Search results for: alternative health care

Authors: Angalabiri-Owei E. Bekekeme, Brambaifa Nelson

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In view of the peculiar environment of the Niger Delta, access to modern health care is limited, hence the inhabitants especially those in the swampy areas resorts to sourcing for alternatives cure for their ailments using plants commonly found in this area without scientific evaluation. Rhizophora racemosa, G. F. Meyer (Rhizophoraceae) is the most abundant mangrove plant in the Niger Delta Area of Nigeria. The plant has been observed to be used for relief of a toothache and dysmenorrhoea among some Ijaw communities in the region. This work has revealed the likely potential of the plant in drug discovery and development. The crude methanol extract at doses of 300 mg/kg and 600 mg/kg (intraperitoneal) were tested for analgesic effect using fresh egg albumin induced inflammatory pain and Randall–Sellito method to assess the pain threshold. The anti-inflammatory effect was also evaluated with the extract at doses of 300 mg/kg and 600 mg/kg (intraperitoneal) using acute inflammatory model; fresh egg albumin induced paw oedema and assessed using Plethysmometer in rats. The methanol extracts 300 mg/kg and 600 mg/kg exhibited a significant (P < 0.001) and dose-dependent analgesic activity compared with the negative control and a standard drug diclofenac using ANOVA with Least Significant Difference post hoc test as evidenced by increased pain threshold. Also, the extract significantly (P < 0.001) reduced the rat paw oedema induced by the sub plantar injection of fresh egg albumin when compared with the negative control and a standard diclofenac using above statistical methods. This study revealed that the plant possesses analgesic and anti-inflammatory activities hence provide scientific bases for use as medicine.

Keywords: analgesic, anti-inflammatory, plethysmometer, Rhizophora racemosa

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Authors: Jenny Lee

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Fat Studies is emerging as an interdisciplinary area of study, intersecting with Gender Studies, Sociology, Human Development and the Creative Arts. A focus on weight loss, and, therefore, fat hatred, has resulted in a form of discriminatory institutional practice that impacts women in the Western world. This focus is sanctioned by a large dieting industry, medical associations, the media, and at times, government initiatives. This paper will discuss the emergence of the so-called ‘Obesity Epidemic’ in Australia and the Western world and the stereotypes that thin equals healthy and fat equals unhealthy. This paper will argue that, for those with a health focus, ‘Health at every size’ is a more effective principle, which involves striving for healthy living, without a focus on weight loss. This discussion will contextualise an autoethnographic exploration of how fat acceptance and Health at Every Size can be encouraged through fat activism and fat political art. As part of this paper, a selection of the recent performance, writing and art in Australia will be presented, including Aquaporko, the fat femme synchronised swim team and VaVaBoomBah, the Melbourne fat burlesque performances.

Keywords: activism, fat, health, obesity, performance

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Authors: Badriya Almutairi, Ashraf El-Hamalawi

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Wind energy technologies are considered to be among the most promising types of renewable energy sources due to the growing concerns over climate change and energy security. Kuwait is amongst the countries that began realising the consequences of climate change and the long-term economic and energy security situation, considering options when oil runs out. Added to this are the fluctuating oil prices, rapid increase in population, high electricity consumption and protection of the environment It began to make efforts in the direction of greener solutions for energy needs by looking for alternative forms of energy and assessing potential renewable energy resources, including wind and solar. The aim of this paper is to examine wind energy as an alternative renewable energy source in Kuwait, due to its availability and low cost, reducing the dependency on fossil fuels compared to other forms of renewable energy. This paper will present a life cycle assessment of onshore wind turbine systems in Kuwait, comprising 4 stages; goal and scope of the analysis, inventory analysis, impact assessment and interpretation of the results. It will also provide an assessment of potential renewable energy resources and technologies applied for power generation and the environmental benefits for Kuwait. An optimum location for a site (Shagaya) will be recommended for reasons such as high wind speeds, land availability and distance to the next grid connection, and be the focus of this study. The potential environmental impacts and resources used throughout the wind turbine system’s life-cycle are then analysed using a Life Cycle Assessment (LCA). The results show the total carbon dioxide (CO₂) emission for a turbine with steel pile foundations is greater than emissions from a turbine with concrete foundations by 18 %. The analysis also shows the average CO₂ emissions from electricity generated using crude oil is 645gCO₂/kWh and the carbon footprint per functional unit for a wind turbine ranges between 6.6 g/kWh to 10 g/kWh, an increase of 98%, thus providing cost and environmental benefits by creating a wind farm in Kuwait. Using a cost-benefit analysis, it was also found that the electricity produced from wind energy in Kuwait would cost 17.6fils/kWh (0.05834 $/kWh), which is less than the cost of electricity currently being produced using conventional methods at 22 fils/kW (0.07$/kWh), i.e., a reduction of 20%.

Keywords: CO₂ emissions, Kuwait, life cycle assessment, renewable energy, wind energy

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Authors: Jia-Jin He, Tzu-Yuan Stessa Chao

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It is generally accepted that community residents with abundant open space have better health status on average, and thus more and more cities around the world began their pursuit of the greatest possible amount of green space within urban areas through urban planning approach. Nevertheless, only a few studies managed to provide empirical evidence regarding the actual relationship between 'providing' green space and 'improving' human health at city level. There is also lack of evidence of direct positive improvement of health by increasing the amount of green space. For urban planning professional, it is important to understand citizens’ usage behaviour towards green space as a critical evidence for future planning and design strategies. There is a research need to further investigate the amount of green space, user behaviour of green spaces and the health outcome of urban dwellers. To this end, we would like to find out other important factors for urban dwellers’ usage behaviours of green spaces. 'Average green spaces per person' is one of the National well-being Indicators in Taiwan as in many other countries. Through our preliminary research, we collected and analyzed the official data of planned open space coverages, average life expectancy, exercise frequency and obesity ratio in all cities of Taiwan. The study result indicates an interesting finding that Kaohsiung city, the second largest city in Taiwan, tells a completely different story. Citizens in Kaosiung city have more open spaces than any other city through urban planning, yet have relatively unhealthy condition in contrary. Whether it pointed out that the amount of the open spaces per person has would not direct to the health outcome. Therefore, the pre-established view which states that open spaces must have positive effects on human health should be examined more prudently. Hence, this paper intends to explore the relationship between user behaviour of open spaces and citizens’ health conditions by critically analyzing past related literature and collecting selective data from government health database in 2015. We also take Kaohsiung city, as a case study area to conduct statistical analysis first followed by questionnaire survey to gain a better understanding. Finally, we aim to feedback our findings to the current planning system in Taiwan for better health promotion urbanized areas.

