Search results for: medical decision support

Authors: Stefan Ninković

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The main purpose of this paper is to examine the different theoretical approaches and relevant empirical evidence and thus, recognize some of the most pressing challenges faced by school leaders. This paper starts from the fact that the new mission of the school is characterized by the need for stronger coordination among students' academic, social and emotional learning. In this sense, school leaders need to focus their commitment, vision and leadership on the issues of students' attitudes, language, cultural and social background, and sexual orientation. More specifically, they should know what a good teaching is for student’s at-risk, students whose first language is not dominant in school, those who’s learning styles are not in accordance with usual teaching styles, or who are stigmatized. There is a rather wide consensus around the fact that the traditionally popular concept of instructional leadership of the school principal is no longer sufficient. However, in a number of "pro-leadership" circles, including certain groups of academic researchers, consultants and practitioners, there is an established tendency of attributing school principal an extraordinary influence towards school achievements. On the other hand, the situation in which all employees in the school are leaders is a utopia par excellence. Although leadership obviously can be efficiently distributed across the school, there are few findings that speak about sources of this distribution and factors making it sustainable. Another idea that is not particularly new, but has only recently gained in importance is related to the fact that the collective capacity of the school is an important resource that often remains under-cultivated. To understand the nature and power of collaborative school cultures, it is necessary to know that these operate in a way that they make their all collective members' tacit knowledge explicit. In this sense, the question is how leaders in schools can shape collaborative culture and create social capital in the school. Pressure exerted on schools to systematically collect and use the data has been accompanied by the need for school leaders to develop new competencies. The role of school leaders is critical in the process of assessing what data are needed and for what purpose. Different types of data are important: test results, data on student’s absenteeism, satisfaction with school, teacher motivation, etc. One of the most important tasks of school leaders are data-driven decision making as well as ensuring transparency of the decision-making process. Finally, the question arises whether the existing models of school leadership are compatible with the current social and economic trends. It is necessary to examine whether and under what conditions schools are in need for forms of leadership that are different from those that currently prevail. Closely related to this issue is also to analyze the adequacy of different approaches to leadership development in the school.

Keywords: educational changes, leaders, leadership, school

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Authors: Fernanda M. Assef, Maria Teresinha A. Steiner

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The aim of this paper is to compare and discuss better classifier algorithm options for credit risk assessment by applying different Machine Learning techniques. Using records from a Brazilian financial institution, this study uses a database of 5,432 companies that are clients of the bank, where 2,600 clients are classified as non-defaulters, 1,551 are classified as defaulters and 1,281 are temporarily defaulters, meaning that the clients are overdue on their payments for up 180 days. For each case, a total of 15 attributes was considered for a one-against-all assessment using four different techniques: Artificial Neural Networks Multilayer Perceptron (ANN-MLP), Artificial Neural Networks Radial Basis Functions (ANN-RBF), Logistic Regression (LR) and finally Support Vector Machines (SVM). For each method, different parameters were analyzed in order to obtain different results when the best of each technique was compared. Initially the data were coded in thermometer code (numerical attributes) or dummy coding (for nominal attributes). The methods were then evaluated for each parameter and the best result of each technique was compared in terms of accuracy, false positives, false negatives, true positives and true negatives. This comparison showed that the best method, in terms of accuracy, was ANN-RBF (79.20% for non-defaulter classification, 97.74% for defaulters and 75.37% for the temporarily defaulter classification). However, the best accuracy does not always represent the best technique. For instance, on the classification of temporarily defaulters, this technique, in terms of false positives, was surpassed by SVM, which had the lowest rate (0.07%) of false positive classifications. All these intrinsic details are discussed considering the results found, and an overview of what was presented is shown in the conclusion of this study.

Keywords: artificial neural networks (ANNs), classifier algorithms, credit risk assessment, logistic regression, machine Learning, support vector machines

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Authors: Belkis L. Cabrera

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Contemporary technological innovations have reshaped possibility, interaction, communication, engagement, education, and training. Indeed, today, a high-quality technology enhanced learning experience can be transformative as much for the learner as for the educator-trainer. As innovative technologies continue to facilitate, support, foster, and enhance collaboration, problem-solving, creativity, adaptiveness, multidisciplinarity, and communication, the field of instructional design (ID) also continues to develop and expand. Shifting its focus from media to the systematic design of instruction, or rather from the gadgets and devices themselves to the theories, models, and impact of implementing educational technology, the evolution of ID marks a restructuring of the teaching, learning, and training paradigms. However, with all of its promise, this latter component of ID remains underdeveloped. The majority of ID models are crafted and guided by learning theories and, therefore, most models are constructed around student and educator roles rather than trainer roles. Thus, when these models or systems are employed for training purposes, they usually have to be re-fitted, tweaked, and stretched to meet the training needs. This paper is concerned with the training or professional development (PD) facet of instructional design and how ID models built on teacher-to-teacher interaction and dialogue can support the creation of professional learning communities (PLCs) or communities of practice (CoPs), which can augment learning and PD experiences for all. Just as technology is changing the face of education, so too can it change the face of PD within the educational realm. This paper not only provides a new ID model but using innovative technologies such as Padlet and Thinkbinder, this paper presents a concrete example of how a traditional body-to-body, brick, and mortar learning community can be transferred and transformed into the online context.

Keywords: communities of practice, e-learning, educational reform, instructional design, professional development, professional learning communities, technology, training

