Search results for: Employed Mothers

Authors: Mishell E. Cabrera, Bryan G. Valencia, Anderson I. Guamán

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Human dependence on plastic products has led to global pollution, with plastic particles ranging in size from 0.001 to 5 millimeters, which are called microplastics (hereafter, MPs). The abundance of microplastics is used as an indicator of pollution. However, reports of pollution (abundance of MPs) in river sediments do not consider that the accumulation of sediments and MPs depends on the energy of the river. That is, the abundance of microplastics will be underestimated if the sediments analyzed come from places where the river flows with a lot of energy, and the abundance will be overestimated if the sediment analyzed comes from places where the river flows with less energy. This bias can generate an error greater than 300% of the MPs value reported for the same river and should increase when comparisons are made between 2 rivers with different characteristics. Sections where the river flows with higher energy allow sands to be deposited and limit the accumulation of MPs, while sections, where the same river has lower energy, allow fine sediments such as clays and silts to be deposited and should facilitate the accumulation of MPs particles. That is, the abundance of MPs in the same river is underrepresented when the sediment analyzed is sand, and the abundance of MPs is overrepresented if the sediment analyzed is silt or clay. The present investigation establishes a protocol aimed at incorporating sample granulometry to calibrate MPs quantification and eliminate over- or under-representation bias (hereafter granulometric bias). A total of 30 samples were collected by taking five samples within six work zones. The slope of the sampling points was less than 8 degrees, referred to as low slope areas, according to the Van Zuidam slope classification. During sampling, blanks were used to estimate possible contamination by MPs during sampling. Samples were dried at 60 degrees Celsius for three days. A flotation technique was employed to isolate the MPs using sodium metatungstate with a density of 2 gm/l. For organic matter digestion, 30% hydrogen peroxide and Fenton were used at a ratio of 6:1 for 24 hours. The samples were stained with rose bengal at a concentration of 200 mg/L and were subsequently dried in an oven at 60 degrees Celsius for 1 hour to be identified and photographed in a stereomicroscope with the following conditions: Eyepiece magnification: 10x, Zoom magnification (zoom knob): 4x, Objective lens magnification: 0.35x for analysis in ImageJ. A total of 630 fibers of MPs were identified, mainly red, black, blue, and transparent colors, with an overall average length of 474,310 µm and an overall median length of 368,474 µm. The particle size of the 30 samples was calculated using 100 g per sample using sieves with the following apertures: 2 mm, 1 mm, 500 µm, 250 µm, 125 µm and 0.63 µm. This sieving allowed a visual evaluation and a more precise quantification of the microplastics present. At the same time, the weight of sediment in each fraction was calculated, revealing an evident magnitude: as the presence of sediment in the < 63 µm fraction increases, a significant increase in the number of MPs particles is observed.

Keywords: microplastics, pollution, sediments, Tena River

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Authors: Orhan Akınoğlu, Arif Çömek, Ersin Elmacı, Tuğba Gündoğdu

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The concept map is known to be a powerful tool to organize the ideas and concepts of an individuals’ mind. This tool is a kind of visual map that illustrates the relationships between the concepts of a certain subject. The effect of concept mapping on cognitive and affective qualities is one of the research topics among educational researchers for last decades. We educators want to utilize it both as an instructional tool or an assessment tool in classes. For that reason, this study aimed to determine the effect of concept mapping as a learning strategy in science classes on students’ academic achievement and attitude. The research employed a randomized pre-test post-test control group design. Data collected from 60 sixth grade students participated in the study from a randomly selected primary school in Turkey. Sixth-grade classes of the school were analyzed according to students’ academic achievement, science attitude, gender, mathematics, science courses grades, and their GPAs before the implementation. Two of the classes found to be equivalent (t=0,983, p>0,05) and one of them was defined as experimental and the other one control group randomly. During a 5-weeks period, the experimental group students (N=30) used the paper-based concept mapping method while the control group students (N=30) were taught with the traditional approach according to the science and technology education curriculum for light and sound subject. Both groups were taught by the same teacher who is experienced using concept mapping in science classes. Before the implementation, the teacher explained the theory of the concept maps and showed how to create paper-based concept mapping individually to the experimental group students for two hours. Then for two following hours she asked them to create some concept maps related to their former science subjects and gave them feedback by reviewing their concept maps to be sure that they can create during the implementation. The data were collected by science achievement test, science attitude scale and personal information form. Science achievement test and science attitude scale were implemented as pre-test and post-test while personal information form was implemented just as once. The reliability coefficient of the achievement test was KR20=0,76 and Cronbach’s Alpha of the attitude scale was 0,89. SPSS statistical software was used to analyze the data. According to the results, there was a statistically significant difference between the experimental and control group for academic achievement but not for attitude. The experimental group had significantly greater gains from academic achievement test than the control group (t=0,02, p<0,05). The findings showed that the paper-and-pencil concept mapping can be used as an effective method for students’ academic achievement in science classes. The results have implications for further researches.