Keywords: open spaces, urban planning systems, healthy cities, health outcomes

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Authors: Iris Maria Velez Osorio

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There has been in the last decade a concern about the environment, particularly about clean and enough water for human consumption but, some enterprises had some trouble to understand the limited resources in the environment. This research tries to understand how some industries are better oriented to the preservation of the environment through investment for strategic management of scarce resources and try in the best way possible, the contaminants. It was made an industry classification since four different group of theories for Corporate Social Responsibility agree with variables of: investment in environmental care, water protection, and residues treatment finding different levels of commitment with CSR.

Keywords: corporate social responsibility, environment, strategic management, water

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Authors: Amanda Aliende da Matta

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In different fields, there are people who have something that stands out. In the educational world, for example, it is clear when some teachers have something: they are the best teachers, but this is not directly attributed to their disciplines, methodologies, etc. It is that they have something that captivates, inspires, and motivates. But we also find this something in other contexts. In this thesis, the interest is in something that some marginalized people, such as Ab (fictitious name), have. Ab was born in a rural community and saw the lifestyle of his family change drastically as a consequence of structural changes in his village. The community became impoverished, and together with a group of teenagers, he decided to migrate to Spain in search of opportunities. His best friend drowned during the crossing. After arriving, he lived in indecent conditions and felt unsafe. He now suffers from anxiety and frequently faints from it. Yet, he’s linked to Joves x la pau (a Christian project, although he is a Muslim), distributing food for people who live on the streets every Thursday afternoon. When he asked about what happens on cold and rainy days, he explained simply: "if it rains, I distribute the food, and immediately I get home, take a bath, and sleep warm under my roof. That is when we most have to go." This something he has will be called caring. And one of the general objectives of the thesis is to discover what are the meaning structures of this caring what is the lived experience of this caring. In this communication, preliminary results of an Applied Hermeneutic Phenomenology (AHP) study on the lived experience of caring as a vulnerable person are presented. The research means to answer what is the lived experience of caring as a vulnerable person. That is, to describe and explain what it is like to caregive for a vulnerable person, what it is, essentially, to caregive for a vulnerable person, what makes the lived experience of caregiving for a vulnerable person different from any other. In order to investigate the meaning of the phenomenon of caregiving as a vulnerable person, as already stated, the method used will be Applied Hermeneutic Phenomenology (AHP). We base ourselves, initially, on the proposal of Raquel Ayala-Carabajo and Max Van Manen. As Van Manen (1990) explains, AHP is a method that works essentially through fieldwork, with the collection of data on lived experience (experiential material). It is a phenomenology of practice. We here present the provisional themes we found: caregiving as a vulnerable person is seeing yourself in the other, identifying with the care-receiver; Caregiving as a vulnerable person is putting the other’s need before oneself’s; Caregiving as a vulnerable person is temporarily overcoming your weaknesses to make yourself strong for the other; Caregiving as a vulnerable person is going beyond the conventional approach; and Caregiving as a vulnerable person is taking responsibility even if it’s not yours.

Keywords: applied hermeneutic phenomenology, care ethics, hermeneutics, phenomenology

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Authors: K. D. Mroczek

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In the study presented institutional context is discussed in terms of companies’ entry mode choice. In contrary to many previous analyses, instead of using one or two aggregated variables, a set of eleven determinants is used to establish equity and non-equity internationalization friendly conditions. Based on secondary data, 140 countries are analysed and grouped into clusters revealing similar framework. The range of the economies explored is wide as it covers all regions distinguished by The World Bank. The results can prove a useful alternative for operationalization of institutional variables in further research concerning entry modes or strategic management in international markets.

Keywords: clustering, entry mode choice, institutional environment, transaction costs

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Authors: John M. Ikome

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In the process of manufacturing, a machine breakdown usually forces a modified flow shop out of the prescribed state, this strategy reschedules part of the initial schedule to match up with the pre-schedule at some point with the objective to create a schedule that is reliable with the other production planning decisions like material flow, production and suppliers by utilizing a critical decision-making concept. We propose a rescheduling strategy and a match-up point that will have a determination procedure through an advanced feedback control mechanism to increase both the schedule quality and stability. These approaches are compared with alternative re-scheduling methods under different experimental settings.

Keywords: scheduling, heuristics, branch, integrated

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Authors: Noof Eid Al Shammari

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Background: Living with haemodialysis (HD) can impose several physical and social restrictions on the lives of individuals. Usually, the patient has three dialysis sessions per week that each run for three to four hours. This limits the social life of patients and causes a lower quality of life, in conjunction with the fact that people with chronic kidney disease must follow strict fluid and food regimens and use multiple medications. Given these factors, patients undergoing HD generally need psychological support. Objective: This scoping review study aims to evaluate the effectiveness of physical and breathing exercises on quality of life (QOL) and psychophysical status in patients undergoing HD. Methodology: Searches for relevant studies were performed in four databases (MEDLINE, CINAHL, Google Scholar, and PubMed) for articles published between 2011 and 2021. Out of all the searched literature, ten studies met the inclusion criteria (8 randomised controlled trials, one quasi-experimental study, and one pilot study), with a total of 588 patients. Different types of physical and breathing exercises were used (breathing, cardiopulmonary, and physical exercises). Results: All included studies in this scoping review revealed that most of the aerobic or anaerobic exercises, as well as breathing exercises, had a positive effect and significantly improved patients’ QOL, physical functioning, and psychological status. Conclusions: In this review, most of the articles demonstrated a positive effect of physical and breathing exercises on the QOL and psychophysical status of HD patients. Based on the findings of these studies, physical and breathing exercises were shown to improve muscle strength and other health-related aspects of QOL, including sexual, social, cognitive, and physical functions. However, more studies will need to be conducted with a larger sample to determine the best intervention that could be implemented and standardised in nursing care for patients undergoing HD.

