Search results for: psychological intervention

Authors: Ciaran Friel, Jerry Suls, Mark Butler, Patrick Robles, Samantha Gordon, Frank Vicari, Karina W. Davidson

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Physical activity guidelines focus on increasing moderate-intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence supports that any increase in physical activity is positively correlated with health benefits. Behavior change techniques (BCTs) have demonstrated effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a Personalized Trials (N-of-1) design to evaluate the efficacy of using four BCTs to promote an increase in low-intensity physical activity (2,000 steps of walking per day) in adults aged 45-75 years old. The 4 BCTs tested were goal setting, action planning, feedback, and self-monitoring. BCTs were tested in random order and delivered by text message prompts requiring participant engagement. The study recruited health system employees in the target age range, without mobility restrictions and demonstrating interest in increasing their daily activity by a minimum of 2,000 steps per day for a minimum of five days per week. Participants were sent a Fitbit® fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7 but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by Fitbit for two weeks. In the 8-week intervention phase of the study, participants received each of the four BCTs, in random order, for a two-week period. Text message prompts were delivered daily each morning at a consistent time. All prompts required participant engagement to acknowledge receipt of the BCT message. Engagement is dependent upon the BCT message and may have included recording that a detailed plan for walking has been made or confirmed a daily step goal (action planning, goal setting). Additionally, participants may have been directed to a study dashboard to view their step counts or compare themselves to their baseline average step count (self-monitoring, feedback). At the end of each two-week testing interval, participants were asked to complete the Self-Efficacy for Walking Scale (SEW_Dur), a validated measure that assesses the participant’s confidence in walking incremental distances, and a survey measuring their satisfaction with the individual BCT that they tested. At the end of their trial, participants received a personalized summary of their step data in response to each individual BCT. The analysis will examine the novel individual-level heterogeneity of treatment effect made possible by N-of-1 design and pool results across participants to efficiently estimate the overall efficacy of the selected behavioral change techniques in increasing low-intensity walking by 2,000 steps, five days per week. Self-efficacy will be explored as the likely mechanism of action prompting behavior change. This study will inform the providers and demonstrate the feasibility of an N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

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Authors: Soroush Pakniyat-Jahromi, Jessica Bucciarelli, Souparno Mitra, Neda Motamedi, Ralph Amazan, Samuel Rothman, Jose Tiburcio, Douglas Reich, Vicente Liz

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Violence is defined as an act of physical force that is intended to cause harm and may lead to physical and/or psychological damage. Violence toward healthcare workers (HCWs) is more common in psychiatric settings, emergency departments, and nursing homes; however, healthcare workers in medical setting are not spared from such events. Workplace violence has a huge burden in the healthcare industry and has a major impact on the physical and mental wellbeing of staff. The purpose of this study is to compare the prevalence of patient agitation and violence in medical-surgical settings in BronxCare Hospital (BCH) Bronx, New York, one year before and during the COVID-19 pandemic. Data collection occurred between June 2021 and August 2021, while the sampling time was from 2019 to 2021. The data were separated into two separate time categories: pre-COVID-19 (03/2019-03/2020) and COVID-19 (03/2020-03/2021). We created frequency tables for 19 variables. We used a chi-square test to determine a variable's statistical significance. We tested all variables against “restraint type”, determining if a patient was violent or became violent enough to restrain. The restraint types were “chemical”, “physical”, or both. This analysis was also used to determine if there was a statistical difference between the pre-COVID-19 and COVID-19 timeframes. Our data shows that there was an increase in incidents of violence in COVID-19 era (03/2020-03/2021), with total of 194 (62.8%) reported events, compared to pre COVID-19 era (03/2019-03/2020) with 115 (37.2%) events (p: 0.01). Our final analysis, completed using a chi-square test, determined the difference in violence in patients between pre-COVID-19 and COVID-19 era. We then tested the violence marker against restraint type. The result was statistically significant (p: 0.01). This is the first paper to systematically review the prevalence of violence in medical-surgical units in a hospital in New York, pre COVID-19 and during the COVID-19 era. Our data is in line with the global trend of increased prevalence of patient agitation and violence in medical settings during the COVID-19 pandemic. Violence and its management is a challenge in healthcare settings, and the COVID-19 pandemic has brought to bear a complexity of circumstances, which may have increased its incidence. It is important to identify and teach healthcare workers the best preventive approaches in dealing with patient agitation, to decrease the number of restraints in medical settings, and to create a less restrictive environment to deliver care.

Keywords: COVID-19 pandemic, patient agitation, restraints, violence

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Authors: Rosina U. Ndukwe, Diane Crone, Nick Cavill

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Active transport (i.e. walking to school, cycle to work schemes etc.) is an effective approach with multiple social and environmental benefits for transforming urban environments into active urban environments. Although walking and cycling often remain on the margins of urban planning and infrastructure, there are new approaches emerging, along with policy intervention relevant for the creation of sustainable urban active environments conductive to active travel, increasing physical activity levels of involved communities and supporting social inclusion through more active participation. SPAcE - Supporting Policy and Action for Active Environments is a 3 year Erasmus+ project that aims to integrate active transport programmes into public policy across the EU. SPAcE focuses on cities/towns with recorded low physical activity levels to support the development of active environments in 5 sites: Latvia [Tukums], Italy [Palermo], Romania [Brasov], Spain [Castilla-La Mancha] and Greece [Trikala]. The first part of the project involved a review of good practice including case studies from across the EU and project partner countries. This has resulted in the first output from the project, an evidence of good practice summary with case study examples. In the second part of the project, working groups across the 5 sites have carried out co-production to develop Urban Active Environments (UActivE) Action Plans aimed at influencing policy and practice for increasing physical activity primarily through the use of cycling and walking. Action plans are based on international evidence and guidance for healthy urban planning. Remaining project partners include Universities (Gloucestershire, Oxford, Zurich, Thessaly) and Fit for Life programme (National physical activity promotion program, Finland) who provide support and advice incorporating current evidence, healthy urban planning and mentoring. Cooperation and co-production with public health professionals, local government officers, education authorities and transport agencies has been a key approach of the project. The third stage of the project has involved training partners in the WHO HEAT tool to support the implementation of the Action Plans. Project results show how multi-agency, transnational collaboration can produce real-life Action Plans in five EU countries, based on published evidence, real-life experience, consultation and collaborative working with other organisations across the EU. Learning from the processes adopted within this project will demonstrate how public health, local government and transport agencies across the EU, can work together to create healthy environments that have the aim of facilitating active behaviour, even in times of constrained public budgets. The SPAcE project has captured both the challenges and solutions for increasing population physical activity levels, health and wellness in urban spaces and translating evidence into policy and practice ensuring innovation at policy level. Funding acknowledgment: SPAcE (www.activeenvironments.eu) is co-funded by the Sport action of the ERASMUS+ programme.

Keywords: action plans, active transport, SPAcE, UActivE urban active environments, walking and cycling

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Authors: Sam J. Cooley, Mary L. Quinton, Benjamin J. Parry, Mark J. G. Holland, Richard J. Whiting, Jennifer Cumming

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Practitioners draw attention to people’s character strengths to promote empowerment and well-being. This paper explores the possibility that existing approaches for assessing character strengths (e.g., the Values in Action survey; VIA-IS) could be even more autonomy supportive and empowering when combined with strengths profiling, an ideographic tool informed by personal construct theory (PCT). A PCT approach ensures that: (1) knowledge is co-created (i.e., the practitioner is not seen as the ‘expert’ who leads the process); (2) individuals are not required to ‘fit’ within a prescribed list of characteristics; and (3) individuals are free to use their own terminology and interpretations. A combined Strengths Profiling and VIA approach was used in a sample of homeless youth (aged 16-25) who are commonly perceived as ‘hard-to-engage’ through traditional forms of assessment. Strengths Profiling was completed face-to-face in small groups. Participants (N = 116) began by listing a variety of personally meaningful characteristics. Participants gave each characteristic a score out of ten for how important it was to them (1 = not so important; 10 = very important), their ideal competency, and their current competency (1 = poor; 10 = excellent). A discrepancy score was calculated for each characteristic (discrepancy score = ideal score - current score x importance), whereby a lower discrepancy score indicated greater satisfaction. Strengths Profiling was used at the beginning and end of a 10-week positive youth development programme. Experiences were captured through video diary room entries made by participants and through reflective notes taken by the facilitators. Participants were also asked to complete a pre-and post-programme questionnaire, measuring perceptions of well-being, self-worth, and resilience. All of the young people who attended the strengths profiling session agreed to complete a profile, and the majority became highly engaged in the process. Strengths profiling was found to be an autonomy supportive and empowering experience, with each participant identifying an average of 10 character strengths (M = 10.27, SD = 3.23). In total, 215 different character strengths were identified, each with varying terms and definitions used, which differed greatly between participants and demonstrated the value in soliciting personal constructs. Using the participants’ definitions, 98% of characteristics were categorized deductively into the VIA framework. Bravery, perseverance, and hope were the character strengths that featured most, whilst temperance and courage received the highest discrepancy scores. Discrepancy scores were negatively correlated with well-being, self-worth, and resilience, and meaningful improvements were recorded following the intervention. These findings support the use of strengths profiling as a theoretically-driven and novel way to engage disadvantaged youth in identifying and monitoring character strengths. When young people are given the freedom to express their own characteristics, the resulting terminologies extend beyond the language used in existing frameworks. This added freedom and control over the process of strengths identification encouraged youth to take ownership over their profiles and apply their strengths. In addition, the ability to transform characteristics post hoc into the VIA framework means that strengths profiling can be used to explore aggregated/nomothetic hypotheses, whilst still benefiting from its ideographic roots.

