Search results for: institutional tools

Authors: Andres Diaz Garcia

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The successful technological development of any bioproduct, including those of the biostimulant type, requires to adequately completion of a series of stages allied to different disciplines that are related to microbiological, engineering, pharmaceutical chemistry, legal and market components, among others. Engineering as a discipline has a key contribution in different aspects of fermentation processes such as the design and optimization of culture media, the standardization of operating conditions within the bioreactor and the scaling of the production process of the active ingredient that it will be used in unit operations downstream. However, all aspects mentioned must take into account many biological factors of the microorganism such as the growth rate, the level of assimilation to various organic and inorganic sources and the mechanisms of action associated with its biological activity. This paper focuses on the practical experience within the Colombian Corporation for Agricultural Research (Agrosavia), which led to the development of a biostimulant bioproduct based on native rhizobacteria Bacillus amyloliquefaciens, oriented mainly to plant growth promotion in cape gooseberry nurseries and fruit crops in Colombia, and the challenges that were overcome from the expertise in the area of engineering. Through the application of strategies and engineering tools, a culture medium was optimized to obtain concentrations higher than 1E09 CFU (colony form units)/ml in liquid fermentation, the process of biomass production was standardized and a scale-up strategy was generated based on geometric (H/D of bioreactor relationships), and operational criteria based on a minimum dissolved oxygen concentration and that took into account the differences in the capacity of control of the process in the laboratory and pilot scales. Currently, the bioproduct obtained through this technological process is in stages of registration in Colombia for cape gooseberry fruits for export.

Keywords: biochemical engineering, liquid fermentation, plant growth promoting, scale-up process

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Authors: Barbara Pittau, Piergiorgio Palla, Antonio Mastino

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Communication is fundamental to health education. The proper use of medicinal products is a crucial aspect of the health of citizens that affects both safety and health care spending. Therefore, encouraging/promoting communication, concerning the importance of proper use of pharmaceuticals, has substantial implications in terms of individual health, health care, and health care system sustainability. In view of these considerations, in the context of two projects, one of which is still in progress, a relational database-backed web application named COLLABORAFARMACISOLA has been designed and developed as a tool to analyze and visualize how people approach the use of medicinal products, with the aim of improving and enhancing communication efficacy. The software application is being used to collect information (anonymously and voluntarily) from the citizens of Sardinia, an Italian region, regarding their knowledge, experiences, and opinions towards pharmaceuticals. This study that was conducted to date on thousand of interviewed people, has focused on different aspects such as: the treatment interruption and the "self-prescription” without medical consultation, the attention paid to reading the leaflets, the awareness of the economic value of the pharmaceuticals, the importance of avoiding the waste of medicinal products and the attitudes towards the use of generics. To this purpose, our software application provides a set of ad hoc parsing routines, to store information into the structure of a relational database and to process and visualize it through a set of interactive tools aimed to emphasize the findings and the insights obtained. The results of our preliminary analysis show the efficacy of the awareness plan and, at the same time, the criticality and the needs of the territory under examination. The ultimate goal of our study is to provide a contribution to the community by improving communication that can result in a benefit for public health in a context strictly connected to the reality of the territory.

Keywords: communication, pharmaceuticals, public health, relational database, tool, web application

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Authors: Iraklis Argyriou

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The transition to net-zero emission urban bus (ZEB) systems is receiving increased attention in research and policymaking throughout the globe. Most studies in this area tend to address techno-economic aspects and the perspectives of a narrow group of stakeholders, while they largely overlook analysis of current bus system dynamics. This offers limited insight into the types of ZEB governance challenges and opportunities that are encountered in real-world contexts, as well as into some of the immediate actions that need to be taken to set off the transition over the longer term. This research offers a multi-stakeholder perspective into both the technical and non-technical factors that influence ZEB transitions within a particular context, the UK. It does so by drawing from a recent transition visioning stakeholder workshop (June 2023) with key public, private and civic actors of the urban bus transportation system. Using NVivo software to qualitatively analyze the workshop discussions, the research examines the key technological and funding aspects, as well as the short-term actions (over the next five years), that need to be addressed for supporting the ZEB transition in UK cities. It finds that ZEB technology has reached a mature stage (i.e., high efficiency of batteries, motors and inverters), but important improvements can be pursued through greater control and integration of ZEB technological components and systems. In this regard, telemetry, predictive maintenance and adaptive control strategies pertinent to the performance and operation of ZEB vehicles have a key role to play in the techno-economic advancement of the transition. Yet, more pressing gaps were identified in the current ZEB funding regime. Whereas the UK central government supports greater ZEB adoption through a series of grants and subsidies, the scale of the funding and its fragmented nature do not match the needs for a UK-wide transition. Funding devolution arrangements (i.e., stable funding settlement deals between the central government and the devolved administrations/local authorities), as well as locally-driven schemes (i.e., congestion charging/workplace parking levy), could then enhance the financial prospects of the transition. As for short-term action, three areas were identified as critical: (1) the creation of whole value chains around the supply, use and recycling of ZEB components; (2) the ZEB retrofitting of existing fleets; and (3) integrated transportation that prioritizes buses as a first-choice, convenient and reliable mode while it simultaneously reduces car dependency in urban areas. Taken together, the findings point to the need for place-based transition approaches that create a viable techno-economic ecosystem for ZEB development but at the same time adopt a broader governance perspective beyond a ‘net-zero’ and ‘bus sectoral’ focus. As such, multi-actor collaborations and the coordination of wider resources and agency, both vertically across institutional scales and horizontally across transport, energy and urban planning, become fundamental features of comprehensive ZEB responses. The lessons from the UK case can inform a broader body of empirical contextual knowledge of ZEB transition governance within domestic political economies of public transportation.

