Search results for: cognitive behavioural therapy

Authors: John Zanetich

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

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

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Authors: Alicia Ettlin

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Amid the rise of neoliberalism to the leading economic policy model in Western societies in the 1980s, people have started to internalise a neoliberal way of thinking, whereby the human body has become an entity that can and needs to be precisely managed through free yet rational decision-making processes. The neoliberal citizen has consequently become an entrepreneur of the self who is free, independent, rational, productive and responsible for themselves, their health and wellbeing as well as their appearance. The focus on individuals as entrepreneurs who manage their bodies through the rationally thinking mind has, however, become increasingly criticised for viewing the social actor as ‘disembodied’, as a detached, social actor whose powerful mind governs over the passive body. On the other hand, the discourse around embodiment seeks to connect rational decision-making processes to the dominant neoliberal discourse which creates an embodied understanding that the body, just as other areas of people’s lives, can and should be shaped, monitored and managed through cognitive and rational thinking. This perspective offers an understanding of the body regarding its connections with the social environment that reaches beyond the debates around mind-body binary thinking. Hence, following this argument, body management should not be thought of as either solely guided by embodied discourses nor as merely falling into a mind-body dualism, but rather, simultaneously and inseparably as both at once. The descriptive, qualitative analysis of semi-structured in-depth interviews conducted with young Australian amateur athletes between the age of 18 and 24 has shown that most participants are interested in measuring and managing their body to create self-knowledge and self-improvement. The participants thereby connected self-improvement to weight loss, muscle gain or simply staying fit and healthy. Self-knowledge refers to body measurements including weight, BMI or body fat percentage. Self-management and self-knowledge that are reliant on one another to take rational and well-thought-out decisions, are both characteristic values of the neoliberal doctrine. A neoliberal way of thinking and looking after the body has also by many been connected to rewarding themselves for their discipline, hard work or achievement of specific body management goals (e.g. eating chocolate for reaching the daily step count goal). A few participants, however, have shown resistance against these neoliberal values, and in particular, against the precise monitoring and management of the body with the help of self-tracking devices. Ultimately, however, it seems that most participants have internalised the dominant discourses around self-responsibility, and by association, a sense of duty to discipline their body in normative ways. Even those who have indicated their resistance against body work and body management practices that follow neoliberal thinking and measurement systems, are aware and have internalised the concept of the rational operating mind that needs or should decide how to look after the body in terms of health but also appearance ideals. The discussion around the collected data thereby shows that embodiment and the mind/body dualism constitute two connected, rather than two separate or opposing concepts.

Keywords: dualism, embodiment, mind, neoliberalism

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Authors: Aussara Panya, Nunghathai Sawasdee, Mutita Junking, Chatchawan Srisawat, Kiattawee Choowongkomon, Pa-Thai Yenchitsomanus

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Dengue virus (DENV) infection is a global public health problem with approximately 100 million infected cases a year. Presently, there is no approved vaccine or effective drug available; therefore, the development of anti-DENV drug is urgently needed. The clinical reports revealing the positive association between the disease severity and viral titer has been reported previously suggesting that the anti-DENV drug therapy can possibly ameliorate the disease severity. Although several anti-DENV agents showed inhibitory activities against DENV infection, to date none of them accomplishes clinical use in the patients. The surface envelope (E) protein of DENV is critical for the viral entry step, which includes attachment and membrane fusion; thus, the blocking of envelope protein is an attractive strategy for anti-DENV drug development. To search the safe anti-DENV agent, this study aimed to search for novel peptide inhibitors to counter DENV infection through the targeting of E protein using a structure-based in silico design. Two selected strategies has been used including to identify the peptide inhibitor which interfere the membrane fusion process whereby the hydrophobic pocket on the E protein was the target, the destabilization of virion structure organization through the disruption of the interaction between the envelope and membrane proteins, respectively. The molecular docking technique has been used in the first strategy to search for the peptide inhibitors that specifically bind to the hydrophobic pocket. The second strategy, the peptide inhibitor has been designed to mimic the ectodomain portion of membrane protein to disrupt the protein-protein interaction. The designed peptides were tested for the effects on cell viability to measure the toxic to peptide to the cells and their inhibitory assay to inhibit the DENV infection in Vero cells. Furthermore, their antiviral effects on viral replication, intracellular protein level and viral production have been observed by using the qPCR, cell-based flavivirus immunodetection and immunofluorescence assay. None of tested peptides showed the significant effect on cell viability. The small peptide inhibitors achieved from molecular docking, Glu-Phe (EF), effectively inhibited DENV infection in cell culture system. Its most potential effect was observed for DENV2 with a half maximal inhibition concentration (IC50) of 96 μM, but it partially inhibited other serotypes. Treatment of EF at 200 µM on infected cells also significantly reduced the viral genome and protein to 83.47% and 84.15%, respectively, corresponding to the reduction of infected cell numbers. An additional approach was carried out by using peptide mimicking membrane (M) protein, namely MLH40. Treatment of MLH40 caused the reduction of foci formation in four individual DENV serotype (DENV1-4) with IC50 of 24-31 μM. Further characterization suggested that the MLH40 specifically blocked viral attachment to host membrane, and treatment with 100 μM could diminish 80% of viral attachment. In summary, targeting the hydrophobic pocket and M-binding site on the E protein by using the peptide inhibitors could inhibit DENV infection. The results provide proof of-concept for the development of antiviral therapeutic peptide inhibitors to counter DENV infection through the use of a structure-based design targeting conserved viral protein.

Keywords: dengue virus, dengue virus infection, drug design, peptide inhibitor

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Authors: Abiodun Afolabi, Rufus Adesoji Adedoyin

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This study investigated and compared the effects of gym-based exercise programme (GEBP) and audio-visual guided home-based exercise programme (AVGHBEP) on selected Anthropometric variables (Weight (W), Body Mass Index (BMI), Waist Circumference (WC), Hip Circumference (HC), Thigh Circumference (TC), Waist-Hip-Ratio (WHR), Waist-Height-Ratio (WHtR), Waist-Thigh-Ratio (WTR), Biceps Skinfold Thickness (BSFT), Triceps Skinfold Thickness (TSFT), Suprailliac Skinfold Thickness (SISFT), Subscapular Skinfold Thickness (SSSFT) and Percent Body Fat (PBF)); and Cardiovasular variables (Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR)) of overweight and obese students of Federal College of Education (Special), Oyo, Oyo State, Nigeria, with a view to providing information and evidence for GBEP and AVGHBEP in reducing overweight and obesity for promoting cardiovascular fitness. Eighty overweight and obese students (BMI ≥ 25 Kg/m²) were involved in this pretest-posttest quasi experimental study. Participants were randomly assigned into GBEP (n = 40) and AVGBBEP (n = 40) groups. Anthropometric and cardiovascular variables were measured using a weighing scale, height meter, tape measure, skinfold caliper and electronic sphygmomanometer following standard protocols. GBEP and AVGHBEP were implemented following a circuit training (aerobic and resistance training) pattern with a duration of 40-60 minutes, thrice weekly for twelve weeks. GBEP consisted of gymnasium supervised exercise programme while AVGHBEP is a Visual Display guided exercise programme conducted at the home setting. Data were analyzed by Descriptive and Inferential Statistics. The mean ages of the participants were 22.55 ± 2.55 and 23.65 ± 2.89 years for the GBEP group and AVGHBEP group, respectively. Findings showed that in the GBEP group, there were significant reductions in anthropometric variables and adiposity measures of Weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHtR, and PBF at week 12 of the study. Similarly, in the AVGHBEP group, there were significant reductions in Weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHtR and PBF at the 12th week of intervention. Comparison of the effects of GEBP and AVGHBEP on anthropometric variables and measures of adiposity showed that there was no significant difference between the two groups in weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHR, WHtR, WTR and PBF between the two groups at week 12 of the study. Furthermore, findings on the effects of exercise on programmes on cardiovascular variables revealed that significant reductions occurred in SBP in GBEP group and AVGHBEP group respectively. Comparison of the effects of GBEP and AVGHBEP on cardiovascular variables showed that there was no significant difference in SBP, DBP and HR between the two groups at week 12 of the study. It was concluded that the Audio-Visual Guided Home-based Exercise Programme was as effective as the Gym-Based Exercise Programme in causing a significant reduction in anthropometric variables and body fat among college students who are overweight and obese over a period of twelve weeks. Both Gymnasium-Based Exercise Programme and Audio-Visual Guided Home-Based Exercise Programme led to significant reduction in Systolic Blood Pressure over a period of weeks. Audio-Visual Guided Home-Based Exercise Programme can, therefore, be used as an alternative therapy in the non-pharmacological management of people who are overweight and obese.