Keywords: concept mapping, science education, constructivism, academic achievement, science attitude

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Authors: Mahshid Arabi

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In recent years, remarkable advancements in the fields of artificial intelligence and machine learning have led to the development of facial recognition technologies. These technologies are now employed in a wide range of applications, including security, surveillance, healthcare, and education. In the field of education, the identification of university entrance exam candidates has been one of the fundamental challenges. Traditional methods such as using ID cards and handwritten signatures are not only inefficient and prone to fraud but also susceptible to errors. In this context, utilizing advanced technologies like facial recognition can be an effective and efficient solution to increase the accuracy and reliability of identity verification in entrance exams. This article examines the use of FaceMatch software for recognizing the faces of university entrance exam candidates in Iran. The main objective of this research is to evaluate the efficiency and accuracy of FaceMatch software in identifying university entrance exam candidates to prevent fraud and ensure the authenticity of individuals' identities. Additionally, this research investigates the advantages and challenges of using this technology in Iran's educational systems. This research was conducted using an experimental method and random sampling. In this study, 1000 university entrance exam candidates in Iran were selected as samples. The facial images of these candidates were processed and analyzed using FaceMatch software. The software's accuracy and efficiency were evaluated using various metrics, including accuracy rate, error rate, and processing time. The research results indicated that FaceMatch software could accurately identify candidates with a precision of 98.5%. The software's error rate was less than 1.5%, demonstrating its high efficiency in facial recognition. Additionally, the average processing time for each candidate's image was less than 2 seconds, indicating the software's high efficiency. Statistical evaluation of the results using precise statistical tests, including analysis of variance (ANOVA) and t-test, showed that the observed differences were significant, and the software's accuracy in identity verification is high. The findings of this research suggest that FaceMatch software can be effectively used as a tool for identifying university entrance exam candidates in Iran. This technology not only enhances security and prevents fraud but also simplifies and streamlines the exam administration process. However, challenges such as preserving candidates' privacy and the costs of implementation must also be considered. The use of facial recognition technology with FaceMatch software in Iran's educational systems can be an effective solution for preventing fraud and ensuring the authenticity of university entrance exam candidates' identities. Given the promising results of this research, it is recommended that this technology be more widely implemented and utilized in the country's educational systems.

Keywords: facial recognition, FaceMatch software, Iran, university entrance exam

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Authors: Rajeev Ravindran, Amit K. Jaiswal