Keywords: physical exercise, breathing exercises, quality of life, depression, hemodialysis

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Authors: Angelica Gonzalez O, Leonardo Rivera Cadavid, Diego Fernando Manotas

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Energy poverty considers a population that does not have access to modern energy service. In particular, an area of a country that is not connected to the national electricity grid is known as a Non-Interconnected Zone (NIZ). Access to electricity has a significant impact on the welfare and development opportunities of the population. Different studies have shown that most health problems have an empirical cause and effect relationship with multidimensional energy poverty. Likewise, research has been carried out to review the consequences of not having access to electricity, and its results have concluded a statistically significant relationship between energy poverty and sources of drinking water, access to clean water, risks of mosquito bites, obesity, sterilization, marital status, occupation, and residence. Therefore, extensive research has been conducted in the construction of an energy poverty measure based on an index. Some of these studies introduce a Multidimensional Energy Poverty Index (MEPI), Compose Energy Poverty Index (CEPI), Low Income High Costs indicator (LIHC), among others. For this purpose, this study analyzes the energy poverty index using a multicriteria analysis determining the set of feasible alternatives - for which Colombia's ZNI will be used as a case study - to be considered in the problem and the set of relevant criteria in the characterization of the ZNI, from which the prioritization is obtained to determine the level of adjustment of each alternative with respect to the performance in each criterion. Additionally, this study considers the installation of Micro-Grids (MG). This is considered a straightforward solution to this problem because an MG is a local electrical grid, able to operate in grid-connected and island mode. Drawing on those insights, this study compares an energy poverty index considering an MG installation and calculates the impacts of different criterias in an energy poverty index in NIZ.

Keywords: multicirteria, energy poverty, rural, microgrids, non-interconnect zones

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Authors: Ma Chu Jui

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Culture plays a pivotal role in shaping societal responses to change and fostering adaptability. In the realm of healthcare provision, hospitals serve as dynamic settings molded by the cultural consciousness of healthcare professionals. This intricate interplay extends to their expectations of leadership, communication styles, and attitudes towards patient care. Recognizing the cultural inclinations of healthcare professionals becomes imperative in navigating this complex landscape. This study will utilize Hofstede's Value Survey Module 2013 (VSM 2013) as a comprehensive analytical tool. The targeted participants for this research are in-service nursing professionals with a tenure of at least three months, specifically employed in the nursing department of an Eastern hospital. This quantitative approach seeks to quantify diverse cultural tendencies among the targeted nursing professionals, elucidating not only abstract cultural concepts but also revealing their cultural inclinations across different dimensions. The study anticipates gathering between 400 to 500 responses, ensuring a robust dataset for a comprehensive analysis. The focused approach on nursing professionals within the Eastern hospital setting enhances the relevance and specificity of the cultural insights obtained. The research aims to contribute valuable knowledge to the understanding of cultural tendencies among in-service nursing personnel in the nursing department of this specific Eastern hospital. The VSM 2013 will be initially distributed to this specific group to collect responses, aiming to calculate scores on each of Hofstede's six cultural dimensions—Power Distance Index (PDI), Individualism vs. Collectivism (IDV), Uncertainty Avoidance Index (UAI), Masculinity vs. Femininity (MAS), Long-Term Orientation vs. Short-Term Normative Orientation (LTO), and Indulgence vs. Restraint (IVR). the study unveils a significant correlation between different cultural dimensions and healthcare professionals' tendencies in understanding leadership expectations through PDI, grasping behavioral patterns via IDV, acknowledging risk acceptance through UAI, and understanding their long-term and short-term behaviors through LTO. These tendencies extend to communication styles and attitudes towards patient care. These findings provide valuable insights into the nuanced interconnections between cultural factors and healthcare practices. Through a detailed analysis of the varying levels of these cultural dimensions, we gain a comprehensive understanding of the predominant inclinations among the majority of healthcare professionals. This nuanced perspective adds depth to our comprehension of how cultural values shape their approach to leadership, communication, and patient care, contributing to a more holistic understanding of the healthcare landscape. A profound comprehension of the cultural paradigms embraced by healthcare professionals holds transformative potential. Beyond a mere understanding, it acts as a catalyst for elevating the caliber of healthcare services. This heightened awareness fosters cohesive collaboration among healthcare teams, paving the way for the establishment of a unified healthcare ethos. By cultivating shared values, our study envisions a healthcare environment characterized by enhanced quality, improved teamwork, and ultimately, a more favorable and patient-centric healthcare landscape. In essence, our research underscores the critical role of cultural awareness in shaping the future of healthcare delivery.

