes of renal colic presentations in two major academic centers and discuss potential implications of these results for the applicability of current evidence in the management of renal colic. Methods: We undertook a retrospective cohort study of patients with renal colic who presented to the Hamad General Hospital Emergency Department (HGH-ED), Qatar, and The Alfred ED, Melbourne, Australia, during a period of one year from August 1, 2012, to July 3, 2013. Cases were identified using ICD-9-CM codes, and an electronic template was used to record the data on predefined clinical variables. Results: A total of 12,223 from the HGH-ED and 384 from The Alfred ED were identified as renal colic presentations during the study period. The rate of renal colic presentations at the HGH-ED was 27.9 per 1000 ED visits compared to 6.7 per 1000 ED visits at The Alfred ED. Patients presenting to the HGH-ED were significantly younger [34.9 years (29.0- 43.4) than The Alfred ED [48 years (37-60); P < 0.001]. The median stone size was larger in the HGH-ED group [6 (4-8) mm] versus The Alfred ED group [4 (3-6) mm, P < 0.001]. The intervention rate in the stone-positive population was significantly higher in the HGH-ED group as opposed to The Alfred ED group (38.7% versus 11.9%, p<0.001). At the time of discharge, The Alfred ED group received less analgesic prescriptions (55.8% versus 83.5%, P < 0.001) and more tamsulosin prescriptions (25.3% versus 11.7%, P < 0.001). Conclusions: Renal colic presentations to the HGH-ED, Qatar, were younger, with larger stone size, compared to The Alfred ED, whereas, medical expulsion therapy use was higher at the Alfred ED. Differences in epidemiology should be considered while tailoring strategies for effective management of patients with renal colic in the given setting.

Keywords: kidney stones, urolithiasis, nephrolithiasis, renal colic, epidemiology

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Authors: Kira Gulko Morse

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Choosing one’s primary language may not be as common as choosing an additional foreign language to study or use during travel. In some instances, however, it becomes a matter of internal personal struggle, as language is tied not only to specific circumstances but also to human background and identity. This phenomenological qualitative study focuses on the factors affecting the decision of a person to undergo a language shift. Specifically, it considers how these factors relate to identity negotiation and expression. The data for the study include the analysis of published autobiographical narratives and personal interviews conducted using the Responsive Interviewing model. While research participants come from a variety of geographical locations and have used different reasons for undergoing their individual language shift, the study identifies a number of common features shared by all the participants. Specifically, while all the participants have been able to maintain their first language to varying degrees of proficiency, they have all completed the shift to establish a primary language different from their first. Additionally, the process of self-identification is found to be directly connected to the phenomenon of language choice for each of the participants. The findings of the study further tie the phenomenon of individual language shift to a more comprehensive issue of individual life choices – ethnic revival, immigration, and inter-cultural marriage among others. The study discusses varying language roles and the data indicate that language shift may occur whether it is a symbolic driving force or a secondary means in fulfilling a set life goal. The concept of language addition is suggested as an alternative to the arbitrariness of language shift. Thus, instead of focusing on subtractive bilingualism or language loss, the emphasis becomes the integration of languages within the individual. The study emphasizes the importance of the construct of personal choice in its connection to individual language shift. It places the focus from society onto an individual and the ability of an individual to make decisions in matters of linguistic identification.

Keywords: choice theory, identity negotiation, language shift, psycholinguistics

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