Keywords: gym-based exercises, audio-visual guided home-based exercises, anthropometric parameters, cardiovascular parameters, overweight students, obese students

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Authors: Dmitry Yu. Korulkin, Raissa A. Muzychkina

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Bioactive substances of plant origin can be one of the advanced means of solution to the issue of combined therapy to inflammation. The main advantages of medical plants are softness and width of their therapeutic effect on an organism, the absence of side effects and complications even if the used continuously, high tolerability by patients. Moreover, medial plants are often the only and (or) cost-effective sources of natural biologically active substances and medicines. Along with other biologically active groups of chemical compounds, essential oils with wide range of pharmacological effects became very ingrained in medical practice. Essential oil was obtained by the method hydrodistillation air-dry aerial part of Polygonum L. plants using Clevenger apparatus. Qualitative composition of essential oils was analyzed by chromatography-mass-spectrometry method using Agilent 6890N apparatus. The qualitative analysis is based on the comparison of retention time and full mass-spectra with respective data on components of reference oils and pure compounds, if there were any, and with the data of libraries of mass-spectra Wiley 7th edition and NIST 02. The main components of essential oil are for: Polygonum amphibium L. - γ-terpinene, borneol, piperitol, 1,8-cyneole, α-pinene, linalool, terpinolene and sabinene; Polygonum minus Huds. Fl. Angl. – linalool, terpinolene, camphene, borneol, 1,8-cyneole, α-pinene, 4-terpineol and 1-octen-3-ol; Polygonum alpinum All. – camphene, sabinene, 1-octen-3-ol, 4-carene, p- and o-cymol, γ-terpinene, borneol, -terpineol; Polygonum persicaria L. - α-pinene, sabinene, -terpinene, 4-carene, 1,8-cyneole, borneol, 4-terpineol. Antibacterial activity was researched relating to strains of gram-positive bacteria Staphylococcus aureus, Bacillus subtilis, Streptococcus agalacticae, relating to gram-negative strain Escherichia coli and to yeast fungus Сandida albicans using agar diffusion method. The medicines of comparison were gentamicin for bacteria and nystatin for yeast fungus Сandida albicans. It has been shown that Polygonum L. essential oils has moderate antibacterial effect to gram-positive microorganisms and weak antifungal activity to Candida albicans yeast fungus. At the second stage of our researches wound healing properties of ointment form of 3% essential oil was researched on the model of flat dermal wounds. To assess the influence of essential oil on healing processes the model of flat dermal wound. The speed of wound healing on rats of different groups was judged based on assessment the area of a wound from time to time. During research of wound healing properties disturbance of integral in neither group: general condition and behavior of animals, food intake, and excretion. Wound healing action of 3% ointment on base of Polygonum L. essential oil and polyethyleneglycol is comparable with the action of reference substances. As more favorable healing dynamics was observed in the experimental group than in control group, the tested ointment can be deemed more promising for further detailed study as wound healing means.

Keywords: antibacterial, antifungal, bioactive substances, essential oils, isolation, Polygonum L.

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Authors: Sophia El Ouazzani, Amer M. Burhan, Mary Wickenden

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Background: Despite improvements in recent years, the Moroccan mental healthcare system still face disparity between available resources and the current population’sneeds. The societal stigma, and limited economic, political, and human resources are all factors in shaping the psychiatric system, exacerbating the discontinuity of services for users after discharged from the hospital. As a result, limited opportunities for social inclusion and meaningful community engagement undermines human rights and recovery potential for people with mental health problems, especially those with psychiatric disabilities from serious mental illness (SMI). Recovery-oriented practice, such as mental health rehabilitation, addresses the complex needs of patients with SMI and support their community inclusion. The cultural acceptability of recovery-oriented practice is an important notion to consider for a successful implementation. Exploring the extent to which recovery-oriented practices are used in Morocco is a necessary first step to assess the cultural relevance of such a practice model. Aims: This study aims to explore understanding and knowledge, perception, and perspective about core concepts in mental health rehabilitation, including psychiatric disability, recovery, and engagement in meaningful occupations for people with SMI in Morocco. Methods: A pilot qualitative study was undertaken. Data was collected via semi-structured interviews and focusgroup discussions with healthcare professional students. Questions were organised around the following themes: 1) students’ perceptions, understanding, and expectations around concepts such as SMI, mental health disability, and recovery, and 2) changes in their views and expectations after starting their professional training. Further analysis of students’ perspectives on the concept of ‘meaningful occupation’ and how is this viewed within the context of the research questions was done. The data was extracted using an inductive thematic analysis approach. This is a pilot stage of a doctoral project, further data will be collected and analysed until saturation is reached. Results: A total of eight students were included in this study which included occupational therapy and mental health nursing students receiving training in Morocco. The following themes emerged as influencing students’ perceptions and views around the main concepts: 1) Stigma and discrimination, 2) Fatalism and low expectations, 3) Gendered perceptions, 4) Religious causation, 5) Family involvement, 6) Professional background, 7) Inaccessibility of services and treatment. Discussion/Contribution: Preliminary analysis of the data suggests that students’ perceptions changed after gaining more clinical experiences and being exposed to people with psychiatric disabilities. Prior to their training, stigma shaped greatly how they viewed people with SMI. The fear, misunderstanding, and shame around SMI and their functional capacities may contribute to people with SMI being stigmatizedand marginalised from their family and their community. Religious causations associated to SMIsare understood as further deepening the social stigma around psychiatric disability. Perceptions are influenced by gender, with women being doubly discriminated against in relation to recovery opportunities. Therapeutic pessimism seems to persist amongst students and within the mental healthcare system in general and regarding the recovery potential and opportunities for people with SMI. The limited resources, fatalism, and stigma all contribute to the low expectations for recovery and community inclusion. Implications and future directions will be discussed.

Keywords: disability, mental health rehabilitation, recovery, serious mental illness, transcultural psychiatry

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Authors: Mballa Abanda Serge, Henda Gnakate Biba, Romaric Guemno Kuate, Akono Rufine Nicole, Petfiang Sidonie, Bella Sidonie

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The main hypotheses proposed around the definition of the syllable and of music, of the common origin of music and language, should lead the reader to reflect on the cross-cutting questions raised by the debate on the notion of universals in linguistics and musicology. These are objects of controversy, and there lies its interest: the debate raises questions that are at the heart of theories on language. It is an inventive, original and innovative research thesis. The main hypotheses proposed around the definition of the syllable and of music, of the common origin of music and language, should lead the reader to reflect on the cross-cutting questions raised by the debate on the notion of universals in linguistics and musicology. These are objects of controversy, and there lies its interest: the debate raises questions that are at the heart of theories on language. It is an inventive, original and innovative research thesis. A contribution to the theoretical, musicological, ethno musicological and linguistic conceptualization of languages, giving rise to the practice of interlocution between the social and cognitive sciences, the activities of artistic creation and the question of modeling in the human sciences: mathematics, computer science, translation automation and artificial intelligence. When you apply this theory to any text of a folksong of a world-tone language, you do not only piece together the exact melody, rhythm, and harmonies of that song as if you knew it in advance but also the exact speaking of this language. The author believes that the issue of the disappearance of tonal languages and their preservation has been structurally resolved, as well as one of the greatest cultural equations related to the composition and creation of tonal, polytonal and random music. The experimentation confirming the theorization, It designed a semi-digital, semi-analog application which translates the tonal languages of Africa (about 2,100 languages) into blues, jazz, world music, polyphonic music, tonal and anatonal music and deterministic and random music). To test this application, I use a music reading and writing software that allows me to collect the data extracted from my mother tongue, which is already modeled in the musical staves saved in the ethnographic (semiotic) dictionary for automatic translation ( volume 2 of the book). Translation is done (from writing to writing, from writing to speech and from writing to music). Mode of operation: you type a text on your computer, a structured song (chorus-verse), and you command the machine a melody of blues, jazz and world music or variety etc. The software runs, giving you the option to choose harmonies, and then you select your melody.

Keywords: music, entanglement, langauge, science

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Authors: Francesco De Giorgio

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As different groups of wild animals are moving from natural to more anthropic environments, the need to overcome the human-animal gap for ethical coexistence becomes a public concern. Ethnology and ethnography play fundamental roles in the understanding of dynamics, perspective and movement in our interaction with (other) animals. In this effort, the Animality perspective provides an essential ethical lens and quality guidance for ethnography. It deconstructs the human/animal distinction and creates an inclusive approach to society. It further transgresses the rigid lines of normalizing images in human cultures, in which individuals are easily marginalized as ‘different’. Just like labeling an animal with species-specific behavior, judging and categorizing humans according to culture-specific expectations is easier than recognizing subjectivity. A fusion of anti-speciesist ethnology and ethnography of natural and social sciences can redress the shortcomings of current practices of multispecies ethnography that largely remain within an exclusively normalized human perspective. Empirically, the paper is based on current research on wild urban animals and human movement in Genua (IT), collecting data from systematic observations in the field regarding wild boars and ethnographic data collection over a period of time (18 months) where the human involved are educated in a changing perspective of coexistence. An “animality-ethnography” starts from observing our animal movement, how much and when we move, how we intersect our movement with that of other animals cohabiting with us, how we can observe and know others by moving, and ways of walking. The research will show how (interspecies) socio-cognition implies motion and movement and animal journeys between nature and the city, but also within the cities themselves, where a web of motion becomes the basic cultural matrix for cohabiting spaces, places, and systems. Here, the term "cognition" does not refer just to the brain or mind or intelligence. Indeed, cognition has a lot to do with movement, space, motion, proprioception, and the body. The ability to be informed, not only through what you see but also through the information you get from being in tune with the motion of a shared dynamic. To be an informative presence instead of an active stimulus or passive expectation, where the latter leaves too much space for projections and interpretations. What is proposed here is an understanding of our own animal movement linked to our own animal cognition. The result of breaking down your own culturally prescribed way in ethnographic research is breaking the barrier of limited options for observation and comprehension of the Other. Walking in the same way results in seeing others in the same way, studying them through only one channel of perception, causing a one-dimensional life instead of a multidimensional web. Returning to an understanding of our Animality, our animal movement, being in tune to improve a socio-cognitive context of cohabitation, both with domestic and wild animals, both in a forest or in a metropolis, represents the challenge of the coming years, and the evolution of the next centuries, to both preserve and share cultures, beyond the boundaries of species.