Keywords: hofstede's cultural, cultural dimensions, cultural values in healthcare, cultural awareness in nursing

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Authors: Orapan Thosingha, Tassana Boontong, Prapa Yuttatri, Vilaivan Thongcharoen, Soparn Potaya, Mattika Chaichan, Chanin Chakkrapopyodhin, Khwanthida Phimphakarn, Taddao Nabnean

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This research aimed to explore symptom experiences among Thai adults with chronic illnesses living in an urban community area of Bangkok. The sample was 670 adults with ages ranging from 20-59 years. The majority of them (65.2%) had more than one disease. Hypertension, dyslipidemia, and diabetes were the first three diseases among them. About 58% were female, and 51.1 % stayed with their couples. The studied sample had relatively low socioeconomic status; 33.7% were wage workers, 15.2% were street vendors, and 10.4% were unemployed. About 54 % had family incomes less than 10,000 baht (300 US Dollars) per month, and 41.6% addressed that their incomes were not adequate for daily living. Although the majority of them (63.7%) did not have to pay for hospital visits, they still had to pay for public transportation and could not earn a wage or any income on the hospital visit day. The first three physical symptoms they experienced were knee pain (60.5%) due to being overweight, headache (47.0%), and insomnia (44.6%). About 45% stated that their incomes decreased after having chronic illnesses and 37.2% expressed that having lower incomes affected their living, 34.5% perceived being a burden, and 34.3% regret about depending on others. It can be concluded that adults with low socioeconomic status who experienced chronic illnesses and resided in an urban community area had complex needs. While caring for them, nurses should pay attention not only to a disease-related domain but also to a social-related domain. Reached-out clinics led by professional nurses who are well-prepared for primary medical care and home visit are strongly recommended. National Health Security Office should adopt this policy and develop an action plan to serve the needs of chronically ill adults with low socioeconomic status.

Keywords: chronic illnesses, urban community, socioeconomic status, symptom experiences, low incomes

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Authors: Da Tao, Mingfu Qin, Wenkai Li, Tieyan Wang

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While the use of electronic personal health portals has gained increasing popularity in the healthcare industry, users usually experience difficulty in comprehending and correctly responding to personal health information, partly due to inappropriate or poor presentation of the information. The way personal health information is visualized may affect how users perceive and assess their personal health information. This study was conducted to examine the effects of information visualization format and visualization mode on the comprehension and perceptions of personal health information among personal health information users with eye tracking techniques. A two-factor within-subjects experimental design was employed, where participants were instructed to complete a series of personal health information comprehension tasks under varied types of visualization mode (i.e., whether the information visualization is static or dynamic) and three visualization formats (i.e., bar graph, instrument-like graph, and text-only format). Data on a set of measures, including comprehension performance, perceptions, and eye movement indicators, were collected during the task completion in the experiment. Repeated measure analysis of variance analyses (RM-ANOVAs) was used for data analysis. The results showed that while the visualization format yielded no effects on comprehension performance, it significantly affected users’ perceptions (such as perceived ease of use and satisfaction). The two graphic visualizations yielded significantly higher favorable scores on subjective evaluations than that of the text format. While visualization mode showed no effects on users’ perception measures, it significantly affected users' comprehension performance in that dynamic visualization significantly reduced users' information search time. Both visualization format and visualization mode had significant main effects on eye movement behaviors, and their interaction effects were also significant. While the bar graph format and text format had similar time to first fixation across dynamic and static visualizations, instrument-like graph format had a larger time to first fixation for dynamic visualization than for static visualization. The two graphic visualization formats yielded shorter total fixation duration compared with the text-only format, indicating their ability to improve information comprehension efficiency. The results suggest that dynamic visualization can improve efficiency in comprehending important health information, and graphic visualization formats were favored more by users. The findings are helpful in the underlying comprehension mechanism of visualized personal health information and provide important implications for optimal design and visualization of personal health information.

Keywords: eye tracking, information comprehension, personal health information, visualization

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Authors: Emigdio Mendoza, Patricia Fernandez, Cristian Gomez

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Magnesium alloys have generated great interest for several industrial applications because their high specific strength and low density make them a very attractive alternative for the manufacture of various components; however, these alloys present a limitation with their hexagonal crystal structure that limits the deformation mechanisms at room temperature likewise the molding components alternatives, it is for this reason that severe plastic deformation processes have taken a huge relevance recently because these, allow high deformation rates to be applied that induce microstructural changes where the deficiency in the sliding systems is compensated with crystallographic grains reorientations or crystal twinning. The present study reports a statistical analysis of process temperature, number of passes and shear angle with respect to the shear stress in severe plastic deformation process denominated 'Equal Channel Angular Sheet Drawing (ECASD)' applied to the magnesium alloy AZ31B through Python Statsmodels libraries, additionally a Post-Hoc range test is performed using the Tukey statistical test. Statistical results show that each variable has a p-value lower than 0.05, which allows comparing the average values of shear stresses obtained, which are in the range of 7.37 MPa to 12.23 MPa, lower values in comparison to others severe plastic deformation processes reported in the literature, considering a value of 157.53 MPa as the average creep stress for AZ31B alloy. However, a higher stress level is required when the sheets are processed using a shear angle of 150°, due to a higher level of adjustment applied for the shear die of 150°. Temperature and shear passes are important variables as well, but there is no significant impact on the level of stress applied during the ECASD process. In the processing of AZ31B magnesium alloy sheets, ECASD technique is evidenced as a viable alternative in the modification of the elasto-plastic properties of this alloy, promoting the weakening of the basal texture, which means, a better response to deformation, whereby, during the manufacture of parts by drawing or stamping processes the formation of cracks on the surface can be reduced, presenting an adequate mechanical performance.

Keywords: plastic deformation, strain, sheet drawing, magnesium

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Authors: Zuzana Crhová, Karel Kolman, Drahomíra Pavelková

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Knowledge is considered as an important asset which can help organizations to create competitive advantage. The necessity of taking care of these assets is more important in these days – in days of turbulent changes in business environment. Knowledge could facilitate adaption to constant changes. The aim of this paper is to describe how the knowledge sharing can be supported in the manufacturing companies. The methods of case studies and grounded theory were used to present information gained by carrying out semi-structured interviews. Results show that knowledge sharing is supported in very similar ways in respondent companies.