Keywords: ideographic, nomothetic, positive youth development, VIA-IS, assessment, homeless youth

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Authors: Katarzyna Wyka, Dana Sylvan, JoAnn Difede

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Background and significance: The following disaster, population-based screening programs are routinely established to assess physical and psychological consequences of exposure. These data sets are highly skewed as only a small percentage of trauma-exposed individuals develop health issues. Commonly used statistical methodology in post-disaster mental health generally involves population-averaged models. Such models aim to capture the overall response to the disaster and its aftermath; however, they may not be sensitive enough to accommodate population heterogeneity in symptomatology, such as post-traumatic stress or depressive symptoms. Methods: We use an archival longitudinal data set from Weill-Cornell 9/11 Mental Health Screening Program established following the World Trade Center (WTC) terrorist attacks in New York in 2001. Participants are rescue and recovery workers who participated in the site cleanup and restoration (n=2960). The main outcome is the post-traumatic stress symptoms (PTSD) severity score assessed via clinician interviews (CAPS). For a detailed understanding of response to the disaster and its aftermath, we are adapting quantile regression methodology with particular focus on predictors of extreme distress and resilience to trauma. Results: The response variable was defined as the quantile of the CAPS score for each individual under two different scenarios specifying the unconditional quantiles based on: 1) clinically meaningful CAPS cutoff values and 2) CAPS distribution in the population. We present graphical summaries of the differential effects. For instance, we found that the effect of the WTC exposures, namely seeing bodies and feeling that life was in danger during rescue/recovery work was associated with very high PTSD symptoms. A similar effect was apparent in individuals with prior psychiatric history. Differential effects were also present for age and education level of the individuals. Conclusion: We evaluate the utility of quantile regression in disaster research in contrast to the commonly used population-averaged models. We focused on assessing the distribution of risk factors for post-traumatic stress symptoms across quantiles. This innovative approach provides a comprehensive understanding of the relationship between dependent and independent variables and could be used for developing tailored training programs and response plans for different vulnerability groups.

Keywords: disaster workers, post traumatic stress, PTSD, quantile regression

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Authors: Cledinaldo A. Dias, Isabela C. Santos, Marcus V. S. Siqueira

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In the contemporary globalization, the competitiveness generated in the search of new markets aiming at the growth of productivity and, consequently, of profits, implies the redefinition of productive processes and new forms of work organization. As a result of this structuring, unemployment, labor force turnover and the increase in outsourcing and informal work occur. Considering the different relationships and working conditions of outsourced employees, this study aims to identify the most present stressors among outsourced service providers from a Federal Institution of Higher Education in Brazil. To reach this objective, a descriptive exploratory study with a quantitative approach was carried out. The qualitative approach was chosen to provide an in-depth analysis of the occupational conditions of outsourced workers since this method seeks to focus on the social as a world of investigated meanings and the language or speech of each subject as the object of this approach. The survey was conducted in the city of Montes Claros - Minas Gerais (Brazil) and involved eighty workers from companies hired by the institution, including armed security guards, porters, cleaners, drivers, gardeners, and administrative assistants. The choice of professionals obeyed non-probabilistic criteria for convenience or accessibility. Data collection was performed by means of a structured questionnaire composed of sixty questions, in a Likert-type frequency interval scale format, in order to identify potential organizational stressors. The results obtained evidence that the stress factors pointed out by the workers are, in most cases, a determining factor due to the low productive performance at work. Amongst the factors associated with stress, the ones that stood out most were those related to organizational communication failures, the incentive to competition, lack of expectations of professional growth, insecurity and job instability. Based on the results, the need for greater concern and organizational responsibility with the well-being and mental health of the outsourced worker and the recognition of their physical and psychological limitations, and care that goes beyond the functional capacity for the work. Specifically for the preservation of mental health, physical and quality of life, it is concluded that it is necessary for the professional to be inserted in the external world that favors it internally since this set is complemented so that the individual remains in balance and obtain satisfaction in your work.

Keywords: occupational health, outsourced, organizational studies, stressors

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Authors: L. D. Upegui, Isabel Alvarez-Solorza, Karina Garduno-Ulloa, Maren Boecker

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Introduction: The increasing prevalence rate of resistant and multiresistant bacterial strains to antibiotics is a threat to public health and requires a rapid multifunctional answer. Individuals that are affected by resistant strains present a higher morbidity and mortality than individuals that are infected with the same species of bacteria but with sensitive strains. There have been identified risk factors that are related to the misuse and overuse of antibiotics, like socio-demographic characteristics and psychological aspects of the individuals that have not been explored objectively due to a lack of valid and reliable instruments for their measurement. Objective: To validate a questionnaire for the evaluation of the levels of knowledge related to the use of antibiotics in a Mexican population. Materials and Methods: Analytical cross-sectional observational study. The questionnaire consists of 12 items to evaluated knowledge (1=no, 2=not sure, 3=yes) regarding the use of antibiotics, with higher scores corresponding to a higher level of knowledge. Data are collected in a sample of students. Data collection is still ongoing. In this abstract preliminary results of 30 respondents are reported which were collected during pilot-testing. The validation of the instrument was done using the Rasch model. Fit to the Rasch model was tested checking overall fit to the model, unidimensionality, local independence and evaluating the presence of Differential Item Functioning (DIF) by age and gender. The software Rumm2030 and the SPSS were used for the analyses. Results: The participants of the pilot-testing presented an average age of 32 years ± 12.6 and 53% were women. The preliminary results indicated that the items showed good fit to the Rasch model (chi-squared=12.8 p=0.3795). Unidimensionality (number of significant t-tests of 3%) could be proven, the items were locally independent, and no DIF was observed. Knowledge was the smallest regarding statements on the role of antibiotics in treating infections, e.g., most of the respondents did not know that antibiotics would not work against viral infections (70%) and that they could also cause side effects (87%). The knowledge score ranged from 0 to 100 points with a transformed measurement (mean of knowledge 27.1 ± 4.8). Conclusions: The instrument showed good psychometric proprieties. The low scores of knowledge about antibiotics suggest that misinterpretations on the use of these medicaments were prevalent, which could influence the production of antibiotic resistance. The application of this questionnaire will allow the objective identification of 'Hight risk groups', which will be the target population for future educational campaigns, to reduce the knowledge gaps on the general population as an effort against antibiotic resistance.

Keywords: antibiotics, knowledge, misuse, overuse, questionnaire, Rasch model, validation

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Authors: Shailendra Kumar Singh

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With the rise of New Linguistic World Order in the 21st century, the Aged Pragmatics is palpitating on the edge of theoretical irrelevance. What appears to be a new sociolinguistic reality is that the enlightening combination of alternative west, inclusive globalization and techno-revolution is adding novel recipes to communicative actions, style and gain among new linguistic breed which is being neither dominated nor powered by the western supremacy. The paper has the following main, interrelated, aims: it is intended to introduce the concept of alternative pragmatics that can offer what exactly is needed for our emerging societal realities; it asserts as to how the basic pillar of linguistic success in the new linguistic world order rests upon linguistic temptation and calibration of all; and it also reviews an inevitability of emerging economies in shaping the communication trends at a time when the western world is struggling to maintain the same control on the others exercised in the past. In particular, the paper seeks answers for the following questions: (a) Do we need an alternative pragmatics, one with alternativist leaning in an era of inclusive globalization and alternative west? (b) What are the pulses of shift which are encapsulating emergence of new communicative behavior among the new linguistic breed by breaking yesterday’s linguistic rigidity? (c) Or, what are those shifts which are making linguistic shift more perceptible? (d) Is New Linguistic World Order succeeding in reversing linguistic priorities of `who speaks, what language, where, how, why, to whom and in which condition’ with no parallel in the history? (e) What is explicit about the contemporary world of 21st century which makes linguistic world all exciting and widely celebrative phenomenon and that is also forced into our vision? (f) What factors will hold key to the future of yesterday’s `influential languages’ and today’s `emerging languages’ as world is in the paradigm transition? (g) Is the collapse of Aged Pragmatics good for the 21st century for understanding the difference between pragmatism of old linguistic world and new linguistic world order? New Linguistic world Order today, unlike in the past, is about a branding of new world with liberal world view for a particular form of ideal to be imagined in the 21st century. At this time without question it is hope that a new set of ideals with popular vocabulary will become the implicit pragmatic model as one of benign majoritarianism in all aspects of sociolinguistic reality. It appears to be a reality that we live in an extraordinary linguistic world with no parallel in the past. In particular, the paper also highlights the paradigm shifts: Demographic, Social-psychological, technological and power. These shifts are impacting linguistic shift which is unique in itself. The paper will highlight linguistic shift in details in which alternative west plays a major role without challenging the west because it is an era of inclusive globalization in which almost everyone takes equal responsibility.