Keywords: antispeciesist ethology, interspecies coexistence, socio-cognition, intersectionality, animality

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Authors: Norma Binti Alias, Che Rahim Che The, Norfarizan Mohd Said, Sakinah Abdul Hanan, Akhtar Ali

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This paper discusses on the transportation of magnetic drug targeting through blood within vessels, tissues and cells. There are three integrated mathematical models to be discussed and analyze the concentration of drug and blood flow through magnetic nanoparticles. The cell therapy brought advancement in the field of nanotechnology to fight against the tumors. The systematic therapeutic effect of Single Cells can reduce the growth of cancer tissue. The process of this nanoscale phenomena system is able to measure and to model, by identifying some parameters and applying fundamental principles of mathematical modeling and simulation. The mathematical modeling of single cell growth depends on three types of cell densities such as proliferative, quiescent and necrotic cells. The aim of this paper is to enhance the simulation of three types of models. The first model represents the transport of drugs by coupled partial differential equations (PDEs) with 3D parabolic type in a cylindrical coordinate system. This model is integrated by Non-Newtonian flow equations, leading to blood liquid flow as the medium for transportation system and the magnetic force on the magnetic nanoparticles. The interaction between the magnetic force on drug with magnetic properties produces induced currents and the applied magnetic field yields forces with tend to move slowly the movement of blood and bring the drug to the cancer cells. The devices of nanoscale allow the drug to discharge the blood vessels and even spread out through the tissue and access to the cancer cells. The second model is the transport of drug nanoparticles from the vascular system to a single cell. The treatment of the vascular system encounters some parameter identification such as magnetic nanoparticle targeted delivery, blood flow, momentum transport, density and viscosity for drug and blood medium, intensity of magnetic fields and the radius of the capillary. Based on two discretization techniques, finite difference method (FDM) and finite element method (FEM), the set of integrated models are transformed into a series of grid points to get a large system of equations. The third model is a single cell density model involving the three sets of first order PDEs equations for proliferating, quiescent and necrotic cells change over time and space in Cartesian coordinate which regulates under different rates of nutrients consumptions. The model presents the proliferative and quiescent cell growth depends on some parameter changes and the necrotic cells emerged as the tumor core. Some numerical schemes for solving the system of equations are compared and analyzed. Simulation and computation of the discretized model are supported by Matlab and C programming languages on a single processing unit. Some numerical results and analysis of the algorithms are presented in terms of informative presentation of tables, multiple graph and multidimensional visualization. As a conclusion, the integrated of three types mathematical modeling and the comparison of numerical performance indicates that the superior tool and analysis for solving the complete set of magnetic drug delivery system which give significant effects on the growth of the targeted cancer cell.

Keywords: mathematical modeling, visualization, PDE models, magnetic nanoparticle drug delivery model, drug release model, single cell effects, avascular tumor growth, numerical analysis

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Authors: Alexander Zibenberg, Rima’a Da’As

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According to the author’s knowledge, individuals are naturally inclined to classify people as leaders and followers. Individuals utilize cognitive structures or prototypes specifying the traits and abilities that characterize the effective leader (implicit leadership theories) and effective follower in an organization (implicit followership theories). Thus, the present study offers insights into understanding how teachers' personal values (self-enhancement and self-transcendence) explain the preference for styles of effective leader (i.e., principal) and assumptions about the traits and behaviors that characterize effective followers (i.e., student). Beyond the direct effect on perceptions of effective types of leader and follower, the present study argues that values may also interact with organizational and personal contexts in influencing perceptions. Thus authors suggest that teachers' managerial position may moderate the relationships between personal values and perception of the effective leader and follower. Specifically, two key questions are addressed in the present research: (1) Is there a relationship between personal values and perceptions of the effective leader and effective follower? and (2) Are these relationships stable or could they change across different contexts? Two hundred fifty-five Israeli teachers participated in this study, completing questionnaires – about the effective student and effective principal. Results of structural equations modeling (SEM) with maximum likelihood estimation showed: first: the model fit the data well. Second: researchers found a positive relationship between self-enhancement and anti-prototype of the effective principal and anti-prototype of the effective student. The relationship between self-transcendence value and both perceptions were found significant as well. Self-transcendence positively related to the way the teacher perceives the prototype of the effective principal and effective student. Besides, authors found that teachers' managerial position moderates these relationships. The article contributes to the literature both on perceptions and on personal values. Although several earlier studies explored issues of implicit leadership theories and implicit followership theories, personality characteristics (values) have garnered less attention in this matter. This study shows that personal values which are deeply rooted, abstract motivations that guide justify or explain attitudes, norms, opinions and actions explain differences in perception of the effective leader and follower. The results advance the theoretical understanding of the relationship between personal values and individuals’ perceptions in organizations. An additional contribution of this study is the application of the teacher's managerial position to explain a potential boundary condition of the translation of personal values into outcomes. The findings suggest that through the management process in the organization, teachers acquire knowledge and skills which augment their ability (beyond their personal values) to predict perceptions of ideal types of principal and student. The study elucidates the unique role of personal values in understanding an organizational thinking in organization. It seems that personal values might explain the differences in individual preferences of the organizational paradigm (mechanistic vs organic).

Keywords: implicit leadership theories, implicit followership theories, organizational paradigms, personal values

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Authors: Eniola Akande

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Introduction: English vocabulary and reading comprehension are core to academic achievement in many school subjects. Deficiency in both accounts for dismal performance in internal and external examinations among primary school pupils in Ibadan Metropolis, Nigeria. Previous studies largely focused on factors influencing pupils’ achievement in English vocabulary and reading comprehension. In spite of what literature has shown, the problem still persists, implying the need for other kinds of intervention. This study was therefore carried out to determine the effect of two transactional strategies Picture Walk (PW) and Know-Want to Learn-Learnt (KWL) on primary four pupils’ achievement in English vocabulary and reading comprehension in Ibadan Metropolis. The moderating effects of gender and learning style were also examined. Methodology: The study was anchored on Rosenblatt’s Transactional Reading and Piaget’s Cognitive Development theories; pretest-posttest control group quasi-experimental design with 3x2x3 factorial matrix was adopted. Six public primary schools were purposively selected based on the availability of qualified English language teachers in Primary Education Studies. Six intact classes (one per school) with a total of 101 primary four pupils (48 males and 53 females) participated. The intact classes were randomly assigned to PW (27), KWL (44) and conventional (30) groups. Instruments used were English Vocabulary (r=0.83), Reading Comprehension (r=0.84) achievement tests, Pupils’ Learning Style Preference Scale (r=0.93) and instructional guides. Treatment lasted six weeks. Data were analysed using the Descriptive statistics, Analysis of Covariance and Bonferroni post-hoc test at 0.05 level of significance. The mean age was 8.86±0.84 years. Result: Treatment had a significant main effect on pupils’ reading comprehension (F(2,82)=3.17), but not on English vocabulary. Participants in KWL obtained the highest post achievement means score in reading comprehension (8.93), followed by PW (8.06) and control (7.21) groups. Pupils’ learning style had a significant main effect on pupils’ achievement in reading comprehension (F(2,82)=4.41), but not on English vocabulary. Pupils with preference for tactile learning style had the highest post achievement mean score in reading comprehension (9.40), followed by the auditory (7.43) and the visual learning style (7.37) groups. Gender had no significant main effect on English vocabulary and reading comprehension. There was no significant two-way interaction effect of treatment and gender on pupils’ achievement in English vocabulary and reading comprehension. The two-way interaction effect of treatment and learning style on pupils’ achievement in reading comprehension was significant (F(4,82)=3.37), in favour of pupils with tactile learning style in PW group. There was no significant two-way interaction effect of gender and learning style on pupils’ achievement in English vocabulary and reading comprehension. The three-way interaction effects were not significant on English vocabulary and reading comprehension. Conclusion: Picture Walk and Know-Want to learn-Learnt instructional strategies were effective in enhancing pupils’ achievement in reading comprehension but not on English vocabulary. Learning style contributed considerably to achievement in reading comprehension but not to English vocabulary. Primary school, English language teachers, should put into consideration pupils’ learning style when adopting both strategies in teaching reading comprehension for improved achievement in the subject.

Keywords: comprehension-based intervention, know-want to learn-learnt, learning style, picture walk, primary school pupils

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Authors: Adu-Ampomah Yaw Junior

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Local procurement has become one of the latest trends in the discourse of sustainable tourism due to the economic benefits it generates for tourist destinations in developing countries. Local procurement helps in creating jobs which consequently helps in alleviating poverty. However, there have been limited studies on local procurement patterns in developing countries. Research on hotel procurement practices has mainly emphasized the challenges that hoteliers face when procuring locally, leaving questions regarding their motivations to engage in local procurement unanswered. The institutional theory provides a suitable framework to better understand these motivations as it underlines the importance of individual cognitive perceptions on issues in shaping organizational response strategies. More specifically, the extent to which an issue is perceived to belong to the organization’s responsibility. Also the organizational actors’ belief of losses or gains resultant from acting or not acting on an issue (degree of importance). Furthermore the organizational actors’ belief of the probability of resolving an issue (degree of feasibility). These factors influence how an organization will act on this issue. Hence, this paper adopts an institutional perspective to examine local procurement patterns of food by hoteliers in Ghana. Qualitative interviews with 20 procurement managers about their procurement practices and motivations, as well as interviews with different stakeholders for data triangulation purposes, indicated that most hotels sourced their food from middlemen who imported most of their products. However, direct importation was more prevalent foreign owned hotels as opposed to locally owned ones. Notwithstanding, the importation and the usage of foreign foods as opposed to local ones can be explained by the lack of pressure from NGOs and trade associations on hotels to act responsibly. Though guests’ menu preferences were perceived as important to hoteliers business operations, western tourists demand foreign food primarily with the foreign owned hotels make it less important to procure local produce. Lastly hoteliers, particularly those in foreign owned ones, perceive local procurement to be less feasible, raising concerns about quality and variety of local produce. The paper outlines strategies to improve the perception and degree of local Firstly, there is the need for stakeholder engagement in order to make hoteliers feel responsible for acting on the issue.Again it is crucial for Ghana government to promote and encourage hotels to buy local produce. Also, the government has to also make funds and storage facilities available for farmers to impact on the quality and quantity of local produce. Moreover, Sites need to be secured for farmers to engage in sustained farming.Furthermore, there is the need for collaborations between various stakeholders to organize training programs for farmers. Notwithstanding hotels need to market local produce to their guests. Finally, the Ghana hotels association has to encourage hotels to indulge in local procurement.

