Search results for: community- based approach

Authors: Emre Kara, Ahmet Fatih Geylan, Kadir Koç, Şura Karakuzu, Metehan Demir, Halil Aykul

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The structures obtained with the use of sandwich technologies combine low weight with high energy absorbing capacity and load carrying capacity. Hence, there is a growing and markedly interest in the use of sandwiches with aluminium foam core because of very good properties such as flexural rigidity and energy absorption capability. The static (bending and penetration) and dynamic (dynamic bending and low velocity impact) tests were already performed on the aluminum foam cored sandwiches with different types of outer skins by some of the authors. In the current investigation, the static three-point bending tests were carried out on the sandwiches with aluminum foam core and glass fiber reinforced polymer (GFRP) skins at different values of support span distances (L= 55, 70, 80, 125 mm) aiming the analyses of their flexural performance. The influence of the core thickness and the GFRP skin type was reported in terms of peak load, energy absorption capacity and energy efficiency. For this purpose, the skins with two different types of fabrics ([0°/90°] cross ply E-Glass Woven and [0°/90°] cross ply S-Glass Woven which have same thickness value of 1.5 mm) and the aluminum foam core with two different thicknesses (h=10 and 15 mm) were bonded with a commercial polyurethane based flexible adhesive in order to combine the composite sandwich panels. The GFRP skins fabricated via Vacuum Assisted Resin Transfer Molding (VARTM) technique used in the study can be easily bonded to the aluminum foam core and it is possible to configure the base materials (skin, adhesive and core), fiber angle orientation and number of layers for a specific application. The main results of the bending tests are: force-displacement curves, peak force values, absorbed energy, energy efficiency, collapse mechanisms and the effect of the support span length and core thickness. The results of the experimental study showed that the sandwich with the skins made of S-Glass Woven fabrics and with the thicker foam core presented higher mechanical values such as load carrying and energy absorption capacities. The increment of the support span distance generated the decrease of the mechanical values for each type of panels, as expected, because of the inverse proportion between the force and span length. The most common failure types of the sandwiches are debonding of the upper or lower skin and the core shear. The obtained results have particular importance for applications that require lightweight structures with a high capacity of energy dissipation, such as the transport industry (automotive, aerospace, shipbuilding and marine industry), where the problems of collision and crash have increased in the last years.

Keywords: aluminum foam, composite panel, flexure, transport application

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Authors: Fernando Vega, Esmeralda Portillo, Sara Camino, Benito Navarrete, Elena Montavez

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The European Union aims at strongly reducing their CO₂ emissions from energy and industrial sector by 2030. The energy sector contributes with more than two-thirds of the CO₂ emission share derived from anthropogenic activities. Although efforts are mainly focused on the use of renewables by energy production sector, carbon capture and storage (CCS) remains as a frontline option to reduce CO₂ emissions from industrial process, particularly from fossil-fuel power plants and cement production. Among the most feasible and near-to-market CCS technologies, namely post-combustion and oxy-combustion, partial oxy-combustion is a novel concept that can potentially reduce the overall energy requirements of the CO₂ capture process. This technology consists in the use of higher oxygen content in the oxidizer that should increase the CO₂ concentration of the flue gas once the fuel is burnt. The CO₂ is then separated from the flue gas downstream by means of a conventional CO₂ chemical absorption process. The production of a higher CO₂ concentrated flue gas should enhance the CO₂ absorption into the solvent, leading to further reductions of the CO₂ separation performance in terms of solvent flow-rate, equipment size, and energy penalty related to the solvent regeneration. This work evaluates a portfolio of CCS technologies applied to fossil-fuel power plants. For this purpose, an economic evaluation methodology was developed in detail to determine the main economical parameters for CO₂ emission removal such as the levelized cost of electricity (LCOE) and the CO₂ captured and avoided costs. ASPEN Plus™ software was used to simulate the main units of power plant and solve the energy and mass balance. Capital and investment costs were determined from the purchased cost of equipment, also engineering costs and project and process contingencies. The annual capital cost and operating and maintenance costs were later obtained. A complete energy balance was performed to determine the net power produced in each case. The baseline case consists of a supercritical 500 MWe coal-fired power plant using anthracite as a fuel without any CO₂ capture system. Four cases were proposed: conventional post-combustion capture, oxy-combustion and partial oxy-combustion using two levels of oxygen-enriched air (40%v/v and 75%v/v). CO₂ chemical absorption process using monoethanolamine (MEA) was used as a CO₂ separation process whereas the O₂ requirement was achieved using a conventional air separation unit (ASU) based on Linde's cryogenic process. Results showed a reduction of 15% of the total investment cost of the CO₂ separation process when partial oxy-combustion was used. Oxygen-enriched air production also reduced almost half the investment costs required for ASU in comparison with oxy-combustion cases. Partial oxy-combustion has a significant impact on the performance of both CO₂ separation and O₂ production technologies, and it can lead to further energy reductions using new developments on both CO₂ and O₂ separation processes.

Keywords: carbon capture, cost methodology, economic evaluation, partial oxy-combustion

Procedia PDF Downloads 126

Authors: Sarra Boukhari

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Refugee studies have lately emerged as a focused area of research, yet there is a vast knowledge gap vis-à-vis the integration experiences and socialization processes of diversified refugees in different educational settings. This research intends to study the diverse experiences of African refugee children in an Algerian mainstream secondary school. The study seeks to explore the nature and complexity of refugees’ experiences and their relevance to the integration processes. Highlighting these diverse perspectives will be for the sake of understanding ways by which integration could be facilitated amongst refugees within mainstream school classrooms. Subsequently, this study shall investigate the possibility of story-telling activities in exploring and dealing with different issues of integration met by refugees in the predefined context. Accordingly, stories and narratives will be used to discuss values designed by the Living Values Educational Programme (LVEP) that could change the negative effect of war and conflict. These stories can potentially develop young refugees’ understanding of the key social concepts that can facilitate acceptance and integration inside refugee communities and the host society. This study invokes the theoretical framework provided by Jerome Bruner’s works on constructing the narrative through real-life experiences. In practice, the idea is to voice children’ sense-making of their own world and integrate it with good values to help them construct a positive narrative. Qualitative methods will be integrated to investigate the readiness and acceptance of African refugee children to each other in an Algerian classroom. Two phases of data collection will be conducted. The first phase will attempt to answer the first research question about the challenges that refugee children encounter in their education in a host society. In this phase, classroom observation and semi-structured interviews will be held to explore the context regarding the research question. After issues and challenges have been identified in this phase, topics of discussion (values) that reflect these issues will be designed for the second phase. The use of participatory methods with children in the second stage of the data collection will help in discussing the core values by giving them the optionality of the arts-based tools through which they can express themselves. Story-telling was the idea behind the activities. It could help children express their thoughts and feelings about the discussed values freely. The methods used promoted a very integrating atmosphere in the classroom where both refugee and non-refugee students showed cohesion and integration. Children identified many issues in their integration processes that exceeded the classroom or the education setting. Political and economic opinions were openly shared in the class. Overall, the study is an attempt to reveal how refugee children in Algeria are experiencing integration in their education. The study will be unveiling the impact of the context on the integration of refugee children. The process of integration involved in this context helped to shape refugee experiences in a very unique way.

Keywords: children’s agency, narrative construction, refugee children, refugee experiences, story-telling

Procedia PDF Downloads 112

Authors: Tiffany Chuang

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The study of inequality in urban space has typically emphasized class and race as dimensions of stratification, but a small and growing body of work also pays attention to exclusionary processes based on moral grounds, as is the case with mainstream disapproval of sexually oriented businesses and red-light districts. However, many sexually-oriented businesses co-exist with similar non-sexually oriented businesses in the tourism and broader entertainment industries. Furthermore, regulators and tourism- and entertainment industries are acknowledged by regulators and ordinary citizens as important contributors to the economy, and in the case of aspiring global cities, to urban prestige. Under such circumstances, it is important to examine how policymakers, residents, and other stakeholders distinguish between sexually oriented and non-sexually oriented businesses, as well as how such efforts shape moral geographies in urban settings. To address this question, this paper introduces the concept of permeable industries to describe businesses that, by their very nature of providing adult entertainment along with a measure of privacy and discretion, facilitate easy interchange between their officially sanctioned purposes and illicit or stigmatised uses, most notably by the sex industry. The permeability and ambiguity surrounding the sexual- and non-sexual activities in such establishments is in fact, a source of tension that generates energetic boundary-drawing exercises that designate legitimate from illegitimate establishments. This paper draws on three years of ethnographic fieldwork, qualitative research, and archival research (1920—2020) on Joo Chiat, a neighborhood in the city-state of Singapore. It then analyzes how middle-class residents reacted to the sudden influx of sexually oriented businesses in the early 2000s, turning the once-quiet residential and commercial neighborhood into a semi-red-light district staffed by migrant Asian women. Ironically, the red-light district had been inadvertently precipitated by the state’s neoliberal policies in the 1990s to cultivate suburban neighborhoods as decentralized tourist attractions while loosening social regulations in pursuit of global city ambitions. Residents mobilized around the discourse of “sleaze”, using it to draw symbolic boundaries while advocating for regulatory boundaries between sexually oriented and non-sexually oriented businesses in the neighborhood. Since the concept of “sleaze” was informed by middle-class distaste for low-status sex work, the result of residents’ efforts was a state-endorsed moral geography that excluded sexually-oriented businesses while tolerating adult-oriented entertainment businesses that dovetailed with global city aspirations. This study contributes to the study of urban inequality by demonstrating the importance of boundary work in reproducing respectability politics, which in turn shapes the urban geographies of moral worth.