Keywords: case study, human resource management, knowledge, knowledge sharing

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Authors: Kate Duggan

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Introduction: Functional Communication Training (FCT) is an approach which aims to reduce behaviours of concern by teaching more effective ways to communicate. It requires identification of the function of the behaviour of concern, through gathering information from key stakeholders and completing observations of the individual’s behaviour including antecedents to, and consequences of the behaviour. Appropriate communicative alternatives are then identified and taught to the individual using systematic instruction techniques. Behaviours of concern demonstrated by individuals with autism spectrum conditions (ASC) frequently have a communication function. When contributing to positive behavior support plans, speech and language therapists and other professionals working with individuals with ASC need to identify alternative communicative behaviours which are equally reinforcing as the existing behaviours of concern. Successful implementation of FCT is dependent on an effective ‘response match’. The new way of communicating must be equally as effective as the behaviour previously used and require the same amount or less effort from the individual. It must also be understood by the communication partners the individual encounters and be appropriate to their communicative contexts. Method: Four case studies within a non-maintained special school environment were described and analysed. A response match framework was used to identify the effectiveness of functional communication training delivered by the student’s speech and language therapist, teacher and learning support assistants. The success of systematic instruction techniques used to develop new communicative behaviours was evaluated using the CODES framework. Findings: Functional communication training can be used as part of a positive behaviour support approach for students within this setting. All case studies reviewed demonstrated ‘response success’, in that the desired response was gained from the new communicative behaviour. Barriers to the successful embedding of new communicative behaviours were encountered. In some instances, the new communicative behaviour could not be consistently understood across all communication partners which reduced ‘response recognisability’. There was also evidence of increased physical or cognitive difficulty in employing the new communicative behaviour which reduced the ‘response effectivity’. Successful use of ‘thinning schedules of reinforcement’, taught students to tolerate a delay to reinforcement once the new communication behaviour was learned.

Keywords: augmentative and alternative communication, autism spectrum conditions, behaviours of concern, functional communication training

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Authors: Harini Aiyer, Kalyani Premkumar

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Health professionals are the key players who can help achieve the goals of population health equity. Social accountability (SA) of health professionals emphasizes their role in addressing issues of equity in the population they serve. Therefore, health professional education must focus on instilling SA in health professionals. There is limited literature offering a longitudinal perspective of how students sustain the practice of SA in later life. This project aims to identify the drivers of social accountability among physicians. This study employed an exploratory mixed methods design (QUAL-> Quant) to explore alumni perceptions and experiences. The qualitative data, collected via 20 in-depth, semi-structured interviews, provided an understanding of the perceptions of the alumni regarding the influence of their undergraduate learning environment on their SA. This was followed by a quantitative portion -a questionnaire designed from the themes identified from the qualitative data. Emerging themes from the study highlighted community-centered education and a focus on social and preventative medicine in both curricular and non-curricular facilitators of SA among physicians. Curricular components included opportunities to engage with the community, such as roadside clinics, community-orientation programs, and postings at a secondary hospital. Other facilitators that emerged were the faculty leading by example, a subsidized fee structure, and a system that prepared students for practice in rural and remote areas. The study offers a fresh perspective and dimension on how SA is addressed by medical schools. The findings may be adapted by medical schools to understand how their own SA initiatives have been sustained among physicians over the long run.

Keywords: community-based work, global health, health education, medical education, providing health in remote areas, social accountability

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Authors: Nazif Fuat Turkmen

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Domestic violence is the most common form of violence that risks the health and psychological well-being of victims and its witnesses. Psychology as a scientific field has made contributions in research, exploration, assessment, intervention, and prevention of domestic violence. The present study will be exploring the level of recognition of Turkish Cypriots on domestic violence and their understanding about it in general terms. While discussing the level of awareness of Turkish Cypriots on domestic violence and the effects of this level of awareness on the general well-being of the members of the society, the most common types of domestic violence as well as how Turkish Cypriots recognize and interpret these different types will be explored. The participants consisted of 224 Turkish Cypriots; 48.4% (n= 109) were female, 51.1% (n=115) were male. For the purpose of the study, a 28-item questionnaire was prepared and used for data collection. According to the results, there is a strong relationship between the education level of the respondents and their awareness on domestic violence. The study shows that cultural approaches on child rearing effect people’s recognition of violence in general and awareness on domestic violence in particular.

Keywords: culture, domestic violence, health psychology, public health, Turkish Cypriots, violence

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Authors: Josiane Yaguibou, Ngoy Kishimba, Issiaka V. Coulibaly, Sabrina Pestilli, Falinirina Razanalison, Hantanirina Andremanisa

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Background: Madagascar has one of the least developed road networks in the world with a majority of its national and local roads being earth roads and in poor condition. In addition, the country is affected by frequent natural disasters that further affect the road conditions limiting the accessibility to some parts of the country. In 2021 and 2022, 2.21 million people were affected by drought in the Grand Sud region, and by cyclones and floods in the coastal regions, with disruptions of the health system including last mile distribution of lifesaving maternal health commodities and reproductive health commodities in the health facilities. Program intervention: The intervention uses drone technology to deliver maternal health and family planning commodities in hard-to-reach health facilities in the Grand Sud and Sud-Est of Madagascar, the regions more affected by natural disasters. Methodology The intervention was developed in two phases. A first phase, conducted in the Grand Sud, used drones leased from a private company to deliver commodities in isolated health facilities. Based on the lesson learnt and encouraging results of the first phase, in the second phase (2023) the intervention has been extended to the Sud Est regions with the purchase of drones and the recruitment of pilots to reduce costs and ensure sustainability. Key findings: The drones ensure deliveries of lifesaving commodities in the Grand Sud of Madagascar. In 2023, 297 deliveries in commodities in forty hard-to-reach health facilities have been carried out. Drone technology reduced delivery times from the usual 3 - 7 days necessary by road or boat to only a few hours. Program Implications: The use of innovative drone technology demonstrated to be successful in the Madagascar context to reduce dramatically the distribution time of commodities in hard-to-reach health facilities and avoid stockouts of life-saving medicines. When the intervention reaches full scale with the completion of the second phase and the extension in the Sud-Est, 150 hard-to-reach facilities will receive drone deliveries, avoiding stockouts and improving the quality of maternal health and family planning services offered to 1,4 million people in targeted areas.

