Search results for: employee assistance program

Authors: Catherine Bradshaw

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Educators often report difficulty managing behavior problems and other mental health concerns that students display at school. These concerns also interfere with the learning process and can create distraction for teachers and other students. As such, schools play an important role in both preventing and intervening with students who experience these types of challenges. A number of models have been proposed to serve as a framework for delivering prevention and early intervention services in schools. One such model is called Positive Behavioral Interventions and Supports (PBIS), which has been scaled-up to over 26,000 schools in the U.S. and many other countries worldwide. PBIS aims to improve a range of student outcomes through early detection of and intervention related to behavioral and mental health symptoms. PBIS blends and applies social learning, behavioral, and organizational theories to prevent disruptive behavior and enhance the school’s organizational health. PBIS focuses on creating and sustaining tier 1 (universal), tier 2 (selective), and tier 3 (individual) systems of support. Most schools using PBIS have focused on the core elements of the tier 1 supports, which includes the following critical features. The formation of a PBIS team within the school to lead implementation. Identification and training of a behavioral support ‘coach’, who serves as a on-site technical assistance provider. Many of the individuals identified to serve as a PBIS coach are also trained as a school psychologist or guidance counselor; coaches typically have prior PBIS experience and are trained to conduct functional behavioral assessments. The PBIS team also identifies a set of three to five positive behavioral expectations that are implemented for all students and by all staff school-wide (e.g., ‘be respectful, responsible, and ready to learn’); these expectations are posted in all settings across the school, including in the classroom, cafeteria, playground etc. All school staff define and teach the school-wide behavioral expectations to all students and review them regularly. Finally, PBIS schools develop or adopt a school-wide system to reward or reinforce students who demonstrate those 3-5 positive behavioral expectations. Staff and administrators create an agreed upon system for responding to behavioral violations that include definitions about what constitutes a classroom-managed vs. an office-managed discipline problem. Finally, a formal system is developed to collect, analyze, and use disciplinary data (e.g., office discipline referrals) to inform decision-making. This presentation provides a brief overview of PBIS and reports findings from a series of four U.S. based longitudinal randomized controlled trials (RCTs) documenting the impacts of PBIS on school climate, discipline problems, bullying, and academic achievement. The four RCTs include 80 elementary, 40 middle, and 58 high schools and results indicate a broad range of impacts on multiple student and school-wide outcomes. The session will highlight lessons learned regarding PBIS implementation and scale-up. We also review the ways in which PBIS can help educators and school leaders engage in data-based decision-making and share data with other decision-makers and stakeholders (e.g., students, parents, community members), with the overarching goal of increasing use of evidence-based programs in schools.

Keywords: positive behavioral interventions and supports, mental health, randomized trials, school-based prevention

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Authors: Javier Comes Fayos, Isabel RodríGuez Moreno, Sara Bressanutti, Marisol Lila, Angel Romero MartíNez, Luis Moya Albiol

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Given the great impact produced by gender-based violence, its comprehensive approach seems essential. Consequently, research has focused on risk factors for violent behaviour, linking various psychosocial variables, as well as cognitive and neuropsychological deficits with the aggressors. However, studies on affective processing are scarce, so the present study investigates possible emotional alterations in men convicted of gender violence. The participants were 51 aggressors, who attended the CONTEXTO program with sentences of less than two years, and 47 men with no history of violence. The sample did not differ in age, socioeconomic level, education, or alcohol and other substances consumption. Anger, alexithymia and facial recognition of other people´s emotions were assessed through the State-Trait Anger Expression Inventory (STAXI-2), the Toronto Alexithymia Scale (TAS-20) and Reading the mind in the eyes (REM), respectively. Men convicted of gender-based violence showed higher scores on the anger trait and temperament dimensions, as well as on the anger expression index. They also scored higher on alexithymia and in the identification and emotional expression subscales. In addition, they showed greater difficulties in the facial recognition of emotions by having a lower score in the REM. These results seem to show difficulties in different affective areas in men condemned for gender violence. The deficits are reflected in greater difficulty in identifying and expressing emotions, in processing anger and in recognizing the emotions of others. All these difficulties have been related to the use of violent behavior. Consequently, it is essential and necessary to include emotional regulation in intervention programs for men who have been convicted of gender-based violence.

Keywords: alexithymia, anger, emotional processing, emotional recognition, empathy, intimate partner violence

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Authors: Jui-Chen Huang

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The purpose of this study is to explore the effects of telecare on preventing and delaying the quality of disability care in elderly people with portable comfort Bluetooth brainwave devices with remote healthcare functions. Through the teaching videos and remotely teaching the elderly, which had ever learned the care courses of the prevent and delay disability, these elderly did muscle strength training. Then this paper explores the effect of training with the data by SPSS 18.0 statistical software. The data is collected with pre-test, post-test and analyze data from the measure of the Bluetooth brain wave equipment including the pressure index, relaxation index, attention and fatigue index of the elderly. In this study, 30 elderly people who had taken preventive and delayed disability care courses were studied to explore the effect of their care quality improvement. The results showed that the pressure index, relaxation index, attention, and fatigue index of the elderly had statistically significant differences in two months. It can be seen that elderly people who have been treated to prevent and delay disability care courses can significantly improve their care quality if they continue to receive intensive training to prevent and delay disability through remote mode. This telecare is applied to the elderly program that has been used to prevent and delay disability care courses. It is worth continuing to promote, and it is recommended that follow-up studies be conducted in a longer-term manner to explore long-term benefits. It can solve the current insufficiency of long-term care resources, but the demand is urgent.