Keywords: net-zero emission transition, stakeholders, transition governance, UK, urban bus transportation

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Authors: Claude Nsobya, Alice Moncaster, Karen Potter, Jed Ramsay

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The shift in Flood Risk Governance (FRG) has moved away from traditional approaches that solely relied on centralized decision-making and structural flood defenses. Instead, there is now the adoption of integrated flood risk management measures that involve various actors and stakeholders. This new approach emphasizes people-centered approaches, including adaptation and learning. This shift to a diversity of FRG approaches has been identified as a significant factor in enhancing resilience. Resilience here refers to a community's ability to withstand, absorb, recover, adapt, and potentially transform in the face of flood events. It is argued that if the FRG merely focused on the conventional 'fighting the water' - flood defense - communities would not be resilient. The move to these people-centered approaches also implies that communities will be more involved in FRG. It is suggested that effective flood risk governance influences resilience through meaningful community involvement, and effective community engagement is vital in shaping community resilience to floods. Successful community participation not only uses context-specific indigenous knowledge but also develops a sense of ownership and responsibility. Through capacity development initiatives, it can also raise awareness and all these help in building resilience. Recent Flood Risk Management (FRM) projects have thus had increasing community involvement, with varied conceptualizations of such community engagement in the academic literature on FRM. In the context of overland floods, there has been a substantial body of literature on Flood Risk Governance and Management. Yet, groundwater flooding has gotten little attention despite its unique qualities, such as its persistence for weeks or months, slow onset, and near-invisibility. There has been a little study in this area on how successful community involvement in Flood Risk Governance may improve community resilience to groundwater flooding in particular. This paper focuses on a case study of a flood risk management project in the United Kingdom. Buckinghamshire Council is leading Project Groundwater, which is one of 25 significant initiatives sponsored by England's Department for Environment, Food and Rural Affairs (DEFRA) Flood and Coastal Resilience Innovation Programme. DEFRA awarded Buckinghamshire Council and other councils 150 million to collaborate with communities and implement innovative methods to increase resilience to groundwater flooding. Based on a literature review, this paper proposes a new paradigm for effective community engagement in Flood Risk Governance (FRG). This study contends that effective community participation can have an impact on various resilience capacities identified in the literature, including social capital, institutional capital, physical capital, natural capital, human capital, and economic capital. In the case of social capital, for example, successful community engagement can influence social capital through the process of social learning as well as through developing social networks and trust values, which are vital in influencing communities' capacity to resist, absorb, recover, and adapt. The study examines community engagement in Project Groundwater using surveys with local communities and documentary analysis to test this notion. The outcomes of the study will inform community involvement activities in Project Groundwater and may shape DEFRA policies and guidelines for community engagement in FRM.

Keywords: flood risk governance, community, resilience, groundwater flooding

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Authors: Alireza Taghdiri, Sara Ghanbarzade Ghomi

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Existing buildings are permanently subjected to change, continuously renovated and repaired in their long service life. Old buildings are destroyed and their material and components are recycled or reused for constructing new ones. In this process, importance of sustainability principles for building construction is obviously known and great significance must be attached to consumption of resources, resulting effects on the environment and economic costs. Utilization strategies for extending buildings service life and delay in destroying have positive effect on environment protection. In addition, simpler alterability or expandability of buildings’ structures and reducing energy and natural resources consumption have benefits for users, producers and environment. To solve these problems, by applying theories of open building, structural components of some conventional building systems have been analyzed and then, a new geometry adaptive building system is developed which can transform and support different imposed loads. In order to achieve this goal, various research methods and tools such as professional and scientific literatures review, comparative analysis, case study and computer simulation were applied and data interpretation was implemented using descriptive statistics and logical arguments. Therefore, hypothesis and proposed strategies were evaluated and an adaptable and reusable 2-dimensional building system was presented which can respond appropriately to dwellers and end-users needs and provide reusability of structural components of building system in new construction or function. Investigations showed that this incremental building system can be successfully applied in achieving the architectural design objectives and by small modifications on components and joints, it is easy to obtain different and adaptable load-optimized component alternatives for flexible spaces.

Keywords: adaptability, durability, open building, service life, structural building system

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Authors: Abdul Basit Kiani

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The software for the digital library system is a cutting-edge solution designed to revolutionize the way libraries manage and provide access to their vast collections of digital content. This advanced software leverages the power of technology to offer a seamless and user-friendly experience for both library staff and patrons. By implementing this software, libraries can efficiently organize, store, and retrieve digital resources, including e-books, audiobooks, journals, articles, and multimedia content. Its intuitive interface allows library staff to effortlessly manage cataloging, metadata extraction, and content enrichment, ensuring accurate and comprehensive access to digital materials. For patrons, the software offers a personalized and immersive digital library experience. They can easily browse the digital catalog, search for specific items, and explore related content through intelligent recommendation algorithms. The software also facilitates seamless borrowing, lending, and preservation of digital items, enabling users to access their favorite resources anytime, anywhere, on multiple devices. With robust security features, the software ensures the protection of intellectual property rights and enforces access controls to safeguard sensitive content. Integration with external authentication systems and user management tools streamlines the library's administration processes, while advanced analytics provide valuable insights into patron behavior and content usage. Overall, this software for the digital library system empowers libraries to embrace the digital era, offering enhanced access, convenience, and discoverability of their vast collections. It paves the way for a more inclusive and engaging library experience, catering to the evolving needs of tech-savvy patrons.

Keywords: software development, empowering digital libraries, digital cataloging and access, management system

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Authors: Noryani Natasha Yahaya, Anas Ibrahim, Juraidah Ahmad, Azura Ahmad, Mohd Ikmal Fazlan Rosli, Zailan Ramli, Muhd Sidek Muhd Norhasri

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The subgrade formation is an important element of the railway structure which holds overall track stability. Conventional track maintenance involves many substructure component replacements, as well as track re-ballasting on a regular basis is partially contributed to the embankment's long-term settlement problem. For subgrade long-term stability analysis, the geophysical method is commonly being used to diagnose those hidden sources/mechanisms of track deterioration problems that the normal visual method is unable to detect. Electrical resistivity tomography (ERT) is one of the applicable geophysical tools that are helpful in railway subgrade inspection/track monitoring due to its flexibility and reliability of the analysis. The ERT was conducted at KM 23.0 of Pinang Tunggal track to investigate the subgrade of railway track through the characterization/mapping on track formation profiling which was directly generated using 2D analysis of Res2dinv software. The profiles will allow examination of the presence and spatial extent of a significant subgrade layer and screening of any poor contact of soil boundary. Based on the finding, there is a mix/interpretation/intermixing of an interlayer between the sub-ballast and the sand. Although the embankment track considered here is at no immediate risk of settlement effect or any failure, the regular monitoring of track’s location will allow early correction maintenance if necessary. The developed data of track formation clearly shows the similarity of the side view with the assessed track. The data visualization in the 2D section of the track embankment agreed well with the initial assumption based on the main element structure general side view.