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Authors: Yasser R. Shaban

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A practical multipurpose device for medical isotopes production is most wanted for clinical centers and researches. Unfortunately, the major supply of these radioisotopes currently comes from aging sources, and there is a great deal of uneasiness in the domestic market. There are also many cases where the cost of certain radioisotopes is too high for their introduction on a commercial scale even though the isotopes might have great benefits for society. The medical isotopes such as radiotracers PET (Positron Emission Tomography), Technetium-99 m, and Iodine-131, Lutetium-177 by is feasible to be generated by a single unit named IEMC (Inertial Electrostatic Magnetic Confinement). The IEMC fusion vessel is the upgrading unit of the Inertial Electrostatic Confinement IEC fusion vessel. Comprehensive experimental works on IEC were carried earlier with promising results. The principle of inertial electrostatic magnetic confinement IEMC fusion is based on forcing the binary fuel ions to interact in the opposite directions in ions cyclotrons orbits with different kinetic energies in order to have equal compression (forces) and with different ion cyclotron frequency ω in order to increase the rate of intersection. The IEMC features greater fusion volume than IEC by several orders of magnitude. The particles rate from the IEMC approach are projected to be 8.5 x 10¹¹ (p/s), ~ 0.2 microampere proton, for D/He-3 fusion reaction and 4.2 x 10¹² (n/s) for D/T fusion reaction. The projected values of particles yield (neutrons and protons) are suitable for medical isotope productions on-site by a single unit without any change in the fusion vessel but only the fuel gas. The PET radiotracers are usually produced on-site by medical ion accelerator whereas Technetium-99m (Tc-99m) is usually produced off-site from the irradiation facilities of nuclear power plants. Typically, hospitals receive molybdenum-99 isotope container; the isotope decays to Tc-99mwith half-life time 2.75 days. Even though the projected current from IEMC is lesser than the proton current from the medical ion accelerator but still the IEMC vessel is simpler, and reduced in components and power consumption which add a new value of populating the PET radiotracers in most clinical centers. On the other hand, the projected neutrons flux from the IEMC is lesser than the thermal neutron flux at the irradiation facilities of nuclear power plants, but in the IEMC case the productions of Technetium-99m is suggested to be at the resonance region of which the resonance integral cross section is two orders of magnitude higher than the thermal flux. Thus it can be said the net activity from both is evened. Besides, the particle accelerator cannot be considered a multipurpose particles production unless a significant change is made to the accelerator to change from neutrons mode to protons mode or vice versa. In conclusion, the projected fusion yield from IEMC is a straightforward since slightly change in the primer IEC and ion source is required.

Keywords: electrostatic versus magnetic confinement fusion vessel, ion source, medical isotopes productions, neutron activation

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Authors: John Zanetich

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Due to their positive associations with student learning and retention, certain undergraduate opportunities are designated ‘high-impact.’ High-Impact Practices (HIPs) such as, learning communities, community based projects, research, internships, study abroad and culminating senior experience, share several traits bin common: they demand considerable time and effort, learning occurs outside of the classroom, and they require meaningful interactions between faculty and students, they encourage collaboration with diverse others, and they provide frequent and substantive feedback. As a result of experiential learning in these practices, participation in these practices can be life changing. High impact learning helps individuals locate tacit knowledge, and build mental models that support the accumulation of knowledge. On-going learning from experience and knowledge conversion provides the individual with a way to implicitly organize knowledge and share knowledge over a lifetime. Knowledge conversion is a knowledge management component which focuses on the explication of the tacit knowledge that exists in the minds of students and that knowledge which is embedded in the process and relationships of the classroom educational experience. Knowledge conversion is required when working with tacit knowledge and the demand for a learner to align deeply held beliefs with the cognitive dissonance created by new information. Knowledge conversion and tacit knowledge result from the fact that an individual's way of knowing, that is, their core belief structure, is considered generalized and tacit instead of explicit and specific. As a phenomenon, tacit knowledge is not readily available to the learner for explicit description unless evoked by an external source. The development of knowledge–related capabilities such as Aggressive Development of Tacit Knowledge (ADTK) can be used in experiential educational programs to enhance knowledge, foster behavioral change, improve decision making, and overall performance. ADTK allows the student in HIPs to use their existing knowledge in a way that allows them to evaluate and make any necessary modifications to their core construct of reality in order to amalgamate new information. Based on the Lewin/Schein Change Theory, the learner will reach for tacit knowledge as a stabilizing mechanism when they are challenged by new information that puts them slightly off balance. As in word association drills, the important concept is the first thought. The reactionary outpouring to an experience is the programmed or tacit memory and knowledge of their core belief structure. ADTK is a way to help teachers design their own methods and activities to unfreeze, create new learning, and then refreeze the core constructs upon which future learning in a subject area is built. This paper will explore the use of ADTK as a technique for knowledge conversion in the classroom in general and in HIP programs specifically. It will focus on knowledge conversion in curriculum development and propose the use of one-time educational experiences, multi-session experiences and sequential program experiences focusing on tacit knowledge in educational programs.

Keywords: tacit knowledge, knowledge management, college programs, experiential learning

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Authors: Magdalena Biela, Marta Weber-Siwirska, Edyta Sierka

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The current noticed trend in Central European countries, as in other regions of the world, is for people to migrate to cities. As a result, the urban population is to have reached 70% of the total by 2050. Due to this tendency, as well as taking high real estate prices and limited reserves of city green areas into consideration, the greenery and agricultural soil adjacent to cities is are to be devoted to housing projects, while city centres are expected to undergo partial depopulation. Urban heat islands and phenomena such as torrential rains may cause serious damage. They may even endanger the very life and health of the inhabitants. Due to these tangible effects of climate change, residents expect that local government takes action to develop green infrastructure (GI). The main purpose of our research has been to assess the degree of readiness on the part of the local government in Poland to develop BGI. A questionnaire using the CAWI method was prepared, and a survey was carried out. The target group were town hall employees in all 380 powiat cities and towns (380 county centres) in Poland. The form contained 14 questions covering, among others, actions taken to support the development of GI and ways of motivating residents to take such actions. 224 respondents replied to the questions. The results of the research show that 52% of the cities/towns have taken or intend to take measures to favour the development of green spaces. Currently, the installation of green roofs and living walls is are only carried out by 6 Polish cities, and a few more are at the stage of preparing appropriate regulations. The problem of rainwater retention is much more widespread. Among the municipalities declaring any activities for the benefit of GI, approximately 42% have decided to work on this problem. Over 19% of the respondents are planning an increase in the surface occupied by green areas, 14% - the installation of green roofs, and 12% - redevelopment of city greenery. It is optimistic that 67% of the respondents are willing to acquire knowledge about BGI by means of taking part in educational activities both at the national and international levels. There are many ways to help GI development. The most common type of support in the cities and towns surveyed is co-financing (35%), followed by full financing of projects (11%). About 15% of the cities declare only advisory support. Thus, the problem of GI in Central European cities is at the stage of initial development and requires advanced measures and implementation of both proven solutions applied in other European and world countries using the concept of Nature-based Solutions.