Keywords: sustainable tourism, feasible, important, local procurement

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Authors: Palita Sooksamran, Katcharin Mahawong

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This research aims to offer the development of innovator teachers training curriculum to create instructional innovation according to active learning approach to enhance learning achievement. The research and development process is carried out in 3 steps: Step 1 The study of the needs necessary to develop a training curriculum: the inquiry was conducted by a sample of teachers in private schools in Phayao province that provide basic education at the level of education. Using a questionnaire of 176 people, the sample was defined using a table of random numbers and stratified samples, using the school as a random layer. Step 2 Training curriculum development: the tools used are developed training curriculum and curriculum assessments, with nine experts checking the appropriateness of the draft curriculum. The statistic used in data analysis is the average ( ) and standard deviation (S.D.) Step 3 study on effectiveness of training curriculum: one group pretest/posttest design applied in this study. The sample consisted of 35 teachers from private schools in Phayao province. The participants volunteered to attend on their own. The results of the research showed that: 1.The essential demand index needed with the list of essential needs in descending order is the choice and create of multimedia media, videos, application for learning management at the highest level ,Developed of multimedia, video and applications for learning management and selection of innovative learning management techniques and methods of solve the problem Learning , respectively. 2. The components of the training curriculum include principles, aims, scope of content, training activities, learning materials and resources, supervision evaluation. The scope of the curriculum consists of basic knowledge about learning management innovation, active learning, lesson plan design, learning materials and resources, learning measurement and evaluation, implementation of lesson plans into classroom and supervision and motoring. The results of the evaluation of quality of the draft training curriculum at the highest level. The Experts suggestion is that the purpose of the course should be used words that convey the results. 3. The effectiveness of training curriculum 1) Cognitive outcomes of the teachers in creating innovative learning management was at a high level of relative gain score. 2) The assessment results of learning management ability according to the active learning approach to enhance learning achievement by assessing from 2 education supervisor as a whole were very high , 3) Quality of innovation learning management based on active learning approach to enhance learning achievement of the teachers, 7 instructional Innovations were evaluated as outstanding works and 26 instructional Innovations passed the standard 4) Overall learning achievement of students who learned from 35 the sample teachers was at a high level of relative gain score 5) teachers' satisfaction towards the training curriculum was at the highest level.

Keywords: training curriculum, innovator teachers, active learning approach, learning achievement

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Authors: Kalliopi Kanaki, Michael Kalogiannakis

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Nowadays, in the digital era, the early acquisition of basic programming skills and knowledge is encouraged, as it facilitates students’ exposure to computational thinking and empowers their creativity, problem-solving skills, and cognitive development. More and more researchers and educators investigate the introduction of computational thinking in K-12 since it is expected to be a fundamental skill for everyone by the middle of the 21st century, just like reading, writing and arithmetic are at the moment. In this paper, a doctoral research in the process is presented, which investigates the infusion of computational thinking into science curriculum in early childhood education. The whole attempt aims to develop young children’s computational thinking by introducing them to the fundamental concepts of object-oriented programming in an enjoyable, yet educational framework. The backbone of the research is the digital environment PhysGramming (an abbreviation of Physical Science Programming), which provides children the opportunity to create their own digital games, turning them from passive consumers to active creators of technology. PhysGramming deploys an innovative hybrid schema of visual and text-based programming techniques, with emphasis on object-orientation. Through PhysGramming, young students are familiarized with basic object-oriented programming concepts, such as classes, objects, and attributes, while, at the same time, get a view of object-oriented programming syntax. Nevertheless, the most noteworthy feature of PhysGramming is that children create their own digital games within the context of physical science courses, in a way that provides familiarization with the basic principles of object-oriented programming and computational thinking, even though no specific reference is made to these principles. Attuned to the ethical guidelines of educational research, interventions were conducted in two classes of second grade. The interventions were designed with respect to the thematic units of the curriculum of physical science courses, as a part of the learning activities of the class. PhysGramming was integrated into the classroom, after short introductory sessions. During the interventions, 6-7 years old children worked in pairs on computers and created their own digital games (group games, matching games, and puzzles). The authors participated in these interventions as observers in order to achieve a realistic evaluation of the proposed educational framework concerning its applicability in the classroom and its educational and pedagogical perspectives. To better examine if the objectives of the research are met, the investigation was focused on six criteria; the educational value of PhysGramming, its engaging and enjoyable characteristics, its child-friendliness, its appropriateness for the purpose that is proposed, its ability to monitor the user’s progress and its individualizing features. In this paper, the functionality of PhysGramming and the philosophy of its integration in the classroom are both described in detail. Information about the implemented interventions and the results obtained is also provided. Finally, several limitations of the research conducted that deserve attention are denoted.

Keywords: computational thinking, early childhood education, object-oriented programming, physical science courses

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Authors: Mikko Salminen, Simo Järvelä, Niklas Ravaja

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One of the central models of emotional intelligence (EI) is that of Mayer and Salovey’s, which includes ability to monitor own feelings and emotions and those of others, ability to discriminate different emotions, and to use this information to guide thinking and actions. There is vast amount of previous research where positive links between EI and, for example, leadership successfulness, work outcomes, work wellbeing and organizational climate have been reported. EI has also a role in the effectiveness of work teams, and the effects of EI are especially prominent in jobs requiring emotional labor. Thus, also the organizational context must be taken into account when considering the effects of EI on work outcomes. Based on previous research, it is suggested that EI can also protect managers from the negative consequences of stress. Stress may have many detrimental effects on the manager’s performance in essential work tasks. Previous studies have highlighted the effects of stress on, not only health, but also, for example, on cognitive tasks such as decision-making, which is important in managerial work. The motivation for the current study came from the notion that, unfortunately, many stressed individuals may not be aware of the circumstance; periods of stress-induced physiological arousal may be prolonged if there is not enough time for recovery. To tackle this problem, physiological stress levels of managers were collected using recording of heart rate variability (HRV). The goal was to use this data to provide the managers with feedback on their stress levels. The managers could access this feedback using a www-based learning environment. In the learning environment, in addition to the feedback on stress level and other collected data, also developmental tasks were provided. For example, those with high stress levels were sent instructions for mindfulness exercises. The current study focuses on the relation between the measured physiological stress levels and EI of the managers. In a pilot study, 33 managers from various fields wore the Firstbeat Bodyguard HRV measurement devices for three consecutive days and nights. From the collected HRV data periods (minutes) of stress and recovery were detected using dedicated software. The effects of EI on HRV-calculated stress indexes were studied using Linear Mixed Models procedure in SPSS. There was a statistically significant effect of total EI, defined as an average score of Schutte’s emotional intelligence test, on the percentage of stress minutes during the whole measurement period (p=.025). More stress minutes were detected on those managers who had lower emotional intelligence. It is suggested, that high EI provided managers with better tools to cope with stress. Managing of own emotions helps the manager in controlling possible negative emotions evoked by, e.g., critical feedback or increasing workload. High EI managers may also be more competent in detecting emotions of others, which would lead to smoother interactions and less conflicts. Given the recent trend to different quantified-self applications, it is suggested that monitoring of bio-signals would prove to be a fruitful direction to further develop new tools for managerial and leadership coaching.

Keywords: emotional intelligence, leadership, heart rate variability, personality, stress

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Authors: Kakali Roy, Sahana P. Raju, Subhra Dhar, Sandipan Dhar

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Introduction: Xeroderma pigmentosa (XP) is a rare inherited (autosomal recessive) disease resulting from impairment in DNA repair that involves recognition and repair of ultraviolet radiation (UVR) induced DNA damage in the nucleotide excision repair pathway. Which results in increased photosensitivity, UVR induced damage to skin and eye, increased susceptibility of skin and ocular cancer, and progressive neurodegeneration in some patients. XP is present worldwide, with higher incidence in areas having frequent consanguinity. Being extremely rare, there is limited literature on XP and associated complications. Here, the clinico-pathological experience (spectrum of clinical presentation, histopathological findings of malignant skin lesions, and progression) of managing 8 cases of XP is presented. Methodology: A retrospective study was conducted in a pediatric tertiary care hospital in eastern India during a ten-year period from 2013 to 2022. A clinical diagnosis was made based on severe sun burn or premature photo-aging and/or onset of cutaneous malignancies at early age (1st decade) in background of consanguinity and autosomal recessive inheritance pattern in family. Results: The mean age of presentation was 1.2 years (range of 7month-3years), while three children presented during their infancy. Male to female ratio was 5:3, and all were born of consanguineous marriage. They presented with dermatological manifestations (100%) followed by ophthalmic (75%) and/or neurological symptoms (25%). Patients had normal skin at birth but soon developed extreme sensitivity to UVR in the form of exaggerated sun tanning, burning, and blistering on minimal sun exposure, followed by abnormal skin pigmentation like freckles and lentiginosis. Subsequently, over time there was progressive xerosis, atrophy, wrinkling, and poikiloderma. Six patients had varied degree of ocular involvement, while three of them had severe manifestation, including madarosis, tylosis, ectropion, Lagopthalmos, Pthysis bulbi, clouding and scarring of the cornea with complete or partial loss of vision, and ophthalmic malignancies. 50% (n=4) cases had skin and ocular pre-malignant (actinic keratosis) and malignant lesions, including melanoma and non melanoma skin cancer (NMSC) like squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in their early childhood. One patient had simultaneous occurrence of multiple malignancies together (SCC, BCC, and melanoma). Subnormal intelligence was noticed as neurological feature, and none had sensory neural hearing loss, microcephaly, neuroregression, or neurdeficit. All the patients had been being managed by a multidisciplinary team of pediatricians, dermatologists, ophthalmologists, neurologists and psychiatrists. Conclusion: Although till date there is no complete cure for XP and the disease is ultimately fatal. But increased awareness, early diagnosis followed by persistent vigorous protection from UVR, and regular screening for early detection of malignancies along with psychological support can drastically improve patients’ quality of life and life expectancy. Further research is required on formulating optimal management of XP, specifically the role and possibilities of gene therapy in XP.