Keywords: telecare, bluetooth brainwave equipment, prevention and delay of disability, the elderly, care quality

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Authors: José Batista de Souza Neto

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This research project has as its theme the implementation of public policies to support micro and small businesses (MSEs). The research problem defined was how public policies for access to markets that drive the entrepreneurial ecosystem of MSEs are implemented. The general objective of this research is to understand the process of implementing a public policy to support the entrepreneurial ecosystem of MSEs by the Support Service for Micro and Small Enterprises of the State of São Paulo (SEBRAESP). Public policies are constituent elements of entrepreneurship ecosystems that influence the creation and development of ventures from the action of the entrepreneur. At the end of the research, it is expected to achieve the results for the following specific objectives: (a) understand how the entrepreneurial ecosystem of MSEs is constituted; (b) understand how market access public policies for MSEs are designed and implemented; (c) understand SEBRAE's role in the entrepreneurship ecosystem; and (d) offer an action plan and monitor its execution up to march, 2023. The field research will be conducted based on Action Research, with a qualitative and longitudinal approach to the data. Data collection will be based on narratives produced since 2019 when the decision to implement Comércio Brasil program, a public policy focused on generating market access for 4280 MSEs yearly, was made. The narratives will be analyzed by the method of document analysis and narrative analysis. It is expected that the research will consolidate the relevance of public policies to market access for MSEs and the role of SEBRAE as a protagonist in the implementation of these public policies in the entrepreneurship ecosystem will be demonstrated. Action research is recognized as an intervention method, it is expected that this research will corroborate its role in supporting management processes.

Keywords: entrepreneurship, entrepreneurship ecosystem, public policies, SEBRAE, action research

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Authors: Veruska C. Dutra, Mary L. G. S. Senna, Afonso R. Aquino

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Tourists bring many benefits to a local community, encouraging it to be involved in that activity; however, it may also have detrimental effects like garbage, noise, violence, external culture and the damaging of the natural environment among others, which may promote community dissatisfaction. The contact between the tourist and the local community is a concern, especially when the community is located near protected areas. In this case, the community must know the tourist destination well, so it can collaborate in the tourism development without harming the environment. In this context, the present article aims to demonstrate the results of a research study conducted as part of a doctorate program in Sciences from the University of Sao Paulo, Brazil. It had as an objective to elaborate a methodology proposal to measure the local community satisfaction indicator, with applicability on a case study in the Mateiros community located in the surrounding area of the Parque Estadual do Jalapão –PEJ conservation unit in the state of Tocantins, Brazil. This is a study of an interdisciplinary nature that had the deductive method as its guide. The indicator result is going to be presented in this study. It pointed out as negative factors: there is no involvement between the local community and the tourism sector, and there is also dissatisfaction with regard to the town’s basic services. The study showed as positive the local community knowledge about the various attractions in the surrounding area and that the group recognizes the importance of the tourism for the town and life. Concerning the methodology that was used, the results showed that it can collaborate in seeking actions of improvement and involvement of the community in the planning and development of the local tourism. It comes out as an efficient analysis tool, thus enabling the perceiving of the local community point of view.

Keywords: satisfaction indicator, tourism, community, Jalapão

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Authors: Moet Moet Myint Lay

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Continuing professional development involves acquiring new knowledge and skills for current work and improving career opportunities in the field through continuing education (OECD, 2000). This article examines the effectiveness of CPD in improving teacher quality and the resulting need for CPD for teacher educators in Myanmar. The purpose of this study is to explore a deeper understanding of teacher-to-teacher continuing professional development in improving teacher education programs. Research questions: (1) How do teachers in Myanmar understand the idea of continuous professional development for professional development? (2) What CPD activities are required for all teachers in teachers' colleges? (3) What are the main challenges of CPD implementation in Myanmar Education College? A qualitative method using semi-structured interviews was used in this study. Seven teacher educators from Mandalay Education College participated in this study. There are three male teacher educators and four female teacher educators. All participants who responded to the semi-structured interviews were between 29 and 45 years old.The interviews revealed that professional development involves acquiring the necessary pedagogical knowledge and skills to encourage students to think creatively and critically. Teachers must participate in a variety of activities, including professional interviews, lesson study, training programs, workshops, and seminars. All results showed that teachers need English and ICT skills for teaching and learning, including extended ICT courses for those who have completed a foundation course, access to e-libraries, and inclusive education (including language teaching and learning), facilitate the assessment (formative and summative), practicum, mentoring, and coaching skills. The study concludes with practical findings that suggest an urgent need for CPD activities for teachers.

Keywords: continuous professional development, teacher educator, teacher training program), mentoring

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Authors: Chen Zhi-Wei, Hsieh Wei-Fang

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Taiwan annual rainfall is global average of 2.5 times, plus city excessive development, green constantly to reduced, instead of is big area of artificial base disc, makes Taiwan rainy season during occurred of storm cannot timely of emissions, led to flood constantly, and rain also cannot was retained again using, led to city hydrological balance suffered damage, and to Regulation city of by brings of negative effect, increased green covered rate became most effective of method, and city land limited, so roof green gradually became a alternative program. Green roofs have become one of the Central and local government policy initiatives for urban development, in foreign countries, such as the United States, and Japan, and Singapore etc. Development of roof greening as an important policy, has become a trend of the times. In recent years, many experts and scholars are also on the roof greening all aspects of research, mostly for green roof for the environmental impact of benefits, such as: carbon reduction, cooling, thermostat, but research on the benefits of green roofs under water cut but it is rare. Therefore, this research literature from green roof in to view and analyze what kind of medium suitable for roof greening and use of green base plate combination simulated green roof structure, via different proportions of the medium with water retention plate and drainage board, experiment with different planting base plate combination of water conservation performance. Research will want to test the effect of roof planting base mix, promotion of relevant departments and agencies in future implementation of green roofs, prompted the development of green roofs, which in the end Taiwan achieve sustainable development of the urban environment help.