Keywords: city/town, blue-green infrastructure, green roofs, climate change adaptation

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Authors: Berfu Guley Goren, Ayse Lale Berkoz

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The aim of the study is to analyze the concept of universal design and accessibility to make the city which allows equality and independence for individuals. In the content of the study, literature researches and observations of samples in Istanbul, Turkey are analyzed. As a result proposals are going to be developed to create the cities which are designed for everyone. In globalization process, in cities, population have been increasing dramatically with social and economic activities. Medical developments have been effective in prolonging human life and the disability that comes with aging has also increased in parallel with the disabled population. Nowadays disability is an important phenomenon. Because approximately 1 billion people live with disabilities. The heterogeneous structure formed by the rapid gathering of individuals with different social, economic and physical characteristics in the cities creates great spatial diversity and richness in the cities with different needs brought together. Unlike the cultural and physical wealth in these places and the potential to integrate and diversify the urban people, unfortunately, the designs in practice cause the urban areas to break apart, the urbanities to tear themselves apart, to interfere with their communication and interactions. The social and physical structure of the city is important to feel belonging to the urban society. In most cities when an observation is made, obstructions for people with disabilities can be seen in urban physical structure and design. With these obstructions, people with disabilities cannot live in urban space, and they are desolated in urban life. The city, which offers equal opportunity, the relation between economic development, social justice and built environment must be planned synchronous. Isolation and stigmatization must be abolished by regulations, activities of awareness and universal urban design. Without regard to social, economical and physical features every individual has the same right, which is using the freedom of movement. Supporting freedom of movement of every individual may be ensured by universal design and its principles. So urban spaces are going to be for every individual. For equal opportunity in urban services, urban design must be the focus on every individual including people with disabilities. In built environment practices, democratic suitable spaces should be created. In this respect, urban planners, architects, political decision-makers and other relevant actors should work together and should think very versatile.

Keywords: disability, equality, universal design, urban design

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Authors: Julia Ive, Lucia Specia

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Understanding and detecting toxicity is an important problem to support safer human interactions online. Our work focuses on the important problem of contextual toxicity detection, where automated classifiers are tasked with determining whether a short textual segment (usually a sentence) is toxic within its conversational context. We use “toxicity” as an umbrella term to denote a number of variants commonly named in the literature, including hate, abuse, offence, among others. Detecting toxicity in context is a non-trivial problem and has been addressed by very few previous studies. These previous studies have analysed the influence of conversational context in human perception of toxicity in controlled experiments and concluded that humans rarely change their judgements in the presence of context. They have also evaluated contextual detection models based on state-of-the-art Deep Learning and Natural Language Processing (NLP) techniques. Counterintuitively, they reached the general conclusion that computational models tend to suffer performance degradation in the presence of context. We challenge these empirical observations by devising better contextual predictive models that also rely on NLP data augmentation techniques to create larger and better data. In our study, we start by further analysing the human perception of toxicity in conversational data (i.e., tweets), in the absence versus presence of context, in this case, previous tweets in the same conversational thread. We observed that the conclusions of previous work on human perception are mainly due to data issues: The contextual data available does not provide sufficient evidence that context is indeed important (even for humans). The data problem is common in current toxicity datasets: cases labelled as toxic are either obviously toxic (i.e., overt toxicity with swear, racist, etc. words), and thus context does is not needed for a decision, or are ambiguous, vague or unclear even in the presence of context; in addition, the data contains labeling inconsistencies. To address this problem, we propose to automatically generate contextual samples where toxicity is not obvious (i.e., covert cases) without context or where different contexts can lead to different toxicity judgements for the same tweet. We generate toxic and non-toxic utterances conditioned on the context or on target tweets using a range of techniques for controlled text generation(e.g., Generative Adversarial Networks and steering techniques). On the contextual detection models, we posit that their poor performance is due to limitations on both of the data they are trained on (same problems stated above) and the architectures they use, which are not able to leverage context in effective ways. To improve on that, we propose text classification architectures that take the hierarchy of conversational utterances into account. In experiments benchmarking ours against previous models on existing and automatically generated data, we show that both data and architectural choices are very important. Our model achieves substantial performance improvements as compared to the baselines that are non-contextual or contextual but agnostic of the conversation structure.

Keywords: contextual toxicity detection, data augmentation, hierarchical text classification models, natural language processing

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Authors: Arman Kishan, Mark Haft, Kiyanna Thomas, Duc Nguyen, Dawn Laporte

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Objective: Patients receiving anticoagulation therapy frequently experience increased rates of postoperative complications. Presently, limited data exist regarding the outcomes of patients undergoing carpal tunnel release surgery (CTR) while on anticoagulation. Our objective is to examine and compare the occurrence of complications in patients on anticoagulation who underwent either endoscopic CTR (ECTR) or open CTR (OCTR) for CTS. Methods: The Trinet X database was utilized to retrospectively identify patients who underwent OCTR or ECTR while concurrently on anticoagulation. Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complications, including wound infection within 90 days, wound dehiscence within 90 days, and intraoperative median nerve injury between the two surgical methods in patients on anticoagulation. Results: A total of 10,919 carpal tunnel syndrome patients on anticoagulation were included in the study, with 9082 and 1837 undergoing OCTR and ECTR, respectively. Among patients on anticoagulation, those undergoing ECTR exhibited a significantly lower occurrence of 90-day wound infection (p < 0.001) and nerve injury (p < 0.001) compared to those who underwent OCTR. However, there was no statistically significant difference in the risk of 90-day wound dehiscence between the two groups (p = 0.323). Conclusion:  In prior studies, ECTR demonstrated reduced rates of postoperative complications compared to OCTR in the general population. Our study demonstrates that among patients on anticoagulation, those undergoing ECTR experienced a significantly lower incidence of 90-day wound infection and nerve injury, with risk reductions of 35% and 40%, respectively. These findings support using ECTR as a preferred surgical method for patients with CTS who are on anticoagulation therapy.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, postoperative complications in patients on anticoagulation, carpal tunnel syndrome

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Authors: Pawel Albrycht, Monika Ksiezopolska-Gocalska, Robert Holyst

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Surface Enhanced Raman Spectroscopy (SERS) is a technique of growing importance not only in purely scientific research related to analytical chemistry. It finds more and more applications in broadly understood testing - medical, forensic, pharmaceutical, food - and everywhere works perfectly, on one condition that SERS substrates used for testing give adequate enhancement, repeatability, and homogeneity of SERS signal. This is a problem that has existed since the invention of this technique. Some laboratories use as SERS amplifiers colloids with silver or gold nanoparticles, others form rough silver or gold surfaces, but results are generally either weak or unrepeatable. Furthermore, these structures are very often highly specific - they amplify the signal only of a small group of compounds. It means that they work with some kinds of analytes but only with those which were used at a developer’s laboratory. When it comes to research on different compounds, completely new SERS 'substrates' are required. That underlay our decision to develop universal substrates for the SERS spectroscopy. Generally, each compound has different affinity for both silver and gold, which have the best SERS properties, and that's what depends on what signal we get in the SERS spectrum. Our task was to create the platform that gives a characteristic 'fingerprint' of the largest number of compounds with very high repeatability - even at the expense of the intensity of the enhancement factor (EF) (possibility to repeat research results is of the uttermost importance). As specified above SERS substrates are offered by SERSitive company. Applied method is based on cyclic potentiodynamic electrodeposition of silver or silver-gold nanoparticles on the conductive surface of ITO-coated glass at controlled temperature of the reaction solution. Silver nanoparticles are supplied in the form of silver nitrate (AgNO₃, 10 mM), gold nanoparticles are derived from tetrachloroauric acid (10 mM) while sodium sulfite (Na₂O₃, 5 mM) is used as a reductor. To limit and standardize the size of the SERS surface on which nanoparticles are deposited, photolithography is used. We secure the desired ITO-coated glass surface, and then etch the unprotected ITO layer which prevents nanoparticles from settling at these sites. On the prepared surface, we carry out the process described above, obtaining SERS surface with nanoparticles of sizes 50-400 nm. The SERSitive platforms present highly sensitivity (EF = 10⁵-10⁶), homogeneity and repeatability (70-80%).