Keywords: inclusive globalization, new linguistic world order, linguistic shift, world order

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Authors: Anu Shrestha, Krassi Rumchev, Ben Mullins, Yun Zhao, Linda Selvey

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Cycling is often promoted as a means of reducing vehicular congestion, noise and greenhouse gas and air pollutant emissions in urban areas. It is also indorsed as a healthy means of transportation in terms of reducing the risk of developing a range of physical and psychological conditions. However, people who cycle regularly may not be aware that they can become exposed to high levels of Vehicular Air Pollutants (VAP) emitted by nearby traffics and therefore experience adverse health effects as a result. The study will highlight the present scenario of ambient air pollution level in different cycling routes in Perth and also highlight significant contribution to the understanding of health risks that cyclist may face from exposure to particulate air pollution. Methodology: This research was conducted in Perth, Western Austral and consisted of two groups of cyclists cycling near high (2 routes) and low (two routes) vehicular traffic roads, at high and low levels of exertion, during the cold and warm seasons. A sample size of 123 regular cyclists who cycled at least 80 km/week, aged 20-55, and non-smoker were selected for this study. There were altogether 100 male and 23 female who were asked to choose one or more routes among four different routes, and each participant cycled the route for warm or cold or both seasons. Cyclist who reported cardiovascular and other chronic health conditions (excluding asthma) were not invited into the study. Exposures to selected air pollutants were assessed by undertaking background and personal measurements alone with the measurement of heart and breathe rate of each participant. Finding: According to the preliminary study findings, the cyclists who used cycling route close to high traffic route were exposed to higher levels of measured air pollutants Nitrogen Oxide (NO₂) =0.12 ppm, sulfur dioxide (SO₂)=0.06 ppm and carbon monoxide (CO)=0.25 PPM compared to those who cycled away from busy roads. However, we measured high concentrations of particulate air pollution near one of the low traffic route which we associate with the close proximity to ferry station. Concluding Statement: As a conclusion, we recommend that cycling routes should be selected away from high traffic routes. If possible, we should also consider that if the cycling route is surrounded by the dense populated infrastructures, it can trap the pollutants and always facilitate in increasing inhalation of particle count among the cyclists.

Keywords: air pollution, carbon monoxide, cyclists' health, nitrogen dioxide, nitrogen oxide, respirable particulate matters

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Authors: Caroline Atef Shoukry Tadros

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Massive Urbanization growth threatens the sustainability of cities and the quality of city life. This raised the need for an alternate model of sustainability, so we need to plan the future cities in a smarter way with smarter mobility. Smart Mobility planning applications are solutions that use digital technologies and infrastructure advances to improve the efficiency, sustainability, and inclusiveness of urban transportation systems. They can contribute to meeting the needs of Urbanization growth by addressing the challenges of traffic congestion, pollution, accessibility, and safety in cities. Some example of a Smart Mobility planning application are Mobility-as-a-service: This is a service that integrates different transport modes, such as public transport, shared mobility, and active mobility, into a single platform that allows users to plan, book, and pay for their trips. This can reduce the reliance on private cars, optimize the use of existing infrastructure, and provide more choices and convenience for travelers. MaaS Global is a company that offers mobility-as-a-service solutions in several cities around the world. Traffic flow optimization: This is a solution that uses data analytics, artificial intelligence, and sensors to monitor and manage traffic conditions in real-time. This can reduce congestion, emissions, and travel time, as well as improve road safety and user satisfaction. Waycare is a platform that leverages data from various sources, such as connected vehicles, mobile applications, and road cameras, to provide traffic management agencies with insights and recommendations to optimize traffic flow. Logistics optimization: This is a solution that uses smart algorithms, blockchain, and IoT to improve the efficiency and transparency of the delivery of goods and services in urban areas. This can reduce the costs, emissions, and delays associated with logistics, as well as enhance the customer experience and trust. ShipChain is a blockchain-based platform that connects shippers, carriers, and customers and provides end-to-end visibility and traceability of the shipments. Autonomous vehicles: This is a solution that uses advanced sensors, software, and communication systems to enable vehicles to operate without human intervention. This can improve the safety, accessibility, and productivity of transportation, as well as reduce the need for parking space and infrastructure maintenance. Waymo is a company that develops and operates autonomous vehicles for various purposes, such as ride-hailing, delivery, and trucking. These are some of the ways that Smart Mobility planning applications can contribute to meeting the needs of the Urbanization growth. However, there are also various opportunities and challenges related to the implementation and adoption of these solutions, such as the regulatory, ethical, social, and technical aspects. Therefore, it is important to consider the specific context and needs of each city and its stakeholders when designing and deploying Smart Mobility planning applications.

Keywords: smart mobility planning, smart mobility applications, smart mobility techniques, smart mobility tools, smart transportation, smart cities, urbanization growth, future smart cities, intelligent cities, ICT information and communications technologies, IoT internet of things, sensors, lidar, digital twin, ai artificial intelligence, AR augmented reality, VR virtual reality, robotics, cps cyber physical systems, citizens design science

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Authors: K. Rhea Devaiah, B. S. Premalatha

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Background: Tonsillar Lingual sulcus is the area between the tonsils and the base of the tongue. The surgical resection of the lesions in the head and neck results in changes in speech and swallowing functions. The severity of the speech and swallowing problem depends upon the site and extent of the lesion, types and extent of surgery and also the flexibility of the remaining structures. Need of the study: This paper focuses on the importance of speech and swallowing rehabilitation in an individual with the lesion in the Tonsillar Lingual Sulcus and post-operative functions. Aim: Evaluating the speech and swallow functions post-intensive speech and swallowing rehabilitation. The objectives are to evaluate the speech intelligibility and swallowing functions after intensive therapy and assess the quality of life. Method: The present study describes a report of an individual aged 47years male, with the diagnosis of basaloid squamous cell carcinoma, left tonsillar lingual sulcus (pT2n2M0) and underwent wide local excision with left radical neck dissection with PMMC flap reconstruction. Post-surgery the patient came with a complaint of reduced speech intelligibility, and difficulty in opening the mouth and swallowing. Detailed evaluation of the speech and swallowing functions were carried out such as OPME, articulation test, speech intelligibility, different phases of swallowing and trismus evaluation. Self-reported questionnaires such as SHI-E(Speech handicap Index- Indian English), DHI (Dysphagia handicap Index) and SESEQ -K (Self Evaluation of Swallowing Efficiency in Kannada) were also administered to know what the patient feels about his problem. Based on the evaluation, the patient was diagnosed with pharyngeal phase dysphagia associated with trismus and reduced speech intelligibility. Intensive speech and swallowing therapy was advised weekly twice for the duration of 1 hour. Results: Totally the patient attended 10 intensive speech and swallowing therapy sessions. Results indicated misarticulation of speech sounds such as lingua-palatal sounds. Mouth opening was restricted to one finger width with difficulty chewing, masticating, and swallowing the bolus. Intervention strategies included Oro motor exercise, Indirect swallowing therapy, usage of a trismus device to facilitate mouth opening, and change in the food consistency to help to swallow. A practice session was held with articulation drills to improve the production of speech sounds and also improve speech intelligibility. Significant changes in articulatory production and speech intelligibility and swallowing abilities were observed. The self-rated quality of life measures such as DHI, SHI and SESE Q-K revealed no speech handicap and near-normal swallowing ability indicating the improved QOL after the intensive speech and swallowing therapy. Conclusion: Speech and swallowing therapy post carcinoma in the tonsillar lingual sulcus is crucial as the tongue plays an important role in both speech and swallowing. The role of Speech-language and swallowing therapists in oral cancer should be highlighted in treating these patients and improving the overall quality of life. With intensive speech-language and swallowing therapy post-surgery for oral cancer, there can be a significant change in the speech outcome and swallowing functions depending on the site and extent of lesions which will thereby improve the individual’s QOL.