Keywords: commodities, drones, last-mile distribution, lifesaving supplies

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Authors: Marie C. Ryan

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The current paper seeks to reconsider differentiation in order to establish whether differentiation has succeeded in its benevolent aim to support individual needs through teaching adaptations or whether paradoxically our attention to differentiation has served to exclude and marginalise. This paper does not deny variation in learner needs and accepts that inclusion requires teachers to adapt and modify curricular content; rather it seeks to examine whether differentiation as it is conceptualised and implemented is fit for purpose when it comes to adapting teaching in view of learner differences. The paper will also explore an alternative approach to supporting learner differences through teaching modifications which may offer a safer path to an inclusive educational reality.

Keywords: inclusion, differentiation, special education, universal design for learning

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Authors: Lise Retat, Maria Carmen Huerta, Laura Webber, Franco Sassi

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Background: Intra-generational social mobility (ISM) can be defined as the extent to which individuals change their socio-economic position over a period of time or during their entire life course. The relationship between poor health and ISM is established. Therefore, quantifying the impact that potential health policies have on ISM now and into the future would provide evidence for how social inequality could be reduced. This paper takes the condition of overweight and obesity as an example and estimates the mean earning change per individual if the UK were to introduce policies to effectively reduce overweight and obesity. Methods: The HealthLumen individual-based model was used to estimate the impact of obesity on social mobility measures, such as earnings, occupation, and wealth. The HL tool models each individual's probability of experiencing downward ISM as a result of their overweight and obesity status. For example, one outcome of interest was the cumulative mean earning per person of implementing a policy which would reduce adult overweight and obesity by 1% each year between 2020 and 2030 in the UK. Results: Preliminary analysis showed that by reducing adult overweight and obesity by 1% each year between 2020 and 2030, the cumulative additional mean earnings would be ~1,000 Euro per adult by 2030. Additional analysis will include other social mobility indicators. Conclusions: These projections are important for illustrating the role of health in social mobility and for providing evidence for how health policy can make a difference to social mobility outcomes and, in turn, help to reduce inequality.

Keywords: modelling, social mobility, obesity, health

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Authors: Candy Chieh Lee

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Objective: The purpose of this study is to investigate the relationship between visual perception and social function in patients with schizophrenia. The specific aims are: 1) To explore performances in visual perception and social function in patients with schizophrenia 2) to examine the correlation between visual perceptual skills and social function in patients with schizophrenia The long-term goal is to be able to provide the most adequate intervention program for promoting patients’ visual perceptual skills and social function, as well as compensatory techniques. Background: Perceptual deficits in schizophrenia have been well documented in the visual system. Clinically, a considerable portion (up to 60%) of schizophrenia patients report distorted visual experiences such as visual perception of motion, color, size, and facial expression. Visual perception is required for the successful performance of most activities of daily living, such as dressing, making a cup of tea, driving a car and reading. On the other hand, patients with schizophrenia usually exhibit psychotic symptoms such as auditory hallucination and delusions which tend to alter their perception of reality and affect their quality of interpersonal relationship and limit their participation in various social situations. Social function plays an important role in the prognosis of patients with schizophrenia; lower social functioning skills can lead to poorer prognosis. Investigations on the relationship between social functioning and perceptual ability in patients with schizophrenia are relatively new but important as the results could provide information for effective intervention on visual perception and social functioning in patients with schizophrenia. Methods: We recruited 50 participants with schizophrenia in the mental health hospital (Taipei City Hospital, Songde branch, Taipei, Taiwan) acute ward. Participants who have signed consent forms, diagnosis of schizophrenia and having no organic vision deficits were included. Participants were administered the test of visual-perceptual skills (non-motor), third edition (TVPS-3) and the personal and social performance scale (PSP) for assessing visual perceptual skill and social function. The assessments will take about 70-90 minutes to complete. Data Analysis: The IBM SPSS 21.0 will be used to perform the statistical analysis. First, descriptive statistics will be performed to describe the characteristics and performance of the participants. Lastly, Pearson correlation will be computed to examine the correlation between PSP and TVPS-3 scores. Results: Significant differences were found between the means of participants’ TVPS-3 raw scores of each subtest with the age equivalent raw score provided by the TVPS-3 manual. Significant correlations were found between all 7 subtests of TVPS-3 and PSP total score. Conclusions: The results showed that patients with schizophrenia do exhibit visual perceptual deficits and is correlated social functions. Understanding these facts of patients with schizophrenia can assist health care professionals in designing and implementing adequate rehabilitative treatment according to patients’ needs.

Keywords: occupational therapy, social function, schizophrenia, visual perception

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Authors: F. Argurio, F. G. Vaccaro

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In a global environment defined by ever-increasing health issues, in spite of the progress made by modern medicine, this paper seeks to readdress the question of global health in an international relations perspective. The research hypothesis is: the lower the security environment, the higher the spread of communicable diseases. This question will be channeled by re-scaling the connotation of 'global' and 'international' dimension through the theoretical lens of glocalization, a theory by Bauman that starts its analysis from simple systems to get to the most complex ones. Glocalization theory will be operationalized by analyzing health in an armed-conflict context. In this respect, the independent variable 'low security environment' translates into the cases of Syria and Yemen, which provide a clear example of the all-encompassing nature of conflict on national health and the effects on regional development. In fact, Syria and Yemen have been affected by poliomyelitis and cholera outbreaks respectively. The dependent variable will be constructed on said communicable diseases which belong to the families of sanitation-related and vaccine-preventable diseases. The research will be both qualitative and quantitative, based on primary (interviews) and secondary (WHO and other NGO’s reports) sources. The methodology is based on the assessment of the vaccine coverage and case-analysis in time and space using epidemiological data. Moreover, local health facilities’ functioning and efficiency will be studied. The article posits that the intervention and cooperation of international organizations with the local authorities becomes crucial to provide the local populations with their primary health needs. In Yemen, the majority of fatal cholera cases were in the regions controlled by the Houthi rebels, not officially accredited by the International Community. Similarly, the polio outbreak in Syria primarily affected the areas not controlled by the Syrian Arab Republic forces, recognized as the leading interlocutor by the WHO. The jeopardized possibilities to access these countries have been pivotal to the determining the problem in controlling sanitation-related and vaccine preventable diseases. This represents a potential threat to global health.