Keywords: moral geography, boundary work, respectability politics, entertainment businesses

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Authors: Muhammad Asghar, Muhammad Ali, Farwah Batool

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Despite the general belief in Islam that figural representations should be avoided, particularly propagated by the Deobandis, a religious group influenced by Salafi and Wahhabi ideas, nevertheless the public interaction spaces such as Shops and offices are decorated with popular, mass-produced, modern devotional prints. This study seeks to focus on popular visual culture, its display in public interaction places such as shops and discusses how people establish relationships with images. The method adopted was basically ethnographic: to describe as precisely and completely as possible the phenomena to be studied, using the language and conceptual categories of the interlocutors themselves. This study has been enriched by ethnographic field research conducted during the months from October to December 2015 in the major cities of Punjab and their brief forays and surroundings where we explored how seeing upon images performs religious identity within the public space. The study examines the pattern of aesthetics and taste in the shops of especially common people whose sensibilities have not been refined or influenced by being exposed to any narrative or fine arts. Furthermore, it is our intention to question the general beliefs and opinions in the context of popular practices, the way in which people relate to these prints. The interpretations and analyses presented in this study illuminate how people create meaning through the display of such items of material culture in the immediate settings of their spaces. This study also seeks to demonstrate how popular Islam is practiced, transformed and understood through the display of popular representations of popular figures of piety like Sufi saints or their shrines are important to many believers and thus occupy important places in their shops. The findings are supported with empirical evidence and based on interviews with the shopkeepers, owners and office employees. Looking upon those popular modern devotional prints keeps people’s reverence of the personages alive. Because of their sacred themes they affect a relationship between the saint and the beholders as well as serve to symbolize and reinforce their belief since they become powerful loci of emotional attachment. Collectively such devotional prints satisfy a local taste to help people establish contact with God through the saints’ intercession in order to receive protection and benediction, and help in spiritual, mental and material problems. By putting all these facets of belief together we gain an insight into both the subjective and cognizant role that icons’ of saints play in the lives of believers. Their veneration through ingeniously contrived modern means of production makes a significant contribution to an understanding of how such imagery promotes a powerful belief in Sufi saints, which ultimately gives indications of how popular Islam is practiced and understood at its gross roots level.

Keywords: ethnographic field research, popular visual culture, protected space, religious identity

Procedia PDF Downloads 207

Authors: Ramprasad Srinivasan

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Engineers create inventions and put their ideas in concrete terms to design new products. Design drivers must be established, which requires, among other things, a complete understanding of the product design, load paths, etc. For Aerospace Vehicles, weight/strength ratio, strength, stiffness and stability are the important design drivers. A complex built-up structure is made up of an assemblage of primitive structural forms of arbitrary shape, which include 1D structures like beams and frames, 2D structures like membranes, plate and shell structures, and 3D solid structures. Justification through simulation involves a check for all the quantities of interest, namely stresses, deformation, frequencies, and buckling loads and is normally achieved through the finite element (FE) method. Over the past few decades, Fiber-reinforced composites are fast replacing the traditional metallic structures in the weight-sensitive aerospace and aircraft industries due to their high specific strength, high specific stiffness, anisotropic properties, design freedom for tailoring etc. Composite panel constructions are used in aircraft to design primary structure components like wings, empennage, ailerons, etc., while thin-walled composite beams (TWCB) are used to model slender structures like stiffened panels, helicopter, and wind turbine rotor blades, etc. The TWCB demonstrates many non-classical effects like torsional and constrained warping, transverse shear, coupling effects, heterogeneity, etc., which makes the analysis of composite structures far more complex. Conventional FE formulations to model 1D structures suffer from many limitations like shear locking, particularly in slender beams, lower convergence rates due to material coupling in composites, inability to satisfy, equilibrium in the domain and natural boundary conditions (NBC) etc. For 2D structures, the limitations of conventional displacement-based FE formulations include the inability to satisfy NBC explicitly and many pathological problems such as shear and membrane locking, spurious modes, stress oscillations, lower convergence due to mesh distortion etc. This mandates frequent re-meshing to even achieve an acceptable mesh (satisfy stringent quality metrics) for analysis leading to significant cycle time. Besides, currently, there is a need for separate formulations (u/p) to model incompressible materials, and a single unified formulation is missing in the literature. Hence coupled field formulation (CFF) is a unified formulation proposed by the author for the solution of complex 1D and 2D structures addressing the gaps in the literature mentioned above. The salient features of CFF and its many advantages over other conventional methods shall be presented in this paper.

Keywords: coupled field formulation, kinematic and material coupling, natural boundary condition, locking free formulation

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Authors: Dinara F. Gaynutdinova, Vladimir Ya Modorsky, Nikolay A. Shevelev

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The problem under research is that of unpredictable modes occurring in two-stage centrifugal hydraulic pump as a result of hydraulic processes caused by vibrations of structural components. Numerical, analytical and experimental approaches are considered. A hypothesis was developed that the problem of unpredictable pressure decrease at the second stage of centrifugal pumps is caused by cavitation effects occurring upon vibration. The problem has been studied experimentally and theoretically as of today. The theoretical study was conducted numerically and analytically. Hydroelastic processes in dynamic “liquid – deformed structure” system were numerically modelled and analysed. Using ANSYS CFX program engineering analysis complex and computing capacity of a supercomputer the cavitation parameters were established to depend on vibration parameters. An influence domain of amplitudes and vibration frequencies on concentration of cavitation bubbles was formulated. The obtained numerical solution was verified using CFM program package developed in PNRPU. The package is based on a differential equation system in hyperbolic and elliptic partial derivatives. The system is solved by using one of finite-difference method options – the particle-in-cell method. The method defines the problem solution algorithm. The obtained numerical solution was verified analytically by model problem calculations with the use of known analytical solutions of in-pipe piston movement and cantilever rod end face impact. An infrastructure consisting of an experimental fast hydro-dynamic processes research installation and a supercomputer connected by a high-speed network, was created to verify the obtained numerical solutions. Physical experiments included measurement, record, processing and analysis of data for fast processes research by using National Instrument signals measurement system and Lab View software. The model chamber end face oscillated during physical experiments and, thus, loaded the hydraulic volume. The loading frequency varied from 0 to 5 kHz. The length of the operating chamber varied from 0.4 to 1.0 m. Additional loads weighed from 2 to 10 kg. The liquid column varied from 0.4 to 1 m high. Liquid pressure history was registered. The experiment showed dependence of forced system oscillation amplitude on loading frequency at various values: operating chamber geometrical dimensions, liquid column height and structure weight. Maximum pressure oscillation (in the basic variant) amplitudes were discovered at loading frequencies of approximately 1,5 kHz. These results match the analytical and numerical solutions in ANSYS and CFM.

Keywords: computing experiment, hydroelasticity, physical experiment, vibration

Procedia PDF Downloads 229

Authors: Jack L. Harris, Marya L. Doerfel, Hyunsook Youn, Minkyung Kim, Kautuki Sunil Jariwala

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Organizational resilience refers to the ability to sustain business or general work functioning despite wide-scale interruptions. We focus on organization and businesses as a pillar of their communities and how they attempt to sustain work when a natural disaster impacts their surrounding regions and economies. While it may be more common to think of resilience as a trait possessed by an organization, an emerging area of research recognizes that for organizations and businesses, resilience is a set of processes that are constituted through communication, social networks, and organizing. Indeed, five processes, robustness, rapidity, resourcefulness, redundancy, and external availability through social media have been identified as critical to organizational resilience. These organizing mechanisms involve multi-level coordination, where individuals intersect with groups, organizations, and communities. Because the nature of such interactions are often networks of people and organizations coordinating material resources, information, and support, they necessarily require some way to coordinate despite being displaced. Little is known, however, if physical and digital spaces can substitute one for the other. We thus are guided by the question, is digital space sufficient when disaster creates a scarcity of physical space? This study presents a cross-case comparison based on field research from four different regions of the United States that were impacted by Hurricanes Katrina (2005), Sandy (2012), Maria (2017), and Harvey (2017). These four cases are used to extend the science of resilience by examining multi-level processes enacted by individuals, communities, and organizations that together, contribute to the resilience of disaster-struck organizations, businesses, and their communities. Using field research about organizations and businesses impacted by the four hurricanes, we code data from interviews, participant observations, field notes, and document analysis drawn from New Orleans (post-Katrina), coastal New Jersey (post-Sandy), Houston Texas (post-Harvey), and the lower keys of Florida (post-Maria). This paper identifies an additional organizing mechanism, networked gathering spaces, where citizens and organizations, alike, coordinate and facilitate information sharing, material resource distribution, and social support. Findings show that digital space, alone, is not a sufficient substitute to effectively sustain organizational resilience during a disaster. Because the data are qualitative, we expand on this finding with specific ways in which organizations and the people who lead them worked around the problem of scarce space. We propose that gatherings after disaster are a sixth mechanism that contributes to organizational resilience.