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Lignocellulose is the largest reservoir of inexpensive, renewable source of carbon. It is composed of lignin, cellulose and hemicellulose. Cellulose and hemicellulose is composed of reducing sugars glucose, xylose and several other monosaccharides which can be metabolised by microorganisms to produce several value added products such as biofuels, enzymes, aminoacids etc. Enzymatic treatment of lignocellulose leads to the release of monosaccharides such as glucose and xylose. However, factors such as the presence of lignin, crystalline cellulose, acetyl groups, pectin etc. contributes to recalcitrance restricting the effective enzymatic hydrolysis of cellulose and hemicellulose. In order to overcome these problems, pre-treatment of lignocellulose is generally carried out which essentially facilitate better degradation of lignocellulose. A range of pre-treatment strategy is commonly employed based on its mode of action viz. physical, chemical, biological and physico-chemical. However, existing pretreatment strategies result in lower sugar yield and formation of inhibitory compounds. In order to overcome these problems, we proposes a novel pre-treatment, which utilises the superior oxidising capacity of alkaline potassium permanganate assisted by ultra-sonication to break the covalent bonds in spent coffee waste to remove recalcitrant compounds such as lignin. The pre-treatment was conducted for 30 minutes using 2% (w/v) potassium permanganate at room temperature with solid to liquid ratio of 1:10. The pre-treated spent coffee waste (SCW) was subjected to enzymatic hydrolysis using enzymes cellulase and hemicellulase. Shake flask experiments were conducted with a working volume of 50mL buffer containing 1% substrate. The results showed that the novel pre-treatment strategy yielded 7 g/L of reducing sugar as compared to 3.71 g/L obtained from biomass that had undergone dilute acid hydrolysis after 24 hours. From the results obtained it is fairly certain that ultrasonication assists the oxidation of recalcitrant components in lignocellulose by potassium permanganate. Enzyme hydrolysis studies suggest that ultrasound assisted alkaline potassium permanganate pre-treatment is far superior over treatment by dilute acid. Furthermore, SEM, XRD and FTIR were carried out to analyse the effect of the new pre-treatment strategy on structure and crystallinity of pre-treated spent coffee wastes. This novel one-step pre-treatment strategy was implemented under mild conditions and exhibited high efficiency in the enzymatic hydrolysis of spent coffee waste. Further study and scale up is in progress in order to realise future industrial applications.

Keywords: spent coffee waste, alkaline potassium permanganate, ultra-sonication, physical characterisation

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Authors: Farhana Nosheen, Maleeha Fatima

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This study on Afghan refugee women living in Punjab, Pakistan, shows a strong relationship between poor socio-economic status and lower nutritional health status. Pakistan is one of the significant countries accepting refugees from the Afghan war. Universally, refugees are vulnerable to food security and basic life necessities. The in-hand study aimed to investigate food insecurity among afghan refugees who recently migrated to Pakistan. Purposive sampling technique was employed to collect the data from afghan women refugees settled in refugee camp settled in Capital city Islamabad, Pakistan. Data was collected through an interview tool. It revealed from data that the majority of women were underweight, about 74.7% in their reproductive years, which is an alarming situation for the forthcoming children and families. It is also shown that There’s a strong impact of their income level, education, dietary habits and food insecurity on their overall health status. It can also be observed in their Body Mass Index and in their physical appearance; they also show extremely poor levels of hemoglobin which is directly indicated anemic condition, especially iron deficiency anemia among the young Afghan refugee women. The illiteracy rate is about 93.33% among the selected participants as well as a majority of this population has 10-12 family size in comparison with their income level of about 10,000-15,000 Pakistani rupees per month, which can hardly meet their daily food expenditure. Adequate food is rarely accessible to young girls and women due to fewer national and international food aids program available in Pakistan. The majority have pale yellowish skin color (due to low iron content) along with clear white eyes (low hemoglobin level), thin hairs (protein deficiency) and spoon-shaped nails (a direct indicator of low iron level). Data showed a significant relation between appetite and BMI as their appetite is very low, which is directly indicated in their underweight body condition. About 56.67% of the participants had Urinary Tract Infections. The main causes included personal unhygienic conditions and lack of washrooms as well as drinking water facilities in their refugee camps. It is suggested that National and international food aid programs should cater to the nutritional demands of women refugees in the world to protect them from food insecurities as well as future researchers should find out better ways of analysis and treatment plans for such kind of communities who are highly prone to nutritional deficiencies and lack of basic supplies.