Keywords: oral cancer, speech and swallowing therapy, speech intelligibility, trismus, quality of life

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Authors: Leja Salciute

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Mental health difficulties are one of the reasons for abnormal feeding behaviour. This is especially evident in a crisis situation. Abnormal feeding behaviour occurs when individuals use food as a method to provide relief for these negative emotions. The study aimed to discover an association between emotional regulation, mental health difficulties and disruption in feeding behaviours in the UK in times of crisis. A mixed-methods design was used. Abnormal feeding behaviour was measured using the Binge Eating Disorder Screener-7, SCOFF scale, Crisis impact scale, Difficulties in Emotion Regulation Scale and demographics. The sample comprised 342 participants with a history of excessive overeating. The participants (male= 198, female= 141 and other= 3) came from the general population and they were aged 16 and over. Participants ranged in age from 16 to 89. Findings from the survey concluded that difficulties with emotion regulation were found to be associated with abnormal feeding behaviours. Mental health difficulties correlated significantly with changes in individuals’ lives, such as work or routines. Individuals differed in their abnormal feeding behaviour in terms of their age, that is, younger individuals showed less struggle with their eating patterns while older individuals faced greater struggles with their abnormal feeding behaviour. Emotion regulation significantly influenced abnormal feeding behaviour. Results from qualitative data suggest four common themes that were identified: demonstration of gratitude, negative emotions, disruptions to social life, and financial loss. For example, participants developed and gained an awareness of being grateful for the simple things in life even when participants experienced hardships. The results also suggested that emotional eating acted like a sedative that allowed the participant to run away from their painful reality. Crisis situation negatively affected relationships among participants and induced negativity related to social interaction. Finally, the respondents highlighted that the presence of uncertainty made it hard to plan ahead and look forward to the future. Although respondents experienced negative emotions and financial losses, some of them still managed to allocate time for themselves and enjoy their time off during crisis. However, majority of respondents referred to their inability to control their external circumstances and turned to and relied upon food overconsumption instead. This had a negative effect on their mental health and presented disruptions in feeding behaviour. It was recommended for individuals in times of crisis to seek psychological support in the form of Cognitive Behavioural Therapy (CBT).

Keywords: binge eating, maladaptive eating behaviours, mental health, negative emotions in crisis

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Authors: Nalika S. Rajapaksha, James Airton, Amina Aboobakar, Nick Chappell, Andy Dyer

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Nutrient pollution and their impact on water quality is a key concern in England. Many water quality issues originate from multiple sources of pollution spread across the catchment. The river water quality in England has improved since 1990s and wastewater effluent discharges into rivers now contain less phosphorus than in the past. However, excess phosphorus is still recognised as the prevailing issue for rivers failing Water Framework Directive (WFD) good ecological status. To achieve WFD Phosphorus objectives, Wastewater Treatment Works (WwTW) permit limits are becoming increasingly stringent. Nevertheless, in some rural catchments, the apportionment of Phosphorus pollution can be greater from agricultural runoff and other sources such as septic tanks. Therefore, the challenge of meeting the requirements of watercourses to deliver WFD objectives often goes beyond water company activities, providing significant opportunities to co-deliver activities in wider catchments to reduce nutrient load at source. The aim of this study was to apply the United Utilities' Catchment Systems Thinking (CaST) strategy and pilot an innovative permitting approach - Catchment Nutrient Balancing (CNB) in a rural catchment in Cumbria (the River Petteril) in collaboration with the regulator and others to achieve WFD objectives and multiple benefits. The study area is mainly agricultural land, predominantly livestock farms. The local ecology is impacted by significant nutrient inputs which require intervention to meet WFD obligations. There are a range of Phosphorus inputs into the river, including discharges from wastewater assets but also significantly from agricultural contributions. Solely focusing on the WwTW discharges would not have resolved the problem hence in order to address this issue effectively, a CNB trial was initiated at a small WwTW, targeting the removal of a total of 150kg of Phosphorus load, of which 13kg were to be reduced through the use of catchment interventions. Various catchment interventions were implemented across selected farms in the upstream of the catchment and also an innovative polonite reactive filter media was implemented at the WwTW as an alternative to traditional Phosphorus treatment methods. During the 3 years of this trial, the impact of the interventions in the catchment and the treatment works were monitored. In 2020 and 2022, it respectively achieved a 69% and 63% reduction in the phosphorus level in the catchment against the initial reduction target of 9%. Phosphorus treatment at the WwTW had a significant impact on overall load reduction. The wider catchment impact, however, was seven times greater than the initial target when wider catchment interventions were also established. While it is unlikely that all the Phosphorus load reduction was delivered exclusively from the interventions implemented though this project, this trial evidenced the enhanced benefits that can be achieved with an integrated approach, that engages all sources of pollution within the catchment - rather than focusing on a one-size-fits-all solution. Primarily, the CNB approach and the act of collaboratively engaging others, particularly the agriculture sector is likely to yield improved farm and land management performance and better compliance, which can lead to improved river quality as well as wider benefits.

Keywords: agriculture, catchment nutrient balancing, phosphorus pollution, water quality, wastewater

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Authors: Kristof Grätz

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Background: Coping with crisis situations (e.g., the identity crisis in adolescence) is omnipresent in today's socialization and should be encouraged as a child. For this reason, students should be given the opportunity to create, endure and manage these crisis situations in a sporting context within the project “Herausforderung.” They should prove themselves by working on a self-assigned task, accompanied by ‚coaches’ in a place outside of their hometown. The aim of the project is to observe this process from a resource-oriented perspective. Health promotion, as called for by the WHO in the Ottawa Charter since 1986, includes strengthening psychosocial resources. These include cognitive, emotional, and social potentials that contribute to improving the quality of life, provide favourable conditions for coping with health burdens and enable people to influence their physical performance and well-being self-confidently and actively. A systematic strengthening of psychosocial resources leads to an improvement in mental health and contributes decisively to the regular implementation and long-term maintenance of this health behavior. Previous studies have already shown significant increases in self-concept following experiential educational measures [Fengler, 2007; Eberle & Fengler, 2018] and positive effects of experience-based school trips on the social competence of students [Reuker, 2009]. Method: The research project examines the influence of the project “Herausforderung” on psychosocial resources such as self-efficacy, self-concept, social support, and group cohesion. The students participating in the project will be tested in a pre-post design in the context of the challenge. This test includes specific questions to capture the different psychosocial resources. For the measurement, modifications of existing scales with good item selectivity and reliability are used to a large extent, so that acceptable item and scale values can be expected. If necessary, the scales were adapted or shortened to the specific context in order to ensure a balanced relationship between reliability and test economy. Specifically, these are already tested scales such as FRKJ 8-16, FSKN, GEQ, and F-SozU. The aim is to achieve a sample size of n ≥ 100. Conclusion: The project will be reviewed with regard to its effectiveness, and implications for a resource-enhancing application in sports settings will be given. Conclusions are drawn as to which extent to specific experiential educational content in physical education can have a health-promoting effect on the participants.

Keywords: children, education, health promotion, psychosocial resources

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Authors: S. Sakhri

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Background: The use of Zoledronic acid (ZA) is an established place in the treatment of malignant tumors with a predilection for the skeleton of interest (in particular metastasis). Although the main target of Zoledronic acid was osteoclasts, there are preclinical data suggest that Zoledronic acid may have an antitumor effect on cells other than osteoclasts, including tumor cells. Antitumor activity, including the inhibition of tumor cell growth and the induction of apoptosis of tumor cells, inhibition of tumor cell adhesion and invasion, and anti-angiogenic effects have been demonstrated. Methods. From (2012 to 2014), 438 patients were included respondents the inclusion criteria, respectively. This is a prospective study over a 4 year period. Of all patients (N=438), 432 received neoadjuvant chemotherapy with Zoledronic acid. The primary end point was the pathologic complete response in advancer breast cancer stage. The secondary end point is to evaluate Clinical response according to RECIST criteria; estimate the bone density before and at the end of chemotherapy in women with locally advanced breast cancer, Toxicity Evaluation and Overall survival using Kaplan-Meier and log test. Result: The Objective response rate was 97% after (C4) with 3% stabilizations and 99, 3% of which 0.7% C8 after stabilization. The clinical complete response was 28% after C4 respectively, and 46.8% after C8, the pathologic complete response rate was 40.13% according to the classification Sataloff. We observed that the pathologic complete response rate was the most raised in the group including Her2 (luminal Her2 and Her2) the lowest in the triple negative group as classified by Sataloff. We found that the pCR is significantly higher in the age group (35-50 years) with 53.17%. Those who have more than 50 years in 2nd place with 27.7% and the lower in young woman 35 years pCR was 19%, not statistically significant, -The pCR was also in favor of the menopausal group in 51, 4%, and 48, 55% for non-menopausal women. The average duration of overall survival was also significantly in the subgroup (Luminal -Her2, Her2) compared with triple negative. It is 47.18 months in the luminal group vs. 38.95 in the triple negative group. -Was observed in our study a difference in quality of life between (C1) was the admission of the patient, and after (C8), we found an increase in general signs and a deterioration in the psychological state C1, in contrast to the C8 these general signs and mental status improves, up to 12, and 24 months. Conclusion The results of this study suggest that the addition of ZA to néoadjuvant CT has potential anti-cancer benefit in patients (Luminal -Her2, Her2) compared with triple negative with or without menopause status.