Keywords: childhood malignancies, dermato-pathological findings, eastern India, Xeroderma pigmentosa

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Authors: Fernanda Mary R. G. Da Silva, Adriana C. F. Mozzambani, Marcelo F. Mello

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Introduction: Sexual assault against children and adolescents is a public health problem with serious consequences on their quality of life, especially for those who develop post-traumatic stress disorder (PTSD). The broad literature in this research area points to greater losses in verbal learning, explicit memory, speed of information processing, attention and executive functioning in PTSD. Objective: To compare the neuropsychological functions of adolescents from 14 to 17 years of age, victims of sexual violence with PTSD with those of healthy controls. Methodology: Application of a neuropsychological battery composed of the following subtests: WASI vocabulary and matrix reasoning; Digit subtests (WISC-IV); verbal auditory learning test RAVLT; Spatial Span subtest of the WMS - III scale; abbreviated version of the Wisconsin test; concentrated attention test - D2; prospective memory subtest of the NEUPSILIN scale; five-digit test - FDT and the Stroop test (Trenerry version) in adolescents with a history of sexual violence in the previous six months, referred to the Prove (Violence Care and Research Program of the Federal University of São Paulo), for further treatment. Results: The results showed a deficit in the word coding process in the RAVLT test, with impairment in A3 (p = 0.004) and A4 (p = 0.016) measures, which compromises the verbal learning process (p = 0.010) and the verbal recognition memory (p = 0.012), seeming to present a worse performance in the acquisition of verbal information that depends on the support of the attentional system. A worse performance was found in list B (p = 0.047), a lower priming effect p = 0.026, that is, lower evocation index of the initial words presented and less perseveration (p = 0.002), repeated words. Therefore, there seems to be a failure in the creation of strategies that help the mnemonic process of retention of the verbal information necessary for learning. Sustained attention was found to be impaired, with greater loss of setting in the Wisconsin test (p = 0.023), a lower rate of correct responses in stage C of the Stroop test (p = 0.023) and, consequently, a higher index of erroneous responses in C of the Stroop test (p = 0.023), besides more type II errors in the D2 test (p = 0.008). A higher incidence of total errors was observed in the reading stage of the FDT test p = 0.002, which suggests fatigue in the execution of the task. Performance is compromised in executive functions in the cognitive flexibility ability, suggesting a higher index of total errors in the alternating step of the FDT test (p = 0.009), as well as a greater number of persevering errors in the Wisconsin test (p = 0.004). Conclusion: The data from this study suggest that sexual violence and PTSD cause significant impairment in the neuropsychological functions of adolescents, evidencing risk to quality of life in stages that are fundamental for the development of learning and cognition.

Keywords: adolescents, neuropsychological functions, PTSD, sexual violence

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Authors: Maryam Tabrizi, Shahrzad Aarup

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Objectives- Understanding the close association between oral health and overall health for older adults at the right time and right place, a person, focus treatment through Project ECHO telementoring. Methodology- Data from monthly ECHO telementoring sessions were provided for three years. Sessions including case presentations, overall health conditions, considering medications, organ functions limitations, including the level of cognition. Contributions- Providing the specialist level of providing care to all elderly regardless of their location and other health conditions and decreasing oral health inequity by increasing workforce via Project ECHO telementoring program worldwide. By 2030, the number of adults in the USA over the age of 65 will increase more than 60% (approx.46 million) and over 22 million (30%) of 74 million older Americans will need specialized geriatrician care. In 2025, a national shortage of medical geriatricians will be close to 27,000. Most individuals 65 and older do not receive oral health care due to lack of access, availability, or affordability. One of the main reasons is a significant shortage of Oral Health (OH) education and resources for the elderly, particularly in rural areas. Poor OH is a social stigma, a thread to quality and safety of overall health of the elderly with physical and cognitive decline. Poor OH conditions may be costly and sometimes life-threatening. Non-traumatic dental-related emergency department use in Texas alone was over $250 M in 2016. Most elderly over the age of 65 present with at least one or multiple chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) are at higher risk to develop gum (periodontal) disease, yet they are less likely to get dental care. In addition, most older adults take both prescription and over-the-counter drugs; according to scientific studies, many of these medications cause dry mouth. Reduced saliva flow due to aging and medications may increase the risk of cavities and other oral conditions. Most dental schools have already increased geriatrics OH in their educational curriculums, but the aging population growth worldwide is faster than growing geriatrics dentists. However, without the use of advanced technology and creating a network between specialists and primary care providers, it is impossible to increase the workforce, provide equitable oral health to the elderly. Project ECHO is a guided practice model that revolutionizes health education and increases the workforce to provide best-practice specialty care and reduce health disparities. Training oral health providers for utilizing the Project ECHO model is a logical response to the shortage and increases oral health access to the elderly. Project ECHO trains general dentists & hygienists to provide specialty care services. This means more elderly can get the care they need, in the right place, at the right time, with better treatment outcomes and reduces costs.

Keywords: geriatric, oral health, project echo, chronic disease, oral health

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Authors: Fossarello Maurizio, Mattana Giorgio, Tatti Filippo.

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The most widely performed surgical procedure in Open-Angle Glaucoma (OAG) is trabeculectomy. Although this filtering procedure is extremely effective, surgical failure and postoperative complications are reported. Due to the its invasive nature and possible complications, trabeculectomy is usually reserved, in practice, for patients who are refractory to medical and laser therapy. Recently, a number of micro-invasive surgical techniques (MIGS: Micro-Invasive Glaucoma Surgery), have been introduced in clinical practice. They meet the criteria of micro-incisional approach, minimal tissue damage, short surgical time, reliable IOP reduction, extremely high safety profile and rapid post-operative recovery. Xen45 Gel Implant (Allergan, Dublin, Ireland) is one of the MIGS alternatives, and consists in a porcine gelatin tube designed to create an aqueous flow from the anterior chamber to the subconjunctival space, bypassing the resistance of the trabecular meshwork. In this study we report the results of this technique as a favorable option in the treatment of OAG for its benefits in term of efficacy and safety, either alone or in combination with cataract surgery. This is a retrospective, single-center study conducted in consecutive OAG patients, who underwent Xen45 Gel Stent implantation alone or in combination with phacoemulsification, from October 2018 to June 2019. The primary endpoint of the study was to evaluate the reduction of both IOP and number of antiglaucoma medications at 12 months. The secondary endpoint was to correlate filtering bleb morphology evaluated by means of anterior segment OCT with efficacy in IOP lowering and eventual further procedures requirement. Data were recorded on Microsoft Excel and study analysis was performed using Microsoft Excel and SPSS (IBM). Mean values with standard deviations were calculated for IOPs and number of antiglaucoma medications at all points. Kolmogorov-Smirnov test showed that IOP followed a normal distribution at all time, therefore the paired Student’s T test was used to compare baseline and postoperative mean IOP. Correlation between postoperative Day 1 IOP and Month 12 IOP was evaluated using Pearson coefficient. Thirty-six eyes of 36 patients were evaluated. As compared to baseline, mean IOP and the mean number of antiglaucoma medications significantly decreased from 27,33 ± 7,67 mmHg to 16,3 ± 2,89 mmHg (38,8% reduction) and from 2,64 ± 1,39 to 0,42 ± 0,8 (84% reduction), respectively, at 12 months after surgery (both p < 0,001). According to bleb morphology, eyes were divided in uniform group (n=8, 22,2%), subconjunctival separation group (n=5, 13,9%), microcystic multiform group (n=9, 25%) and multiple internal layer group (n=14, 38,9%). Comparing to baseline, there was no significative difference in IOP between the 4 groups at month 12 follow-up visit. Adverse events included bleb function decrease (n=14, 38,9%), hypotony (n=8, 22,2%) and choroidal detachment (n=2, 5,6%). All eyes presenting bleb flattening underwent needling and MMC injection. The higher percentage of patients that required secondary needling was in the uniform group (75%), with a significant difference between the groups (p=0,03). Xen45 gel stent, either alone or in combination with phacoemulsification, provided a significant lowering in both IOP and medical antiglaucoma treatment and an elevated safety profile.