Keywords: thin-layer roof greening and planting medium, water efficiency

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Authors: Elena Parmentier, Henrik Endeman

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Introduction: Large mediastinal masses often present with diagnostic and clinical challenges due to compression of the respiratory and hemodynamic system. We present a case of a mediastinal mass with symptomatic mechanical compression of the trachea, resulting in challenging airway management. Methods: We present a case of 66-year-old male, complaining of progressive dysphagia. Initial esophagogastroscopy revealed a stenosis secondary to external compression, biopsies were inconclusive. Additional CT scan showed a large mediastinal mass of unknown origin, situated between the vertebrae and esophagus. Symptoms progressed and patient developed dyspnea and stridor. A new CT showed quick growth of the mass with compression of the trachea, subglottic to just above the carina. A tracheal covered stent was successfully placed. Endobronchial ultrasound revealed a large irregular mass without tracheal invasion, biopsies were taken. 4 days after stent placement, the patients’ condition deteriorated with worsening of stridor, dyspnea and desaturation. Migration of the tracheal stent into the right main bronchus was seen on chest X ray, with obstruction of the left main bronchus and secondary atelectasis. Different methods have been described in the literature for tracheobronchial stent removal (surgical, endoscopic, fluoroscopyguided), our first choice in this case was flexible bronchoscopy. However, this revealed tracheal compression above the migrated stent and passage of the scope occurred impossible. Patient was admitted to the ICU, high-flow nasal oxygen therapy was started and the situation stabilized, giving time for extensive assessment and preparation of the airway management approach. Close cooperation between the intensivist, pulmonologist, anesthesiologist and otorhinolaryngologist was essential. Results: In case of sudden deterioration, a protocol for emergency situations was made. Given the increased risk of additional tracheal compression after administration of neuromuscular blocking agents, an approach with awake fiberoptic intubation maintaining spontaneous ventilation was proposed. However, intubation without retrieval of the tracheal stent was found undesirable due to expected massive shunting over the left atelectatic lung. As rescue option, assistance of extracorporeal circulation was considered and perfusionist was kept on standby. The patient stayed stable and was transferred to the operating theatre. High frequency jet ventilation under general anesthesia resulted in desaturations up to 50%, making rigid bronchoscopy impossible. Subsequently an endotracheal tube size 8 could be placed successfully and the stent could be retrieved via bronchoscopy over (and with) the tube, after which the patient was reintubated. Finally, a tracheostomy (Shiley™ Tracheostomy Tube With Cuff, size 8) was placed, fiberoptic control showed a patent airway. Patient was readmitted to the ICU and could be quickly weaned of the ventilator. Pathology was positive for rhabdomyosarcoma, without indication for systemic therapy. Extensive surgery (laryngectomy, esophagectomy) was suggested, but patient refused and palliative care was started. Conclusion: Due to meticulous planning in an interdisciplinary team, we showed a successful airway management approach in this complicated case of critical airway compression secondary to a rare rhabdomyosarcoma, complicated by tracheal stent migration. Besides presenting our thoughts and considerations, we support exploring other possible approaches of this specific clinical problem.

Keywords: airway management, rhabdomyosarcoma, stent displacement, tracheal stenosis

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Authors: Yeşim Özer Özkan, Fatma Büşra Fincan

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Biased sample is a regression of an observation, design process and all of the specifications lead to tendency of a side or the situation of leaving from the objectivity. It is expected that, test items are answered by the students who come from different social groups and the same ability not to be different from each other. The importance of the expectation increases especially during student selection and placement examinations. For example, all of the test items should not be beneficial for just a male or female group. The aim of the research is an investigation of item bias whether or not the exam included in 2014 free boarding and scholarship examination in terms of gender variable. Data which belong to 5th, 6th, and 7th grade the secondary education students were obtained by the General Directorate of Measurement, Evaluation and Examination Services in Turkey. 20% students were selected randomly within 192090 students. Based on 38418 students’ exam paper were examined for determination item bias. Winsteps 3.8.1 package program was used to determine bias in analysis of data, according to Rasch Model in respect to gender variable. Mathematics items tests were examined in terms of gender bias. Firstly, confirmatory factor analysis was applied twenty-five math questions. After that, NFI, TLI, CFI, IFI, RFI, GFI, RMSEA, and SRMR were examined in order to be validity and values of goodness of fit. Modification index values of confirmatory factor analysis were examined and then some of the items were omitted because these items gave an error in terms of model conformity and conceptual. The analysis shows that in 2014 free boarding and scholarship examination exam does not include bias. This is an indication of the gender of the examination to be made in favor of or against different groups of students.

Keywords: gender, item bias, placement test, Rasch model

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Authors: Farhad Abbas Gandomkar, Mona Danesh

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This paper aims to determine Fundamental Natural Frequency (FNF) of a structural composite floor system known as Chromite. To achieve this purpose, FNFs of studied panels are determined by development of Finite Element Models (FEMs) in ABAQUS program. American Institute of Steel Construction (AISC) code in Steel Design Guide Series 11, presents a fundamental formula to calculate FNF of a steel framed floor system. This formula has been used to verify results of the FEMs. The variability in the FNF of the studied system under various parameters such as dimensions of floor, boundary conditions, rigidity of main and secondary beams around the floor, thickness of concrete slab, height of composite joists, distance between composite joists, thickness of top and bottom flanges of the open web steel joists, and adding tie beam perpendicular on the composite joists, is determined. The results show that changing in dimensions of the system, its boundary conditions, rigidity of main beam, and also adding tie beam, significant changes the FNF of the system up to 452.9%, 50.8%, -52.2%, %52.6%, respectively. In addition, increasing thickness of concrete slab increases the FNF of the system up to 10.8%. Furthermore, the results demonstrate that variation in rigidity of secondary beam, height of composite joist, and distance between composite joists, and thickness of top and bottom flanges of open web steel joists insignificant changes the FNF of the studied system up to -0.02%, -3%, -6.1%, and 0.96%, respectively. Finally, the results of this study help designer predict occurrence of resonance, comfortableness, and design criteria of the studied system.

Keywords: Fundamental Natural Frequency, Chromite Composite Floor System, Finite Element Method, low and high frequency floors, Comfortableness, resonance.