Keywords: communication, coordination, disaster management, information and communication technologies, interorganizational relationships, resilience, work

Procedia PDF Downloads 146

Authors: Heichia Wang, Yalan Chao

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Social inequality is a persistent problem. One of the ways to solve this problem is through education. At present, vulnerable groups are often less geographically accessible to educational resources. However, compared with educational resources, communication equipment is easier for vulnerable groups. Now that information and communication technology (ICT) has entered the field of education, today we can accept the convenience that ICT provides in education, and the mobility that it brings makes learning independent of time and place. With mobile learning, teachers and students can start discussions in an online chat room without the limitations of time or place. However, because liquidity learning is quite convenient, people tend to solve problems in short online texts with lack of detailed information in a lack of convenient online environment to express ideas. Therefore, the ICT education environment may cause misunderstanding between teachers and students. Therefore, in order to better understand each other's views between teachers and students, this study aims to clarify the essays of the analysts and classify the students into several types of learning questions to clarify the views of teachers and students. In addition, this study attempts to extend the description of possible omissions in short texts by using external resources prior to classification. In short, by applying a short text classification, this study can point out each student's learning problems and inform the instructor where the main focus of the future course is, thus improving the ICT education environment. In order to achieve the goals, this research uses convolutional neural network (CNN) method to analyze short discussion content between teachers and students in an ICT education environment. Divide students into several main types of learning problem groups to facilitate answering student problems. In addition, this study will further cluster sub-categories of each major learning type to indicate specific problems for each student. Unlike most neural network programs, this study attempts to extend short texts with external resources before classifying them to improve classification performance. In short, by applying the classification of short texts, we can point out the learning problems of each student and inform the instructors where the main focus of future courses will improve the ICT education environment. The data of the empirical process will be used to pre-process the chat records between teachers and students and the course materials. An action system will be set up to compare the most similar parts of the teaching material with each student's chat history to improve future classification performance. Later, the function of short text classification uses CNN to classify rich chat records into several major learning problems based on theory-driven titles. By applying these modules, this research hopes to clarify the main learning problems of students and inform teachers that they should focus on future teaching.

Keywords: ICT education improvement, social equality, short text analysis, convolutional neural network

Procedia PDF Downloads 101

Authors: Sadia Munir, Diana White, Aya Albahri, Pratiwi Hastania, Eltahir Mohamed, Mahmood Khan, Fathima Mohamed, Ayat Kadhi, Haila Saleem

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Preeclampsia is a major complication of pregnancy. Prediction and management of preeclampsia is a challenge for obstetricians. To our knowledge, no major progress has been achieved in the prevention and early detection of preeclampsia. There is very little known about the clear treatment path of this disorder. Preeclampsia puts both mother and baby at risk of several short term- and long term-health problems later in life. There is huge health service cost burden in the health care system associated with preeclampsia and its complications. Preeclampsia is divided into two different types. Early onset preeclampsia develops before 34 weeks of gestation, and late onset develops at or after 34 weeks of gestation. Different genetic and environmental factors, prognosis, heritability, biochemical and clinical features are associated with early and late onset preeclampsia. Prevalence of preeclampsia greatly varies all over the world and is dependent on ethnicity of the population and geographic region. To authors best knowledge, no published data on preeclampsia exist in Qatar. In this study, we are reporting the incidence of preeclampsia in Qatar. The purpose of this study is to compare the incidence and risk factors of both early onset and late onset preeclampsia in Qatar. This retrospective longitudinal cohort study was conducted using data from the hospital record of Women’s Hospital, Hamad Medical Corporation (HMC), from May 2014-May 2016. Data collection tool, which was approved by HMC, was a researcher made extraction sheet that included information such as blood pressure during admission, socio demographic characteristics, delivery mode, and new born details. A total of 1929 patients’ files were identified by the hospital information management when they apply codes of preeclampsia. Out of 1929 files, 878 had significant gestational hypertension without proteinuria, 365 had preeclampsia, 364 had severe preeclampsia, and 188 had preexisting hypertension with superimposed proteinuria. In this study, 78% of the data was obtained by hospital electronic system (Cerner) and the remaining 22% was from patient’s paper records. We have gone through detail data extraction from 560 files. Initial data analysis has revealed that 15.02% of pregnancies were complicated with preeclampsia from May 2014-May 2016. We have analyzed difference in the two different disease entities in the ethnicity, maternal age, severity of hypertension, mode of delivery and infant birth weight. We have identified promising differences in the risk factors of early onset and late onset preeclampsia. The data from clinical findings of preeclampsia will contribute to increased knowledge about two different disease entities, their etiology, and similarities/differences. The findings of this study can also be used in predicting health challenges, improving health care system, setting up guidelines, and providing the best care for women suffering from preeclampsia.

Keywords: preeclampsia, incidence, risk factors, maternal

Procedia PDF Downloads 117

Authors: Anita Bajpai, Sarah Duan, Ashlee Erskine, Shehzein Khan, Raymond Kramer

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Introduction: This research focuses on exploring the beneficial effects if any, of Vitamin-D in reducing the need for supplemental oxygen among hospitalized COVID-19 patients. Two questions are investigated – Q1)Doeshaving a healthy level of baselineVitamin-D 25-OH (≥ 30ng/ml) help,andQ2) does administering Vitamin-D therapy after-the-factduring inpatient hospitalization help? Methods/Study Design: This is a comprehensive, retrospective, observational study of all inpatients at RUHS from March through December 2020 who tested positive for COVID-19 based on real-time reverse transcriptase–polymerase chain reaction assay of nasal and pharyngeal swabs and rapid assay antigen test. To address Q1, we looked atall N1=182 patients whose baseline plasma Vitamin-D 25-OH was known and who needed supplemental oxygen. Of this, a total of 121 patients had a healthy Vitamin-D level of ≥30 ng/mlwhile the remaining 61 patients had low or borderline (≤ 29.9ng/ml)level. Similarly, for Q2, we looked at a total of N2=893 patients who were given supplemental oxygen, of which713 were not given Vitamin-D and 180 were given Vitamin-D therapy. The numerical value of the maximum amount of oxygen flow rate(dependent variable) administered was recorded for each patient. The mean values and associated standard deviations for each group were calculated. Thesetwo sets of independent data served as the basis for independent, two-sample t-Test statistical analysis. To be accommodative of any reasonable benefitof Vitamin-D, ap-value of 0.10(α< 10%) was set as the cutoff point for statistical significance. Results: Given the large sample sizes, the calculated statistical power for both our studies exceeded the customary norm of 80% or better (β< 0.2). For Q1, the mean value for maximumoxygen flow rate for the group with healthybaseline level of Vitamin-D was 8.6 L/min vs.12.6L/min for those with low or borderline levels, yielding a p-value of 0.07 (p < 0.10) with the conclusion that those with a healthy level of baseline Vitamin-D needed statistically significant lower levels of supplemental oxygen. ForQ2, the mean value for a maximum oxygen flow rate for those not administered Vitamin-Dwas 12.5 L/min vs.12.8L/min for those given Vitamin-D, yielding a p-valueof 0.87 (p > 0.10). We thereforeconcludedthat there was no statistically significant difference in the use of oxygen therapy between those who were or were not administered Vitamin-D after-the-fact in the hospital. Discussion/Conclusion: We found that patients who had healthy levels of Vitamin-D at baseline needed statistically significant lower levels of supplemental oxygen. Vitamin-D is well documented, including in a recent article in the Lancet, for its anti-inflammatory role as an adjuvant in the regulation of cytokines and immune cells. Interestingly, we found no statistically significant advantage for giving Vitamin-D to hospitalized patients. It may be a case of “too little too late”. A randomized clinical trial reported in JAMA also did not find any reduction in hospital stay of patients given Vitamin-D. Such conclusions come with a caveat that any delayed marginal benefits may not have materialized promptly in the presence of a significant inflammatory condition. Since Vitamin-D is a low-cost, low-risk option, it may still be useful on an inpatient basis until more definitive findings are established.

Keywords: COVID-19, vitamin-D, supplemental oxygen, vitamin-D in primary care

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Authors: Antonis Skouloudis, Georgios Deligiannakis, Panagiotis Vouros, Konstantinos Evangelinos, Loannis Nikolaou

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On November 15th, 2017, a catastrophic flash flood devastated the city of Mandra in Central Greece, resulting in 24 fatalities and extensive damages to the built environment and infrastructure. It was Greece's deadliest and most destructive flood event for the past 40 years. In this paper, we examine the consequences of this event too small and medium-sized enterprises (SMEs) operating in Mandra during the flood event, which were affected by the floodwaters to varying extents. In this context, we conducted semi-structured interviews with business owners-managers of 45 SMEs located in flood inundated areas and are still active nowadays, based on an interview guide that spanned 27 topics. The topics pertained to the disaster experience of the business and business owners-managers, knowledge and attitudes towards climate change and extreme weather, aspects of disaster preparedness and related assistance needs. Our findings reveal that the vast majority of the affected businesses experienced heavy damages in equipment and infrastructure or total destruction, which resulted in business interruption from several weeks up to several months. Assistance from relatives or friends helped for the damage repairs and business recovery, while state compensations were deemed insufficient compared to the extent of the damages. Most interviewees pinpoint flooding as one of the most critical risks, and many connect it with the climate crisis. However, they are either not willing or unable to apply property-level prevention measures in their businesses due to cost considerations or complex and cumbersome bureaucratic processes. In all cases, the business owners are fully aware of the flood hazard implications, and since the recovery from the event, they have engaged in basic mitigation measures and contingency plans in case of future flood events. Such plans include insurance contracts whenever possible (as the vast majority of the affected SMEs were uninsured at the time of the 2017 event) as well as simple relocations of critical equipment within their property. The study offers fruitful insights on latent drivers and barriers of SMEs' resilience capacity to flash flooding. In this respect, findings such as ours, highlighting tensions that underpin behavioral responses and experiences, can feed into a) bottom-up approaches for devising actionable and practical guidelines, manuals and/or standards on business preparedness to flooding, and, ultimately, b) policy-making for an enabling environment towards a flood-resilient SME sector.