Keywords: food insecurity, refugees, women, vulnerable

Procedia PDF Downloads 100

Authors: Sabrina Servot, Annick St-Amand, Michel Rousseau, Valerie Simard, Evelyne Touchette

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Child maltreatment has a profound impact on children’s development. In its victims, internalizing and externalizing problems are highly prevalent, and sleep problems are common. Furthermore, the environment they live in is often disorganized, lacking routine and consistency. In non-maltreated children, several studies documented the important role of sleep regulation and sleep ecology. A poor sleep ecology (e.g., lack of sleep hygiene and bedtime routine, inappropriate sleeping location) may lead to sleep regulation problems (e.g., short sleep duration, nocturnal awakenings), and sleep regulation problems may increase the risk of behavior problems. Therefore, this scoping review aims to map evidence about sleep ecology and sleep regulation and the associations between sleep ecology, sleep regulation, and behavior problems in maltreated preschoolers. Literature from 1993 was searched in PsycInfo, Pubmed, Medline, Eric, and Proquest Dissertations and Theses. Articles and thesis were comprehensively reviewed based upon inclusion/exclusion criteria: 1) it concerns maltreated children aged 1-5 years, and 2) it addresses at least one of the following: sleep ecology, sleep regulation, and/or their associations with behavior problems in maltreated preschoolers. From the 650 studies screened, nine of them were included. Data were charted according to study characteristics, nature of variable documented, measures, analyses performed, and results of each study, then synthesized in a narrative summary. The main results show all included articles were quantitative. Foster children samples were used in four studies, children experienced different types of maltreatment in six studies, while one was specifically about sexually abused children. Regarding sleep ecology, only one study describing maltreated preschoolers’ sleep ecology was found, while seven studies documented sleep regulation. Among these seven studies, 17 different sleep variables (e.g., parasomnia, dyssomnia, total 24-h sleep duration) were used, each study documenting from one to nine of them. Actigraphic measures were employed in three studies, the others used parent-reported questionnaires or sleep diaries. Maltreated children’s sleep was described and/or compared to non-maltreated children’s sleep, or an intervention group, showing mild differences. As for associations between sleep regulation and behavior problems, five studies investigated it and performed correlational or linear regression analyses between sleep and behavior problems, revealing some significant associations. No study was found about associations between sleep ecology and sleep regulation, between sleep ecology and behavior problems, or between these three variables. In conclusion, literature about sleep ecology, sleep regulation, and their associations with behavior problems are far more scarce in maltreated preschoolers than in non-maltreated ones. At present, there is especially a paucity of research about sleep ecology and the association between sleep ecology and sleep regulation in maltreated preschoolers, while studies on non-maltreated children showed sleep ecology plays a major role in sleep regulation. In addition, as sleep regulation is measured in many different ways among the studies, it is difficult to compare their findings. Finally, it seems necessary that research fill these gaps, as recommendations could be made to clinicians working with maltreated preschoolers regarding the use of sleep ecology and sleep regulation as intervention tools.

Keywords: maltreated preschoolers, sleep ecology, sleep regulation, behavior problems

Procedia PDF Downloads 148

Authors: Ayla Roberta Galaco, Juliana Fonseca De Lima, Osvaldo Antonio Serra

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Coordination polymers, also known as metal-organic frameworks (MOFs) or lanthanoide organic frameworks (LOFs) have been reported due of their promising applications in gas storage, separation, catalysis, luminescence, magnetism, drug delivery, and so on. As a type of organic–inorganic hybrid materials, the properties of coordination polymers could be chosen by deliberately selecting the organic and inorganic components. LOFs have received considerable attention because of their properties such as porosity, luminescence, and magnetism. Methods such as solvothermal synthesis are important as a strategy to control the structural and morphological properties as well as the composition of the target compounds. In this work the first solvothermal synthesis was employed to obtain the compound [Y0.4,Yb0.4,Er0.2(dmf)(for)(H2O)(tft)], by using terephthalic acid (tft) and oxalic acid, decomposed in formate (for), as ligands; Yttrium, Ytterbium and, Erbium as metal centers, in DMF and water for 4 days under 160 °C. The semi-rigid terephthalic acid (dicarboxylic) coordinates with Ln3+ ions and also is possible to form a polyfunctional bridge. On the other hand, oxalate anion has no high-energy vibrational groups, which benefits the excitation of Yb3+ in upconversion process. It was observed that the compounds with water molecules in the coordination sphere of the lanthanoide ions cause lower crystalline properties and change the structure of the LOF (1D, 2D, 3D). In the FTIR, the bands at 1589 and 1500 cm-1 correspond to the asymmetric stretching vibration of –COO. The band at 1383 cm-1 is assigned to the symmetric stretching vibration of –COO. Single crystal X-ray diffraction study reveals an infinite 3D coordination framework that crystalizes in space group P21/c. The other three products, [TR(chel)(ofd)0,5(H2O)2], where TR= Eu3+, Y3, and Yb3+/Er3+ were obtained by using 1, 2-phenylenedioxydiacetic acid (ofd) and chelidonic acid (chel) as organic ligands. Thermal analysis shows that the lanthanoide organic frameworks do not collapse at temperatures below 250 °C. By the polycrystalline X-ray diffraction patterns (PXRD) it was observed that the compounds with Eu3+, Y3+, and Yb3+/Er3+ ions are isostructural. From PXRD patterns, high crystallinity can be noticed for the complexes. The final products were characterized by single X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), energy dispersive spectroscopy (EDS) and thermogravimetric analysis (TGA). The X-ray diffraction (XRD) is an effective method to investigate crystalline properties of synthesized materials. The solid crystal obtained in the synthesis show peaks at 2θ < 10°, indicating the MOF formation. The chemical composition of LOFs was also confirmed by EDS.