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Authors: Pil Kyoo Jo, Jee Young Kim, Yu Jin Oh, Sohyun Park, Young Ha Joo, Hye Suk Kim, Semi Kang

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When convenience drives daily food choices, the increased consumption of processed foods may be associated with the increased intakes of sodium and fat and further with the onset of chronic diseases. The purpose of this study was to investigate the levels of sodium, saturated fat, and calories intakes through processed foods and the dietary patterns among adult populations in South Korea. We used the nationally representative data from the 5th Korea National Health and Nutrition Examination Survey (KNHANES, 2010-2012) and a cross-sectional survey on the eating behaviors among university students(N=893, 380 men, 513 women) aged from 20 to 24 years. Results showed that South Koreans consumed 43.5% of their total food consumption from processed foods. The 24-hour recalls data showed that 77% of sodium, 60% of fats, 59% of saturated fat, and 44% of calories were consumed from processed food. The intake of processed foods increased by 1.7% in average since 2008 annually. Only 33% of processed food that respondents consumed had nutrition labeling. The data from university students showed that students selected processed foods in convenience store when eating alone compared to eating with someone else. Given the convenience and lack of time, more people will consume processed foods and it may impact their overall dietary intake and further their health. In order to help people to make healthier food choices, regulations and policies to reduce the potentially unhealthy nutrients of processed foods should be strengthened. This research was supported by the National Research Foundation of Korea for 2011 Korea-Japan Basic Scientific Cooperation Program. This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2015S1A5B6037369).

Keywords: sodium, fat, processed foods, diet trends

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Authors: Danielle Schneider, Ying Xie

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Middle school science, technology, engineering, and math (STEM) teachers experience an exceptional challenge in the expectation to incorporate curricula that builds strong spatial reasoning skills on rudimentary geometry concepts. Because spatial ability is so closely tied to STEM students’ success, researchers are tasked to determine effective instructional practices that create an authentic learning environment within the immersive virtual reality learning environment (IVRLE). This study looked to investigate the effect of the IVRLE on middle school STEM students’ spatial reasoning skills as a methodology to benefit the STEM middle school students’ spatial reasoning skills. This experimental study was comprised of thirty 7th-grade STEM students divided into a treatment group that was engaged in an immersive VR platform where they engaged in building an object in the virtual realm by applying spatial processing and visualizing its dimensions and a control group that built the identical object using a desktop computer-based, computer-aided design (CAD) program. Before and after the students participated in the respective “3D modeling” environment, their spatial reasoning abilities were assessed using the Middle Grades Mathematics Project Spatial Visualization Test (MGMP-SVT). Additionally, both groups created a physical 3D model as a secondary measure to measure the effectiveness of the IVRLE. The results of a one-way ANOVA in this study identified a negative effect on those in the IVRLE. These findings suggest that with middle school students, virtual reality (VR) proved an inadequate tool to benefit spatial relation skills as compared to desktop-based CAD.

Keywords: virtual reality, spatial reasoning, CAD, middle school STEM

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Authors: Merkineh Markos Lorato, Gedefaw Diress Alene

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Introduction: Visual impairment is any condition of the eye or visual system that results in loss/reduction of visual functioning. It significantly influences the academic routine and social activities of children, and the effect is severe for low-income countries like Ethiopia. So, this study aimed to determine the pooled prevalence of visual impairment among school children in Ethiopia. Methods: Databases such as Medical Literature Analysis and Retrieval System Online, Excerpta Medica dataBASE, World Wide Web of Science, and Cochrane Library searched to retrieve eligible articles. In addition, Google Scholar and a reference list of the retrieved eligible articles were addressed. Studies that reported the prevalence of visual impairment were included to estimate the pooled prevalence. Data were extracted using a standardized data extraction format prepared in Microsoft Excel and analysis was held using STATA 11 statistical software. I² was used to assess the heterogeneity. Because of considerable heterogeneity, a random effect meta-analysis model was used to estimate the pooled prevalence of visual impairment among school children in Ethiopia. Results: The result of 9 eligible studies showed that the pooled prevalence of visual impairment among school children in Ethiopia was 7.01% (95% CI: 5.46, 8.56%). In the subgroup analysis, the highest prevalence was reported in South Nations Nationalities and Tigray region together (7.99%; 3.63, 12.35), while the lowest prevalence was reported in Addis Ababa (5.73%; 3.93, 7.53). Conclusion: The prevalence of visual impairment among school children is significantly high in Ethiopia. If it is not detected and intervened early, it will cause a lifetime threat to visually impaired school children, so that school vision screening program plan and its implementation may cure the life quality of future generations in Ethiopia.

Keywords: visual impairment, school children, Ethiopia, prevalence

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Authors: Tukur Daiyabu Abdulkadir, Wan Ishak Wan Ismail, Muhammad Saufi Mohd Kassim

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Seed singulation and accuracy in seed spacing are the major challenges associated with the adoption of mechanical seeder for system of rice intensification. In this research the metering system of a pneumatic planter was modified and automated for increase precision to meet the demand of system of rice intensification SRI. The chain and sprocket mechanism of a conventional vacuum planter were now replaced with an electro mechanical system made up of a set of servo motors, limit switch, micro controller and a wheel divided into 10 equal angles. The circumference of the planter wheel was determined based on which seed spacing was computed and mapped to the angles of the metering wheel. A program was then written and uploaded to arduino micro controller and it automatically turns the seed plates for seeding upon covering the required distance. The servo motor was calibrated with the aid of labVIEW. The machine was then calibrated using a grease belt and varying the servo rpm through voltage variation between 37 rpm to 47 rpm until an optimum value of 40 rpm was obtained with a forward speed of 5 kilometers per hour. A pressure of 1.5 kpa was found to be optimum under which no skip or double was recorded. Precision in spacing (coefficient of variation), miss index, multiple index, doubles and skips were investigated. No skip or double was recorded both at laboratory and field levels. The operational parameters under consideration were both evaluated at laboratory and field. Even though there was little variation between the laboratory and field values of precision in spacing, multiple index and miss index, the different is not significant as both laboratory and field values fall within the acceptable range.