Keywords: ground track, assessment, resistivity, geophysical railway, method

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Authors: Pilly Joseph Kagosi

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The study aims at assessing challenges observed during the implementation of participatory irrigation management (PIM) approach for food security in semi-arid areas of Tanzania. Data were collected through questionnaire, PRA tools, key informants discussion, Focus Group Discussion (FGD), participant observation, and literature review. Data collected from the questionnaire was analysed using SPSS while PRA data was analysed with the help of local communities during PRA exercise. Data from other methods were analysed using content analysis. The study revealed that PIM approach has a contribution in improved food security at household level due to the involvement of communities in water management activities and decision making which enhanced the availability of water for irrigation and increased crop production. However, there were challenges observed during the implementation of the approach including; minimum participation of beneficiaries in decision-making during planning and designing stages, meaning inadequate devolution of power among scheme owners. Inadequate and lack of transparency on income expenditure in Water Utilization Associations’ (WUAs), water conflict among WUAs members, conflict between farmers and livestock keepers and conflict between WUAs leaders and village government regarding training opportunities and status; WUAs rules and regulation are not legally recognized by the National court and few farmers involved in planting trees around water sources. However, it was realized that some of the mentioned challenges were rectified by farmers themselves facilitated by government officials. The study recommends that the identified challenges need to be rectified for farmers to realize impotence of PIM approach as it was realized by other Asian countries.

Keywords: challenges, participatory approach, irrigation management, food security, semi arid areas

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Authors: Nessreen Y. Ibrahim

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Designing the future according to realistic analytical study for the futuristic market needs can be a milestone strategy to make a huge improvement in developing countries economics. In developing countries, access to high technology and latest science approaches is very limited. The financial problems in low and medium income countries have negative effects on the kind and quality of imported new technologies and application for their markets. Thus, there is a strong need for shifting paradigm thinking in the design process to improve and evolve their development strategy. This paper discusses future possibilities in developing countries, and how they can design their own future according to specific future models FDM (Future Design Models), which established to solve certain economical problems, as well as political and cultural conflicts. FDM is strategic thinking framework provides an improvement in both content and process. The content includes; beliefs, values, mission, purpose, conceptual frameworks, research, and practice, while the process includes; design methodology, design systems, and design managements tools. In this paper the main objective was building an innovative economic model to design a chosen possible futuristic scenario; by understanding the market future needs, analyze real world setting, solve the model questions by future driven design, and finally interpret the results, to discuss to what extent the results can be transferred to the real world. The paper discusses Egypt as a potential case study. Since, Egypt has highly complex economical problems, extra-dynamic political factors, and very rich cultural aspects; we considered Egypt is a very challenging example for applying FDM. The paper results recommended using FDM numerical modeling as a starting point to design the future.

Keywords: developing countries, economic models, future design, possible futures

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Authors: Mohamed M. Elsherbiny, Ahmed T. Helal Ibrahim

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Social isolation is one of the common problems faced visual impaired students especially in new situations. It refers to lack of interactions with others (students, staff members, and others) and dissatisfaction of social networks with others. In addition, it means "a lack of quantity and quality of social contacts". The situation became more complicated if we know that visual impaired students at Sultan Qaboos University were in special schools for the blind completely away from any integration with regular student, which may lead to isolation for being with regular students for the first time. Because the researcher is an academic advisor for all blind students in the College of Arts and Social Sciences at Sultan Qaboos University, he has noted (from the regular meetings with them) some aspects of isolation and many complaints from staff which motivated the researcher to try to alleviate the problem. Logotherapy is an important therapy used in clinical social work with various problems to help children and young people who are facing problems related to the lack of meaning in their life. So, the aim of the therapy is to find meaning in life and to be satisfied with that life. The basic meaning for visual impaired students in this study is to provide opportunities to build relationships and friendships with others and help them to be satisfied about interactions with their networks. The study aimed to identify whether there is a relationship between the use of logotherapy and alleviating social isolation for visual impaired students. This study is considered one of the quasi-experimental studies, the researcher has used experimental method. The researcher used one design which is before and after experiment on two groups, one control (did not apply to the therapy) and experimental group which is applied to the therapy. About the study tools, social isolation scale (SIS) was used to assess the degree of isolation. The sample was (20) of the visually impaired students at the College of Arts and Social Sciences, Sultan Qaboos University. The results showed the effectiveness of logotherapy in alleviating isolation for students.

Keywords: social isolation, logotherapy, visually impaired, disability

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Authors: Taif Rocky, Uttam Saha, Mahobul Islam

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With a rapid urbanisation in Bangladesh, waste management remains one of the core challenges. Turning municipal waste into biogas for mass usage is a solution that Bangladesh needs to adopt urgently. Practical Action with its commitment to challenging poverty with technological justice has piloted such idea in Gaibandha. The initiative received immense success and drew the attention of policy makers and practitioners. We believe, biogas from waste can highly contribute to meet the growing demand for energy in the country at present and in the future. Practical Action has field based experience in promoting small scale and innovative technologies. We have proven track record in integrated solid waste management. We further utilized this experience to promote waste to biogas at end users’ level. In 2011, we have piloted a project on waste to biogas in Gaibandha, a northern secondary town of Bangladesh. With resource and support from UNICEF and with our own innovative funds we have established a complete chain of utilizing waste to the renewable energy source and organic fertilizer. Biogas is produced from municipal solid waste, which is properly collected, transported and segregated by private entrepreneurs. The project has two major focuses, diversification of biogas end use and establishing a public-private partnership business model. The project benefits include Recycling of Wastes, Improved institutional (municipal) capacity, Livelihood from improved services and Direct Income from the project. Project risks include Change of municipal leadership, Traditional mindset, Access to decision making, Land availability. We have observed several outcomes from the initiative. Up scaling such an initiative will certainly contribute for sustainable cleaner and healthier urban environment and urban poverty reduction. - It reduces the unsafe disposal of wastes which improve the cleanliness and environment of the town. -Make drainage system effective reducing the adverse impact of water logging or flooding. -Improve public health from better management of wastes. -Promotes usage of biogas replacing the use of firewood/coal which creates smoke and indoor air pollution in kitchens which have long term impact on health of women and children. -Reduce the greenhouse gas emission from the anaerobic recycling of wastes and contributes to sustainable urban environment. -Promote the concept of agroecology from the uses of bio slurry/compost which contributes to food security. -Creates green jobs from waste value chain which impacts on poverty alleviation of urban extreme poor. -Improve municipal governance from inclusive waste services and functional partnership with private sectors. -Contribute to the implementation of 3R (Reduce, Reuse, Recycle) Strategy and Employment Creation of extreme poor to achieve the target set in Vision 2021 by Government of Bangladesh.