Keywords: isostructural, lanthanoids, lanthanoids organic frameworks (LOFs), metal organic frameworks (MOFs), thermogravimetry, X-Ray diffraction

Procedia PDF Downloads 259

Authors: Khin Thandar Soe, Mark Stephen Pulham

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Ballistic building materials play a crucial role in ensuring the safety of the occupants within protective structures. Traditional options like Ordinary Portland Cement (OPC)-based walls, including reinforced concrete walls, precast concrete walls, masonry walls, and concrete blocks, are frequently employed for ballistic protection, but they have several drawbacks such as being thick, heavy, costly, and challenging to construct. On the other hand, glass and composite materials offer lightweight and easier construction alternatives, but they come with a high price tag. There has been no reported test data on magnesium-based ballistic wall panels or modular wall systems so far. This paper presents groundbreaking small arms test data related to the development of the world’s first magnesia cement ballistic wall panels and modular wall system. Non-hydraulic magnesia cement exhibits several superior properties, such as lighter weight, flexibility, acoustics, and fire performance, compared to the traditional Portland Cement. However, magnesia cement is hydrophilic and may degrade in prolonged contact with water. In this research, modified magnesia cement for water resistant and durability from UBIQ Technology is applied. The specimens are made of a modified magnesia cement formula and prepared in the Laboratory of UBIQ Technology Pty Ltd. The specimens vary in thickness, and the tests cover various small arms threats in compliance with standards AS/NZS2343 and UL752 and are performed up to the maximum threat level of Classification R2 (NATO) and UL-Level 8(NATO) by the Accredited Test Centre, BMT (Ballistic and Mechanical Testing, VIC, Australia). In addition, the results of the test conducted on the specimens subjected to the small 12mm diameter steel ball projectile impact generated by a gas gun are also presented and discussed in this paper. Gas gun tests were performed in UNSW@ADFA, Canberra, Australia. The tested results of the magnesia panels and wall systems are compared with one of concrete and other wall panels documented in the literature. The conclusion drawn is that magnesia panels and wall systems exhibit several advantages over traditional OPC-based wall systems, and they include being lighter, thinner, and easier to construct, all while providing equivalent protection against threats. This makes magnesia cement-based materials a compelling choice of application where efficiency and performance are critical to create a protective environment.