Keywords: automation, calibration, pneumatic seed planter, system of rice intensification

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Authors: Okhee Woo

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Purpose: With increasing concern of individual radiation exposure doses, studies analyzing radiation dosage in breast imaging modalities are required. Aim of this study is to compare radiation dosage and image quality between digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM). Methods and Materials: 303 patients (mean age 52.1 years) who studied DBT and FFDM were retrospectively reviewed. Radiation dosage data were obtained by radiation dosage scoring and monitoring program: Radimetrics (Bayer HealthCare, Whippany, NJ). Entrance dose and mean glandular doses in each breast were obtained in both imaging modalities. To compare the image quality of DBT with two-dimensional synthesized mammogram (2DSM) and FFDM, 5-point scoring of lesion clarity was assessed and the better modality between the two was selected. Interobserver performance was compared with kappa values and diagnostic accuracy was compared using McNemar test. The parameters of radiation dosages (entrance dose, mean glandular dose) and image quality were compared between two modalities by using paired t-test and Wilcoxon rank sum test. Results: For entrance dose and mean glandular doses for each breasts, DBT had lower values compared with FFDM (p-value < 0.0001). Diagnostic accuracy did not have statistical difference, but lesion clarity score was higher in DBT with 2DSM and DBT was chosen as a better modality compared with FFDM. Conclusion: DBT showed lower radiation entrance dose and also lower mean glandular doses to both breasts compared with FFDM. Also, DBT with 2DSM had better image quality than FFDM with similar diagnostic accuracy, suggesting that DBT may have a potential to be performed as an alternative to FFDM.

Keywords: radiation dose, DBT, digital mammography, image quality

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Authors: Samar Mousa, Rebecca Shirley

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Injuries to the hand account for 20% of all emergency department attendances, with an estimated annual treatment cost of over £100 million in the UK. Functional impairments as a result of hand injuries often necessitate absence from employment, resulting in reduced productivity estimated to incur an additional £600m loss to the UK economy. Appropriate and early management is vital to preserve anatomy, prevent stiffness and allow function. The initial assessment and management of hand injuries are usually undertaken by junior staff, many of whom have little or no training or experience in splinting hand fractures. In our plastic surgery department at Stoke Mandeville hospital Buckinghamshire trust, we carried out an audit project to detect errors in hand splinting in the period between April 2022 and July 2022 and find out measures to support junior doctors, nurses and hand therapists in providing the best possible care for hand trauma patients. Our standards were The British Society for Surgery of the Hand (BSSH) standard of care in hand trauma, AO surgery reference and Stoke Mandeville hospital hand therapy mini protocol Feb 2022 During the period of 4 months, 5 cases were identified. Two cases of wrong splint choice, two cases of early removal of the splint and one tight splint that required change. In order to avoid those mistakes, a training program was given to junior doctors and nurses in collaboration with the hand therapy team regarding ways of splinting the hand in different injuries like fractures, tendons injuries, muscle injuries and ligamentous injuries. In addition to, a poster hung in the examination rooms and theatres to help junior doctors reach the correct decision.

Keywords: splinting, hand trauma, plastic surgery, tendon injury, hand fracrture

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Authors: Nur Inayah Ismaniar, Sukri Palutturi, Ansariadi, Atjo Wahyu

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Background: In various countries in the world, the problem of smoking is now considered something serious because of the effects of smoking which can not only lead to addiction but also have the potential to harm health. Public health authorities have concluded that one solution that can be done to protect the public from active smokers is to issue a policy that requires public facilities to be completely smoke-free. The hospital is one of the public facilities that has been designated as a smoke-free area. However, the implementation and maintenance of a successful program based on a smoke-free hospital are still considered an ongoing challenge worldwide due to the very low level of adherence. The low level of compliance with this smoke-free policy is also seen in other public facilities. The purpose of the literature review is to review the level of compliance with the application of the Non-Smoking Area policy, how this policy has succeeded in reducing smoking activity in hospitals, and what factors lead to such compliance in each country in the world. Methods: A literature review of articles was carried out on all types of research methods, both qualitative and quantitative. The sample is all subjects who are in the research location, which includes patients, staff and hospital visitors. Results: Various variations in the level of compliance were found in various kinds of literature. The literature with the highest level of compliance is 88.4%. Furthermore, several determinants that are known to affect the compliance of the Non-Smoking Area policies in hospitals include communication, information, knowledge, perceptions, interventions, attitudes and support. Obstacles to its enforcement are the absence of sanctions against violators of the Non-Smoking Area policy, the ineffectiveness of the function of policymakers in hospitals, and negative perceptions of smoking related to mental health. Conclusion: Violations of the Non-Smoking Area policy are often committed by the hospital staff themselves, which makes it difficult for this policy to be fully enforced at various points in the hospital.

Keywords: health policy, non-smoking area, hospital, implementation

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Authors: Abdul Haseeb Wani, Shruti Sharma, Rafat Siddique

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Self-compacting concrete is an engineered concrete that flows and de-airs without additional energy input. Such concrete requires a high slump which can be achieved by the addition of superplasticizers to the concrete mix. In the present work, bagasse ash is utilised as a replacement of cement in self-compacting concrete. This serves the purpose of both land disposal and environmental concerns related to the disposal of bagasse ash. Further, an experimental program was carried out to study the fresh, strength, and durability properties of self-compacting concrete made with bagasse ash. The mixes were prepared with four percentages (0, 5, 10 and 15) of bagasse ash as partial replacement of cement. Properties investigated were; Slump-flow, V-funnel and L-box, Compressive strength, Splitting tensile strength, Chloride-ion penetration resistance and Water absorption. Compressive and splitting tensile strength tests were conducted at the age of 7 and 28 days. Rapid chloride-ion permeability test was carried at the age of 28 days and water absorption test was carried out at the age of 7 days after initial curing of 28 days. Test results showed that there is an increase in the compressive strength and splitting tensile strength of the concrete specimens having up to 10% replacement level, however, there is a slight decrease at 15% level of replacement. Resistance to chloride-ion penetration of the specimens increased as the percentage of replacement was increased. The charge passed in all the specimens containing bagasse ash was lower than that of the specimen without bagasse ash. Water absorption of the specimens decreased up to 10% replacement level and increased at 15% level of replacement. Hence, it can be concluded that optimum level of replacement of cement with bagasse ash in self-compacting concrete comes out to be 10%; at which the self-compacting concrete has satisfactory flow characteristics (as per the European guidelines), improved compressive and splitting tensile strength and better durability properties as compared to the control mix.