Keywords: health in conflict-affected areas, cholera, polio, Yemen, Syria, glocalization

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Authors: Michiko Miyamoto

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The market for "functional foods" and "foods with functional claims" that are effective in maintaining and improving health, has expanded year by year due to the entry of major food and beverage manufacturers following the introduction of the specified health food system in 1991 in Japan. To bring health claims related products or services to the market, it is necessary to let consumers to learn about these products or services; an effective marketing through advertising are important. This research proposes a framework for an effective advertisement medium for the food supplement industry by using survey data of 2,500 people.

Keywords: functional foods, dietary supplements, marketing strategy, structural equation modeling

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Authors: Celal Kocatepe, Eyup Taslak, Celal Fadil Kumru, Oktay Arikan

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While choosing insulating oil, characteristic features such as thermal cooling, endurance, efficiency and being environment-friendly should be considered. Mineral oils are referred as petroleum-based oil. In this study, vegetable oils investigated as an alternative insulating liquid to mineral oil. Dissipation factor, breakdown voltage, relative dielectric constant and resistivity changes with the frequency and voltage of mineral, rapeseed and nut oils were measured. Experimental studies were performed according to ASTM D924 and IEC 60156 standards.

Keywords: breakdown voltage, dielectric dissipation factor, mineral oil, vegetable oils

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Authors: Jo Anne Rey

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Caring for Country (Ngurrain Dharug language) is core to Aboriginal identity, Law/Lore, practice, and resilience within the continent called ‘Australia’. It is the basis of thousands of years of sustainability. However, when Ngurra is a city known as Sydney, due to 235 years of colonial impact, caring for the Country is limited, being controlled by the State and private ownership of the land title. Recent research indicates that localised Indigenous activism is most successful when community members are geographically proximate to the presences and places of connection, caring, and belonging. This article frames these findings through the cadence that proximity provides. This presentation is centred on the proximate agency that is being exercised by Dharug community through three significant sites within the Sydney basin. Those sites include, firstly, Shaw’s Creek Aboriginal Place, at the foot of the Blue Mountains in far western Sydney. Second inclusion is the site of Blacktown Native Institution, that was the part of the authoritarian colonial governance of British Governor Lachlan Macquarie (after who Macquarie University is named), which saw the beginnings of the removal of children from their families and culture to ‘civilize’ them. The third site is that of the so-called Brown’s Waterhole in the State government administered Lane Cove National Park. Each of these sites is being activated through Dharug and, more broadly, Aboriginalways of knowing, doing, and being. These ways involvethe land, water, wind, and star-based ecologies interwoven with traditional transgenerational storying of the presences (Ancestral and spiritual) creating them. Activations include, but are not limited to, the return of cultural fire for reviving plants, soils, animals, and birds. These fire practices have traditionally been at the basis of sustainable, regenerative biodiversity. These practices involve the literacy of reading Ngurra and the seasonal interactions across the ecologies. Together, they both care for the Country and support humanity, and have done so across thousands of years. However, when the cost of real-estate and rental accommodation prevents community members from being able to live on Dharug Ngurra when bureaucratic governance restricts and/or excludes traditional custodial relationships, and when private treaty land title destroys the presences and places while disconnecting people from their Ancestral practices, it becomes clear that caring for Country is only possible when the community can afford to live nearby. Recognising the cadence of proximityas the agency that underpinscaring for Country-in-the-city, sustainable change opportunities don’t have to only focus on regional and remote areas. Urban-based Aboriginal relationality offers an alternative to the unsustainable practices that underpin human-centric disconnection. Weaving Indigenous cadence offers opportunities for sustainable futures even when facing the extremes of climate changing catastrophes.

Keywords: australian aboriginal, biocultural knowledges, climate change, dharug ngurra, sustainability, resilience