Keywords: HER2+, RH+, breast cancer, tyrosine kinase

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Authors: Pompilia Buzatu, Hazim Qiblawey, Albert Odai, Jana Jamaleddin, Mustafa Nasser, Simon J. Judd

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Membrane bioreactor (MBR) technology is challenged by the tendency for the membrane permeability to decrease due to ‘clogging’. Clogging includes ‘sludging’, the filling of the membrane channels with sludge solids, and ‘ragging’, the aggregation of short filaments to form long rag-like particles. Both sludging and ragging demand manual intervention to clear out the solids, which is time-consuming, labour-intensive and potentially damaging to the membranes. These factors impact on costs more significantly than membrane surface fouling which, unlike clogging, is largely mitigated by the chemical clean. However, practical evaluation of MBR clogging has thus far been limited. This paper presents the results of recent work attempting to quantify sludging and clogging based on simple bench-scale tests. Results from a novel ragging simulation trial indicated that rags can be formed within 24-36 hours from dispersed < 5 mm-long filaments at concentrations of 5-10 mg/L under gently agitated conditions. Rag formation occurred for both a cotton wool standard and samples taken from an operating municipal MBR, with between 15% and 75% of the added fibrous material forming a single rag. The extent of rag formation depended both on the material type or origin – lint from laundering operations forming zero rags – and the filament length. Sludging rates were quantified using a bespoke parallel-channel test cell representing the membrane channels of an immersed flat sheet MBR. Sludge samples were provided from two local MBRs, one treating municipal and the other industrial effluent. Bulk sludge properties measured comprised mixed liquor suspended solids (MLSS) concentration, capillary suction time (CST), particle size, soluble COD (sCOD) and rheology (apparent viscosity μₐ vs shear rate γ). The fouling and sludging propensity of the sludge was determined using the test cell, ‘fouling’ being quantified as the pressure incline rate against flux via the flux step test (for which clogging was absent) and sludging by photographing the channel and processing the image to determine the ratio of the clogged to unclogged regions. A substantial difference in rheological and fouling behaviour was evident between the two sludge sources, the industrial sludge having a higher viscosity but less shear-thinning than the municipal. Fouling, as manifested by the pressure increase Δp/Δt, as a function of flux from classic flux-step experiments (where no clogging was evident), was more rapid for the industrial sludge. Across all samples of both sludge origins the expected trend of increased fouling propensity with increased CST and sCOD was demonstrated, whereas no correlation was observed between clogging rate and these parameters. The relative contribution of fouling and clogging was appraised by adjusting the clogging propensity via increasing the MLSS both with and without a commensurate increase in the COD. Results indicated that whereas for the municipal sludge the fouling propensity was affected by the increased sCOD, there was no associated increased in the sludging propensity (or cake formation). The clogging rate actually decreased on increasing the MLSS. Against this, for the industrial sludge the clogging rate dramatically increased with solids concentration despite a decrease in the soluble COD. From this was surmised that sludging did not relate to fouling.

Keywords: clogging, membrane bioreactors, ragging, sludge

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Authors: Md. Abu Sufian, Robiqul Islam, Imam Hossain Shajid, Mahesh Hanumanthu, Jarasree Varadarajan, Md. Sipon Miah, Mingbo Niu

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Coronary Heart Disease (CHD) remains a principal cause of global morbidity and mortality, characterized by atherosclerosis—the build-up of fatty deposits inside the arteries. The study introduces an innovative methodology that leverages cloud-based platforms like AWS Live Streaming and Artificial Intelligence (AI) to early detect and prevent CHD symptoms in web applications. By employing novel simulation processes and AI algorithms, this research aims to significantly mitigate the health and societal impacts of CHD. Methodology: This study introduces a novel simulation process alongside a multi-phased model development strategy. Initially, health-related data, including heart rate variability, blood pressure, lipid profiles, and ECG readings, were collected through user interactions with web-based applications as well as API Integration. The novel simulation process involved creating synthetic datasets that mimic early-stage CHD symptoms, allowing for the refinement and training of AI algorithms under controlled conditions without compromising patient privacy. AWS Live Streaming was utilized to capture real-time health data, which was then processed and analysed using advanced AI techniques. The novel aspect of our methodology lies in the simulation of CHD symptom progression, which provides a dynamic training environment for our AI models enhancing their predictive accuracy and robustness. Model Development: it developed a machine learning model trained on both real and simulated datasets. Incorporating a variety of algorithms including neural networks and ensemble learning model to identify early signs of CHD. The model's continuous learning mechanism allows it to evolve adapting to new data inputs and improving its predictive performance over time. Results and Findings: The deployment of our model yielded promising results. In the validation phase, it achieved an accuracy of 92% in predicting early CHD symptoms surpassing existing models. The precision and recall metrics stood at 89% and 91% respectively, indicating a high level of reliability in identifying at-risk individuals. These results underscore the effectiveness of combining live data streaming with AI in the early detection of CHD. Societal Implications: The implementation of cloud-based AI for CHD symptom detection represents a significant step forward in preventive healthcare. By facilitating early intervention, this approach has the potential to reduce the incidence of CHD-related complications, decrease healthcare costs, and improve patient outcomes. Moreover, the accessibility and scalability of cloud-based solutions democratize advanced health monitoring, making it available to a broader population. This study illustrates the transformative potential of integrating technology and healthcare, setting a new standard for the early detection and management of chronic diseases.

Keywords: coronary heart disease, cloud-based ai, machine learning, novel simulation techniques, early detection, preventive healthcare

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Authors: Monika Szpringer, Aneta Pawlinska

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Adverse childhood experiences are linked to various types of health and adapt problems at different stages of life. They include various types of abuse, neglect, and dysfunctional environment. They have an unfavorable impact on the development of a child and his future functioning in society. Adolescents who were exposed to bad treatment may suffer from health problems during adulthood, like chronic diseases, psychological disorders, drug addiction, and suicide attempts. Objective: The aim of the project is to assess the relationship between adverse childhood experiences and the sense of efficacy and coping with emotions among teenagers aged 16-18 taking drugs. Material And Methods: The research was carried out in the period from March to December 2018 in Mazowieckie, Świętokrzyskie, Łódzkie, and Lubelskie Voivodship. The group consisted of 600 people aged 16-18 (M=16,58; SD=0, 78), men (63,2%) aged 16-18 (M=16,60;SD= 0,78) and women (35,5%) aged 16-18 (M16,55;SD=0,79). Participants included residents from Youth Educational Centers and Youth Sociotherapy Centers. Each participant filled in Author's Questionnaire, Adverse Childhood Questionnaire, then Courtland Emotional Control Scale-CECS and Generalized Self Efficacy Scale-GSES. Results and conclusions: The most common adverse experiences, according to teenagers, were family abuse, divorce/separation/parent's death, overuse of alcohol or drugs by an inmate, and emotional neglect. Adolescents who suffered from five to twelve adverse experiences had a higher level of depression's control. Adverse childhood experiences have an importance for the level of anger and depression's control among teenagers taking drugs. The greatest importance of the level of anger's control has emotional neglect. A higher level of emotional neglect is linked to a lower ability to control anger. The greatest importance of the level of depression's control has physical abuse and emotional neglect. The higher physical abuse during childhood, and the higher frequency of emotional neglect, the bigger the depression's control. The sense of efficacy in the group of people who suffered from one to four adverse experiences is close to the sense of efficacy that suffered people from five to twelve adverse experiences. The most important factor lowering the sense of one's efficacy was the intensification of sexual abuse. It was confirmed that the intensification and frequency of adverse childhood experiences were higher among women than men. Women also characterized lower anger control and greater depression's control. The authors’ own analyses confirmed the relationship between adverse childhood experiences and the sense of efficacy and coping with emotions among teenagers aged 16-18 taking drugs.