Keywords: anterior segment OCT, bleb morphology, micro-invasive glaucoma surgery, open angle glaucoma, Xen45 gel implant

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Authors: Panagiotis Roupas, Yota Passia

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This paper aims at establishing an index of design mechanisms - immanent in spatial objects - based on the affective capacity of their material formations. While spatial objects (design objects, buildings, urban configurations, etc.) are regarded as systems composed of interacting parts, within the premises of assemblage theory, their ability to affect and to be affected has not yet been mapped or sufficiently explored. This ability lies in excess, a latent potentiality they contain, not transcendental but immanent in their pre-subjective aesthetic power. As spatial structures are theorized as assemblages - composed of heterogeneous elements that enter into relations with one another - and since all assemblages are parts of larger assemblages, their components' ability to engage is contingent. We thus seek to unfold the mechanisms inherent in spatial objects that allow to the constituent parts of design assemblages to perpetually enter into new assemblages. To map architectural assemblage's affective ability, spatial objects are analyzed in two axes. The first axis focuses on the relations that the assemblage's material and expressive components develop in order to enter the assemblages. Material components refer to those material elements that an assemblage requires in order to exist, while expressive components includes non-linguistic (sense impressions) as well as linguistic (beliefs). The second axis records the processes known as a-signifying signs or a-signs, which are the triggering mechanisms able to territorialize or deterritorialize, stabilize or destabilize the assemblage and thus allow it to assemble anew. As a-signs cannot be isolated from matter, we point to their resulting effects, which without entering the linguistic level they are expressed in terms of intensity fields: modulations, movements, speeds, rhythms, spasms, etc. They belong to a molecular level where they operate in the pre-subjective world of perceptions, effects, drives, and emotions. A-signs have been introduced as intensities that transform the object beyond meaning, beyond fixed or known cognitive procedures. To that end, from an archive of more than 100 spatial objects by contemporary architects and designers, we have created an effective mechanisms index is created, where each a-sign is now connected with the list of effects it triggers and which thoroughly defines it. And vice versa, the same effect can be triggered by different a-signs, allowing the design object to lie in a perpetual state of becoming. To define spatial objects, A-signs are categorized in terms of their aesthetic power to affect and to be affected on the basis of the general categories of form, structure and surface. Thus, different part's degree of contingency are evaluated and measured and finally, we introduce as material information that is immanent in the spatial object while at the same time they confer no meaning; they only convey some information without semantic content. Through this index, we are able to analyze and direct the final form of the spatial object while at the same time establishing the mechanism to measure its continuous transformation.

Keywords: affective mechanisms index, architectural assemblages, a-signifying signs, cartography, virtual

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Authors: Nourah Almulhim

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This paper takes a critical discourse analysis (CDA) approach to investigate discourse and ideology in political blogs, focusing in particular on the Conservative Home blog from the UK’s current governing party. The Conservative party member’s discourse strategies as the blogger, alongside the discourse used by members of the public who reply to the blog in the below-the-lines comments, will be examined. The blog discourse reflects the writer's political identity and authorial voice. The analysis of the below-the-lines comments enables members of the public to engage in creating adversative positions, introducing different language users who bring their own individual and collective identities. These language users can play the role of news reporters, political analysts, protesters or supporters of a specific agenda and current socio-political topics or events. This study takes a qualitative approach to analyze the discriminatory context towards Islam/Muslims in ' The Conservative Home' blog. A cognitive approach is adopted and an analysis of dominant discourses in the blog text and the below-the-line comments is used. The focus of the study is, firstly, on the construction of self/ collective national identity in comparison to Muslim identity, highlighting the in-group and out-group construction. Second, the type of attitudes, whether feelings or judgments, related to these social actors as they are explicated to draw on the social values. Third, the role of discursive strategies in justifying and legitimizing those Islamophobic discriminatory practices. Therefore, the analysis is based on the systematic analysis of social actors drawing on actors, actions, and arguments to explicate identity construction and its development in the different discourses. A socio-semantic categorization of social actors is implemented to draw on the discursive strategies in addition to using literature to understand these strategies. An appraisal analysis is further used to classify attitudes and elaborate on core values in both genres. Finally, the grammar of othering is applied to explain how discriminatory dichotomies of 'Us' Vs. ''Them' actions are carried in discourse. Some of the key findings of the analysis can be summarized in two main points. First, the discursive practice used to represent Muslims/Islam as different from ‘Us’ are different in both genres as the blogger uses a covert voice while the commenters generally use an overt voice. This is to say that the blogger uses a mitigated strategy to represent the Muslim identity, for example, using the noun phrase ‘British Muslim’ but then representing them as ‘radical’ and ‘terrorists'. Contrary to this is in below the lines comments, where a direct strategy with an active declarative voice is used to negatively represent the Muslim identity as ‘oppressors’ and ‘terrorists’ with no inclusion of the noun phrase ‘British Muslims’. Second, the negotiation of the ‘British’ identity and values, such as culture and democracy, are prominent in the comment section as being unique and under threat by Muslims, while in the article, these standpoints are not represented.

Keywords: xenophobia, blogs, identity, critical discourse analysis

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Authors: Ahmad Saad, Shuja Abbas, Breanna Marine

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Introduction: This study explores the potential applications of autologous pedal fat pad grafting as a minimally invasive therapeutic strategy for addressing pedal fat pad loss. Without adequate shock absorbing tissue, a patient can experience functional deficits, ulcerations, loss of quality of life, and significant limitations with ambulation. This study details a novel technique involving autologous adipose grafting from the abdomen to enhance plantar fat pad thickness in a patient involved in a severe motor vehicle accident which resulted in total fat pad loss of the heel. Autologous adipose grafting (AAG) was used following adipose allografting in an effort to recreate a normal shock absorbing surface to allow return to activities of daily living and painless ambulation. Methods: A 46-year-old male sustained multiple open pedal fractures and necrosis to the heel fat pad after a motorcycle accident, which resulted in complete loss of the calcaneal fat pad. The patient underwent serial debridement’s, utilization of wound vac therapy and split thickness skin grafting to accomplish complete closure, despite complete loss of adipose to area. Patient presented with complaints of pain on ambulation, inability to bear weight on the heel, recurrent ulcerations, admitted had not been ambulating for two years. Clinical exam demonstrated complete loss of the plantar fat pad with a thin layer of epithelial tissue overlying the calcaneal bone, allowing visibility of the osseous contour of the calcaneus. Scar tissue had formed in place of the fat pad, with thickened epithelial tissue extending from the midfoot to the calcaneus. After conservative measures were exhausted, the patient opted for initial management by adipose allograft matrix (AAM) injections. Post operative X-ray imaging revealed noticeable improvement in calcaneal fat pad thickness. At 1 year follow up, the patient was able to ambulate without assistive devices. The fat pad at this point was significantly thicker than it was pre-operatively, but the thickness did not restore to pre-accident thickness. In order to compare the take of allograft versus autografting of adipose tissue, the decision to use adipose autograft through abdominal liposuction harvesting was deemed suitable. A general surgeon completed harvesting of adipose cells from the patient’s abdomen via liposuction, and a podiatric surgeon performed the AAG injection into the heel. Total of 15 cc’s of autologous adipose tissue injected to the calcaneus. Results: There was a visual increase in the calcaneal fat pad thickness both clinically and radiographically. At the 6-week follow up, imaging revealed retention of the calcaneal fat pad thickness. Three months postop, patient returned to activities of daily living and increased quality of life due to their increased ability to ambulate. Discussion: AAG is a novel treatment for pedal fat pad loss. These treatments may be viable and reproducible therapeutic choices for patients suffering from fat pad atrophy, fat pad loss, and/or plantar ulcerations. Both treatments of AAM and AAG exhibited similar therapeutic results by providing pain relief for ambulation and allowing for patients to return to their quality of life.

Keywords: podiatry, wound, adipose, allograft, autograft, wound care, limb reconstruction, injection, limb salvage

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Authors: Cinzia Russi, Chiyo Nishida

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Using data from online corpora (Spanish CREA, Italian CORIS), this paper examines the relatively understudied use of Spanish se and Italian si exemplified in (1) and (2), respectively. (1) El rojo es … el que se come a los demás. ‘The red (bottle) is the one that outshines/*eats the rest.’(2) … ebbe anche la saggezza di mangiarsi tutto il suo patrimonio. ‘… he even had the wisdom to squander/*eat all his estate.’ In these sentences, se/si accompanies the consumption verb comer/mangiare ‘to eat’, without which the sentences would not be interpreted appropriately. This se/si cannot readily be attributed to any of the multiple functions so far identified in the literature: reflexive, ergative, middle/passive, inherent, benefactive, and complete consumptive. In particular, this paper argues against the feasibility of a recent construction-based analysis of sentences like (1) and (2), which situates se/si within a prototype-based network of meanings all deriving from the central meaning of 'COMPLETE CONSUMPTION' (e.g., Alice se comió toda la torta/Alicesi è mangiata tutta la torta ‘John ate the whole cake’). Clearly, the empirical adequacy of such an account is undermined by the fact that the events depicted in the se/si-sentences at issue do not always entail complete consumption because they may lack an INCREMENTAL THEME, the distinguishing property of complete consumption. Alternatively, it is proposed that the sentences under analysis represent instances of verbal METAPHORICAL EXTENSION: se/si represents an explicit marker of this cognitive process, which has independently developed from the complete consumptive se/si, and the meaning extension is captured by the general tenets of Conceptual Metaphor Theory (CMT). Two conceptual domains, Source (DS) and target (DT), are related by similarity, assigning an appropriate metaphorical interpretation to DT. The domains paired here are comer/mangiare (DS) and comerse/mangiarsi (DT). The eating event (DS) involves (a) the physical process of xEATER grinding yFOOD-STUFF into pieces and swallowing it; and (b) the aspect of xEATER savoring yFOOD-STUFF and being nurtured by it. In the physical act of eating, xEATER has dominance and exercises his force over yFOOD-STUFF. This general sense of dominance and force is mapped onto DT and is manifested in the ways exemplified in (1) and (2), and many others. According to CMT, two other properties are observed in each pair of DS & DT. First, DS tends to be more physical and concrete and DT more abstract, and systematic mappings are established between constituent elements in DS and those in DT: xEATER corresponds to the element that destroys and yFOOD-STUFF to the element that is destroyed in DT, as exemplified in (1) and (2). Though the metaphorical extension marker se/si appears by far most frequently with comer/mangiare in the corpora, similar systematic mappings are observed in several other verb pairs, for example, jugar/giocare ‘to play (games)’ and jugarse/giocarsi ‘to jeopardize/risk (life, reputation, etc.)’, perder/perdere ‘to lose (an object)’ and perderse/perdersi ‘to miss out on (an event)’, etc. Thus, this study provides evidence that languages may indeed formally mark metaphor using means available to them.