Keywords: kitchen waste, secondary town, biogas, segregation

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Authors: Nigina Toktasynova, Sholpan Sagyndykova, Zhanat Kenzhebayeva, Maksat Kalimoldayev, Mariya Ishimova, Irbulat Utepbergenov

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Any business needs a stable operation and continuous improvement, therefore it is necessary to constantly interact with the environment, to analyze the work of the enterprise in terms of employees, executives and consumers, as well as to correct any inconsistencies of certain types of processes and their aggregate. In the case of heat supply organizations, in addition to suppliers, local legislation must be considered which often is the main regulator of pricing of services. In this case, the process approach used to build a functional organizational structure in these types of businesses in Kazakhstan is a challenge not only in the implementation, but also in ways of analyzing the employee's salary. To solve these problems, we investigated the management system of heating enterprise, including strategic planning based on the balanced scorecard (BSC), quality management in accordance with the standards of the Quality Management System (QMS) ISO 9001 and analysis of the system based on expert judgment using fuzzy inference. To carry out our work we used the theory of fuzzy sets, the QMS in accordance with ISO 9001, BSC according to the method of Kaplan and Norton, method of construction of business processes according to the notation IDEF0, theory of modeling using Matlab software simulation tools and graphical programming LabVIEW. The results of the work are as follows: We determined possibilities of improving the management of heat-supply plant-based on QMS; after the justification and adaptation of software tool it has been used to automate a series of functions for the management and reduction of resources and for the maintenance of the system up to date; an application for the analysis of the QMS based on fuzzy inference has been created with novel organization of communication software with the application enabling the analysis of relevant data of enterprise management system.

Keywords: balanced scorecard, heat supply, quality management system, the theory of fuzzy sets

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Authors: F. Lazzeri, I. Reiter

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Energy production optimization has been traditionally very important for utilities in order to improve resource consumption. However, load forecasting is a challenging task, as there are a large number of relevant variables that must be considered, and several strategies have been used to deal with this complex problem. This is especially true also in microgrids where many elements have to adjust their performance depending on the future generation and consumption conditions. The goal of this paper is to present a solution for short-term load forecasting in microgrids, based on three machine learning experiments developed in R and web services built and deployed with different components of Cortana Intelligence Suite: Azure Machine Learning, a fully managed cloud service that enables to easily build, deploy, and share predictive analytics solutions; SQL database, a Microsoft database service for app developers; and PowerBI, a suite of business analytics tools to analyze data and share insights. Our results show that Boosted Decision Tree and Fast Forest Quantile regression methods can be very useful to predict hourly short-term consumption in microgrids; moreover, we found that for these types of forecasting models, weather data (temperature, wind, humidity and dew point) can play a crucial role in improving the accuracy of the forecasting solution. Data cleaning and feature engineering methods performed in R and different types of machine learning algorithms (Boosted Decision Tree, Fast Forest Quantile and ARIMA) will be presented, and results and performance metrics discussed.

Keywords: time-series, features engineering methods for forecasting, energy demand forecasting, Azure Machine Learning

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Authors: Lamin B Ceesay, Cecilia Rossignoli

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Inter-organizational collaboration is a growing phenomenon in both research and practice. The partnership between organizations enables firms to leverage external resources, experiences, and technology that lie with other firms. This collaborative practice is a source of improved business model performance, technological advancement, and increased competitive advantage for firms. However, the competitive intents, and even diverse institutional logics of firms, make inter-firm innovation-based partnership even more complex, and its governance more challenging. The purpose of this paper is to present a systematic review of research linking the inter-organizational relationship of firms with their innovation practice and specify the different project management issues and gaps addressed in previous research. To do this, we employed a systematic review of the literature on inter-organizational innovation using two complementary scholarly databases - ScienceDirect and Web of Science (WoS). Article scoping relies on the combination of keywords based on similar terms used in the literature:(1) inter-organizational relationship, (2) business network, (3) inter-firm project, and (4) innovation network. These searches were conducted in the title, abstract, and keywords of conceptual and empirical research papers done in English. Our search covers between 2010 to 2019. We applied several exclusion criteria including Papers published outside the years under the review, papers in a language other than English, papers neither listed in WoS nor ScienceDirect and papers that are not sharply related to the inter-organizational innovation-based partnership were removed. After all relevant search criteria were applied, a final list of 84 papers constitutes the data for this review. Our review revealed an increasing evolution of inter-organizational relationship research during the period under the review. The descriptive analysis of papers according to Journal outlets finds that International Journal of Project Management (IJPM), Journal of Industrial Marketing, Journal of Business Research (JBR), etc. are the leading journal outlets for research in the inter-organizational innovation project. The review also finds that Qualitative methods and quantitative approaches respectively are the leading research methods adopted by scholars in the field. However, literature review and conceptual papers constitute the least in the field. During the content analysis of the selected papers, we read the content of each paper and found that the selected papers try to address one of the three phenomena in inter-organizational innovation research: (1) project antecedents; (2) project management and (3) project performance outcomes. We found that these categories are not mutually exclusive, but rather interdependent. This categorization also helped us to organize the fragmented literature in the field. While a significant percentage of the literature discussed project management issues, we found fewer extant literature on project antecedents and performance. As a result of this, we organized the future research agenda addressed in several papers by linking them with the under-researched themes in the field, thus providing great potential to advance future research agenda especially, in the under-researched themes in the field. Finally, our paper reveals that research on inter-organizational innovation project is generally fragmented which hinders a better understanding of the field. Thus, this paper contributes to the understanding of the field by organizing and discussing the extant literature to advance the theory and application of inter-organizational relationship.

Keywords: inter-organizational relationship, inter-firm collaboration, innovation projects, project management, systematic review

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Authors: Florge Francis A. Sy

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Physicians develop emotional and psychological distress after facing a patient’s death. This can result in stress or burnout. Coping mechanisms in dealing with these deaths may be maladaptive. Determining grief, emotional impact, and coping strategies in physicians is necessary to identify those needing intervention. This can be done by employing validated assessment tools such as the Texas Revised Inventory of Grief (TRIG) scale, Impact of Events Scale (IES), and BriefCOPE tool, respectively. This prospective, observational study was done in a private hospital in Cebu City. Fifty-five internal medicine residents were included and tasked to answer a survey based on their most memorable patient death encounter. The TRIG, IES, and BriefCOPE scores were determined. Participants were divided into severe grief and non-severe grief based on TRIG scores, low-impact, moderate-impact, and high-impact based on IES, and low-use, moderate-use, and high-use based on the BriefCOPE. The differences in the groups’ characteristics were statistically determined, and a p-value of < 0.05 was significant. The participants’ average age was 28.45 years. Most were female and single. Most belonged to the non-severe group based on TRIG, a moderate-impact group based on the IES, and high-use group based on the BriefCOPE. However, 21.8% reported severe grief, 27.3% reported high-impact, and 10.9% had low use of coping strategies. The proportion of residents who encountered CPR prior to the patient’s death was greater in the severe group. Proportions of both high-impact and non-high impact groups were comparable. The proportion of female residents was higher in the high-use group. There were a number of residents who reported severe grief, high emotional impact, and low coping strategies. This highlights the need for interventions such as debriefing after CPR or formal training in residency programs in dealing with emotional burden to counteract maladaptive coping behaviors and prevent negative outcomes.