Keywords: adolescences, adverse childhood experiences, coping with emotions, drugs

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Authors: Michal Almagor, Rivka Tuval-Mashiach

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This presentation will explore the main processes identified in women writing group, as an interdisciplinary field with personal and social effects. It is based on the initial findings of a Ph.D. research focus on the intersection of group processes with the element of writing, in the context of gender. Writing as a therapeutic mean has been recognized and found to be highly effective. Additionally, a substantial amount of research reveals the psychological impact of group processes. However, the combination of writing and groups as a therapeutic tool was hardly investigated; this is the contribution of this research. In the following qualitative-phenomenological study, the experiences of eight women participating in a 10-sessions structured writing group were investigated. We used the meetings transcripts, semi-structured interviews, and the texts to analyze and understand the experience of participating in the group. The two significant findings revealed were spiral intersubjectivity and archaic level of semiotic language. We realized that the content and the process are interwoven; participants are writing, reading and discussing their texts in a group setting that enhanced self-dialogue between the participants and their own narratives and texts, as well as dialogue with others. This process includes working through otherness within and between while discovering and creating a multiplicity of narratives. A movement of increasing shared circles from the personal to the group and to the social-cultural environment was identified, forming what we termed as spiral intersubjectivity. An additional layer of findings was revealed while we listened to the resonance of the group-texts, and discourse; during this process, we could trace the semiotic level in addition to the symbolic one. We were witness to the dominant presence of the body, and primal sensuality, expressed by rhythm, sound and movements, signs of pre-verbal language. Those findings led us to a new understanding of the semiotic function as a way to express the fullness of women experience and the enabling role of writing in reviving what was repressed. The poetic language serves as a bridge between the symbolic and the semiotic. Re-reading the group materials, exposed another layer of expression, an old-new language. This approach suggests a feminine expression of subjective experience with personal and social importance. It is a subversive move, encouraging women to write themselves, as a craft that every woman can use, giving voice to the silent and hidden, and experiencing the power of performing 'my story'. We suggest that women writing group is an efficient, powerful yet welcoming way to raise the awareness of researchers and clinicians, and more importantly of the participants, to the uniqueness of the feminine experience, and to gender-sensitive curative approaches.

Keywords: group, intersubjectivity, semiotic, writing

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Authors: Alberto Azevedo, Ricardo Martins, André B. Fortunato, Anabela Oliveira

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Water is under severe threat today because of the rising population, increased agricultural and industrial needs, and the intensifying effects of climate change. Due to sea-level rise, erosion, and demographic pressure, the coastal regions are of significant concern to the scientific community. The Water Monitoring Sentinel Cloud platform (WORSICA) service is focused on providing new tools for monitoring water in coastal and inland areas, taking advantage of remote sensing, in situ and tidal modeling data. WORSICA is a service that can be used to determine the coastline, coastal inundation areas, and the limits of inland water bodies using remote sensing (satellite and Unmanned Aerial Vehicles - UAVs) and in situ data (from field surveys). It applies to various purposes, from determining flooded areas (from rainfall, storms, hurricanes, or tsunamis) to detecting large water leaks in major water distribution networks. This service was built on components developed in national and European projects, integrated to provide a one-stop-shop service for remote sensing information, integrating data from the Copernicus satellite and drone/unmanned aerial vehicles, validated by existing online in-situ data. Since WORSICA is operational using the European Open Science Cloud (EOSC) computational infrastructures, the service can be accessed via a web browser and is freely available to all European public research groups without additional costs. In addition, the private sector will be able to use the service, but some usage costs may be applied, depending on the type of computational resources needed by each application/user. Although the service has three main sub-services i) coastline detection; ii) inland water detection; iii) water leak detection in irrigation networks, in the present study, an application of the service to Óbidos lagoon in Portugal is shown, where the user can monitor the evolution of the lagoon inlet and estimate the topography of the intertidal areas without any additional costs. The service has several distinct methodologies implemented based on the computations of the water indexes (e.g., NDWI, MNDWI, AWEI, and AWEIsh) retrieved from the satellite image processing. In conjunction with the tidal data obtained from the FES model, the system can estimate a coastline with the corresponding level or even topography of the inter-tidal areas based on the Flood2Topo methodology. The outcomes of the WORSICA service can be helpful for several intervention areas such as i) emergency by providing fast access to inundated areas to support emergency rescue operations; ii) support of management decisions on hydraulic infrastructures operation to minimize damage downstream; iii) climate change mitigation by minimizing water losses and reduce water mains operation costs; iv) early detection of water leakages in difficult-to-access water irrigation networks, promoting their fast repair.

Keywords: remote sensing, coastline detection, water detection, satellite data, sentinel, Copernicus, EOSC

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Authors: Fizza Saghir

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Rohingyas are an ethnic minority of predominantly Buddhist-Myanmar. Living in ghettos in Rakhine, one of the poorest states of Myanmar, for decades, they have been marginalized, discriminated, deprived of the basic amenities and have faced ghastly violations of their rights- politically, socially, economically and culturally. In 2012, in violence that, erupted between ethnic Rakhine Buddhists and Rohingya Muslims, hundreds of Rohingyas were slayed and many more displaced. The state does not recognize them as ‘citizens’ and the military and police have constantly persecuted and pushed them to either migrate to other countries like India, Bangladesh or else die of deprivation. Amidst the deadly violence, Rohingya women are the most vulnerable. Many of them have faced sexual abuse and gender-based violence. Minimalistic to insignificant studies have been done on the plight of Rohingya women refugees in context of India. Thus, this paper focuses on psycho-social status of Rohingya women refugees settled in Delhi, India. The research study used both quantitative and qualitative methods. It was explorative in nature and used non-probability sampling, purposive sampling, in particular. A sample size of 30 Rohingya women refugees was interviewed out of the universe of 45 Rohingya refugee families living in Kalindi Kunj Refugee Camp of Delhi. Case studies were developed. The paper explores the psychological and social status of the respondents along with a deep understanding of their issues and concerns. Moreover, it assesses the impact of violence and migration on respondents. It was found that Rohingya women refugees are deeply and severely affected by a violent past, an insecure present and an uncertain future. Major problems they face in Delhi, India are finding employment, lack of identity cards to avail government services, language barrier, lack of health and education facilities. All they desire is peace and shelter in India. Besides, recommendations and suggestions have been given to various stakeholders of the forced mass migration of Rohingya refugees which includes, Government of Myanmar, Government of India, other bordering nations of Myanmar, international NGOs and media and the Rohingya community, itself. Only an immediate, peaceful and continuous dialogue process can help resolve the issue of exodus of Rohingyas. Countries, including India, must come together to help the Rohingyas who are in need of urgent humanitarian aid and assistance.

Keywords: dialogue process, ethnic minority, forced mass migration, impact of violence and migration, psycho-social status, Rohingya women refugees, sexual abuse

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Authors: Juliane Toce, Steven Holochwost

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A substantial and growing literature has demonstrated that arts education benefits young children’s socioemotional and cognitive development. Less is known about the capacity of arts-integrated instruction to yield benefits to similar domains, particularly among demographically and socioeconomically diverse groups of young children. However, the small literature on this topic suggests that arts-integrated instruction may foster young children’s socioemotional and cognitive development by presenting opportunities to 1) engage in instructional content in diverse ways, 2) experience and regulate strong emotions, 3) experience growth-oriented feedback, and 4) engage in collaborative work with peers. Start with the Art is a new program of arts-integrated instruction currently being implemented in four schools in a school district that serves students from a diverse range of backgrounds. The program employs a co-teaching model in which teaching artists and classroom teachers engage in collaborative lesson planning and instruction over the course of the academic year and is currently the focus of an impact study featuring a randomized-control design, as well as an implementation study, both of which are funded through an Educational Innovation and Research grant from the United States Department of Education. The paper will present the early results from the Start with the Art implementation study. These results will provide an overview of the extent to which the program was implemented in accordance with design, with a particular emphasis on the degree to which the four opportunities enumerated above (e.g., opportunities to engage in instructional content in diverse ways) were presented to students. There will be a review key factors that may influence the fidelity of implementation, including classroom teachers’ reception of the program and the extent to which extant conditions in the classroom (e.g., the overall level of classroom organization) may have impacted implementation fidelity. With the explicit purpose of creating a program that values and meets the needs of the teachers and students, Start with the Art incorporates the feedback from individuals participating in the intervention. Tracing its trajectory from inception to ongoing development and examining the adaptive changes made in response to teachers' transformative experiences in the post-pandemic classroom, Start with the Art continues to solicit input from experts in integrating artistic content into core curricula within educational settings catering to students from under-represented backgrounds in the arts. Leveraging the input from this rich consortium of experts has allowed for a comprehensive evaluation of the program’s implementation. The early findings derived from the implementation study emphasize the potential of arts-integrated instruction to incorporate restorative practices. Such practices serve as a crucial support system for both students and educators, providing avenues for children to express themselves, heal emotionally, and foster social development, while empowering teachers to create more empathetic, inclusive, and supportive learning environments. This all-encompassing analysis spotlights Start with the Art’s adaptability to any learning environment through the program’s effectiveness, resilience, and its capacity to transform - through art - the classroom experience within the ever-evolving landscape of education.