Keywords: complete consumption value, conceptual metaphor, Italian si/Spanish se, metaphorical extension.

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Authors: W. S. Barber, S. L. King

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This paper is a qualitative case study analysis of the development of a fully online learning community of graduate students through arts-based community building activities. With increasing numbers and types of online learning spaces, it is incumbent upon educators to continue to push the edge of what best practices look like in digital learning environments. In digital learning spaces, instructors can no longer be seen as purveyors of content knowledge to be examined at the end of a set course by a final test or exam. The rapid and fluid dissemination of information via Web 3.0 demands that we reshape our approach to teaching and learning, from one that is content-focused to one that is process-driven. Rather than having instructors as formal leaders, today’s digital learning environments require us to share expertise, as it is the collective experiences and knowledge of all students together with the instructors that help to create a very different kind of learning community. This paper focuses on innovations pursued in a 36 hour 12 week graduate course in higher education entitled “Critical and Reflective Practice”. The authors chronicle their journey to developing a fully online learning community (FOLC) by emphasizing the elements of social, cognitive, emotional and digital spaces that form a moving interplay through the community. In this way, students embrace anywhere anytime learning and often take the learning, as well as the relationships they build and skills they acquire, beyond the digital class into real world situations. We argue that in order to increase student online engagement, pedagogical approaches need to stem from two primary elements, both creativity and critical reflection, that are essential pillars upon which instructors can co-design learning environments with students. The theoretical framework for the paper is based on the interaction and interdependence of Creativity, Intuition, Critical Reflection, Social Constructivism and FOLCs. By leveraging students’ embedded familiarity with a wide variety of technologies, this case study of a graduate level course on critical reflection in education, examines how relationships, quality of work produced, and student engagement can improve by using creative and imaginative pedagogical strategies. The authors examine their professional pedagogical strategies through the lens that the teacher acts as facilitator, guide and co-designer. In a world where students can easily search for and organize information as self-directed processes, creativity and connection can at times be lost in the digitized course environment. The paper concludes by posing further questions as to how institutions of higher education may be challenged to restructure their credit granting courses into more flexible modules, and how students need to be considered an important part of assessment and evaluation strategies. By introducing creativity and critical reflection as central features of the digital learning spaces, notions of best practices in digital teaching and learning emerge.

Keywords: online, pedagogy, learning, communities

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Authors: Mariia V. Efremova, Iana O. Tcareva, Anastasia D. Blokhina, Ivan S. Grebennikov, Anastasia S. Garanina, Maxim A. Abakumov, Yury I. Golovin, Alexander G. Savchenko, Alexander G. Majouga, Natalya L. Klyachko

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During last decades magnetite nanoparticles (NPs) attract a deep interest of scientists due to their potential application in therapy and diagnostics. However, magnetite nanoparticles are toxic and non-stable in physiological conditions. To solve these problems, we decided to create two types of hybrid systems based on magnetite and gold which is inert and biocompatible: gold as a shell material (first type) and gold as separate NPs interfacially bond to magnetite NPs (second type). The synthesis of the first type hybrid nanoparticles was carried out as follows: Magnetite nanoparticles with an average diameter of 9±2 nm were obtained by co-precipitation of iron (II, III) chlorides then they were covered with gold shell by iterative reduction of hydrogen tetrachloroaurate with hydroxylamine hydrochloride. According to the TEM, ICP MS and EDX data, final nanoparticles had an average diameter of 31±4 nm and contained iron even after hydrochloric acid treatment. However, iron signals (K-line, 7,1 keV) were not localized so we can’t speak about one single magnetic core. Described nanoparticles covered with mercapto-PEG acid were non-toxic for human prostate cancer PC-3/ LNCaP cell lines (more than 90% survived cells as compared to control) and had high R2-relaxivity rates (>190 mМ-1s-1) that exceed the transverse relaxation rate of commercial MRI-contrasting agents. These nanoparticles were also used for chymotrypsin enzyme immobilization. The effect of alternating magnetic field on catalytic properties of chymotrypsin immobilized on magnetite nanoparticles, notably the slowdown of catalyzed reaction at the level of 35-40 % was found. The synthesis of the second type hybrid nanoparticles also involved two steps. Firstly, spherical gold nanoparticles with an average diameter of 9±2 nm were synthesized by the reduction of hydrogen tetrachloroaurate with oleylamine; secondly, they were used as seeds during magnetite synthesis by thermal decomposition of iron pentacarbonyl in octadecene. As a result, so-called dumbbell-like structures were obtained where magnetite (cubes with 25±6 nm diagonal) and gold nanoparticles were connected together pairwise. By HRTEM method (first time for this type of structure) an epitaxial growth of magnetite nanoparticles on gold surface with co-orientation of (111) planes was discovered. These nanoparticles were transferred into water by means of block-copolymer Pluronic F127 then loaded with anti-cancer drug doxorubicin and also PSMA-vector specific for LNCaP cell line. Obtained nanoparticles were found to have moderate toxicity for human prostate cancer cells and got into the intracellular space after 45 minutes of incubation (according to fluorescence microscopy data). These materials are also perspective from MRI point of view (R2-relaxivity rates >70 mМ-1s-1). Thereby, in this work magnetite-gold hybrid nanoparticles, which have a strong potential for biomedical application, particularly in targeted drug delivery and magnetic resonance imaging, were synthesized and characterized. That paves the way to the development of special medicine types – theranostics. The authors knowledge financial support from Ministry of Education and Science of the Russian Federation (14.607.21.0132, RFMEFI60715X0132). This work was also supported by Grant of Ministry of Education and Science of the Russian Federation К1-2014-022, Grant of Russian Scientific Foundation 14-13-00731 and MSU development program 5.13.

Keywords: drug delivery, magnetite-gold, MRI contrast agents, nanoparticles, toxicity

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Authors: Rajeswari Raguraman, Sowmya Parameswaran, Krishnakumar Subramanian, Jagat Kanwar, Rupinder Kanwar

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Background: Tumor microenvironment has been implicated in several cancers to regulate cell growth, invasion and metastasis culminating in outcome of therapy. Tumor stroma consists of multiple cell types that are in constant cross-talk with the tumor cells to favour a pro-tumorigenic environment. Not much is known about the existence of tumor microenvironment in the pediatric intraocular malignancy, Retinoblastoma (RB). In the present study, we aim to understand the multiple stromal cellular subtypes and tumor stromal interactions expressed in RB tumors. Materials and Methods: Immunohistochemistry for stromal cell markers CD31, CD68, alpha-smooth muscle (α-SMA), vimentin and glial fibrillary acidic protein (GFAP) was performed on formalin fixed paraffin embedded tissues sections of RB (n=12). The differential expression of stromal target molecules; fibroblast activation protein (FAP), tenascin-C (TNC), osteopontin (SPP1), bone marrow stromal antigen 2 (BST2), stromal derived factor 2 and 4 (SDF2 and SDF4) in primary RB tumors (n=20) and normal retina (n=5) was studied by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) and Western blotting. The differential expression was correlated with the histopathological features of RB. The interaction between RB cell lines (Weri-Rb-1, NCC-RbC-51) and Bone marrow stromal cells (BMSC) was also studied using direct co-culture and indirect co-culture methods. The functional effect of the co-culture methods on the RB cells was evaluated by invasion and proliferation assays. Global gene expression was studied by using Affymetrix 3’ IVT microarray. Pathway prediction was performed using KEGG and the key molecules were validated using qRT-PCR. Results: The immunohistochemistry revealed the presence of several stromal cell types such as endothelial cells (CD31+;Vim+/-); macrophages (CD68+;Vim+/-); Fibroblasts (Vim+; CD31-;CD68- );myofibroblasts (α-SMA+/ Vim+) and invading retinal astrocytes/ differentiated retinal glia (GFAP+; Vim+). A characteristic distribution of these stromal cell types was observed in the tumor microenvironment, with endothelial cells predominantly seen in blood vessels and macrophages near actively proliferating tumor or necrotic areas. Retinal astrocytes and glia were predominant near the optic nerve regions in invasive tumors with sparse distribution in tumor foci. Fibroblasts were widely distributed with rare evidence of myofibroblasts in the tumor. Both gene and protein expression revealed statistically significant (P<0.05) up-regulation of FAP, TNC and BST2 in primary RB tumors compared to the normal retina. Co-culture of BMSC with RB cells promoted invasion and proliferation of RB cells in direct and indirect contact methods respectively. Direct co-culture of RB cell lines with BMSC resulted in gene expression changes in ECM-receptor interaction, focal adhesion, IL-8 and TGF-β signaling pathways associated with cancer. In contrast, various metabolic pathways such a glucose, fructose and amino acid metabolism were significantly altered under the indirect co-culture condition. Conclusion: The study suggests that the close interaction between RB cells and the stroma might be involved in RB tumor invasion and progression which is likely to be mediated by ECM-receptor interactions and secretory factors. Targeting the tumor stroma would be an attractive option for redesigning treatment strategies for RB.