Keywords: electrodeposition, nanoparticles, Raman spectroscopy, SERS, SERSitive, SERS platforms, SERS substrates

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Authors: Atiwit Sinyoo, Sekh Thanprasertsuk, Sithiporn Agthong, Pasakorn Watanatada, Shaun Peter Qureshi, Saknan Bongsebandhu-Phubhakdi

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Background: Since the SARS-CoV-2 virus became extensively disseminated throughout the world, online learning has become one of the most hotly debated topics in educational reform. While some studies have already shown the advantage of online learning, there are still questions concerning how online learning affects students’ learning behavior and academic achievement when each student learns in a different way. Hence, we aimed to develop a guide for preclinical medical students to avoid drawbacks and get benefits from online learning that possibly a double-edged sword. Methods: We used a multiple-choice questionnaire to evaluate the learning behavior of second-year Thai medical students in the neuroscience course. All traditional face-to-face lecture classes were video-recorded and promptly posted to the online learning platform throughout this course. Students could pick and choose whatever classes they wanted to attend, and they may use online learning as often as they wished. Academic performance was evaluated as summative score, spot exam score and pre-post-test improvement. Results: More frequently students used online learning platform, the less they attended lecture classes (P = 0.035). High proactive online learners (High PO) who were irregular attendee (IrA) had significantly lower summative scores (P = 0.026), spot exam score (P = 0.012) and pre-post-test improvement (P = 0.036). In the meanwhile, conditional attendees (CoA) who only attended classes with attendance check had significantly higher summative score (P = 0.025) and spot exam score (P = 0.001) if they were in the High PO group. Conclusions: The benefit and drawbacks edges of using an online learning platform were demonstrated in our research. Based on this double-edged sword effect, we believe that online learning is a valuable learning strategy, but students must carefully plan their study schedule to gain the “benefit edge” meanwhile avoiding its “drawback edge”.

Keywords: academic performance, assessment, attendance, online learning, preclinical medical students

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Authors: Iva Trako, Maris Micaela Sviatschi, Guadalupe Kavanaugh

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Domestic violence is a major concern in developing countries, with important social, economic and health consequences. However, institutions do not usually address the problems facing women or ethnic and religious minorities. For example, the police do very little to stop domestic violence in rural areas of developing countries. This paper exploits the introduction of women’s justice centers (WJCs) in Peru to provide causal estimates on the effects of improving access to justice for women and children. These centers offer a new integrated public service model for women by including medical, psychological and legal support in cases of violence against women. Our empirical approach uses a difference in difference estimation exploiting variation over time and space in the opening of WJC together with province-by-year fixed effects. Exploiting administrative data from health providers and district attorney offices, we find that after the opening of these centers, there are important improvements on women's welfare: a large reduction in femicides and female hospitalizations for assault. Moreover, using geo-coded household surveys we find evidence that the existence of these services reduces domestic violence, improves women's health, increases women's threat points and, therefore, lead to household decisions that are more aligned with their interests. Using administrative data on the universe of schools, we find large gains on human capital for their children: affected children are more likely to enroll, attend school and have better grades in national exams, instead of working for the family. In sum, the evidence in this paper shows that providing access to justice for women can be a powerful tool to reduce domestic violence and increase education of children, suggesting a positive inter-generational benefit.

Keywords: access to justice, domestic violence, education, household bargaining

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Authors: Bharti Bhandari, Bharati Mehta, Sabyasachi Sircar

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Medical education is advancing in India, with its advancement newer innovations are being incorporated in teaching and assessment methodology. Our study focusses on a teaching innovation that is more student-centric than teacher-centric and is the need of the day. The teaching innovation was carried out in 1st year MBBS students of our institute. Students were assigned control and test groups. Priming was done for the students in the test group with an open-book MCQ based test in a particular topic before delivering formal didactic lecture on that topic. The control group was not assigned any such exercise. This was followed by formal didactic lecture on the same topic. Thereafter, both groups were assessed on the same topic. The marks were compiled and analysed using appropriate statistical tests. Students were also given questionnaire to elicit their views on the benefits of “self-priming”. The mean marks scored in theory assessment by the test group were statistically higher than the marks scored by the controls. According to students’ feedback, the ‘self-priming “process was interesting, helped in better orientation during class-room lectures and better understanding of the topic. They want it to be repeated for other topics with moderate difficulty level. Better performance of the students in the primed group validates the combination of student-centric priming model and didactic lecture as superior to the conventional, teacher-centric methods alone. If this system is successfully followed, the present teacher-centric pedagogy should increasingly give way to student-centric activities where the teacher is only a facilitator.

Keywords: medical education, open-book test, pedagogy, priming

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Authors: Ng Liang Shen, Ngahzaifa Abdul Ghani

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This research aimed at developing an early warning system for pre-diabetic and diabetics by analyzing simple and easily determinable signs and symptoms of diabetes among the people living in Malaysia using Particle Swarm Optimized Artificial. With the skyrocketing prevalence of Type 2 diabetes in Malaysia, the system can be used to encourage affected people to seek further medical attention to prevent the onset of diabetes or start managing it early enough to avoid the associated complications. The study sought to find out the best predictive variables of Type 2 Diabetes Mellitus, developed a system to diagnose diabetes from the variables using Artificial Neural Networks and tested the system on accuracy to find out the patent generated from diabetes diagnosis result in machine learning algorithms even at primary or advanced stages.

Keywords: diabetes diagnosis, Artificial Neural Networks, artificial intelligence, soft computing, medical diagnosis

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Authors: Noura Al-Ajmi, Mohammed A. Almulla

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With the increased utilization of technology devices around the world, healthcare and medical diagnosis are critical issues that people worry about these days. Doctors are doing their best to avoid any medical errors while diagnosing diseases and prescribing the wrong medication. Subsequently, artificial intelligence applications that can be installed on mobile devices such as rule-based expert systems facilitate the task of assisting doctors in several ways. Due to their many advantages, the usage of expert systems has increased recently in health sciences. This work presents a backward rule-based expert system that can be used for a headache diagnosis and medication recommendation system. The structure of the system consists of three main modules, namely the input unit, the processing unit, and the output unit.