Keywords: flash flood, small and medium-sized enterprises, organizational resilience capacity, disaster preparedness, qualitative study

Procedia PDF Downloads 116

Authors: O. Gsib, U. Peirera, C. Egles, S. A. Bencherif

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In skin regenerative medicine, one of the critical issues is to produce a three-dimensional scaffold with optimized porosity for dermal fibroblast infiltration and neovascularization, which exhibits high mechanical properties and displays sufficient wound healing characteristics. In this study, we report on the synthesis and characterization of macroporous sequential interpenetrating polymer networks (IPNs) combining skin wound healing properties of fibrin with the excellent physical properties of polyethylene glycol (PEG). Fibrin fibers serve as a provisional biologically active network to promote cell adhesion and proliferation while PEG provides the mechanical stability to maintain the entire 3D construct. After having modified both PEG and Serum Albumin (used for promoting enzymatic degradability) by adding methacrylate residues (PEGDM and SAM, respectively), Fibrin/PEGDM-SAM sequential IPNs were synthesized as follows: Macroporous sponges were first produced from PEGDM-SAM hydrogels by a freeze-drying technique and then rehydrated by adding the fibrin precursors. Environmental Scanning Electron Microscopy (ESEM) and Confocal Laser Scanning Microscopy (CLSM) were used to characterize their microstructure. Human dermal fibroblasts were cultivated during one week in the constructs and different cell culture parameters (viability, morphology, proliferation) were evaluated. Subcutaneous implantations of the scaffolds were conducted on five-week old male nude mice to investigate their biocompatibility in vivo. We successfully synthesized interconnected and macroporous Fibrin/PEGDM-SAM sequential IPNs. The viability of primary dermal fibroblasts was well maintained (above 90%) after 2 days of culture. Cells were able to adhere, spread and proliferate in the scaffolds suggesting the suitable porosity and intrinsic biologic properties of the constructs. The fibrin network adopted a spider web shape that covered partially the pores allowing easier cell infiltration into the macroporous structure. To further characterize the in vitro cell behavior, cell proliferation (EdU incorporation, MTS assay) is being studied. Preliminary histological analysis of animal studies indicated the persistence of hydrogels even after one-month post implantation and confirmed the absence of inflammation response, good biocompatibility and biointegration of our scaffolds within the surrounding tissues. These results suggest that our Fibrin/PEGDM-SAM IPNs could be considered as potential candidates for dermis regenerative medicine. Histological analysis will be completed to further assess scaffold remodeling including de novo extracellular matrix protein synthesis and early stage angiogenesis analysis. Compression measurements will be conducted to investigate the mechanical properties.

Keywords: fibrin, hydrogels for dermal reconstruction, polyethylene glycol, semi-interpenetrating polymer network

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Authors: Nikeshala Weerasekara, Roshan Ajward

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Contemporary business environment, given the circumstance of stringent scrutiny toward corporate behavior, organizations are under pressure to develop and implement solid overarching Corporate Social Responsibility (CSR) strategies. In that milieu, in order to differentiate themselves from competitors and maintain stakeholder confidence banks spend millions of dollars on CSR programmes. However, knowledge on how non-western bank employees perceive such activities is inconclusive. At the same time recently only researchers have shifted their focus on positive effects of compassion at work or the organizational conditions under which it arises. Nevertheless, mediation mechanisms between CSR and compassion at work have not been adequately examined leaving a vacuum to be explored. Despite finding a purpose in work that is greater than extrinsic outcomes of the work is important to employees, meaningful work has not been examined adequately. Thus, in addition to examining the direct relationship between CSR and compassion at work, this study examined the mediating capability of meaningful work between these variables. Specifically, the researcher explored how CSR enables employees to sense work as meaningful which in turn would enhance their level of compassion at work. Hypotheses were developed to examine the direct relationship between CSR and compassion at work and the mediating effect of meaningful work on the relationship between CSR and compassion at work. Both Social Identity Theory (SIT) and Social Exchange Theory (SET) were used to theoretically support the relationships. The sample comprised of 450 respondents covering different levels of the bank. A convenience sampling strategy was used to secure responses from 13 local licensed commercial banks in Sri Lanka. Data was collected using a structured questionnaire which was developed based on a comprehensive review of literature and refined using both expert opinions and a pilot survey. Structural equation modeling using Smart Partial Least Square (PLS) was utilized for data analysis. Findings indicate a positive and significant (p < .05) relationship between CSR and compassion at work. Also, it was found that meaningful work partially mediates the relationship between CSR and compassion at work. As per the findings it is concluded that bank employees’ perception of CSR engagement not only directly influence compassion at work but also impact such through meaningful work as well. This implies that employees consider working for a socially responsible bank since it creates greater meaningfulness of work to retain with the organization, which in turn trigger higher level of compassion at work. By utilizing both SIT and SET in explaining relationships between CSR and compassion at work it amounts to theoretical significance of the study. Enhance existing literature on CSR and compassion at work. Also, adds insights on mediating capability of psychologically related variables such as meaningful work. This study is expected to have significant policy implications in terms of increasing compassion at work where managers must understand the importance of including CSR activities into their strategy in order to thrive. Finally, it provides evidence of suitability of using Smart PLS to test models with mediating relationships involving non normal data.

Keywords: compassion at work, corporate social responsibility, employee commitment, meaningful work, positive affect

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Authors: Ha Phuong Tran, Feng Wang, Jo Dewulf, Hai Trung Huynh, Thomas Schaubroeck

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The fast increase and complex components have made waste of electrical and electronic equipment (or e-waste) one of the most problematic waste streams worldwide. Precise information on its size on national, regional and global level has therefore been highlighted as prerequisite to obtain a proper management system. However, this is a very challenging task, especially in developing countries where both formal e-waste management system and necessary statistical data for e-waste estimation, i.e. data on the production, sale and trade of electrical and electronic equipment (EEE), are often lacking. Moreover, there is an inflow of non-registered electronic and electric equipment, which ‘invisibly’ enters the EEE domestic market and then is used for domestic consumption. The non-registration/invisibility and (in most of the case) illicit nature of this flow make it difficult or even impossible to be captured in any statistical system. The e-waste generated from it is thus often uncounted in current e-waste estimation based on statistical market data. Therefore, this study focuses on enhancing e-waste estimation in developing countries and proposing a calculation pathway to quantify the magnitude of the non-registered EEE inflow. An advanced Input-Out Analysis model (i.e. the Sale–Stock–Lifespan model) has been integrated in the calculation procedure. In general, Sale-Stock-Lifespan model assists to improve the quality of input data for modeling (i.e. perform data consolidation to create more accurate lifespan profile, model dynamic lifespan to take into account its changes over time), via which the quality of e-waste estimation can be improved. To demonstrate the above objectives, a case study on televisions (TVs) in Vietnam has been employed. The results show that the amount of waste TVs in Vietnam has increased four times since 2000 till now. This upward trend is expected to continue in the future. In 2035, a total of 9.51 million TVs are predicted to be discarded. Moreover, estimation of non-registered TV inflow shows that it might on average contribute about 15% to the total TVs sold on the Vietnamese market during the whole period of 2002 to 2013. To tackle potential uncertainties associated with estimation models and input data, sensitivity analysis has been applied. The results show that both estimations of waste and non-registered inflow depend on two parameters i.e. number of TVs used in household and the lifespan. Particularly, with a 1% increase in the TV in-use rate, the average market share of non-register inflow in the period 2002-2013 increases 0.95%. However, it decreases from 27% to 15% when the constant unadjusted lifespan is replaced by the dynamic adjusted lifespan. The effect of these two parameters on the amount of waste TV generation for each year is more complex and non-linear over time. To conclude, despite of remaining uncertainty, this study is the first attempt to apply the Sale-Stock-Lifespan model to improve the e-waste estimation in developing countries and to quantify the non-registered EEE inflow to domestic consumption. It therefore can be further improved in future with more knowledge and data.

Keywords: e-waste, non-registered electrical and electronic equipment, TVs, Vietnam

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Authors: Eduardo Antonio Lozano Hernandez, Nancy Ramirez Alvarez, Lorena Margarita Rios Mendoza, Jose Vinicio Macias Zamora, Felix Augusto Hernandez Guzman, Jose Luis Sanchez Osorio

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Microplastics (MPs) are one of the most numerous reported wastes found in the marine ecosystem, representing one of the greatest risks for organisms that inhabit that environment due to their bioavailability. Such is the case of bivalve mollusks, since they are capable of filtering large volumes of water, which increases the risk of contamination by microplastics through the continuous exposure to these materials. This study aims to determine, quantify and characterize microplastics found in the cultured oyster Crassostrea gigas. We also analyzed if there are spatio-temporal differences in the microplastic concentration of organisms grown in two bays having quite different human population. In addition, we wanted to have an idea of the possible impact on humans via consumption of these organisms. Commercial size organisms (>6cm length; n = 15) were collected by triplicate from eight oyster farming sites in Baja California, Mexico during winter and summer. Two sites are located in Todos Santos Bay (TSB), while the other six are located in San Quintin Bay (SQB). Site selection was based on commercial concessions for oyster farming in each bay. The organisms were chemically digested with 30% KOH (w/v) and 30% H₂O₂ (v/v) to remove the organic matter and subsequently filtered using a GF/D filter. All particles considered as possible MPs were quantified according to their physical characteristics using a stereoscopic microscope. The type of synthetic polymer was determined using a FTIR-ATR microscope and using a user as well as a commercial reference library (Nicolet iN10 Thermo Scientific, Inc.) of IR spectra of plastic polymers (with a certainty ≥70% for polymers pure; ≥50% for composite polymers). Plastic microfibers were found in all the samples analyzed. However, a low incidence of MP fragments was observed in our study (approximately 9%). The synthetic polymers identified were mainly polyester and polyacrylonitrile. In addition, polyethylene, polypropylene, polystyrene, nylon, and T. elastomer. On average, the content of microplastics in organisms were higher in TSB (0.05 ± 0.01 plastic particles (pp)/g of wet weight) than found in SQB (0.02 ± 0.004 pp/g of wet weight) in the winter period. The highest concentration of MPs found in TSB coincides with the rainy season in the region, which increases the runoff from streams and wastewater discharges to the bay, as well as the larger population pressure (> 500,000 inhabitants). Otherwise, SQB is a mainly rural location, where surface runoff from streams is minimal and in addition, does not have a wastewater discharge into the bay. During the summer, no significant differences (Manne-Whitney U test; P=0.484) were observed in the concentration of MPs found in the cultured oysters of TSB and SQB, (average: 0.01 ± 0.003 pp/g and 0.01 ± 0.002 pp/g, respectively). Finally, we concluded that the consumption of oyster does not represent a risk for humans due to the low concentrations of MPs found. The concentration of MPs is influenced by the variables such as temporality, circulations dynamics of the bay and existing demographic pressure.