Keywords: gene expression profiles, retinoblastoma, stromal cells, tumor microenvironment

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Authors: Nam Sze Cheng, P. C. Janita Chau

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Background: Eczema is a chronic inflammatory disease with high global prevalence rates in many childhood populations. It is also the most common paediatric skin problem. Although eczema education and proper skin care were effective in controlling eczema symptoms, the lack of both sufficient time for patient consultation and structured eczema education programme hindered the transferability of knowledge to patients and their parents. As a result, these young patients and their families suffer from a significant physical disability and psychological distress, which can substantially impair their quality of life. Objectives: This integrative review is to examine the effects of educational interventions for children with eczema and identify the core elements associated with an effective intervention. Methods: This integrative review targeted all articles published in 10 databases between May 2016 and February 2017 that reported the outcomes of disease interventions of any format for children and adolescents with the clinical diagnosis of eczema who were under 18 years of age. Five randomized controlled trials (RCT) and one systematic review of 10 RCTs were identified for review. All these publications had high methodological quality, except one study of web-based eczema education that was limited by selection bias and poor subject blinding. Findings: This review found that most studies adopted nurse-led or multi-disciplinary parental eczema education programme at the outpatient clinic setting. The format of these programmes included individual lectures, demonstration and group sharing, and the educational materials covered basic eczema knowledge and management as well as methods to interrupt itch-scratch cycle. The main outcome measures of these studies included severity of eczema symptoms, treatment adherence and quality of life of both patients and their families. Nine included studies reported statistically significant improvement in the primary outcome of symptom severity of these eczematous children. On the other hand, all these reviews failed to identify an effective dosage of intervention under these educational programmes that was attributed to the heterogeneity of the interventions. One study that was designed based on the social cognitive theory to guide the interventional content yielded statistically significant results. The systematic review recommended the importance of measuring parental self-efficacy. Implication: This integrative review concludes that structured educational programme can help nurses understand the theories behind different health interventions. They can then deliver eczema education to their patients in a consistent manner. These interventions also result in behavioral changes through patient education. Due to the lack of validated educational programmes in Chinese, it is imperative to conduct an RCT of eczema educational programme to investigate its effects on eczema severity, quality of life and treatment adherence in Hong Kong children as well as to promote the importance of parental self-efficacy.

Keywords: children, eczema, education, intervention

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Authors: Frederick Huie, Lauren Fusfeld, William Burchenal, Scott Howell, Alyssa McVey, Thomas F. Goss

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Alzheimer’s Disease (AD) is a degenerative brain disease characterized by memory loss and cognitive decline that presents a substantial economic burden for patients and health insurers in the US. This study evaluates the payer budget impact of the DISCERN™ test in the diagnosis and management of patients with symptoms of dementia evaluated for AD. DISCERN™ comprises three assays that assess critical factors related to AD that regulate memory, formation of synaptic connections among neurons, and levels of amyloid plaques and neurofibrillary tangles in the brain and can provide a quicker, more accurate diagnosis than tests in the current diagnostic pathway (CDP). An Excel-based model with a three-year horizon was developed to assess the budget impact of DISCERN™ compared with CDP in a Medicare Advantage plan with 1M beneficiaries. Model parameters were identified through a literature review and were verified through consultation with clinicians experienced in diagnosis and management of AD. The model assesses direct medical costs/savings for patients based on the following categories: •Diagnosis: costs of diagnosis using DISCERN™ and CDP. •False Negative (FN) diagnosis: incremental cost of care avoidable with a correct AD diagnosis and appropriately directed medication. •True Positive (TP) diagnosis: AD medication costs; cost from a later TP diagnosis with the CDP versus DISCERN™ in the year of diagnosis, and savings from the delay in AD progression due to appropriate AD medication in patients who are correctly diagnosed after a FN diagnosis.•False Positive (FP) diagnosis: cost of AD medication for patients who do not have AD. A one-way sensitivity analysis was conducted to assess the effect of varying key clinical and cost parameters ±10%. An additional scenario analysis was developed to evaluate the impact of individual inputs. In the base scenario, DISCERN™ is estimated to decrease costs by $4.75M over three years, equating to approximately $63.11 saved per test per year for a cohort followed over three years. While the diagnosis cost is higher with DISCERN™ than with CDP modalities, this cost is offset by the higher overall costs associated with CDP due to the longer time needed to receive a TP diagnosis and the larger number of patients who receive a FN diagnosis and progress more rapidly than if they had received appropriate AD medication. The sensitivity analysis shows that the three parameters with the greatest impact on savings are: reduced sensitivity of DISCERN™, improved sensitivity of the CDP, and a reduction in the percentage of disease progression that is avoided with appropriate AD medication. A scenario analysis in which DISCERN™ reduces the utilization for patients of computed tomography from 21% in the base case to 16%, magnetic resonance imaging from 37% to 27% and cerebrospinal fluid biomarker testing, positive emission tomography, electroencephalograms, and polysomnography testing from 4%, 5%, 10%, and 8%, respectively, in the base case to 0%, results in an overall three-year net savings of $14.5M. DISCERN™ improves the rate of accurate, definitive diagnosis of AD earlier in the disease and may generate savings for Medicare Advantage plans.

Keywords: Alzheimer’s disease, budget, dementia, diagnosis.

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Authors: Roberta Martino, Viviana Ventre

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Empirical evidence has, over time, confirmed that the behavior of individuals is inconsistent with the descriptions provided by the Discounted Utility Model, an essential reference for calculating the utility of intertemporal prospects. The model assumes that individuals calculate the utility of intertemporal prospectuses by adding up the values of all outcomes obtained by multiplying the cardinal utility of the outcome by the discount function estimated at the time the outcome is received. The trend of the discount function is crucial for the preferences of the decision maker because it represents the perception of the future, and its trend causes temporally consistent or temporally inconsistent preferences. In particular, because different formulations of the discount function lead to various conclusions in predicting choice, the descriptive ability of models with a hyperbolic trend is greater than linear or exponential models. Suboptimal choices from any time point of view are the consequence of this mechanism, the psychological factors of which are encapsulated in the discount rate trend. In addition, analyzing the decision-making process from a psychological perspective, there is an equivalence between the selection of dominated prospects and a degree of impatience that decreases over time. The first part of the paper describes and investigates the anomalies of the discounted utility model by relating the cognitive distortions of the decision-maker to the emotional factors that are generated during the evaluation and selection of alternatives. Specifically, by studying the degree to which impatience decreases, it’s possible to quantify how the psychological and emotional mechanisms of the decision-maker result in a lack of decision persistence. In addition, this description presents inconsistency as the consequence of an inconsistent attitude towards time-delayed choices. The second part of the paper presents an experimental phase in which we show the relationship between inconsistency and impatience in different contexts. Analysis of the degree to which impatience decreases confirms the influence of the decision maker's emotional impulses for each anomaly in the utility model discussed in the first part of the paper. This work provides an application in the field of personalized behavioral finance. Indeed, the numerous behavioral diversities, evident even in the degrees of decrease in impatience in the experimental phase, support the idea that optimal strategies may not satisfy individuals in the same way. With the aim of homogenizing the categories of investors and to provide a personalized approach to advice, the results proven in the experimental phase are used in a complementary way with the information in the field of behavioral finance to implement the Analytical Hierarchy Process model in intertemporal choices, useful for strategic personalization. In the construction of the Analytic Hierarchy Process, the degree of decrease in impatience is understood as reflecting irrationality in decision-making and is therefore used for the construction of weights between anomalies and behavioral traits.

Keywords: analytic hierarchy process, behavioral finance, financial anomalies, impatience, time inconsistency

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Authors: Ankita Baidya, Vanishri Ganakumar, Ranveer S. Jadon, Piyush Ranjan, Rita Sood

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Septic embolism can have varied presentations and clinical considerations. Infected central venous catheters are commonly associated with septic emboli but peripheral vascular catheters are rarely implicated. We describe a rare case of septic pulmonary emboli related to infected peripheral venous cannulation caused by an unusual etiological agent. A young male presented with complaints of fever, productive cough, sudden onset shortness of breath and cellulitis in both the upper limbs. He was recently hospitalised for dengue fever and administered intravenous fluids through peripheral venous line. The patient was febrile, tachypneic and in respiratory distress, there were multiple pus filled bullae in left hand alongwith swelling and erythema involving right forearm that started at the site of cannulation. Chest examination showed active accessory muscles of respiration, stony dull percussion at the base of right lung and decreased breath sounds at right infrascapular, infraaxillary and mammary area. Other system examination was within normal limits. Chest X-ray revealed bilateral multiple patchy heterogenous peripheral opacities and infiltrates with right-sided pleural effusion. Contrast-enhanced computed tomography (CECT) chest showed feeding vessel sign confirming the diagnosis as septic emboli. Venous Doppler and 2D-echocardiogarm were normal. Laboratory findings showed marked leucocytosis (22000/mm3). Pus aspirate, blood sample, and sputum sample were sent for microbiological testing. The patient was started empirically on ceftriaxone, vancomycin, and clindamycin. The Pus culture and sputum culture showed Klebsiella pneumoniae sensitive to cefoperazone-sulbactum, piperacillin-tazobactum, meropenem and amikacin. The antibiotics were modified accordingly to antimicrobial sensitivity profile to Cefoperazone-sulbactum. Bronchoalveolar lavage (BAL) was done and sent for microbiological investigations. BAL culture showed Klebsiella pneumoniae with same antimicrobial resistance profile. On day 6 of starting cefoperazone-sulbactum, he became afebrile. The skin lesions improved significantly. He was administered 2 weeks of cefoperazone–sulbactum and discharged on oral faropenem for 4 weeks. At the time of discharge, TLC was 11200/mm3 with marked radiological resolution of infection and healed skin lesions. He was kept in regular follow up. Chest X-ray and skin lesions showed complete resolution after 8 weeks. Till date, only couple of case reports of septic emboli through peripheral intravenous line have been reported in English literature. This case highlights that a simple procedure of peripheral intravenous cannulation can lead to catastrophic complication of septic pulmonary emboli and widespread cellulitis if not done with proper care and precautions. Also, the usual pathogens in such clinical settings are gram positive bacteria, but with the history of recent hospitalization, empirical therapy should also cover drug resistant gram negative microorganisms. It also emphasise the importance of appropriate healthcare practices to be taken care during all procedures.

Keywords: antibiotics, cannula, Klebsiella pneumoniae, septic emboli

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