Keywords: bagasse ash, compressive strength, self-compacting concrete, splitting tensile strength

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Authors: P. S. Dhananjaya Swamy, B. Chinnappa, G. B. Ramesh, Naveen P. Kumar

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Kodagu district is one of the most densely forested districts in the India as around sixty five per cent of geographical areas under tree cover. Nearly 53 per cent of the flora of Kodagu is endemic. The district is also a hotspot of endemic orchids found mainly in the Thadiandamol. Shade grown, eco-friendly coffee farms are perhaps a selected few places on this planet where nature runs wild. The Kodagu accounts for more than 8.8 per cent of floral diversity of Karnataka state. Estimation of unit cost of cultivation plays a vital role in determining the governmental program their market intervention policies. On an average, planters incurred around Rs. 17041 per acre. The extent of production risk was highest among small category of planters (66 %) compared to other two exhibiting production instability. The result shows that, the coffee productivity in medium plantations was 1051.2 kg per acre as against 758.5 and 789.2 kg in the case of small and large plantations. An annual net return per acre was highest in the case of medium planters (Rs. 26109.3) as against Rs. 20566.7 and Rs. 18572.7 in the case of small and large planters. Cost of production was lowest in the case of small planters (Rs. 18.9 per kg of output) followed by medium planters (Rs. 21.2 per kg of output) and large planters (Rs. 22.5 per kg of output). The productivity of coffee is less whenever it is grown under high shade and native tree cover; it is around 6 quintals per acre when compared with low shade conditions, which is around 8.9 quintals per acre, without a significant difference in the amount invested for growing coffee. Net gain was lower by Rs. 15.5 per kg for the planters growing under high shade and native trees cover when compared with low shade and exotic trees cover.

Keywords: coffee, cultivation, economics, Kodagu

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Authors: Gülay Dalgıç, Gildis Tachir

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Architectural design studios are ambiencein where architecture design is realized as a palpable product in architectural education. In the design studios that the architect candidate will use in the design processthe information, the methods of approaching the design problem, the solution proposals, etc., are set uptogetherwith the studio coordinators. The architectural design process, on the other hand, is complex and uncertain.Candidate architects work in a process that starts with abstre and ill-defined problems. This process starts with the generation of alternative solutions with the help of representation tools, continues with the selection of the appropriate/satisfactory solution from these alternatives, and then ends with the creation of an acceptable design/result product. In the studio ambience, many designs and thought relationships are evaluated, the most important step is the early design phase. In the early design phase, the first steps of converting the information are taken, and converted information is used in the constitution of the first design decisions. This phase, which positively affects the progress of the design process and constitution of the final product, is complex and fuzzy than the other phases of the design process. In this context, the aim of the study is to investigate the effects of face-to-face learning model and e-learning model on the early design phase. In the study, the early design phase was defined by literature research. The data of the defined early design phase criteria were obtained with the feedback graphics created for the architect candidates who performed e-learning in the first year of architectural education and continued their education with the face-to-face learning model. The findings of the data were analyzed with the common graphics program. It is thought that this research will contribute to the establishment of a contemporary architectural design education model by reflecting the evaluation of the data and results on architectural education.

Keywords: education modeling, architecture education, design education, design process

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Authors: Laila Khawaja

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In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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Authors: N. Tal-Alon, O. Shapira-Lishchinsky

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Disability disclosure is one of the most complicated dilemmas that people with invisible disabilities face. There are only a few research studies that have focused on the difficulties and dilemmas of teachers who have different disabilities. In addition, there are currently no research studies focusing specifically on the different aspects of disability disclosure, which are unique to teachers. This research has, therefore, broadened the knowledge base and understanding of the dilemma of disability disclosure among teachers with invisible physical disabilities. In addition, it has shed light on the ways this issue is perceived by different groups: the perspective of school principals, the perspective of colleagues, and the perspective of teachers with physical disabilities themselves. The study sample included 12 teachers with invisible physical disabilities, 10 school principals who employ at least one teacher with an invisible physical disability, and 10 professional colleagues of at least one teacher with an invisible physical disability. This particular research study was conducted using a qualitative approach through the Narralizer computer program based on a series of in-depth interviews. The data analysis was carried out by grouping major points of interest into specific categories and sub-categories. The findings of this research suggest that teachers with disabilities struggle with the dilemma of whether or not to reveal their disability to the school staff and to their students. It was found that there were considerable differences between the issues that faculty members considered regarding this dilemma and the ones that teachers with disabilities considered. While the principals and professional colleagues focused solely on their own interests, the teachers with a disability emphasized more on the ways that they might have a positive influence on their students, as well as their own individual interests. In addition, school principals on a whole tended to view negatively the option of disclosing the disability to the students and were often critical towards teachers who concealed their disability from the school staff. The importance of this research is in its potential to influence policy decisions that can be implemented by the Ministry of Education regarding the support system for teachers with invisible physical disabilities.

Keywords: education, employment, invisible disabilities, teachers

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Authors: Nevila Bardhi, Joanna Magda, Kolapo Alex-Oni, Slavenka Sedlar, Paromita Hore

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The New York City Department of Health and Mental Hygiene (NYC DOHMH) receives blood lead test results for NYC residents and conducts lead poisoning case investigations for individuals with elevated blood lead levels exposed to lead occupationally and non-occupationally. To (1) improve participant engagement, (2) aid the identification of potential lead sources, and (3) better tailor recommendations to reduce lead exposure, Motivational Interviewing (MI) techniques were incorporated during risk assessment interviews of non-pregnant adults by DOHMH’s Adult Lead Poisoning Prevention (ALP) Program. MI is an evidence-based counselling method used in clinical settings that have been effective in promoting behavior change by resolving ambivalence and enhancing motivation in treating both physiological and psychological health conditions. The incorporation of MI techniques in the ALP risk assessment interview was effective in improving the identification of lead sources for non-pregnant adult cases, thus, allowing for the opportunity to better tailor lead poisoning prevention recommendations. The embedding of MI cues in the ALP risk assessment interview also significantly increased engagement in the interview process, resulting in approximately 50 more interviews conducted per year and a decrease in interview refusals during case investigations. Additionally, the pre-MI interview completion rate was 57%, while the post-MI Interview completion rate was 68%. We recommend MI techniques to be used by other lead poisoning prevention programs during lead poisoning investigations in similar diverse populations.