Keywords: residents, grief, emotional impact, coping, patient death

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Authors: Ram Chandra Sah

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Few years back, naturally a very beautiful country Nepal was facing a lot of problems related to the practice of open defecation (having no toilet) by almost 98% people of the country. Now, the scenario is changed. Government of Nepal set the target of achieving the situation of basic level sanitation (toilets) facilities by 2017 AD for which the Sanitation and Hygiene Master Plan (SHMP) was brought in 2011 AD with the major beauty as institutional set up formation, local formal authority leadership, locally formulated strategic plan; partnership, harmonized and coordinated approach to working; no subsidy or support at a blanket level, community and local institutions or organizations mobilization approaches. Now, the Open Defecation Free (ODF) movement in the country is at a full swing. The Sanitation and Hygiene Master Plan (SHMP) has clearly defined Total Sanitation which is accepted to be achieved if all the households of the related boundary have achieved the 6 indicators such as the access and regular use of toilet(s), regular use of soap and water at the critical moments, regular practice of use of food hygiene behavior, regular practice of use of water hygiene behavior including household level purification of locally available drinking water, maintenance of regular personal hygiene with household level waste management and the availability of the state of overall clean environment at the concerned level of boundary. Nepal has 3158 Village Development Committees (VDC's) in the rural areas. Amarapuri VDC was selected for the purpose of achieving Total Sanitation. Based on the SHMP; different methodologies such as updating of Village Water Sanitation and Hygiene Coordination Committee (V-WASH-CC), Total Sanitation team formation including one volunteer for each indicator, campaigning through settlement meetings, midterm evaluation which revealed the need of ward level 45 (5 for all 9 wards) additional volunteers, ward wise awareness creation with the help of the volunteers, informative notice boards and hoarding boards with related messages at important locations, management of separate waste disposal rings for decomposable and non-decomposable wastes, related messages dissemination through different types of local cultural programs, public toilets construction and management by community level; mobilization of local schools, offices and health posts; reward and recognition to contributors etc. were adopted for achieving 100 % coverage of each indicator. The VDC was in a very worse situation in 2010 with just 50, 30, 60, 60, 40, 30 percent coverage of the respective indicators and became the first VDC of the country declared with Total Sanitation. The expected result of 100 percent coverage of all the indicators was achieved in 2 years 10 months and 19 days. Experiences of Amarapuri were replicated successfully in different parts of the country and many VDC's have been declared with the achievement of Total Sanitation. Thus, Community Mobilized Total Sanitation Movement in Nepal has supported a lot for achieving a Total Sanitation situation of the country with a minimal cost and it is believed that the approach can be very useful for other developing or under developed countries of the world.

Keywords: community mobilized, open defecation free, sanitation and hygiene master plan, total sanitation

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Authors: Magigi Wakuru, Gaudensi Kapinga

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This study examines land use changes and its implications on livelihood activities of peri-urban settlements in Msaranga, Moshi Municipality. Specifically; it analyses the historical development of the settlement, socioeconomic characteristics and land use changes over time. Likely, find out existing livelihood activities and how have been changing over time in the context of urbanization, and lastly highlights land use change implications on livelihood activities to residents. Interviews, observations, documentary reviews and mapping were data collection tools employed. The study shows that housing, urban agriculture, roads infrastructure, recreational, open spaces and institutions are some land use types existing in the settlement. On-farm and off-farm livelihood activities have been identified livelihood activities in the settlement. These include crop cultivation, livestock keeping, trading and formal employment and have been changing over time. However, urbanisation observed to be a catalyst of change and affect livelihood activities over time. Resorting to off-farm livelihoods activities including engaging in retail business and seeking employment in formal and informal sector are some copying strategies documented. The study wind up by pointing roles of different actors and issues of particular attention to different stakeholders towards reducing impact of land use changes on livelihood strategies in the settlement. Likely, unresolved issues for future research and policy development agenda are highlighted in this study. The study concludes that the impact of land use changes on livelihood activities need collaborative effort of different stakeholders, policy enforcement as well as public private partnership in issues based implementation in cities like Moshi where land use is rapidly changing over time within urban planning cycles due to increasing population demand in cities of Sub-Saharan Africa.

Keywords: land use, land use changes, livelihood activities, peri-urban settlement, Moshi, Tanzania

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Authors: Naz Najma, Grace T. M. Dal Sasso, Maria de Lourdes de Souza

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The development of information and communication technologies and the accessibility of mobile devices has increased the possibilities of the teaching and learning process anywhere and anytime. Mobile and web application allows the production of constructive teaching and learning models in various educational settings, showing the potential for active learning in nursing. The objective of this study was to present the development of an educational technology (Savinglife®, an app) for learning cardiopulmonary resuscitation and advanced cardiovascular life support training. Savinglife® is a technological production, based on the concept of virtual learning and problem-based learning approach. The study was developed from January 2016 to November 2016, using five phases (analyze, design, develop, implement, evaluate) of the instructional systems development process. The technology presented 10 scenarios and 12 simulations, covering different aspects of basic and advanced cardiac life support. The contents can be accessed in a non-linear way leaving the students free to build their knowledge based on their previous experience. Each scenario is presented through interactive tools such as scenario description, assessment, diagnose, intervention and reevaluation. Animated ECG rhythms, text documents, images and videos are provided to support procedural and active learning considering real life situation. Accessible equally on small to large devices with or without an internet connection, Savinglife® offers a dynamic, interactive and flexible tool, placing students at the center of the learning process. Savinglife® can contribute to the student’s learning in the assessment and management of basic and advanced cardiac life support in a safe and ethical way.