Keywords: headache diagnosis system, prescription recommender system, expert system, backward rule-based system

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Authors: Abdelhalim. N. Mohammed, Mohammed. Y. Esmail

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In the course of recent decades, medical imaging has been dominated by the use of costly film media for review and archival of medical investigation, however due to developments in networks technologies and common acceptance of a standard digital imaging and communication in medicine (DICOM) another approach in light of World Wide Web was produced. Web technologies successfully used in telemedicine applications, the combination of web technologies together with DICOM used to design a web-based and open source DICOM viewer. The Web server allowance to inquiry and recovery of images and the images viewed/manipulated inside a Web browser without need for any preinstalling software. The dynamic site page for medical images visualization and processing created by using JavaScript and HTML5 advancements. The XAMPP ‘apache server’ is used to create a local web server for testing and deployment of the dynamic site. The web-based viewer connected to multiples devices through local area network (LAN) to distribute the images inside healthcare facilities. The system offers a few focal points over ordinary picture archiving and communication systems (PACS): easy to introduce, maintain and independently platforms that allow images to display and manipulated efficiently, the system also user-friendly and easy to integrate with an existing system that have already been making use of web technologies. The wavelet-based image compression technique on which 2-D discrete wavelet transform used to decompose the image then wavelet coefficients are transmitted by entropy encoding after threshold to decrease transmission time, stockpiling cost and capacity. The performance of compression was estimated by using images quality metrics such as mean square error ‘MSE’, peak signal to noise ratio ‘PSNR’ and compression ratio ‘CR’ that achieved (83.86%) when ‘coif3’ wavelet filter is used.

Keywords: DICOM, discrete wavelet transform, PACS, HIS, LAN

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Authors: Nutcha Taneepanichskul, Helen C. Hailes, Mark Miodownik

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Plastic waste has emerged as a critical global environmental challenge, primarily driven by the prevalent use of conventional plastics derived from petrochemical refining and manufacturing processes in modern packaging. While these plastics serve vital functions, their persistence in the environment post-disposal poses significant threats to ecosystems. Addressing this issue necessitates approaches, one of which involves the development of biodegradable plastics designed to degrade under controlled conditions, such as industrial composting facilities. It is imperative to note that compostable plastics are engineered for degradation within specific environments and are not suited for uncontrolled settings, including natural landscapes and aquatic ecosystems. The full benefits of compostable packaging are realized when subjected to industrial composting, preventing environmental contamination and waste stream pollution. Therefore, effective sorting technologies are essential to enhance composting rates for these materials and diminish the risk of contaminating recycling streams. In this study, it leverage hyperspectral imaging technology (HSI) coupled with advanced machine learning algorithms to accurately identify various types of plastics, encompassing conventional variants like Polyethylene terephthalate (PET), Polypropylene (PP), Low density polyethylene (LDPE), High density polyethylene (HDPE) and biodegradable alternatives such as Polybutylene adipate terephthalate (PBAT), Polylactic acid (PLA), and Polyhydroxyalkanoates (PHA). The dataset is partitioned into three subsets: a training dataset comprising uncontaminated conventional and biodegradable plastics, a validation dataset encompassing contaminated plastics of both types, and a testing dataset featuring real-world packaging items in both pristine and contaminated states. Five distinct machine learning algorithms, namely Partial Least Squares Discriminant Analysis (PLS-DA), Support Vector Machine (SVM), Convolutional Neural Network (CNN), Logistic Regression, and Decision Tree Algorithm, were developed and evaluated for their classification performance. Remarkably, the Logistic Regression and CNN model exhibited the most promising outcomes, achieving a perfect accuracy rate of 100% for the training and validation datasets. Notably, the testing dataset yielded an accuracy exceeding 80%. The successful implementation of this sorting technology within recycling and composting facilities holds the potential to significantly elevate recycling and composting rates. As a result, the envisioned circular economy for plastics can be established, thereby offering a viable solution to mitigate plastic pollution.

Keywords: biodegradable plastics, sorting technology, hyperspectral imaging technology, machine learning algorithms

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Authors: Sawarni Hasibuan, Juliza Hidayati

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Competitiveness and sustainability issues not only put pressure on big companies, but also small and medium enterprises (SMEs). SMEs Batik Bogor is one of the local culture-based creative industries in Bogor city which is also dealing with the issue of sustainability. The purpose of this research is to develop framework of sustainability at SMEs Batik Indonesia case of SMEs Batik Bogor by integrating innovation of cleaner production in its supply chain. The approach used is desk study, field survey, in-depth interviews, and benchmarking best practices of SMEs sustainability. In-depth interviews involve stakeholders to identify the needs and standards of sustainability of SMEs Batik. Data analysis was done by benchmarking method, Multi Dimension Scaling (MDS) method, and Strength, Weakness, Opportunity, Threat (SWOT) analysis. The results recommend the framework of sustainability for SMEs Batik in Indonesia. The sustainability status of SMEs Batik Bogor is classified as Moderate Sustainable. Factors that support the sustainability of SMEs Batik Bogor such is a strong commitment of top management in adopting cleaner production innovation and creativity approach. Successful cleaner production innovations are implemented primarily in the substitution of dye materials from toxic to non-toxic, reducing the intensity of non-renewable energy use, as well as the reuse and recycle of solid waste. “Mosaic Batik” is one of the innovations of solid waste utilization of batik waste produced by company R&D center that gives benefit to three pillars of sustainability, that is financial benefit, environmental benefit, and social benefit. The sustainability of SMEs Batik Bogor cannot be separated from the support of Bogor City Government which proactively facilitates the promotion of sustainable innovation produced by SMEs Batik Bogor.