Keywords: lead poisoning prevention, motivational interviewing, behavior change, lead poisoning risk factors, self-efficacy

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Authors: Shi-Uk Lee, Chae Young Lim

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Objective: The aim of this study was to evaluate the changes of lumbar deep muscle thickness and cross-sectional area using ultrasonography with magnetic stimulation. Methods: To evaluate the changes of lumbar deep muscle by using magnetic stimulation, 12 healthy volunteers (39.6±10.0 yrs) without low back pain during 3 months participated in this study. All the participants were checked with X-ray and electrophysiologic study to confirm that they had no problems with their back. Magnetic stimulation was done on the L5 and S1 root with figure-eight coil as previous study. To confirm the proper motor root stimulation, the surface electrode was put on the tibialis anterior (L5) and abductor hallucis muscles (S1) and the hot spots of magnetic stimulation were found with 50% of maximal magnetic stimulation and determined the stimulation threshold lowering the magnetic intensity by 5%. Ultrasonography was used to assess the changes of L5 and S1 lumbar multifidus (superficial and deep) cross-sectional area and thickness with maximal magnetic stimulation. Cross-sectional area (CSA) and thickness was evaluated with image acquisition program, ImageJ software (National Institute of Healthy, USA). Wilcoxon signed-rank was used to compare outcomes between before and after stimulations. Results: The mean minimal threshold was 29.6±3.8% of maximal stimulation intensity. With minimal magnetic stimulation, thickness of L5 and S1 deep multifidus (DM) were increased from 1.25±0.20, 1.42±0.23 cm to 1.40±0.27, 1.56±0.34 cm, respectively (P=0.005, P=0.003). CSA of L5 and S1 DM were also increased from 2.26±0.18, 1.40±0.26 cm2 to 2.37±0.18, 1.56±0.34 cm2, respectively (P=0.002, P=0.002). However, thickness of L5 and S1 superficial multifidus (SM) were not changed from 1.92±0.21, 2.04±0.20 cm to 1.91±0.33, 1.96±0.33 cm (P=0.211, P=0.199) and CSA of L5 and S1 were also not changed from 4.29±0.53, 5.48±0.32 cm2 to 4.42±0.42, 5.64±0.38 cm2. With maximal magnetic stimulation, thickness of L5, S1 of DM and SM were increased (L5 DM, 1.29±0.26, 1.46±0.27 cm, P=0.028; L5 SM, 2.01±0.42, 2.24±0.39 cm, P=0.005; S1 DM, 1.29±0.19, 1.67±0.29 P=0.002; S1 SM, 1.90±0.36, 2.30±0.36, P=0.002). CSA of L5, S1 of DM and SM were also increased (all P values were 0.002). Conclusions: Deep lumbar muscles could be stimulated with lumbar motor root magnetic stimulation. With minimal stimulation, thickness and CSA of lumbosacral deep multifidus were increased in this study. Further studies are needed to confirm whether the similar results in chronic low back pain patients are represented. Lumbar magnetic stimulation might have strengthening effect of deep lumbar muscles with no discomfort.

Keywords: magnetic stimulation, lumbar multifidus, strengthening, ultrasonography

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Authors: Roya Kelishadi, Mostafa Amini-Rarani, Mostafa Qorbani

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Introduction: As a health-related behavior, physical activity (PA) has an unequal distribution relating to individual's socioeconomic status. This study aimed to assess socioeconomic inequality in PA among Iranian students and their parents at national level and according to socioeconomic status (SES) of the living regions. Method: This study was conducted as part of a national surveillance program conducted among 14400 Iranian students and their parents. Non-linear principal component analysis was used to construct the households' socioeconomic status, and the concentration index approach was applied to measure inequality in father, mother, and student’s PA. Results: The data of 13313 students and their parents were complete for the current study. At national level and SES regions, students had more PA than their parents (except in the lowest SES region), and fathers have more PA than mothers. The lowest means of mother and student's PA were find in the highest SES region. At national level, the concentration indices of father and mother’s PA were -0.050 (95 % CI: -0.067 ~ -0.030) and -0.028 (95% CI: -0.044 ~ -0.012), respectively; indicating pro-poor inequality and, the CI value of student PA was nearly equal to zero (P > 0.05). At SES regions, father and mother's PA were more concentrated in the poor, except for lower middle region. Regional concentration indices for students reveal that inequality not statistically significant at all regions. Conclusion: This study suggests that reliable evidence that comparing different aspects of inequality of PA, based on socioeconomic status and residence areas of students and their parents, could be used for better planning for health promotion programs. Moreover, given the average of mother's and student’s PA in the richer regions were low, it can be suggested that richer focused-PA planning may further increase the level of PA across higher SES and, consequently, reduce inequality in PA. These findings can be applied in the health system services.

Keywords: concentration index, health system services, physical activity, socioeconomic inequality

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Authors: Rian O. Miranda, Lidia V. de Sa, Julio C. Suita

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The Brazilian Nuclear Energy Commission (CNEN) is the main manufacturer of radiopharmaceuticals in Brazil. The Nuclear Engineering Institute (IEN), located at Rio de Janeiro, is one of its main centers of research and production, attending public and private hospitals in the state. This radiopharmaceutical production is used in diagnostic and therapy procedures and allows one and a half million nuclear medicine procedures annually. Despite this, the country is not self-sufficient to meet national demand, creating the need for importation and consequent dependence on other countries. However, IEN facilities were designed in the 60's, and today its structure is inadequate in relation to the good manufacturing practices established by sanitary regulator (ANVISA) and radiological protection leading to the need for a new project. In order to adapt and increase production in the country, a new plant will be built and integrated to the existing facilities with a new 30 MeV Cyclotron that is actually in project detailing process. Thus, it is proposed to survey current CNEN and ANVISA standards for radiopharmaceutical production facilities, as well as the radiological protection analysis of each area of the plant, following good manufacturing practices recommendations adopted nationally besides licensing exigencies for radioactive facilities. In this way, the main requirements for proper operation, equipment location, building materials, area classification, and maintenance program have been implemented. The access controls, interlocks, segregation zones and pass-through boxes integrated into the project were also analyzed. As a result, IEN will in future have the flexibility to produce all necessary radioisotopes for nuclear medicine application, more efficiently by simultaneously bombarding two targets, allowing the simultaneous production of two different radioisotopes, minimizing radiation exposure and saving operating costs.