Keywords: problem-based learning, cardiopulmonary resuscitation, nursing education, advanced cardiac life support, educational technology

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Authors: Dena A. Hussain

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The objective of this project is to design an Information and Communication Technologies (ICT) tool based on a standardized platform to assist the work-integrated learning process of caretakers of disabled children. The tool should assist the intercommunication between caretakers and improve the learning process through knowledge bridging between all involved caretakers. Some children are born with disabilities while others have special needs after an illness or accident. Special needs children often need help in their learning process and require tools and services in a different way. In some cases the child has multiple disabilities that affect several capabilities in different ways. These needs are to be transformed into different learning techniques that the staff or personal (called caretakers in this project) caring for the child needs to learn and adapt. The caretakers involved are also required to learn new learning or training techniques and utilities specialized for the child’s needs. In many cases the number of people caring for the child’s development is rather large; the parents, specialist pedagogues, teachers, therapists, psychologists, personal assistants, etc. Each group of specialists has different objectives and in some cases the merge between theses specifications is very unique. This makes the synchronization between different caretakers difficult, resulting often in low level cooperation. By better intercommunication between professions both the child’s development could be improved but also the caretakers’ methods and knowledge of each other’s work processes and their own profession. This introduces a unique work integrated learning environment for all personnel involve, merging learning and knowledge in the work environment and at the same time assist the children’s development process. Creating an iterative process generates a unique learning experience for all involved. Using a work integrated platform will help encourage and support the process of all the teams involved in the process.We believe that working with children who have special needs is a continues learning/working process that is always integrated to achieve one main goal, which is to make a better future for all children.

Keywords: information and communication technologies (ICT), work integrated learning (WIL), sustainable learning, special needs children

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Authors: Hanna Mamo Ergando

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Climate change is already having a severe influence on agriculture, affecting crop yields, the nutritional content of main grains, and livestock productivity. Significant adaptation investments will be necessary to sustain existing yields and enhance production and food quality to fulfill demand. Climate-smart agriculture (CSA) provides numerous potentials in this regard, combining a focus on enhancing agricultural output and incomes while also strengthening resilience and responding to climate change. To improve agriculture production and productivity, the Ethiopian government has adopted and implemented a series of strategies, including the recent agricultural cluster farming that is practiced as an effort to change, improve, and transform subsistence farming to modern, productive, market-oriented, and climate-smart approach through farmers production cluster. Besides, greater attention and focus have been given to wheat production and productivity by the government, and wheat is the major crop grown in cluster farming. Therefore, the objective of this assessment was to examine various opportunities and challenges farmers face in a cluster farming system. A qualitative research approach was used to generate primary and secondary data. Respondents were chosen using the purposeful sampling technique. Accordingly, experts from the Federal Ministry of Agriculture, the Ethiopian Agricultural Transformation Institute, the Ethiopian Agricultural Research Institute, and the Ethiopian Environment Protection Authority were interviewed. The assessment result revealed that farming in clusters is an economically viable technique for sustaining small, resource-limited, and socially disadvantaged farmers' agricultural businesses. The method assists farmers in consolidating their products and delivering them in bulk to save on transportation costs while increasing income. Smallholders' negotiating power has improved as a result of cluster membership, as has knowledge and information spillover. The key challenges, on the other hand, were identified as a lack of timely provision of modern inputs, insufficient access to credit services, conflict of interest in crop selection, and a lack of output market for agro-processing firms. Furthermore, farmers in the cluster farming approach grow wheat year after year without crop rotation or diversification techniques. Mono-cropping has disadvantages because it raises the likelihood of disease and insect outbreaks. This practice may result in long-term consequences, including soil degradation, reduced biodiversity, and economic risk for farmers. Therefore, the government must devote more resources to addressing the issue of environmental sustainability. Farmers' access to complementary services that promote production and marketing efficiencies through infrastructure and institutional services has to be improved. In general, the assessment begins with some hint that leads to a deeper study into the efficiency of the strategy implementation, upholding existing policy, and scaling up good practices in a sustainable and environmentally viable manner.

Keywords: cluster farming, smallholder farmers, wheat, challenges, opportunities

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Authors: Satpal Yadav, Ashish Phulkar, Krishna K. Sahu

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Aim: The research aims at doing a 3 Dimension biomechanical analysis in the shot put techniques of International throwers to evaluate the performance. Research Method: The researcher adopted the descriptive method and the data was subjected to calculate by using Pearson’s product moment correlation for the correlation of the biomechanical parameters with the performance of shot put throw. In all the analyses, the 5% critical level (p ≤ 0.05) was considered to indicate statistical significance. Research Sample: Eight (N=08) international shot putters using rotational/glide technique in male category was selected as subjects for the study. The researcher used the following methods and tools to obtain reliable measurements the instrument which was used for the purpose of present study namely the tesscorn slow-motion camera, specialized motion analyzer software, 7.260 kg Shot Put (for a male shot-putter) and steel tape. All measurement pertaining to the biomechanical variables was taken by the principal investigator so that data collected for the present study was considered reliable. Results: The finding of the study showed that negative significant relationship between the angular velocity right shoulder, acceleration distance at pre flight (-0.70), (-0.72) respectively were obtained, the angular displacement of knee, angular velocity right shoulder and acceleration distance at flight (0.81), (0.75) and (0.71) respectively were obtained, the angular velocity right shoulder and acceleration distance at transition phase (0.77), (0.79) respectively were obtained and angular displacement of knee, angular velocity right shoulder, release velocity shot, angle of release, height of release, projected distance and measured distance as the values (0.76), (0.77), (-0.83), (-0.79), (-0.77), (0.99) and (1.00) were found higher than the tabulated value at 0.05 level of significance. On the other hand, there exists an insignificant relationship between the performance of shot put and acceleration distance [m], angular displacement shot, C.G at release and horizontal release distance on the technique of shot put.