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Authors: Maria Ledinskaya

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This paper examines the Morris Collection Conservation Project at the Sainsbury Centre for Visual Arts in the context of Agile, Lean, and Hybrid project management. It is part case study and part literature review. To date, relatively little has been written about non-traditional project management approaches in heritage conservation. This paper seeks to introduce Agile, Lean, and Hybrid project management concepts from business, software development, and manufacturing fields to museum conservation, by referencing their practical application on a recent museum-based conservation project. The Morris Collection Conservation Project was carried out in 2019-2021 in Norwich, UK, and concerned the remedial conservation of around 150 Abstract Constructivist artworks bequeathed to the Sainsbury Centre for Visual Arts by private collectors Michael and Joyce Morris. The first part introduces the chronological timeline and key elements of the project. It describes a medium-size conservation project of moderate complexity, which was planned and delivered in an environment with multiple known unknowns – unresearched collection, unknown condition and materials, unconfirmed budget. The project was also impacted by the unknown unknowns of the COVID-19 pandemic, such as indeterminate lockdowns, and the need to accommodate social distancing and remote communications. The author, a staff conservator at the Sainsbury Centre who acted as project manager on the Morris Collection Conservation Project, presents an incremental, iterative, and value-based approach to managing a conservation project in an uncertain environment. Subsequent sections examine the project from the point of view of Traditional, Agile, Lean, and Hybrid project management. The author argues that most academic writing on project management in conservation has focussed on a Traditional plan-driven approach – also known as Waterfall project management – which has significant drawbacks in today’s museum environment, due to its over-reliance on prediction-based planning and its low tolerance to change. In the last 20 years, alternative Agile, Lean and Hybrid approaches to project management have been widely adopted in software development, manufacturing, and other industries, although their recognition in the museum sector has been slow. Using examples from the Morris Collection Conservation Project, the author introduces key principles and tools of Agile, Lean, and Hybrid project management and presents a series of arguments on the effectiveness of these alternative methodologies in museum conservation, as well as the ethical and practical challenges to their implementation. These project management approaches are discussed in the context of consequentialist, relativist, and utilitarian developments in contemporary conservation ethics, particularly with respect to change management, bespoke ethics, shared decision-making, and value-based cost-benefit conservation strategy. The author concludes that the Morris Collection Conservation Project had multiple Agile and Lean features which were instrumental to the successful delivery of the project. These key features are identified as distributed decision making, a co-located cross-disciplinary team, servant leadership, focus on value-added work, flexible planning done in shorter sprint cycles, light documentation, and emphasis on reducing procedural, financial, and logistical waste. Overall, the author’s findings point largely in favour of a Hybrid model which combines traditional and alternative project processes and tools to suit the specific needs of the project.

Keywords: project management, conservation, waterfall, agile, lean, hybrid

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Authors: Narayanakumar Somasundaram, Venkat Nihit Chirivella, Venkata Dilip Kumar Pasupuleti

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Ajakool, India, has a multi-span bridge that is constructed for rail transport with a maximum operating speed of 100 km/hr. It is a standard RDSO design of a PSC box girder carrying a single railway track. The Structural Health Monitoring System (SHM) is designed and installed to compare and analyze the vibrations and displacements on the bridge due to different live loads from moving trains. The study is conducted for three different spans of the same bridge to understand the health of the elastomeric bearings. Also, to validate the same, a three-dimensional finite element model is developed, and modal analysis is carried out. The proposed methodology can help in detecting deteriorated elastomeric bearings using only wireless tri-accelerometer sensors. Detailed analysis and results are presented in terms of mode shapes, accelerations, displacements, and their importance to each other. This can be implemented with a lot of ease and can be more accurate.

Keywords: dynamic effects, vibration analysis, accelerometer sensors, finite element analysis, structural health monitoring, elastomeric bearing

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Authors: Thiago M. R Dias, Gray F. Moita

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The analysis of scientific collaboration networks has contributed significantly to improving the understanding of how does the process of collaboration between researchers and also to understand how the evolution of scientific production of researchers or research groups occurs. However, the identification of collaborations in large scientific databases is not a trivial task given the high computational cost of the methods commonly used. This paper proposes a method for identifying collaboration in large data base of curriculum researchers. The proposed method has low computational cost with satisfactory results, proving to be an interesting alternative for the modeling and characterization of large scientific collaboration networks.

Keywords: extraction, data integration, information retrieval, scientific collaboration

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Authors: Victor Kang, Sirene Bellahnid, Amy Al-Simaani

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Efficient documentation and completion of clerical tasks are pillars of efficient patient-centered care in acute settings such as the emergency department (ED). Medical scribes aid physicians with documentation, navigation of electronic health records, results gathering, and communication coordination with other healthcare teams. However, the use of medical scribes is not widespread, with some hospitals even continuing to discontinue their programs. One reason for this could be the lack of studies that have outlined concrete improvements in efficiency and patient and provider satisfaction in emergency departments before and after incorporating scribes. Methods: We conducted a review of the literature concerning the implementation of a medical scribe program and emergency department performance. For this review, a narrative synthesis accompanied by textual commentaries was chosen to present the selected papers. PubMed was searched exclusively. Initially, no date limits were set, but seeing as the electronic medical record was officially implemented in Canada in 2013, studies published after this date were preferred as they provided insight into the interplay between its implementation and scribes on quality improvement. Results: Throughput, efficiency, and cost-effectiveness were the most commonly used parameters in evaluating scribes in the Emergency Department. Important throughput metrics, specifically door-to-doctor and disposition time, were significantly decreased in emergency departments that utilized scribes. Of note, this was shown to be the case in community hospitals, where the burden of documentation and clerical tasks would fall directly upon the attending physician. Academic centers differ in that they rely heavily on residents and students; so the implementation of scribes has been shown to have limited effect on these metrics. However, unique to academic centers was the provider’s perception of incrased time for teaching was unique to academic centers. Consequently, providers express increased work satisfaction in relation to time spent with patients and in teaching. Patients, on the other hand, did not demonstrate a decrease in satisfaction in regards to the care that was provided, but there was no significant increase observed either. Of the studies we reviewed, one of the biggest limitations was the lack of significance in the data. While many individual studies reported that medical scribes in emergency rooms improved relative value units, patient satisfaction, provider satisfaction, and increased number of patients seen, there was no statistically significant improvement in the above criteria when compiled in a systematic review. There is also a clear publication bias; very few studies with negative results were published. To prove significance, data from more emergency rooms with scribe programs would need to be compiled which also includes emergency rooms who did not report noticeable benefits. Furthermore, most data sets focused only on scribes in academic centers. Conclusion: Ultimately, the literature suggests that while emergency room physicians who have access to medical scribes report higher satisfaction due to lower clerical burdens and can see more patients per shift, there is still variability in terms of patient and provider satisfaction. Whether or not this variability exists due to differences in training (in-house trainees versus contractors), population profile (adult versus pediatric), setting (academic versus community), or which shifts scribe work cannot be determined based on the studies that exist. Ultimately, more scribe programs need to be evaluated to determine whether these variables affect outcomes and prove whether scribes significantly improve emergency room efficiency.

Keywords: emergency medicine, medical scribe, scribe, documentation

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