Keywords: ballistics, small arms, gas gun, projectile, impact, wall panels, modular, magnesia cement

Procedia PDF Downloads 75

Authors: Karin Eines, Riki Tesler

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Introduction: The Mamanet Cachibol League (MCL) is a community-based model developed in Israel to promote physical activity (PA) and amateur team sports among women. team sports are not just groups in the context of specific sport activity but also incorporated into a person’s sense of self and become influencing factor on sport-related behavior among the players. While in the non-Arabic sector, sport venues are available for the local authority population, the Arabic sector authorities face limited access sport facilities, with 168 sport venues and authorities with no venues at all. Within the Arab community, women participation in sports has traditionally been limited and, even more so for participation in team sports. Aims: The purpose of the study was to explore attributes of women MCL activity via: (1) assess differences between participants in the MCL and non-participants among Arab women regarding well-being level; (2) to examine among MCL participants the relationship between health maintenance characteristics and the likelihood of participating in the MCL; and (3) Use qualitative approach to shed light over the question why Arabic women participate in MCL and continue their engagement in PA. Methods: An explanatory sequential mixed-method design was employed to gain a deeper understanding of the advantages and motivations among women participating in community-based team sports. A cross-sectional survey was conducted among Israeli Arab women aged 25–59. Demographic characteristics, well-being (SRH and psychosomatic symptoms), eating habits, and social support were analyzed using two-way analyses of covariance and multiple regression models with a sequential entry of the variables. Quantitative results were further explored in qualitative in-depth interviews among 30 of the MCL participants, which shed light on additional reasons for participation in PA. Results: MCL participants reported better self-reported health (p < 0.001) and lower rates of psychosomatic symptoms (p < 0.001) compared to non-participants. Participation in MCL was also related to higher levels of well-being and healthy eating habits. Women who participated also experienced a profound sense of belonging, leading to enhanced social interactions and positivity in their personal and professional lives. They were dedicated to the group and felt empowered by the reciprocal commitment. The group promoted equality, making the women feel valued and respected, resulting in community admiration. Their involvement positively impacted their families, justifying their time commitment.

Keywords: wellbeing, obesity, community based sports, healthy eating habits, arab women

Procedia PDF Downloads 73

Authors: Ezinne K. Okoro, Takahiko Katoh, Yoko Kawamura, Stanley C. Meribe

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HIV infection in children is largely as a result of vertical transmission (mother to child transmission [MTCT]). Thus, elimination of mother to child transmission of HIV/AIDS is critical in eliminating HIV infection in children. In Nigeria, drawbacks such as; limited pediatric screening, limited human capital, insufficient advocacy and poor understanding of ART guidelines, have impacted efforts at combating the disease, even as treatment services are free. Prevention of Mother to Child Transmission (PMTCT) program relies on health workers who not only counsel pregnant women on first contact but can competently provide HIV-positive pregnant women with accurate information about the PMTCT program such as feeding techniques and drug adherence. In developing regions like Nigeria where health care delivery faces a lot of drawbacks, it becomes paramount to address these issues of poor PMTCT coverage by conducting a baseline assessment of the knowledge, practices and perceptions related to HIV prevention amongst healthcare workers in Nigeria. A descriptive cross-sectional study was conducted amongst 250 health workers currently employed in health facilities in Abuja, Nigeria where PMTCT services were offered with the capacity to carry out early infant diagnosis testing (EID). Data was collected using a self-administered, pretested, structured questionnaire. This study showed that the knowledge of PMTCT of HIV was poor (30%) among healthcare workers who offer this service day-to-day to pregnant women. When PMTCT practices were analyzed in keeping with National PMTCT guidelines, over 61% of the respondents reported observing standard practices and the majority (58%) had good attitudes towards caring for patients with HIV/AIDS. Although 61% of the respondents reported being satisfied with the quality of service being rendered, 63% reported not being satisfied with their level of knowledge. Predictors of good knowledge were job designation and level of educational attainment. Health workers who were more satisfied with their working conditions and those who had worked for a longer time in the PMTCT service were more likely to observe standard PMTCT practices. With over 62% of the healthcare workers suggesting that more training would improve the quality of service being rendered, this is a strong pointer to stakeholders to consider a ‘healthcare worker-oriented approach’ when planning and conducting PMTCT training for healthcare workers. This in turn will increase pediatric ARV coverage, the knowledge and effectiveness of the healthcare workers in carrying out appropriate PMTCT interventions and culminating in the reduction/elimination of HIV transmission to newborns.