Keywords: biomechanics, analysis, shot put, international throwers

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Authors: Dilek Saritas Atalar, Cansu Alsancak Akbulut, İrem Metin Orta, Feyza Yön, Zeynep Yenen, Joan Grusec

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Objective: The aim of this study was to develop semi-structured Domains of Socialization Interview and its coding manual and to test their psychometric properties. Domains of Socialization Interview was designed to assess maternal awareness regarding effective parenting in five socialization domains (protection, mutual reciprocity, control, guided learning, and group participation) within the framework of the domains-of-socialization approach. Method: A series of two studies were conducted to develop and validate the interview and its coding manual. The pilot study, sampled 13 mothers of preschool-aged children, was conducted to develop the assessment tools and to test their function and clarity. Participants of the main study were 82 Turkish mothers (Xage = 34.25, SD = 3.53) who have children aged between 35-76 months (Xage = 50.75, SD = 11.24). Mothers filled in a questionnaire package including Coping with Children’s Negative Emotions Questionnaire, Social Competence and Behavior Evaluation-30, Child Rearing Questionnaire, and Two Dimensional Social Desirability Questionnaire. Afterward, interviews were conducted online by a single interviewer. Interviews were rated independently by two graduate students based on the coding manual. Results: The relationships of the awareness of effective parenting scores to the other measures demonstrate convergent, discriminant, and predictive validity of the coding manual. Intra-class correlation coefficient estimates were ranged between 0.82 and 0.90, showing high interrater reliability of the coding manual. Conclusion: Taken as a whole, the results of these studies demonstrate the validity and reliability of a new and useful interview to measure maternal awareness regarding effective parenting within the framework of the domains-of-socialization approach.

Keywords: domains of socialization, parenting, interview, assessment

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Authors: Nabila Farhin, Israt Jahan

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Despite the feminisation of the global health force, women mostly engage in nursing, midwifery and community health workers (HWs), and the posts like surgeons, doctors, and specialists are generally male-dominated. It is also prominent in Bangladesh, where female HWs witness systematic workplace inequalities, discrimination, and underpayment. The Covid-19 pandemic put unsurmountable pressure on HWs as they had to serve in high-risk workplaces as frontliners. The already disadvantaged female HWs shouldered the same burden, were overworked without adequate occupational health and safety measures (OSH) and risked their lives. Acknowledging their vulnerable workplace conditions, the World Health Organization (WHO) and International Labour Organization (ILO) circulated a few specialised guidelines amid the peril. Bangladesh tried to adhere to international guidelines while formulating pandemic management strategies. In reality, the already weak and understaffed health sector collapsed with the patient influx and many HWs got infected and died in the line of duty, exposing the high-risk nature of the work. Unfortunately, the gender-segregated data of infected HWs are absent. This qualitative research investigates whether the existing laws of Bangladesh are adequate in protecting female HWs as frontliners in high-risk workplaces during the Covid-19 pandemic. The paper first examines international labour laws safeguarding female frontline HWs. It also analyses the specialised Covid-19 pandemic guidelines protecting their interests. Finally, the research investigates the compliance of Bangladesh as per international legal guidance during the pandemic. In doing so, it explores the domestic laws, professional guidelines for HWs and pandemic response strategies. The paper critically examines the primary sources like international and national statutes, rules, regulations and guidelines. Secondary sources like authoritative journal articles, books and newspaper reports are contextually analysed in line with the objective of the paper. The definition of HW is ambiguous in the labour laws of Bangladesh. It leads to confusion regarding the extent of legal protection rendered to female HWs at private hospitals in high-risk situations. The labour laws are not applicable in Public hospitals, as the employees follow the public service rules. Unfortunately, the country has no specialised law to protect HWs in high-risk workplaces, and the professional guidelines for HWs also remain inadequate in this regard. Even though the pandemic management strategies highlight some protective measures in high-risk situations, they only deal with HWs who are pregnant or have underlying health issues. No specialised protective guidelines can be found for female HWs as frontliners. Therefore, the laws are insufficient and failed to render adequate legal protection to female frontline HWs during the pandemic. The country also lacks comprehensive health legislation and uniform institutional and professional guidelines, preventing them from accessing grievance mechanisms. Hence, the female HWs felt victimised while duty-bound to serve in high-risk workplaces without adequate safeguards. Bangladesh should clarify the definition of HWs and standardise the service rules for providing medical care in high-risk workplaces. The research also recommends adequate health legislation and specialised legal protection to safeguard female HWs in future emergencies.

Keywords: female health workers (HWs), high-risk workplaces, Covid-19 pandemic, Bangladesh

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Authors: Megha Jain, K. K. Pathak

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In sub-tropical humid climates, it is estimated most of the urban peak load of energy consumption is used to satisfy air-conditioning or air-coolers cooling demand in summer time. As the urbanization rate in developing nation – like the case in India is rising rapidly, the pressure placed on energy resources to satisfy inhabitants’ indoor comfort requirements is consequently increasing too. This paper introduces passive cooling through roof as a means of reducing energy cooling loads for satisfying human comfort requirements in a sub-tropical climate. Experiments were performed by applying different insulators which are locally available solar reflective materials to insulate the roofs of five rooms of 4 case buildings; three rooms having RCC (Reinforced Cement Concrete) roof and two having Asbestos sheet roof of existing buildings. The results are verified by computer simulation using Computational Fluid Dynamics tools with FLUENT software. The result of using solar reflective paint with high albedo coating shows a fall of 4.8⁰C in peak hours and saves 303 kWh considering energy load with air conditioner during the summer season in comparison to non insulated flat roof energy load of residential buildings in Bhopal. An optimum solution of insulator for both types of roofs is presented. It is recommended that the selected cool roof solution be combined with insulation on other elements of envelope, to increase the indoor thermal comfort. The application is intended for low cost residential buildings in composite and warm climate like Bhopal.

Keywords: cool roof, computational fluid dynamics, energy loads, insulators, passive cooling, subtropical climate, thermal performance

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Authors: Mohd Zubairy Bin Shamsudin

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Work-related Musculoskeletal Disorder (WMSDs) is one of the occupational health problems encountered by workers over the world. In Malaysia, there is increasing in trend over the years, particularly in the manufacturing sectors. Current method to observe workplace WMSDs is self-report questionnaire, observation and direct measurement. Observational method is most frequently used by the researcher and practitioner because of the simplified, quick and versatile when it applies to the worksite. However, there are some limitations identified e.g. some approach does not cover a wide spectrum of biomechanics activity and not sufficiently sensitive to assess the actual risks. This paper elucidates the development of Work Movement Task Analysis (WMTA), which is an observational tool for industrial practitioners’ especially untrained personnel to assess WMSDs risk factors and provide a basis for suitable intervention. First stage of the development protocol involved literature reviews, practitioner survey, tool validation and reliability. A total of six themes/comments were received in face validity stage. New revision of WMTA consisted of four sections of postural (neck, back, shoulder, arms, and legs) and associated risk factors; movement, load, coupling and basic environmental factors (lighting, noise, odorless, heat and slippery floor). For inter-rater reliability study shows substantial agreement among rater with K = 0.70. Meanwhile, WMTA validation shows significant association between WMTA score and self-reported pain or discomfort for the back, shoulder&arms and knee&legs with p<0.05. This tool is expected to provide new workplace ergonomic observational tool to assess WMSDs for the next stage of the case study.