Keywords: cleaner production innovation, creativity, SMEs Batik, sustainability supply chain

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Authors: Raya Kathreen T. Fuentes, Christian Owen P. Domingo, Kaisha V. Durana, Kristine Chelsea Shynne M. Evangelista, Nicole A. Feliciano, Kathleen Patricia Q. Ferido, Christianna Joy J. Ferrer

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Diabetes Mellitus (DM) is a global public health concern. The foot ulcer is one of the most serious and costly complications of DM. Among the components of diabetes self-management (DSM), foot self-care was found to be one of the best preventive measures for foot ulcers yet is seldom performed. Thus, the purpose of this study is to determine how adequate foot self-care practices (FSP) are among Filipino adults with DM with the following objectives: 1) determine their DSM, 2) describe their FSP, 3) determine the relationship between FSP and DSM, and 4) determine the relationship of FSP to sociodemographic characteristics, disease-related characteristics, social support, and knowledge. A descriptive correlational design was utilized. 114 respondents aged 19-65 were selected through purposive sampling from diabetes clinics. A self-administered questionnaire regarding FSP, DSM, sociodemographic and disease-related characteristics, social support, and knowledge on diabetes were used. Pearson's correlation was utilized to determine the relationship between FSP and DSM while simple linear regression was used to determine the relationship of FSP to the factors aforementioned. Results showed that majority of the respondents have desirable DSM but inadequate FSP. FSP and DSM were shown to be positively correlated but not statistically significant (p = 0.8). Disparity among the two suggests that there is less emphasis on foot self-care compared to other components of DSM. Findings further revealed that patients diagnosed with DM for < 5 years demonstrated more adequate FSP compared to patients diagnosed for > 5 years which may suggest that newly diagnosed patients are more receptive to new information about DSM. Health education on DSM should place more emphasis on FSP. Reiteration of health education and continuous motivation should be done to all DM patients, not just to newly diagnosed patients, to improve compliance to FSP and enhance patient empowerment regarding self-care.

Keywords: diabetes mellitus, diabetes self-management, foot self-care practices, foot ulcer

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Authors: Hennie Boeije, Renate Verkaik, Joke Korevaar

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In Dutch national policy, it is promoted that the elderly remain living at home longer. They are less often admitted to a nursing home or only later in life. While living at home, it is important that they experience a good quality of life. Care providers in primary care support this. In this study, it was investigated what quality of life means for the elderly and which characteristics care should have that supports living at home longer with quality of life. To explore this topic, a qualitative methodology was used. Four focus groups were conducted: two with elderly people who live at home and their family caregivers, one with district nurses employed in-home care services and one with elderly care physicians working in primary care. Next to this individual interviews were employed with general practitioners (GPs). In total 32 participants took part in the study. The data were thematically analysed with MaxQDA software for qualitative analysis and reported. Quality of life is a multi-faceted term for elderly. The essence of their description is that they can still undertake activities that matter to them. Good physical health, mental well-being and social connections enable them to do this. Own control over their life is important for some. They are of opinion that how they experience life and manage old age is related to their resilience and coping. Key terms in the definitions of quality of life by GPs are also physical and mental health and social contacts. These are the three pillars. Next, to this elderly care, physicians mention security and safety and district nurses add control over their own life and meaningful daily activities. They agree that with frail elderly people, the balance is delicate and a change in one of the three pillars can cause it to collapse like a house of cards. When discussing what support is needed, professionals agree on access to care with a low threshold, prevention, and life course planning. When care is provided in a timely manner, a worsening of the situation can be prevented. They agree that hospital care often is not needed since most of the problems with the elderly have to do with care and security rather than with a cure per se. GPs can consult elderly care physicians to lower their workload and to bring in specific knowledge. District nurses often signal changes in the situation of the elderly. According to them, the elderly predominantly need someone to watch over them and provide them with a feeling of security. Life course planning and advance care planning can contribute to uniform treatment in line with older adults’ wishes. In conclusion, all stakeholders, including elderly persons, agree on what entails quality of life and the quality of care that is needed to support that. A future challenge is to shape conditions for the right skill mix of professionals, cooperation between the professions and breaking down differences in financing and supply. For the elderly, the challenge is preparing for aging.

Keywords: elderly living at home, quality of life, quality of care, professional cooperation, life course planning, advance care planning

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Authors: Mariana Anaya Villafana

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The sudden change of a significant percentage of the Latino community in the United States elections towards a Republican political orientation was reflected during the 2016 presidential election. This moment represented a radical change that is happening inside the Latino community in the United States, the support they have given to Trump's campaign only demonstrates their support for new anti-immigration regulations and conservative values, which are causing a division of ideologies inside the Latino community. One of the main goals of the following research is to understand the whole phenomenon 'Why would people join their own oppressor?' Align themselves with the politics that prevent many of their relatives to come to the United States and made the assimilation process difficult for their parents. It is important to prove that a change in the identity has happened, through the use of power relations and the attachment to the desired object. A group of Hispanics/Latinos have decided to vote for Trump in order to belong to a society that hasn’t been able to fully include them within it, an action that can result on the non-intentional harm of the values and aims of the rest of the Latino/Hispanic community. In order to understand their new political beliefs, it is necessary to use the method of discourse analysis to comprehend those comments and interviews that are published on web sites such as: 'Latinos for Trump' and 'GOP Hispanic Division'. Among the results that the research has shown, the notion of the 'American Dream' can be considered as a determinant object for the construction of a new identity that is rooted in hard work and legality. One that is proud of the Latino heritage but still wants to maintain the boundaries between legality and illegality in relation to the immigrants. This discourse results on a contradiction to most of the cases because they mention that their families came to the U.S. as immigrants; the only difference is that they work hard to obtain legal citizenship.

Keywords: populism, identity, Latino Community, migration

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Authors: Nathan Reeves

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Aim: The aim of this study was to evaluate if there was an impact on student learning when peer role play was substituted for a professional actor in the role of simulated patient in a simulation-based scenario. Method: Third-year exercise science students enrolled in a field project course in 2015 (n=24), and 2016 (n=20) participated in a simulation-based case scenario designed to develop their client-centred exercise prescription skills. During the simulation, students were provided with feedback from the simulated patients. In 2015, three professional actors played the part of the simulated patient, and in 2016 one of the simulated patients was a student from another exercise science cohort (peer role play). The student learning experience, consistency in case fidelity and feedback provided by the simulated patients was evaluated using a 5-point Likert scale survey and collecting phenomenological data. Results: Improvements to student pre and post confidence remained constant between the 2015 and 2016 cohorts (1.04 and 0.85). The perceived usefulness and enjoyability also remained high across the two cohorts (4.96 and 4.71). The feedback provided by all three simulated patients in 2016 was seen to strongly support student learning experience (4.82), and was of a consistent level (4.47). Significance of the findings to allied health: Simulation-based education is rapidly expanding in the curricula across the allied health professions. The simulated patient methodology continues to receive support as a pedagogy to develop a range of clinical skills including communication, engagement and client-centeredness. Upskilling students to peer role play can be a reasonable alternative to engaging paid actors.