Keywords: cyclotron, legislation, norms, production, radiopharmaceuticals

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Authors: Janos Juhasz, Sandor Pongor, Balazs Ligeti

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Next-generation sequencing, especially whole genome shotgun sequencing, is becoming a common approach to gain insight into the microbiomes in a culture-independent way, even in clinical practice. It does not only give us information about the species composition of an environmental sample but opens the possibility to detect antimicrobial resistance and novel, or currently unknown, pathogens. Accurately and reliably detecting the microbial strains is a challenging task. Here we present a sensitive approach for detecting pathogens in metagenomics samples with special regard to detecting novel variants of known pathogens. We have developed a pipeline that uses fast, short read aligner programs (i.e., Bowtie2/BWA) and comprehensive nucleotide databases. Taxonomic binning is based on the lowest common ancestor (LCA) principle; each read is assigned to a taxon, covering the most significantly hit taxa. This approach helps in balancing between sensitivity and running time. The program was tested both on experimental and synthetic data. The results implicate that our method performs as good as the state-of-the-art BLAST-based ones, furthermore, in some cases, it even proves to be better, while running two orders magnitude faster. It is sensitive and capable of identifying taxa being present only in small abundance. Moreover, it needs two orders of magnitude less reads to complete the identification than MetaPhLan2 does. We analyzed an experimental anthrax dataset (B. anthracis strain BA104). The majority of the reads (96.50%) was classified as Bacillus anthracis, a small portion, 1.2%, was classified as other species from the Bacillus genus. We demonstrate that the evaluation of high-throughput sequencing data is feasible in a reasonable time with good classification accuracy.

Keywords: metagenomics, taxonomy binning, pathogens, microbiome, B. anthracis

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Authors: Opara Monica, Suriani Ismail, Ahmad Iqmer Nashriq Mohd Nazan

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The true magnitude of the mortality and morbidity attributable to malaria worldwide is, at best, a scientific guess, although it is not disputable that the greatest burden is in sub-Saharan Africa. Those at highest risk are children younger than 5 years and pregnant women, particularly primigravidae. Nationally, malaria remains the third leading cause of death and is still considered a major public health problem. Therefore, this study is aimed to assess the effectiveness of health education intervention on insecticide-treated net use and its practices among pregnant women attending antenatal clinics. Materials and Methods: This study will be an intervention study with two arms double parallel randomized controlled trial (blinded) to be conducted in 3 stages. The first stage will develop health belief model (HBM) program, while in the second stage, pregnant women will be recruited, assessed (baseline data), randomized into two arms of the study, and follow-up for six months. The third stage will evaluate the impact of the intervention on HBM and disseminate the findings. Data will be collected with the use of a structured questionnaire which will contain validated tools. The main outcome measurement will be the treatment effect using HBM, while data will be analysed using SPSS, version 22. Discussion: The study will contribute to the existing knowledge on hospital-based care programs for pregnant women in developing countries where the literature is scanty. It will generally give insight into the importance of HBM measurement in interventional studies on malaria and other related infectious diseases in this setting.

Keywords: malaria, health education, insecticide-treated nets, sub-Saharan Africa

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Authors: H. Nikzad, S. Yoshitomi

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In this paper, the optimal seismic design of reinforced concrete shear wall-frame building structures was done using structural optimization. The optimal section sizes were generated through structural optimization based on linear static analysis conforming to American Concrete Institute building design code (ACI 318-14). An analytical procedure was followed to validate the accuracy of the proposed method by comparing stresses on structural members through output files of MATLAB and ETABS. In order to consider the difference of stresses in structural elements by ETABS and MATLAB, and to avoid over-stress members by ETABS, a stress constraint ratio of MATLAB to ETABS was modified and introduced for the most critical load combinations and structural members. Moreover, seismic design of the structure was done following the International Building Code (IBC 2012), American Concrete Institute Building Code (ACI 318-14) and American Society of Civil Engineering (ASCE 7-10) standards. Typical reinforcement requirements for the structural wall, beam and column were discussed and presented using ETABS structural analysis software. The placement and detailing of reinforcement of structural members were also explained and discussed. The outcomes of this study show that the modification of section sizes play a vital role in finding an optimal combination of practical section sizes. In contrast, the optimization problem with size constraints has a higher cost than that of without size constraints. Moreover, the comparison of optimization problem with that of ETABS program shown to be satisfactory and governed ACI 318-14 building design code criteria.

Keywords: structural optimization, seismic design, linear static analysis, etabs, matlab, rc shear wall-frame structures

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Authors: Vicent Lwanga

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Issue: Communication between parent and child is important and necessary. Poor parenting and lack of openness and communication between parents and their children contribute to the increasing rate of HIV infection among young persons between the ages of 10-25. The young person, when left on their own are at the risk of misinformation from peers and from other sources. Description: Parent-Child Communication (PCC) was designed as a key component of a community-based HIV and AIDS intervention focused on young persons by Elderly Widows Orphans Family Support Organisation. Findings from the preliminary community-level process indicated that the lack of parent-child communication militates against young persons adopting and maintaining healthier sexual behaviors. An integrated youth strategy consisting of youth Peer Education/Facilitation and PCC was used to bridge this gap. The process involved an interactive parent-child forum, which allowed parents and children to meet and have open and frank discussions on the needs of young persons and the role of parents. This forum addressed all emerging issues from all parties and created better cordiality amongst them. Lessons Learnt: When young people feel unconnected to their parents, family, or home, they may become involved in activities that put their health at risk. Equally, when parents affirm the value of their children through open interaction, children are more likely to develop positive and healthy attitudes about themselves. Creating the opportunity for this interactive forum is paramount in any intervention program focused on young persons. Conclusion: HIV and AIDS-related programmes, especially those focusing on youth, should have PCC as an integral, essential component. Parents should be vehicles for information dissemination and need to be equipped with the capacity and skills to take on the onerous task of talking sexual reproductive health and sexuality with their children and wards.

Keywords: aids, communication, HIV, youth

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