Keywords: assessment, biomechanics, musculoskeletal disorders, observational tools

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Authors: Fulufhelo Oscar Makananise

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Digital technologies have played a significant role in bridging the information gap between the haves and the have nots in society. In developing countries such as South Africa, historically marginalised groups such as women in rural communities have an opportunity to use digital technologies to network among themselves as well as interact with their government, thereby enhancing prospects for poverty eradication, political participation, community development and democracy. However, the extent to which these goals can be achieved in a developing context through harnessing digital technologies is not quite clear, particularly given the fact that access to these technologies is not evenly distributed and the fact that women’s access to digital technologies is hampered by factors that go beyond the question of infrastructure. Informed by the technological dependency theory, this paper is about how female youth in rural South Africa are deploying digital media tools for socio-economic empowerment. In particular, the study investigated the extent to which female youth in Limpopo province, South Africa access and use digital media platforms and gadgets and the extent to which those technologies are breaking down barriers that stand in the way of female youth empowerment. Data were gathered using a self-administered questionnaire disseminated to selected 100 female youth in Limpopo Province, South Africa. The data were analysed using SPSS version 9, and the results were analysed using descriptive statistics. The paper argues that wider and constant access to digital media by female youth in rural areas is indicative of the great potential for empowering female youth in rural areas through harnessing digital media. The study established that the majority of female youth had access to digital media technologies and used them to share valuable information among themselves. The study further established that female youth are active users of digital media in South Africa, which is the significant driver for socio-economic empowerment.

Keywords: digital technologies, empowerment, female youth, South Africa, survey, technological dependency

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Authors: Fatemeh Abbasi, Sahand Daneshvar

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Productivity is one of the essential goals of companies to improve performance, which as a strategy-oriented method, determines the basis of the company's economic growth. The history of productivity goes back centuries, but most researchers defined productivity as the relationship between a product and the factors used in production in the early twentieth century. Productivity as the optimal use of available resources means that "more output using less input" can increase companies' economic growth and prosperity capacity. Also, having a quality life based on economic progress depends on productivity growth in that society. Therefore, productivity is a national priority for any developed country. There are several methods for calculating productivity growth measurements that can be divided into parametric and non-parametric methods. Parametric methods rely on the existence of a function in their hypotheses, while non-parametric methods do not require a function based on empirical evidence. One of the most popular non-parametric methods is Data Envelopment Analysis (DEA), which measures changes in productivity over time. The DEA evaluates the productivity of decision-making units (DMUs) based on mathematical models. This method uses multiple inputs and outputs to compare the productivity of similar DMUs such as banks, government agencies, companies, airports, Etc. Non-parametric methods are themselves divided into the frontier and non frontier approaches. The Malmquist productivity index (MPI) proposed by Caves, Christensen, and Diewert (1982), the Hicks–Moorsteen productivity index (HMPI) proposed by Bjurek (1996), or the Luenberger productivity indicator (LPI) proposed by Chambers (2002) are powerful tools for measuring productivity changes over time. This study will compare the Malmquist, Hicks–Moorsteen, and Luenberger indices theoretically and empirically based on DEA models and review their strengths and weaknesses.

Keywords: data envelopment analysis, Hicks–Moorsteen productivity index, Leuenberger productivity indicator, malmquist productivity index

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Authors: Neslihan Sahin Celik, Ali Eraslan

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Mathematical model and modeling are one of the topics that have been intensively discussed in recent years. In line with the results of the PISA studies, researchers in many countries have begun to question how much students in school-education system are prepared to solve the real-world problems they encounter in their future professional lives. As a result, many mathematics educators have begun to emphasize the importance of new skills and understanding such as constructing, Hypothesizing, Describing, manipulating, predicting, working together for complex and multifaceted problems for success in beyond the school. When students increasingly face this kind of situations in their daily life, it is important to make sure that students have enough experience to work together and interpret mathematical situations that enable them to think in different ways and share their ideas with their peers. Thus, model eliciting activities are one of main tools that help students to gain experiences and the new skills required. This research study was carried on the town center of a big city located in the Black Sea region in Turkey. The participants were eighth-grade students in a middle school. After a six-week preliminary study, three students in an eighth-grade classroom were selected using criterion sampling technique and placed in a focus group. The focus group of three students was videotaped as they worked on a model eliciting activity, the Summer Job Problem. The conversation of the group was transcribed, examined with students’ written work and then qualitatively analyzed through the lens of Blum’s (1996) modeling processing cycle. The study results showed that eighth grade students can successfully work with the model eliciting, develop a model based on the two parameters and review the whole process. On the other hand, they had difficulties to relate parameters to each other and take all parameters into account to establish the model.

Keywords: middle school, modeling, mathematical modeling, summer job problem

Procedia PDF Downloads 333

Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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Authors: Abdul Ghani Khan

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This paper focuses on the Buddhist rock carvings in the Diamer-Basha reservoir area, Gilgit-Baltistan, which is perhaps the largest rock art province of the world. The study region has thousands of rock carvings, particularly of the stupa carvings, engraved by artists, devotees or pilgrims, merchants have left their marks in the landscape or for the propagation of Buddhism. The Pak-German Archaeological Mission prepared, documented, and published the extensive catalogues of these carvings. Though, to date, very little systematic or statistically driven analysis was undertaken for in-depth understandings of the Buddhist rock carving tradition of the study region. This paper had made an attempt to examine stupa carvings and their constituent parts from the five selected sites, namely Oshibat, Shing Nala, Gichi Nala, Dadam Das, and Chilas Bridge. The statistical analyses and classification of the stupa carvings and their chronological contexts were carried out with the help of modern scientific tools such as STATA, FileMaker Pro, and MapSource softwares. The study had found that the tradition of stupa carvings on the surfaces of the rocks at the five selected sites continued for around 900 years, from the 1st century BCE to 8th century CE. There is a variation within the chronological settings of each of selected sites, possibly impacted by their utilization within particular landscapes, such as political (for example, change in political administrations or warfare) landscapes and geographical (for example, shifting of routes). The longer existence of the stupa carvings' tradition at these specific locations also indicates their central position on the trade and communication routes, and these were possibly also linked with religious ideologies within their particular times. The analyses of the different architectural elements of stupa carvings in the study area show that this tradition had structural similarities and differences in temporal and spatial contexts.

Keywords: rock carvings, stupa, stupa carvings, Buddhism, Pak-German archaeological mission

Procedia PDF Downloads 215