Keywords: exercise science, simulation-based learning, simulated patient, peer role play

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Authors: Cheyenne Johnson, Samantha Robinson, Christina Chant, Ann M. Mitchell, Carol Price, Carmel Clancy, Adam Searby, Deborah S. Finnell

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Introduction: Substance use along the continuum from at-risk use to a substance use disorder (SUD) contributes substantially to the burden of disease and related harms worldwide. There is a growing body of literature that highlights the lack of substance use related content in nursing curricula. Furthermore, there is also a lack of consensus on key competencies necessary for entry-level nurses. Globally, there is a lack of established nursing competencies related to prevention, health promotion, harm reduction and treatment of at-risk substance use and SUDs. At a critical time in public health, this gap in nursing curricula contributes to a lack of preparation for entry-level nurses to support people along the continuum of substance use. Thus, in practice, early opportunities for screening, support, and interventions may be missed. To address this gap, an international committee was convened to develop international entry-level nursing competencies specifying the knowledge, skills, and abilities that all nurses should possess in order to address the continuum of substance use. Methodology: An international steering committee, including representation from Canada, United States, United Kingdom, and Australia was established to lead this work over a one-year time period. The steering committee conducted a scoping review, undertaken to examine nursing competency frameworks, and to inform a competency structure that would guide this work. The next steps were to outline key competency areas and establish leaders for working groups to develop the competencies. In addition, a larger international committee was gathered to contribute to competency working groups, review the collective work and concur on the final document. Findings: A comprehensive framework was developed with competencies covering a wide spectrum of substance use across the lifespan and in the context of prevention, health promotion, harm reduction and treatment, including special populations. The development of this competency-based framework meets an identified need to provide guidance for universities, health authorities, policy makers, nursing regulators and other organizations that provide and support nursing education which focuses on care for patients and families with at-risk substance use and SUDs. Conclusion: Utilizing these global competencies as expected outcomes of an educational and skill building curricula for entry-level nurses holds great promise for incorporating evidence-informed training in the care and management of people across the continuum of substance use.

Keywords: addiction nursing, addiction nursing curriculum, competencies, substance use

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Authors: Kholod Khairy Salama, Shabban Hassan Thabet

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In the present study, a comprehensive investigation has been undertaken into an Egyptian mural painting with feet wear slippers approach to choose the most successful restoration methods. The mural painting under examination dates back to the Amarna period; it was detached from a wall of an unknown tomb in Egypt, and currently, it is initially displayed in a showcase at the Egyptian Museum – Tahrir Square – Cairo, Egypt. The main objectives of this research were to (a) reveal the pigment used in the mural painting, (b) reveal the medium used with colours, (c) determine the technique of manufacturing, (e) determine the ground support, and (f) reveal the main deterioration aspects. The analytical techniques used for investigation were Optical Microscopy, Raman, X-ray Florescence, X-ray diffraction, and Fourier transform infrared coupled with attenuated total reflectance “FTIR-ATR”. The investigation revealed that the vital deterioration factors affecting the object. This research aims to examine and analyze the mural painting to choose the suitable method for the restoration process (a) define the colours through comparative analysis to choose the suitable material for cleaning, (b) define the natural structure of the ground support layer, which appeared as mud layer (c) determine the medium used with colours (d) diagnosis the presence of the white wash layer, and (e) choose the suitable restoration methods according to the results. Conclusion: This study focused mainly on the physical and chemical properties of the mural painting compound and the main changes that happened to the mural painting material, which caused deterioration and fall down of the painting parts, so we can find the best and optimum restoration ways for this object.

Keywords: mural paintings, Tal Al-Amarna, digital microscope, Raman, XRF, XRD, FTIR

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Authors: T. Marinaci, C. Venuleo

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Different conceptualizations of disease affect patient care. This study aims to address this gap. It explores how health professionals conceptualize gambling problem, addiction and the goals of recovery process. In-depth, semi-structured, open-ended interviews were conducted with Italian psychologists, psychiatrists, general practitioners, and support staff (N= 114), working within health centres for the treatment of addiction (public health services or therapeutic communities) or medical offices. A Lexical Correspondence Analysis (LCA) was applied to the verbatim transcripts. LCA allowed to identify two main factorial dimensions, which organize similarity and dissimilarity in the discourses of the interviewed. The first dimension labelled 'Models of relationship with the problem', concerns two different models of relationship with the health problem: one related to the request for help and the process of taking charge and the other related to the identification of the psychopathology underlying the disorder. The second dimension, labelled 'Organisers of the intervention' reflects the dialectic between two ways to address the problem. On the one hand, they are the gambling dynamics and its immediate life-consequences to organize the intervention (whatever the request of the user is); on the other hand, they are the procedures and the tools which characterize the health service to organize the way the professionals deal with the user’ s problem (whatever it is and despite the specify of the user’s request). The results highlight how, despite the differences, the respondents share a central assumption: understanding gambling problem implies the reference to the gambler’s identity, more than, for instance, to the relational, social, cultural or political context where the gambler lives. A passive stance is attributed to the user, who does not play any role in the definition of the goal of the intervention. The results will be discussed to highlight the relationship between professional models and users’ ways to understand and deal with the problems related to gambling.

Keywords: cultural models, health professionals, intervention models, problem gambling

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Authors: Razi Khalafi

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Brain is the information processing center of the human body. Stimuli in form of information are transferred to the brain and then brain makes the decision on how to respond to them. In this research we propose a new partial differential equation which analyses the EEG signals and make a relationship between the incoming stimuli and the brain response to them. In order to test the proposed model, a set of external stimuli applied to the model and the model’s outputs were checked versus the real EEG data. The results show that this model can model the EEG signal well. The proposed model is useful not only for modeling of the EEG signal in case external stimuli but it can be used for the modeling of brain response in case of internal stimuli.

Keywords: Brain, stimuli, partial differential equation, response, eeg signal

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Authors: Wei-Jing Li, Ren-Xuan Yang, Kui-Hao Chuang, Ming-Yen Wey

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Nowadays, plastic product and utilization are extensive and have greatly improved our life. Yet, plastic wastes are stable and non-biodegradable challenging issues to the environment. Waste-to-energy strategies emerge a promising way for waste management. This work investigated the co-production of hydrogen and carbon nanotubes from the syngas which was from the gasification of polypropylene. A nickel-silica core-shell catalyst was applied for syngas reaction from plastic waste gasification in a fixed-bed reactor. SiO2 were prepared through various synthesis solvents by Stöber process. Ni plays a role as modified SiO2 support, which were synthesized by deposition-precipitation method. Core-shell catalysts have strong interaction between active phase and support, in order to avoid catalyst sintering. Moreover, Fe or Co metal acts as promoter to enhance catalytic activity. The effects of calcined atmosphere, second metal addition, and reaction temperature on hydrogen production and carbon yield were examined. In this study, the catalytic activity and carbon yield results revealed that the Ni/SiO2 catalyst calcined under H2 atmosphere exhibited the best performance. Furthermore, Co promoted Ni/SiO2 catalyst produced 3 times more than Ni/SiO2 on carbon yield at long-term operation. The structure and morphological nature of the calcined and spent catalysts were examined using different characterization techniques including scanning electron microscopy, transmission electron microscopy, X-ray diffraction. In addition, the quality and thermal stability of the nano-carbon materials were also evaluated by Raman spectroscopy and thermogravimetric analysis.