Keywords: FTIR-ATR, Human risk, Microplastic, Oyster

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Authors: Naima Umar

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Mid-1960’s has been landmark in the history of Indian agriculture. It was in 1966-67 when a New Agricultural Strategy was put into practice to tide over chronic shortages of food grains in the country. This strategy adopted was the use High-Yielding Varieties (HYV) of seeds (wheat and rice), which was popularly known as the Green Revolution. This phase of agricultural development has saved us from hunger and starvation and made the peasants more confident than ever before, but it has also created a number of socio-economic and environmental implications such as the reduction in area under forest, salinization, waterlogging, soil erosion, lowering of underground water table, soil, water and air pollution, decline in soil fertility, silting of rivers and emergence of several diseases and health hazards. The state of Uttar Pradesh in the north is bounded by the country of Nepal, the states of Uttrakhand on the northwest, Haryana on the west, Rajasthan on the southwest, Madhya Pradesh on the south and southwest, and Bihar on the east. It is situated between 23052´N and 31028´N latitudes and 7703´ and 84039´E longitudes. It is the fifth largest state of the country in terms of area, and first in terms of population. Forming the part of Ganga plain the state is crossed by a number of rivers which originate from the snowy peaks of Himalayas. The fertile plain of the Ganga has led to a high concentration of population with high density and the dominance of agriculture as an economic activity. Present paper highlights the negative impact of new agricultural technology on health of the people and environment and will attempt to find out factors which are responsible for these implications. Karl Pearson’s Correlation coefficient technique has been applied by selecting 1 dependent variable (i.e. Productivity Index) and some independent variables which may impact crop productivity in the districts of the state. These variables have categorized as: X1 (Cropping Intensity), X2 (Net irrigated area), X3 (Canal Irrigated area), X4 (Tube-well Irrigated area), X5 (Irrigated area by other sources), X6 (Consumption of chemical fertilizers (NPK) Kg. /ha.), X7 (Number of wooden plough), X8 (Number of iron plough), X9 (Number of harrows and cultivators), X10 (Number of thresher machines), X11(Number of sprayers), X12 (Number of sowing instruments), X13 (Number of tractors) and X14 (Consumption of insecticides and pesticides (in Kg. /000 ha.). The entire data during 2001-2005 and 2006- 2010 have been taken and 5 years average value is taken into consideration, based on secondary sources obtained from various government, organizations, master plan report, economic abstracts, district census handbooks and village and town directories etc,. put on a standard computer programmed SPSS and the results obtained have been properly tabulated.

Keywords: agricultural technology, environmental implications, health hazards, socio-economic problems

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Authors: Radik D. Aglyamov, Alexander K. Naumov, Alexey A. Shavelev, Oleg A. Morozov, Arsenij D. Shishkin, Yury P.Brodnikovsky, Alexander A.Karabutov, Alexander A. Oraevsky, Vadim V. Semashko

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The development of medical optoacoustic tomography with the using human blood as endogenic contrast agent is constrained by the lack of reliable, easy-to-use and inexpensive sources of high-power pulsed laser radiation in the spectral region of 750-900 nm [1-2]. Currently used titanium-sapphire, alexandrite lasers or optical parametric light oscillators do not provide the required and stable output characteristics, they are structurally complex, and their cost is up to half the price of diagnostic optoacoustic systems. Here we are developing the lasers based on Cr:LiCaAlF6 crystals which are free of abovementioned disadvantages and provides intensive ten’s ns-range tunable laser radiation at specific absorption bands of oxy- (~840 nm) and -deoxyhemoglobin (~757 nm) in the blood. Cr:LiCAF (с=3 at.%) crystals were grown in Kazan Federal University by the vertical directional crystallization (Bridgman technique) in graphite crucibles in a fluorinating atmosphere at argon overpressure (P=1500 hPa) [3]. The laser elements have cylinder shape with the diameter of 8 mm and 90 mm in length. The direction of the optical axis of the crystal was normal to the cylinder generatrix, which provides the π-polarized laser action correspondent to maximal stimulated emission cross-section. The flat working surfaces of the active elements were polished and parallel to each other with an error less than 10”. No any antireflection coating was applied. The Q-switched master oscillator-power amplifiers laser system (MOPA) with the dual-Xenon flashlamp pumping scheme in diffuse-reflectivity close-coupled head were realized. A specially designed laser cavity, consisting of dielectric highly reflective reflectors with a 2 m-curvature radius, a flat output mirror, a polarizer and Q-switch sell, makes it possible to operate sequentially in a circle (50 ns - laser one pulse after another) at wavelengths of 757 and 840 nm. The programmable pumping system from Tomowave Laser LLC (Russia) provided independent to each pulses (up to 250 J at 180 μs) pumping to equalize the laser radiation intensity at these wavelengths. The MOPA laser operates at 10 Hz pulse repetition rate with the output energy up to 210 mJ. Taking into account the limitations associated with physiological movements and other characteristics of patient tissues, the duration of laser pulses and their energy allows molecular and functional high-contrast imaging to depths of 5-6 cm with a spatial resolution of at least 1 mm. Highly likely the further comprehensive design of laser allows improving the output properties and realizing better spatial resolution of medical multispectral optoacoustic tomography systems.

Keywords: medical optoacoustic, endogenic contrast agent, multiwavelength tunable pulse lasers, MOPA laser system

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Authors: Elena Filova, Ondrej Kaplan, Marie Markova, Helena Dragounova, Roman Matejka, Eduard Brynda, Lucie Bacakova

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Decellularized vessels have been evaluated as small-diameter vascular prostheses. Reseeding autologous cells onto decellularized tissue prior implantation should prolong prostheses function and make them living tissues. Suitable cell types for reseeding are both endothelial cells and bone marrow-derived stem cells, with a capacity for differentiation into smooth muscle cells upon mechanical loading. Endothelial cells assure antithrombogenicity of the vessels and MSCs produce growth factors and, after their differentiation into smooth muscle cells, they are contractile and produce extracellular matrix proteins as well. Fibrin is a natural scaffold, which allows direct cell adhesion based on integrin receptors. It can be prepared autologous. Fibrin can be modified with bound growth factors, such as basic fibroblast growth factor (FGF-2) and vascular endothelial growth factor (VEGF). These modifications in turn make the scaffold more attractive for cells ingrowth into the biological scaffold. The aim of the study was to prepare thin surface-attached fibrin assemblies with bound FGF-2 and VEGF, and to evaluate growth and differentiation of bone marrow-derived mesenchymal stem cells on the fibrin (Fb) assemblies. Following thin surface-attached fibrin assemblies were prepared: Fb, Fb+VEGF, Fb+FGF2, Fb+heparin, Fb+heparin+VEGF, Fb+heparin+FGF2, Fb+heparin+FGF2+VEGF. Cell culture poly-styrene and glass coverslips were used as controls. Human MSCs (passage 3) were seeded at the density of 8800 cells/1.5 mL alpha-MEM medium with 2.5% FS and 200 U/mL aprotinin per well of a 24-well cell culture. The cells have been cultured on the samples for 6 days. Cell densities on day 1, 3, and 6 were analyzed after staining with LIVE/DEAD cytotoxicity/viability assay kit. The differentiation of MSCs is being analyzed using qPCR. On day 1, the highest density of MSCs was observed on Fb+VEGF and Fb+FGF2. On days 3 and 6, there were similar densities on all samples. On day 1, cell morphology was polygonal and spread on all sample. On day 3 and 6, MSCs growing on Fb assemblies with FGF2 became apparently elongated. The evaluation of expression of genes for von Willebrand factor and CD31 (endothelial cells), for alpha-actin (smooth muscle cells), and for alkaline phosphatase (osteoblasts) is in progress. We prepared fibrin assemblies with bound VEGF and FGF-2 that supported attachment and growth of mesenchymal stem cells. The layers are promising for improving the ingrowth of MSCs into the biological scaffold. Supported by the Technology Agency of the Czech Republic TA04011345, and Ministry of Health NT11270-4/2010, and BIOCEV – Biotechnology and Biomedicine Centre of the Academy of Sciences and Charles University” project (CZ.1.05/1.1.00/02.0109), funded by the European Regional Development Fund for their financial supports.