Keywords: arts-integration, social emotional learning, diverse learners, co-teaching, teaching artists, post-pandemic teaching

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Authors: Felix Lankester, Alicia Davis, Safari Kinung'hi, Catherine Bunga, Shayo Alkara, Imam Mzimbiri, Jonathan Yoder, Sarah Cleaveland, Guy H. Palmer

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Achieving the London Declaration goal of a 90% reduction in neglected tropical diseases (NTDs) by 2030 requires cost-effective strategies that attain high and comprehensive coverage. The first objective of this trial was to assess the impact on cost and coverage of employing a novel integrative One Health approach linking two NTD control programs: mass drug administration (MDA) for soil-transmitted helminths in humans (STH) and mass dog rabies vaccination (MDRV). The second objective was to compare the coverage achieved by the MDA, a community-wide deworming intervention, with that of the existing national primary school-based deworming program (NSDP), with particular focus on the proportion of primary school-age children reached and their school enrolment status. Our approach was unconventional because, in line with the One Health approach to disease control, it coupled the responsibilities and resources of the Ministries responsible for human and animal health into one program with the shared aim of preventing multiple NTDs. The trial was carried out in hard-to-reach pastoral communities comprising 24 villages of the Ngorongoro District, Tanzania, randomly allocated to either Arm A (MDA and MDRV), Arm B (MDA only) or Arm C (MDRV only). Objective one: The percentage of people in each target village that received treatment through MDA in Arms A and B was 63% and 65%, respectively (χ2 = 1, p = 0.32). The percentage of dogs vaccinated in Arm A and C was 70% and 81%, respectively (χ2 =9, p = 0.003). It took 33% less time for a single person and a dog to attend the integrated delivery than two separate events. Cost per dose (including delivery) was lower under the integrated strategy, with delivery of deworming and rabies vaccination reduced by $0.13 (54%) and $0.85 (19%) per dose, respectively. Despite a slight reduction in the proportion of village dogs vaccinated in the integrated event, both the integrated and non-integrated strategies achieved the target threshold of 70% required to eliminate rabies. Objective two: The percentages of primary school age children enrolled in school that was reached by this trial (73%) and the existing NSDP (80%) were not significantly different (F = 0.9, p = 0.36). However, of the primary school age children treated in this trial, 46% were not enrolled in school. Furthermore, 86% of the people treated would have been outside the reach of the NSDP because they were not primary school age or were primary school age children not enrolled in school. The comparable reach, the substantial reductions in cost per dose delivered and the decrease in participants’ time support this integrated One Health approach to control multiple NTDs. Further, the recorded level of non-enrolment at primary school suggests that, in remote areas, school-based delivery strategies could miss a large fraction of school-age children and that programs that focus delivery solely at the level of the primary school will miss a substantial proportion of both primary school age children as well as other individuals from the community. We have shown that these populations can be effectively reached through extramural programs.

Keywords: canine mediated human rabies, integrated health interventions, mass drug administration, neglected tropical disease, One Health, soil-transmitted helminths

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Authors: Byron Baron

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Typical of the Mediterranean region, the Maltese islands exhibit calcareous soils containing low organic carbon content and high salinity, in addition to being relatively shallow. This has lead to the common practice of applying copious amounts of artificial fertilisers as well as other chemical inputs, together with the use of ground water having high salinity. Such intensive agricultural activities, over a prolonged time period, on such land has lead further to the loss of any soil fertility, together with direct negative impacts on the quality of fresh water reserves and the local ecosystem. The aim of this study was to investigate whether the natural resources on the island would be sufficient to apply ecological intensification i.e. the use of natural processes to replace anthropological inputs without any significant loss in food production. This was implementing through a sustainable agricultural system based on permaculture practices. Ecological intensification following permaculture principles was implemented for two years in order to capture the seasonal changes in duplicate. The areas dedicated to wild plants were only trimmed back to avoid excessive seeding but never mowing. A number of local staple crops were grown throughout this period, also in duplicate. Concomitantly, a number of practices were implemented following permaculture principles such as reducing land tilling, applying only natural fertiliser, mulching, monitoring of soil parameters using sensors, no use of herbicides or pesticides, and precision irrigation linked to a desalination system. Numerous environmental parameters were measured at regular intervals so as to quantify any improvements in ecological conditions. Crop output was also measured as kilos of produce per area. The results clearly show that over the two year period, the variety of wild plant species increased, the number of visiting pollinators increased, there were no pest infestations (although an increase in the number of pests was observed), and a slight improvement in overall soil health was also observed. This was obviously limited by the short duration of the testing implementation. Dedicating slightly less than 15% of total land area to wild plants in the form of borders around plots of crops assisted pollination and provided a foraging area for gleaning bats (measured as an increased number of feeding buzzes) whilst not giving rise to any pest infestations and no apparent yield losses or ill effects to the crops. Observed increases in crop yields were not significant. The study concluded that with the right support for the initial establishment of a healthy ecosystem and controlled intervention, the available natural resources on the island can substantially improve the condition of the local agricultural land area, resulting is a more prolonged economical output with greater ecological sustainability. That being said, more comprehensive and long-term monitoring is required in order to fully validate these results and design a sustainable agriculture system that truly achieves the best outcome for the Maltese context.

Keywords: ecological intensification, soil health, sustainable agriculture, permaculture

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Authors: Magdalena Hasplova, Katerina Ivanova

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Perinatal palliative care is a relatively young and developing field that includes the care of a fetus or newborn with a life-threatening or limiting defect and his family. However, the training of midwives in perinatal palliative care is insufficient and midwives do not feel prepared for this aspect of their work. This fact can affect the barriers to communication with the mother or family of the endangered child. The main aim was to analyze the awareness of midwifery students on the issue of perinatal palliative care in the Czech Republic. Based on the analysis, draw attention to possible communication barriers that may be caused by insufficient information. The research was carried out using a qualitative method, the method of data collection was a semi-structured interview. Eleven female students took part in the research, and the respondents were selected using the Snowballing method. Some methods of grounded theory (open coding and category creation) were used to analyze the data. Based on the results of the research, questions were set in a questionnaire focused on communication barriers between mothers (family) and health care professionals in the care of newborns with life-threatening or limiting disabilities. Based on the analysis of data, categories 1 were determined. Knowledge of perinatal palliative care 2. Education 3. Practical experience 4. Readiness and concerns in the provision of perinatal palliative care 6. Supervision. The questions in the questionnaire were then derived taking into account the data obtained, and the operationalization of health literacy in the field of perinatal palliative care was performed. The analysis of the interviews revealed that the education of midwives in the Czech Republic in the issue of perinatal palliative care is not uniform. The research confirmed the insufficient knowledge and skills of midwifery students preparing to provide perinatal palliative care. Respondents reported feelings of unpreparedness in the areas of communication with a woman after perinatal loss, psychological support for a woman and her family, the care of a stillborn or dying child, or self-coping with death. The questions in the questionnaire then develop these areas. We assumed that by analyzing and interpreting the data obtained from our research, we will help to better understand the concerns and motivations of students in providing holistic perinatal palliative care. We came to the conclusion that it would be appropriate to set up a unified and comprehensive education on this issue in the Czech Republic. Healthcare professionals are in a unique position that can positively or negatively affect the intensity of perinatal loss. Already properly set up education of health professionals leads to overcoming barriers in communication between health professionals and the family, experiencing perinatal loss.