Keywords: plastic wastes, hydrogen, carbon nanotube, core-shell catalysts

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Authors: Yu-Tzu Hsu, Alice Wu, Hsiang-Kuang Tseng

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Introduction: Hepatitis A virus causes acute hepatitis and is usually transmitted by a fecal-oral route of food contamination, which is more prevalent in areas with poor hygienic practices. However, we described a hepatitis A outbreak associated with a fecal-oral route of sexual behavior in men who has sex with men (MSM) in Northern Taiwan. Methods: We retrospectively collected patients with acute HAV infection in MacKay Memorial Hospital, Taipei, Taiwan between July 2015 and November 2016. Demographic data (age, gender, onset time and infection risk), laboratory data (GOT, GPT, bilirubin, HIV status, HBsAg, HCV antibody and syphilis), clinical symptoms and travel history with a foreign tour were analyzed. We compared variables between HIV and non-HIV group. Unless otherwise stated, continuous variables were expressed as mean ± SD, and categorical variables were expressed as number (percentage) for each item. The t test for continuous variables was applied for the comparison between two groups and chi-square for categorical variables were applied for measures of association. Results: We collected 80 cases during the study period. Among them, 54 (67.5%) cases were MSM and 43 (53.8%) cases were HIV positive. The average age was 32.6±7.59 years-old. The average value of initial liver function was 1324 IU/L for AST (GOT), 2100 IU/L for ALT (GPT), and 5.82 mg/dL for bilirubin. We found seven (8.6%) cases were in the status of HBV carrier, five (6.3%) cases were positive for HCV antibody, and 15 (18.6%) cases were co-infected with syphilis. With regards to associated symptoms, 32 (40%) had fever, 46 (57.5%) had nausea, 34 (42.5%) had abdominal discomfort and 46 (57.5%) had general malaise. To compare the non-HIV patients with HIV patients, HIV patients were more likely to be male (p=0.008), MSM (p=0.000), co-infected syphilis (p=0.000) and slowly improving liver function of transaminases (p=0.033, 0.027). Conclusion: The HAV outbreak in Northern Taiwan was mainly occurred in MSM population. Hereafter, our cohort data support a policy in Taiwan to provide one dose of free HAV vaccine shot in this population. Hopefully, the outbreak could be stop by the free vaccine policy and public education.

Keywords: acute hepatitis A, men who has sex with men, human immunodeficiency virus, vaccine

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Authors: Muhammad Shoaib

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Every society has a set of beliefs, norms, values, folkways, mores and laws. All the principles, customs, traditions and procedures of societies are directly or indirectly related to the religion of the society and changed with the passage of time by the mediation of democratic values attitudes and mass media influence. The main objective of the present study is to examine the effects of rational thinking values on forgiveness attitude by the mediation of democratic values and mass media attitude among family members. As many other developing settings, Pakistani society is undergoing a rapid and multifaceted social change, in which traditional thinking coexists and often clashes with modern thinking. Rational thinking attitude has great effects on the forgiveness attitude among family members as well as all the members of Pakistani society. For the present study 520 respondents were sampled from two urban areas of Punjab province; Lahore and Faisalabad, through proportionate random sampling technique. A survey method was used as a technique of data collection and an interview schedule was administered to collect information from the respondents. The results support that the net of other factors, favorable democratic values attitudes are positively associated rational thinking attitudes. The results also provide support that all other things equal, mass media attitudes also have a significant positive effect on rational thinking attitudes. Favorable democratic values attitudes have a significant net positive effect and the effect of mass media attitudes is positive and statistically highly significant. It shows that the effects of both democratic values attitudes and mass media attitudes diminish in magnitude when the rational thinking attitudes scale is included. However, the effect of democratic values remains highly significant. In comparison, the effect of mass media attitudes is only marginally significant.

Keywords: rationality, forgiveness, democratic values, mass media, attitudes, Pakistan

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Authors: Nur Azha Putra Abdul Azim, Denise Cheong, S. Nivedita

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Currently, there are no nuclear power reactors among the Association of Southeast Asian Nations (ASEAN) member states (AMS) but there are seven operational nuclear research reactors, and Indonesia is about to construct the region’s first experimental power reactor by the end of the decade. If successful, the experimental power reactor will lay the foundation for the country’s and region’s first nuclear power plant. Despite projecting confidence during the period of nuclear power renaissance in the region in the last decade, none of the AMS has committed to a political decision on the use of nuclear energy and this is largely due to the Fukushima nuclear power accident in 2011. Of the ten AMS, Vietnam, Indonesia and Malaysia have demonstrated the most progress in developing nuclear energy based on the nuclear power infrastructure development assessments made by the International Atomic Energy Agency. Of these three states, Vietnam came closest to building its first nuclear power plant but decided to delay construction further due to safety and security concerns. Meanwhile, Vietnam along with Indonesia and Malaysia continue with their nuclear power infrastructure development and the remaining SEA states, with the exception of Brunei and Singapore, continue to build their expertise and capacity for nuclear power energy. At the current rate of progress, Indonesia is expected to make a national decision on the use of nuclear power by 2023 while Malaysia, the Philippines, and Thailand have included the use of nuclear power in their mid to long-term power development plans. Vietnam remains open to nuclear power but has not placed a timeline. The medium to short-term power development projection in the region suggests that the use of nuclear energy in the region is a matter of 'when' rather than 'if'. In lieu of the prospects for nuclear energy in Southeast Asia (SEA), this presentation will review the literature on ASEAN radiological emergency and preparedness response (EPR) plans and examine ASEAN’s disaster management and emergency framework. Through a combination of institutional mapping and stakeholder analysis methods, which we examine in the context of the international EPR, and nuclear safety and security regimes, we will identify the issues and challenges in developing a regional radiological EPR framework in the SEA. We will conclude with the observation that ASEAN faces serious structural, institutional and governance challenges due to the AMS inherent political structures and history of interstate conflicts, and propose that ASEAN should either enlarge the existing scope of its disaster management and response framework or that its radiological EPR framework should exist as a separate entity.

Keywords: nuclear power, nuclear accident, ASEAN, Southeast Asia

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