Keywords: fibrin assemblies, FGF-2, mesenchymal stem cells, VEGF

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Authors: Zeradam Yeshiwas, A. Krishnaia

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The aim of this study is to verify the resulting surface roughness of parts formed by the Single-Point Incremental Forming (SPIF) process for an ISO 3574 Drawing Quality Cold Rolled CR2 Steel. The chemical composition of drawing quality Cold Rolled CR2 steel is comprised of 0.12 percent of carbon, 0.5 percent of manganese, 0.035 percent of sulfur, 0.04 percent phosphorous, and the remaining percentage is iron with negligible impurities. The experiments were performed on a 3-axis vertical CNC milling machining center equipped with a tool setup comprising a fixture and forming tools specifically designed and fabricated for the process. The CNC milling machine was used to transfer the tool path code generated in Mastercam 2017 environment into three-dimensional motions by the linear incremental progress of the spindle. The blanks of Drawing Quality Cold Rolled CR2 steel sheets of 1 mm of thickness have been fixed along their periphery by a fixture and hardened high-speed steel (HSS) tools with a hemispherical tip of 8, 10 and 12mm of diameter were employed to fabricate sample parts. To investigate the surface roughness, hyperbolic-cone shape specimens were fabricated based on the chosen experimental design. The effect of process parameters on the surface roughness was studied using three important process parameters, i.e., tool diameter, feed rate, and step depth. In this study, the Taylor-Hobson Surtronic 3+ surface roughness tester profilometer was used to determine the surface roughness of the parts fabricated using the arithmetic mean deviation (Rₐ). In this instrument, a small tip is dragged across a surface while its deflection is recorded. Finally, the optimum process parameters and the main factor affecting surface roughness were found using the Taguchi design of the experiment and ANOVA. A Taguchi experiment design with three factors and three levels for each factor, the standard orthogonal array L9 (3³) was selected for the study using the array selection table. The lowest value of surface roughness is significant for surface roughness improvement. For this objective, the ‘‘smaller-the-better’’ equation was used for the calculation of the S/N ratio. The finishing roughness parameter Ra has been measured for the different process combinations. The arithmetic means deviation (Rₐ) was measured via the experimental design for each combination of the control factors by using Taguchi experimental design. Four roughness measurements were taken for a single component and the average roughness was taken to optimize the surface roughness. The lowest value of Rₐ is very important for surface roughness improvement. For this reason, the ‘‘smaller-the-better’’ Equation was used for the calculation of the S/N ratio. Analysis of the effect of each control factor on the surface roughness was performed with a ‘‘S/N response table’’. Optimum surface roughness was obtained at a feed rate of 1500 mm/min, with a tool radius of 12 mm, and with a step depth of 0.5 mm. The ANOVA result shows that step depth is an essential factor affecting surface roughness (91.1 %).

Keywords: incremental forming, SPIF, drawing quality steel, surface roughness, roughness behavior

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Authors: Hale Kirer Silva Lecuna, Beyza Aydin

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Health is one of the main components of human capital and sustainable development, and it is very important for economic growth. Health economics, which is an indisputable part of the science of economics, has five stages in general. These are health and development, financing of health services, economic regulation in the health, allocation of resources and efficiency of health services. A well-developed and efficient health sector plays a major role by increasing the level of development of countries. The most crucial pillars of the health sector are the hospitals that are divided into public and private. The main purpose of the hospitals is to provide more efficient services. Therefore the aim is to meet patients’ satisfaction by increasing the service quality. Health-related studies in Turkey date back to the Ottoman and Seljuk Empires. In the near past, Turkey applied 'Health Sector Transformation Programs' under different titles between 2003 and 2010. Our aim in this paper is to measure how effective these transformation programs are for the health sector, to see how much they can increase the efficiency of hospitals over the years, to see the return of investments, to make comments and suggestions on the results, and to provide a new reference for the literature. Within this framework, the public and private hospitals in Balıkesir, Bilecik, Bursa, Çanakkale, Edirne, Istanbul, Kirklareli, Kocaeli, Sakarya, Tekirdağ, Yalova will be examined by using Data Envelopment Analysis (DEA) for the years between 2000 and 2019. DEA is a linear programming-based technique, which gives relatively good results in multivariate studies. DEA basically estimates an efficiency frontier and make a comparison. Constant returns to scale and variable returns to scale are two most commonly used DEA methods. Both models are divided into two as input and output-oriented. To analyze the data, the number of personnel, number of specialist physicians, number of practitioners, number of beds, number of examinations will be used as input variables; and the number of surgeries, in-patient ratio, and crude mortality rate as output variables. 11 hospitals belonging to the Marmara region were included in the study. It is seen that these hospitals worked effectively only in 7 provinces (Balıkesir, Bilecik, Bursa, Edirne, İstanbul, Kırklareli, Yalova) for the year 2001 when no transformation program was implemented. After the transformation program was implemented, for example, in 2014 and 2016, 10 hospitals (Balıkesir, Bilecik, Bursa, Çanakkale, Edirne, İstanbul, Kocaeli, Kırklareli, Tekirdağ, Yalova) were found to be effective. In 2015, ineffective results were observed for Sakarya, Tekirdağ and Yalova. However, since these values are closer to 1 after the transformation program, we can say that the transformation program has positive effects. For Sakarya alone, no effective results have been achieved in any year. When we look at the results in general, it shows that the transformation program has a positive effect on the effectiveness of hospitals.

Keywords: data envelopment analysis, efficiency, health sector, Marmara region

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Authors: Katarina Ott, Velibor Mačkić, Mihaela Bronić, Branko Stanić

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The determinants of national budget transparency have been widely discussed in the literature, while research on determinants of local budget transparency are scarce and empirically inconclusive, particularly in the new, fiscally centralised, EU member states. To fill the gap, we combine two strands of the literature: that concerned with public administration and public finance, shedding light on the economic and financial determinants of local budget transparency, and that on the political economy of transparency (principal agent theory), covering the relationships among politicians and between politicians and voters. Our main hypothesis states that variables describing residents’ capacity have a greater impact on local budget transparency than variables indicating the institutional capacity of local government units (LGUs). Additional subhypotheses test the impact of each variable analysed on local budget transparency. We address the determinants of local budget transparency in Croatia, measured by the number of key local budget documents published on the LGUs’ websites. By using a data set of 128 cities and 428 municipalities over the 2015-2017 period and by applying panel data analysis based on Poisson and negative binomial distribution, we test our main hypothesis and sub-hypotheses empirically. We measure different characteristics of institutional and residents’ capacity for each LGU. Age, education and ideology of the mayor/municipality head, political competition indicators, number of employees, current budget revenues and direct debt per capita have been used as a measure of the institutional capacity of LGU. Residents’ capacity in each LGU has been measured through the numbers of citizens and their average age as well as by average income per capita. The most important determinant of local budget transparency is average residents' income per capita at both city and municipality level. The results are in line with most previous research results in fiscally decentralised countries. In the context of a fiscally centralised country with numerous small LGUs, most of whom have low administrative and fiscal capacity, this has a theoretical rationale in the legitimacy and principal-agent theory (opportunistic motives of the incumbent). The result is robust and significant, but because of the various other results that change between city and municipality levels (e.g. ideology and political competition), there is a need for further research (both on identifying other determinates and/or methods of analysis). Since in Croatia the fiscal capacity of a LGU depends heavily on the income of its residents, units with higher per capita incomes in many cases have also higher budget revenues allowing them to engage more employees and resources. In addition, residents’ incomes might be also positively associated with local budget transparency because of higher citizen demand for such transparency. Residents with higher incomes expect more public services and have more access to and experience in using the Internet, and will thus typically demand more budget information on the LGUs’ websites.

Keywords: budget transparency, count data, Croatia, local government, political economy

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Authors: Laura Kocsor, Laszlo Peter, Laszlo Kovacs, Zsolt Kis

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The aim of our research is to prepare rare-earth-doped lithium niobate (LiNbO3) nanocrystals, having only a few dopant ions in the focal point of an exciting laser beam. These samples will be used to achieve individual addressing of the dopant ions by light beams in a confocal microscope setup. One method for the preparation of nanocrystalline materials is to reduce the particle size by mechanical grinding. High-energy ball-milling was used in several works to produce nano lithium niobate. Previously, it was reported that dry high-energy ball-milling of lithium niobate in a shaker mill results in the partial reduction of the material, which leads to a balanced formation of bipolarons and polarons yielding gray color together with oxygen release and Li2O segregation on the open surfaces. In the present work we focus on preparing LiNbO3 nanocrystals by high-energy ball-milling using a Fritsch Pulverisette 7 planetary mill. Every ball-milling process was carried out in zirconia vial with zirconia balls of different sizes (from 3 mm to 0.1 mm), wet grinding with water, and the grinding time being less than an hour. Gradually decreasing the ball size to 0.1 mm, an average particle size of about 10 nm could be obtained determined by dynamic light scattering and verified by scanning electron microscopy. High-energy ball-milling resulted in sample darkening evidenced by optical absorption spectroscopy measurements indicating that the material underwent partial reduction. The unwanted lithium oxide loss decreases the Li/Nb ratio in the crystal, strongly influencing the spectroscopic properties of lithium niobate. Zirconia contamination was found in ground samples proved by energy-dispersive X-ray spectroscopy measurements; however, it cannot be explained based on the hardness properties of the materials involved in the ball-milling process. It can be understood taking into account the presence of lithium hydroxide formed the segregated lithium oxide and water during the ball-milling process, through chemically induced abrasion. The quantity of the segregated Li2O was measured by coulometric titration. During the wet milling process in the planetary mill, it was found that the lithium oxide loss increases linearly in the early phase of the milling process, then a saturation of the Li2O loss can be seen. This change goes along with the disappearance of the relatively large particles until a relatively narrow size distribution is achieved in accord with the dynamic light scattering measurements. With the 3 mm ball size and 1100 rpm rotation rate, the mean particle size achieved is 100 nm, and the total Li2O loss is about 1.2 wt.% of the original LiNbO3. Further investigations have been done to minimize the Li2O segregation during the ball-milling process. Since the Li2O loss was observed to increase with the growing total surface of the particles, the influence of ball-milling parameters on its quantity has also been studied.