Keywords: midwife, perinatal loss, perinatal palliative care, communication, barriers, mothers, family

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Authors: Dorothy Kagazi

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The African elephant (Loxodonta africana) remains one of the most crop-damaging species around Kibale National Park, western Uganda. Elephant crop raiding deprives communities of food and incomes, consequently impacting livelihoods, attitude, and support for conservation. It also attracts an aggressive reaction from local communities including the retaliatory killing of a species that is already endangered and listed under Appendix I of the Convention on Endangered Species of Flora and Fauna (CITES). In order to mitigate against elephant crop raiding and minimize conflict, a number of interventions were devised by the government of Uganda such as physical guarding, scare-shooting, excavation of trenches, growing of unpalatable crops and fire lighting all of which have over the years been implemented around the park. These generated varying degrees of effectiveness but largely never solved the problem of elephants crossing into communities to destroy food and shelter which had a negative effect onto sustainable tourism of the communities who often resorted to killing these animals and hence contributing the falling numbers of these animals. It was until government discovered that there are far more effective ways of deterring these animals from crossing to communities that it commissioned a study to deploy the African honeybee (Apis mellifera scutellata) as a deterrent against elephant crop raiding and income enhancement for local people around the park. These efforts led to a number of projects around Kibale National Park where communities were facilitated to keep bees for human-elephant conflict mitigation and rural income enhancement through the sale of honey. These projects have registered tremendous success in reducing crop damage, enhance rural incomes, influence positive attitude change and ultimately secure community support for elephant and park conservation which is a clear manifestation of sustainable tourism development in the area. To address the issue of sustainability, the project was aligned with four major objectives that contributed to the overall goal of maintaining the areas around the parks and the national park itself in such a manner that it remains viable over an infinite period. Among these included determining deterrence effects of bees against elephant crop raiding, assessing the contribution of beekeeping towards rural income enhancement, determining the impact of community involvement of park conservation and management among others. The project deployed 500 improved hives by placing them at specific and previously identified and mapped out elephant crossing points along the park boundary. A control site was established without any intervention to facilitate comparison of findings and data was collected on elephant raiding frequency, patterns, honey harvested, and community attitude towards the park. A socio-economic assessment was also undertaken to ascertain the contribution of beekeeping to incomes and attitude change. In conclusion, human-wildlife conflicts have disturbed conservation and sustainable tourism development efforts. Such success stories like the beekeeping strategy should hence be extensively discussed and widely shared as a conservation technique for sustainable tourism.

Keywords: bees, communities, conservation, elephants

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Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

Abstract:

An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavoured to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learner. Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: medical education, clinical education, andragogy, pedagogy

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Authors: Stephanie Remedios, Linda Veronica Rios

Abstract:

Background. Pediatric obesity is a serious health problem linked to multiple physical diseases and ailments, including diabetes, heart disease, and joint issues. While research has shown pediatric obesity can bring about an array of physical illnesses, it is less known how such a condition can affect children’s cognitive development. With childhood overweight and obesity prevalence rates on the rise, it is essential to understand the scope of their cognitive consequences. The present review of the literature tested the hypothesis that poor physical health, such as childhood obesity or malnutrition, negatively impacts a child’s cognitive development. Methodology. A systematic review was conducted to determine the relationship between poor physical health and lower cognitive functioning in children ages 4-16. Electronic databases were searched for studies dating back to ten years. The following databases were used: Science Direct, FIU Libraries, and Google Scholar. Inclusion criteria consisted of peer-reviewed academic articles written in English from 2012 to 2022 that analyzed the relationship between childhood malnutrition and obesity on cognitive development. A total of 17,000 articles were obtained, of which 16,987 were excluded for not addressing the cognitive implications exclusively. Of the acquired articles, 13 were retained. Results. Research suggested a significant connection between diet and cognitive development. Both diet and physical activity are strongly correlated with higher cognitive functioning. Cognitive domains explored in this work included learning, memory, attention, inhibition, and impulsivity. IQ scores were also considered objective representations of overall cognitive performance. Studies showed physical activity benefits cognitive development, primarily for executive functioning and language development. Additionally, children suffering from pediatric obesity or malnutrition were found to score 3-10 points lower in IQ scores when compared to healthy, same-aged children. Conclusion. This review provides evidence that the presence of physical activity and overall physical health, including appropriate diet and nutritional intake, has beneficial effects on cognitive outcomes. The primary conclusion from this research is that childhood obesity and malnutrition show detrimental effects on cognitive development in children, primarily with learning outcomes. Assuming childhood obesity and malnutrition rates continue their current trade, it is essential to understand the complete physical and psychological implications of obesity and malnutrition in pediatric populations. Given the limitations encountered through our research, further studies are needed to evaluate the areas of cognition affected during childhood.

Keywords: childhood malnutrition, childhood obesity, cognitive development, cognitive functioning

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Authors: Mingxin Li, Liya Ni

Abstract:

Autonomous parking is a valuable feature applicable to many robotics applications such as tour guide robots, UV sanitizing robots, food delivery robots, and warehouse robots. With auto-parking, the robot will be able to park at the charging zone and charge itself without human intervention. As compared to self-driving vehicles, auto-parking is more challenging for a small-scale mobile robot only equipped with a front camera due to the camera view limited by the robot’s height and the narrow Field of View (FOV) of the inexpensive camera. In this research, auto-parking of a small-scale mobile robot with a front camera only was achieved in a four-step process: Firstly, transfer learning was performed on the AlexNet, a popular pre-trained convolutional neural network (CNN). It was trained with 150 pictures of empty parking slots and 150 pictures of occupied parking slots from the view angle of a small-scale robot. The dataset of images was divided into a group of 70% images for training and the remaining 30% images for validation. An average success rate of 95% was achieved. Secondly, the image of detected empty parking space was processed with edge detection followed by the computation of parametric representations of the boundary lines using the Hough Transform algorithm. Thirdly, the positions of the entrance point and center of available parking space were predicted based on the robot kinematic model as the robot was driving closer to the parking space because the boundary lines disappeared partially or completely from its camera view due to the height and FOV limitations. The robot used its wheel speeds to compute the positions of the parking space with respect to its changing local frame as it moved along, based on its kinematic model. Lastly, the predicted entrance point of the parking space was used as the reference for the motion control of the robot until it was replaced by the actual center when it became visible again by the robot. The linear and angular velocities of the robot chassis center were computed based on the error between the current chassis center and the reference point. Then the left and right wheel speeds were obtained using inverse kinematics and sent to the motor driver. The above-mentioned four subtasks were all successfully accomplished, with the transformed learning, image processing, and target prediction performed in MATLAB, while the motion control and image capture conducted on a self-built small scale differential drive mobile robot. The small-scale robot employs a Raspberry Pi board, a Pi camera, an L298N dual H-bridge motor driver, a USB power module, a power bank, four wheels, and a chassis. Future research includes three areas: the integration of all four subsystems into one hardware/software platform with the upgrade to an Nvidia Jetson Nano board that provides superior performance for deep learning and image processing; more testing and validation on the identification of available parking space and its boundary lines; improvement of performance after the hardware/software integration is completed.

Keywords: autonomous parking, convolutional neural network, image processing, kinematics-based prediction, transfer learning

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Authors: Md. Nuru Miah, A. F. M. Akhter Uddin

Abstract:

Medicinal plants are grown naturally in a tropical environment in Bangladesh and used as drug and therapeutic agents in the health care system. According to Bangladesh Agricultural Research Institute (BARI), there are 722 species of medicinal plants in the country. Of them, 255 plants are utilized by the manufacturers of Ayurvedic and Unani medicines. Medicinal plants like Aloevera, Ashwagonda, shotomul,Tulsi, Vuikumra, Misridana are extensively cultivated in some selected areas as well; where Aloevera scored the highest position in production. In the early 1980, Ayurvedic and Unani companies procured 80 percent of medicinal plants from natural forests, and the rest 20 percent was imported. Now the scenario has changed; 80 percent is imported, and the rest 20 percent is collected from local products(Source: Astudy on sectorbased need assessment of Business promotion council-Herbal products and medicinal plants, page-4). Uttara Development Program Society, a leading Non- Government development organization in Bangladesh, has been implementing a value chain development project under promoting Agricultural commercialization and Enterprises of Pally Karma Sahayak Foundation (PKSF) funded by the International Fund for Agricultural Development (IFAD) in Natore Sadar Upazila from April 2017 to sustainably develop the technological interventions for products and market development. The ultimate goal of the project is to increase income, generate employment and develop this sector as a sustainable business enterprise. Altogether 10,000 farmers (Nursery owners, growers, input supplier, processors, whole sellers, and retailers) are engaged in different activities of the project. The entrepreneurs engaged in medicinal plant cultivation did not know and follow environmental and good agricultural practices. They used to adopt traditional methodology in production and processing. Locally the farmers didn’t have any positive initiative to expand their business as well as developvalue added products. A lot of diversified products could be possible to develop and marketed with the introduction of post-harvest processing technology and market linkage with the local and global buyer. Training is imparted to the nursery owners and herbal growers on production technologies, sowing method, use of organic fertilizers/compost/pesticides, harvesting procedures, and storage facilities. Different types of herbal tea like Rosella, Moringa, Tulshi, and Basak are being produced and packed locally with a good scope of its marketing in different cities of the country. The project has been able to achieve a significant impact in the development of production technologies, but still, there is room for further improvement in processing, packaging, and marketing level. The core intervention of the current project to develop some entrepreneurs for branding, packaging, promotion, and marketing while considering environment friendly practices. The present strategies will strengthen the knowledge and skills of the entrepreneurs for the production and marketing of their products, maintaining worldwide accepted compliance system for easy access to the global market.

Keywords: aloe vera, herbs and shrubs, market, interventions

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