Keywords: high-energy ball-milling, lithium niobate, mechanochemical reaction, nanocrystals

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Authors: Rasmila Kawan, Sanjay Juvekar, Sandeep Salvi, Gufran Beig, Rainer Sauerborn

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Background: Indoor air pollution especially from the use of biomass fuels, remains a potentially large global health threat. The inefficient use of such fuels in poorly ventilated conditions results in high levels of indoor air pollution, most seriously affecting women and young children. Objectives: The main aim of this study was to measure and compare the lung function of the women exposed in the biomass fuels and LPG fuels and relate it to the indoor emission measured using a structured questionnaire, spirometer and filter based low volume samplers respectively. Methodology: This cross-sectional comparative study was conducted among the women (aged > 18 years) living in rural villages of Pune district who were not diagnosed of chronic pulmonary diseases or any other respiratory diseases and using biomass fuels or LPG for cooking for a minimum period of 5 years or more. Data collection was done from April to June 2017 in dry season. Spirometer was performed using the portable, battery-operated ultrasound Easy One spirometer (Spiro bank II, NDD Medical Technologies, Zurich, Switzerland) to determine the lung function over Forced expiratory volume. The primary outcome variable was forced expiratory volume in 1 second (FEV1). Secondary outcome was chronic obstruction pulmonary disease (post bronchodilator FEV1/ Forced Vital Capacity (FVC) < 70%) as defined by the Global Initiative for Obstructive Lung Disease. Potential confounders such as age, height, weight, smoking history, occupation, educational status were considered. Results: Preliminary results showed that the lung function of the women using Biomass fuels (FEV1/FVC = 85% ± 5.13) had comparatively reduced lung function than the LPG users (FEV1/FVC = 86.40% ± 5.32). The mean PM 2.5 mass concentration in the biomass user’s kitchen was 274.34 ± 314.90 and 85.04 ± 97.82 in the LPG user’s kitchen. Black carbon amount was found higher in the biomass users (black carbon = 46.71 ± 46.59 µg/m³) than LPG users (black carbon=11.08 ± 22.97 µg/m³). Most of the houses used separate kitchen. Almost all the houses that used the clean fuel like LPG had minimum amount of the particulate matter 2.5 which might be due to the background pollution and cross ventilation from the houses using biomass fuels. Conclusions: Therefore, there is an urgent need to adopt various strategies to improve indoor air quality. There is a lacking of current state of climate active pollutants emission from different stove designs and identify major deficiencies that need to be tackled. Moreover, the advancement in research tools, measuring technique in particular, is critical for researchers in developing countries to improve their capability to study the emissions for addressing the growing climate change and public health concerns.

Keywords: black carbon, biomass fuels, indoor air pollution, lung function, particulate matter

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Authors: K. S. Vimal, D. Bodhini, K. Ramya, N. Lakshmipriya, R. M. Anjana, V. Sudha, J. A. Lovegrove, V. Mohan, V. Radha

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Gene-lifestyle interaction studies have been carried out in various populations. However, to date there are no studies in an Asian Indian population. Hence, we examined whether lifestyle factors such as diet and physical activity modify the association between fat mass and obesity–associated (FTO) gene variants and obesity and type 2 diabetes (T2D) in an Asian Indian population. We studied 734 unrelated T2D and 884 normal glucose-tolerant (NGT) participants randomly selected from the Chennai Urban Rural Epidemiology Study (CURES) in Southern India. Obesity was defined according to the World Health Organization Asia Pacific Guidelines (non-obese, BMI < 25 kg/m2; obese, BMI ≥ 25 kg/m2). Six single nucleotide polymorphisms (SNPs) in the FTO gene (rs9940128, rs7193144, rs8050136, rs918031, rs1588413 and rs11076023) identified from recent genome-wide association studies for T2D were genotyped by polymerase chain reaction-restriction fragment length polymorphism and direct sequencing. Dietary assessment was carried out using a validated food frequency questionnaire and physical activity was based upon the self-report. Interaction analyses were performed by including the interaction terms in the model. A joint likelihood ratio test of the main SNP effects and the SNP-diet/physical activity interaction effects was used in the linear regression analyses to maximize statistical power. Statistical analyses were performed using STATA version 13. There was a significant interaction between FTO SNP rs8050136 and carbohydrate energy percentage (Pinteraction=0.04) on obesity, where the ‘A’ allele carriers of the SNP rs8050136 had 2.46 times higher risk of obesity than those with ‘CC’ genotype (P=3.0x10-5) among individuals in the highest tertile of carbohydrate energy percentage. Furthermore, among those who had lower levels of physical activity, the ‘A’ allele carriers of the SNP rs8050136 had 1.89 times higher risk of obesity than those with ‘CC’ genotype (P=4.0x10-5). We also found a borderline interaction between SNP rs11076023 and carbohydrate energy percentage (Pinteraction=0.08) on T2D, where the ‘A’ allele carriers in the highest tertile of carbohydrate energy percentage, had 1.57 times higher risk of T2D than those with ‘TT’ genotype (P=0.002). There was also a significant interaction between SNP rs11076023 and physical activity (Pinteraction=0.03) on T2D. No further significant interactions between SNPs and macronutrient intake or physical activity on obesity and T2D were observed. In conclusion, this is the first study to provide evidence for a gene-diet and gene-physical activity interaction on obesity and T2D in an Asian Indian population. These findings suggest that the association between FTO gene variants and obesity and T2D is influenced by carbohydrate intake and physical activity levels. Greater understanding of how FTO gene influences obesity and T2D through dietary and exercise interventions will advance the development of behavioral intervention and personalised lifestyle strategies predicted to reduce the development of metabolic diseases in ‘A’ allele carriers of both SNPs in this Asian Indian population.

Keywords: dietary intake, FTO, obesity, physical activity, type 2 diabetes, Asian Indian.

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Authors: Raj Chandran, Saul Datwyler, Jaime Marino, Daniel West, Karla Grasso, Adam Buss, Hina Syed, Zina Al Sahouri, Jennifer Yen, Krista Caudle, Beth McQuiston

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The Alinity i TBI test is Therapeutic Goods Administration (TGA) registered and is a panel of in vitro diagnostic chemiluminescent microparticle immunoassays for the measurement of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) in plasma and serum. The Alinity i TBI performance was evaluated in a multi-center pivotal study to demonstrate the capability to assist in determining the need for a CT scan of the head in adult subjects (age 18+) presenting with suspected mild TBI (traumatic brain injury) with a Glasgow Coma Scale score of 13 to 15. TBI has been recognized as an important cause of death and disability and is a growing public health problem. An estimated 69 million people globally experience a TBI annually1. Blood-based biomarkers such as glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have shown utility to predict acute traumatic intracranial injury on head CT scans after TBI. A pivotal study using prospectively collected archived (frozen) plasma specimens was conducted to establish the clinical performance of the TBI test on the Alinity i system. The specimens were originally collected in a prospective, multi-center clinical study. Testing of the specimens was performed at three clinical sites in the United States. Performance characteristics such as detection limits, imprecision, linearity, measuring interval, expected values, and interferences were established following Clinical and Laboratory Standards Institute (CLSI) guidance. Of the 1899 mild TBI subjects, 120 had positive head CT scan results; 116 of the 120 specimens had a positive TBI interpretation (Sensitivity 96.7%; 95% CI: 91.7%, 98.7%). Of the 1779 subjects with negative CT scan results, 713 had a negative TBI interpretation (Specificity 40.1%; 95% CI: 37.8, 42.4). The negative predictive value (NPV) of the test was 99.4% (713/717, 95% CI: 98.6%, 99.8%). The analytical measuring interval (AMI) extends from the limit of quantitation (LoQ) to the upper LoQ and is determined by the range that demonstrates acceptable performance for linearity, imprecision, and bias. The AMI is 6.1 to 42,000 pg/mL for GFAP and 26.3 to 25,000 pg/mL for UCH-L1. Overall, within-laboratory imprecision (20 day) ranged from 3.7 to 5.9% CV for GFAP and 3.0 to 6.0% CV for UCH-L1, when including lot and instrument variances. The Alinity i TBI clinical performance results demonstrated high sensitivity and high NPV, supporting the utility to assist in determining the need for a head CT scan in subjects presenting to the emergency department with suspected mild TBI. The GFAP and UCH-L1 assays show robust analytical performance across a broad concentration range of GFAP and UCH-L1 and may serve as a valuable tool to help evaluate TBI patients across the spectrum of mild to severe injury.

Keywords: biomarker, diagnostic, neurology, TBI

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Authors: Henry Nicholas Lee, George Thomas, Juliana Johari, Carmilla Freddie, Caroline Val Madin

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Research in comparative and international education often provides value-laden views of an education system within and in between other countries. These views are frequently used by policy makers or educators to explore similarities and differences for, among others, benchmarking purposes. In this study, a comparison is made between Malaysia and England, focusing on the process of writing children went through to create a text, using a multimodal theoretical framework to analyse this comparison. The main purpose is political in nature as it served as an answer to Malaysia’s call for benchmarking of best practices for language learning. Furthermore, the focus on writing in this study adds into more empirical findings about early writers’ writing development and writing improvement, especially for children at the ages of 5-9. In research, comparative studies in English as a Second Language (ESL) writing pedagogy – particularly in Malaysia since the introduction of the Standard- based English Language Curriculum (KSSR) in 2011 as a draft and its full implementation in 2017; reviewed 2018 KSSR-CEFR aligned – has not been done comparatively. In theory, a multimodal theoretical framework somehow allows a logical comparison between first language and ESL which would provide useful insights to illuminate the writing process between Malaysia and England. The comparisons are not representative because of the different school systems in both countries. So far, the literature informs us that the curriculum for language learning is very much emphasised on children’s linguistic abilities, which include their proficiency and mastery of the language, its conventions, and technicalities. However, recent empirical findings suggested that literacy in its concepts and characters need change. In view of this suggestion, the comparison will look at how the process of writing is implemented through the five modes of communication: linguistic, visual, aural, spatial, and gestural. This project draws on data from Malaysia and England, involving 10 teachers, 26 classroom observations, 20 lesson plans, 20 interviews, and 20 brief conversations with teachers. The research focused upon 20 primary children of different genders aged 5-9, and in addition to primary data descriptions, 40 children’s works, 40 brief classroom conversations, 30 classroom photographs, and 30 school compound photographs were undertaken to investigate teachers and children’s use of modes and semiotic resources to design a text. The data were analysed by means of within-case analysis, cross-case analysis, and constant comparative analysis, with an initial stage of data categorisation, followed by general and specific coding, which clustered the data into thematic groups. The study highlights the importance of teachers’ and children’s engagement and interaction with various modes of communication, an adaptation from the English approaches to teaching writing within the KSSR framework and providing ‘voice’ to ESL writers to ensure that both have access to the knowledge and skills required to make decisions in developing multimodal texts and artefacts.

Keywords: comparative education, early writers, KSSR, multimodal theoretical framework, writing development

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Authors: Nirit Gavish, Rotem Halutz, Liad Neta

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Nowadays, chatbots are gaining more and more attention due to the advent of large language models. One of the important considerations in chatbot design is how to create an interface to achieve high user satisfaction, trust, and acceptance. Since WhatsApp conversations sometimes substitute for face-to-face communication, we studied whether WhatsAppization of the chatbot -making the conversation resemble a WhatsApp conversation more- will improve user satisfaction, trust, and acceptance, or whether the opposite will occur due to the Uncanny Valley (UV) effect. The task was a drive-sharing task, in which participants communicated with a textual chatbot via WhatsApp and could decide whether to participate in a ride to college with a driver suggested by the chatbot. WhatsAppization of the chatbot was done in two ways: By a dialog-style conversation (Dialog versus No Dialog), and by adding WhatsApp indicators – “Last Seen”, “Connected”, “Read Receipts”, and “Typing…” (Indicators versus No Indicators). Our 120 participants were randomly assigned to one of the four 2 by 2 design groups, with 30 participants in each. They interacted with the WhatsApp chatbot and then filled out a questionnaire. The results demonstrated that, as expected from the manipulation, the interaction with the chatbot was longer for the dialog condition compared to the no dialog. This extra interaction, however, did not lead to higher acceptance -quite the opposite, since participants in the dialog condition were less willing to implement the decision made at the end of the conversation with the chatbot and continue the interaction with the driver they chose. The results are even more striking when considering the Indicators condition. Both for the satisfaction measures and the trust measures, participants’ ratings were lower in the Indicators condition compared to the No Indicators. Participants in the Indicators condition felt that the ride search process was harder to operate, and slower (even though the actual interaction time was similar). They were less convinced that the chatbot suggested real trips and they trusted the person offering the ride and referred to them by the chatbot less. These effects were more evident for participants who preferred to share their rides using WhatsApp compared to participants who preferred chatbots for that purpose. Considering our findings, we can say that the WhatsAppization of the chatbot was detrimental. This is true for the both chatbot WhatsAppization methods – by making the conversation more a dialog and adding WhatsApp indicators. For the chosen drive-sharing task, the results were, in addition to lower satisfaction, less trust in the chatbot’s suggestion and even in the driver suggested by the chatbot, and lower willingness to actually undertake the suggested ride. In addition, it seems that the most problematic WhatsAppization method was using WhatsApp’s indicators during the interaction with the chatbot. The current study suggests that a conversation with an artificial agent should also not imitate a WhatsApp conversation very closely. With the proliferation of WhatsApp use, the emotional and social aspect of face-to face commination are moving to WhatsApp communication. Based on the current study’s findings, it is possible that the UV effect also occurs in WhatsAppization, and not only in humanization, of the chatbot, with a similar feeling of eeriness, and is more pronounced for people who prefer to use WhatsApp over chatbots. The current research can serve as a starting point to study the very interesting and important topic of chatbots WhatsAppization. More methods of WhatsAppization and other tasks could be the focus of further studies.

Keywords: chatbot, WhatsApp, humanization, Uncanny Valley, drive sharing

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Authors: Mingyan Hong, Shuozhao Hou

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Collaborative Strategic Learning (CSL) teaches students to use learning strategies while working cooperatively. Student strategies include the following steps: defining the learning task and purpose; conducting ongoing negotiation of the learning materials by deciding "click" (I get it and I can teach it – green card, I get it –yellow card) or "clunk" (I don't get it – red card) at the end of each learning unit; "getting the gist" of the most important parts of the learning materials; and "wrapping up" key ideas. Find out how to help students of mixed achievement levels apply learning strategies while learning content area in materials in small groups. The design of CSL is based on social-constructivism and Vygotsky’s best-known concept of the Zone of Proximal Development (ZPD). The definition of ZPD is the distance between the actual acquisition level as decided by individual problem solution case and the level of potential acquisition level, similar to Krashen (1980)’s i+1, as decided through the problem-solution case under the facilitator’s guidance, or in group work with other more capable members (Vygotsky, 1978). Vygotsky claimed that learners’ ideal learning environment is in the ZPD. An ideal teacher or more-knowledgable-other (MKO) should be able to recognize a learner’s ZPD and facilitates them to develop beyond it. Then the MKO is able to leave the support step by step until the learner can perform the task without aid. Steven Krashen (1980) proposed Input hypothesis including i+1 hypothesis. The input hypothesis models are the application of ZPD in second language acquisition and have been widely recognized until today. Krashen (2019)’s optimal language learning environment (2019) further developed the application of ZPD and added the component of strategic group learning. The strategic group learning is composed of desirable learning materials learners are motivated to learn and desirable group members who are more capable and are therefore able to offer meaningful input to the learners. Purpose-driven Collaborative Strategic Learning Model is a strategic integration of ZPD, i+1 hypothesis model, and Optimal Language Learning Environment Model. It is purpose driven to ensure group members are motivated. It is collaborative so that an optimal learning environment where meaningful input from meaningful conversation can be generated. It is strategic because facilitators in the model strategically assign each member a meaningful and collaborative role, e.g., team leader, technician, problem solver, appraiser, offer group learning instrument so that the learning process is structured, and integrate group learning and team building making sure holistic development of each participant. Using data collected from college year one and year two students’ English courses, this presentation will demonstrate how purpose-driven collaborative strategic learning model is implemented in the second/foreign language classroom, using the qualitative data from questionnaire and interview. Particular, this presentation will show how second/foreign language learners grow from functioning with facilitator or more capable peer’s aid to performing without aid. The implication of this research is that purpose-driven collaborative strategic learning model can be used not only in language learning, but also in any subject area.

Keywords: collaborative, strategic, optimal input, second language acquisition

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Authors: Megan Glyde, Louise Dye, David Keane, Ed Sutherland

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Background: Typically patient education is provided either verbally, in the form of written material, or with a multimedia-based tool such as videos, CD-ROMs, DVDs, or via the internet. By providing patients with effective educational tools, this can help to meet their information needs and subsequently empower these patients and allow them to participate within medical-decision making. Video education may have some distinct advantages compared to other modalities. For instance, whilst eHealth is emerging as a promising modality of patient education, an individual’s ability to access, read, and navigate through websites or online modules varies dramatically in relation to health literacy levels. Literacy levels may also limit patients’ ability to understand written education, whereas video education can be watched passively by patients and does not require high literacy skills. Other benefits of video education include that the same information is provided consistently to each patient, it can be a cost-effective method after the initial cost of producing the video, patients can choose to watch the videos by themselves or in the presence of others, and they can pause and re-watch videos to suit their needs. Health information videos are not only viewed by patients in formal educational sessions, but are increasingly being viewed on websites such as YouTube. Whilst there is a lot of anecdotal and sometimes misleading information on YouTube, videos from government organisations and professional associations contain trustworthy and high-quality information and could enable YouTube to become a powerful information dissemination platform for patients and carers. This systematic review will examine the efficacy of video education to improve treatment or illness-related knowledge in patients with various long-term conditions, in comparison to other modalities of education. Methods: Only studies which match the following criteria will be included: participants will have a long-term physical health condition, video education will aim to improve treatment or illness related knowledge and will be tested in isolation, and the study must be a randomised controlled trial. Knowledge will be the primary outcome measure, with modality preference, anxiety, and behaviour change as secondary measures. The searches have been conducted in the following databases: OVID Medline, OVID PsycInfo, OVID Embase, CENTRAL and ProQuest, and hand searching for relevant published and unpublished studies has also been carried out. Screening and data extraction will be conducted independently by 2 researchers. Included studies will be assessed for their risk of bias in accordance with Cochrane guidelines, and heterogeneity will also be assessed before deciding whether a meta-analysis is appropriate or not. Results and Conclusions: Appropriate synthesis of the studies in relation to each outcome measure will be reported, along with the conclusions and implications.

Keywords: long-term condition, patient education, systematic review, video

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