Keywords: attitudes, HIV/AIDS, healthcare workers, knowledge, mother to child transmission, Nigeria, perceptions

Procedia PDF Downloads 204

Authors: Nova Grail S. Luminang, Gwyneth B. Gortiza, Alvin E. Haboc, Marinol K. Hate, Rhean Mitchel N. Joven, Kara Kate D. Lammao, Rosemarie M. Lambayung, Elmo Carl D. Lardizabal, Zyra B. Linggayo, Rizza Mae G. Liwag, Ronalyn O. Songcuan

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Breast cancer survivorship represents a complex and continuous journey extending beyond the completion of treatment, involving coping with physical, emotional, and psychological aspects of life post-treatment. This study aimed to explore the lived experiences of breast cancer survivors after successful treatment in Tabuk City, focusing on their post-treatment experiences, coping mechanisms, and necessary lifestyle changes. Researchers have selected Tabuk City as their research locale. Utilizing Martin Heidegger’s descriptive phenomenological design, this qualitative research included six participants, allowing for data saturation. Purposive sampling was employed to select participants. Researchers used Colaizzi’s Phenomenological Method in analyzing the data in order to achieve a reliable understanding of the participants’ experiences. The findings revealed three main themes: going through post-treatment hurdles, building resilience, and transformative wellness adjustments. Breast cancer survivors faced significant challenges, including physical adversities, emotional turmoil, limited social life, memory lapses, decreased sexual intimacy, and economic constraints. To cope, survivors adjusted their thoughts and attitudes, accepted their situation, relied on religious beliefs, and joined the support group Kalinga Cancer Care Ministry INC. Additionally, they strived to return to a normal life and embraced gratitude. Survivors made essential changes to their daily routines, modifying their diets, exploring herbal remedies, and incorporating physical activities such as walking and household chores. These adjustments helped improve their overall well-being and prevent cancer recurrence. The researchers concluded that the journey of breast cancer survivors is marked by significant challenges and inspiring resilience. The impact of breast cancer treatment extends beyond physical recovery, encompassing profound emotional and social dimensions. Despite these difficulties, survivors demonstrate remarkable strength and adaptability, making positive lifestyle changes that offer a hopeful and inspiring narrative of recovery and perseverance.

Keywords: breast cancer, lived experiences, breast cancer survivor, post-treatment hurdles, emotional turmoil

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Authors: Sharmistha Chanda, Anindita Choudhuri

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This exploratory study highlights the psychological aspects of women's empowerment to find the importance of the psychological dimension of empowerment, such as; meaning, competence, self-determination, impact, and assumption, especially in the weaker marginalized section of women. A large proportion of rural, suburban, and urban poor survive by working in unorganized sectors of metropolitan cities. Relative Poverty and lack of employment in rural areas and small towns drive many people to the metropolitan city for work and livelihood. Women working in that field remain unrecognized as people of low socio-economic status. They are usually willing to do domestic work as daily wage workers, single wage earners, street vendors, family businesses like agricultural activities, domestic workers, and self-employed. Usually, these women accept such jobs because they do not have such an opportunity as they lack the basic level of education that is required for better-paid jobs. The unorganized sector, on the other hand, has no such clear-cut employer-employee relationships and lacks most forms of social protection. Having no fixed employer, these workers are casual, contractual, migrant, home-based, own-account workers who attempt to earn a living from whatever meager assets and skills they possess. Women have become more empowered both financially and individually through small-scale business ownership or entrepreneurship development and in household-based work. In-depth interviews have been done with 10 participants in order to understand their living styles, habits, self-identity, and empowerment in their society in order to evaluate the key challenges that they may face following by qualitative research approach. Transcription has been done from the collected data. The three-layer coding technique guides the data analysis process, encompassing – open coding, axial coding, and selective coding. Women’s Entrepreneurship is one of the foremost concerns as the Government, and non-government institutions are readily serving this domain with the primary objectives of promoting self-employment opportunities in general and empowering women in specific. Thus, despite hardship and unrecognition unorganized sector provides a huge array of opportunities for rural and sub-urban poor to earn. Also, the upper section of society tends to depend on this working force. This study gave an idea about the well-being, and meaning in life, life satisfaction on the basis of their lived experience.

Keywords: marginalized women, psychological empowerment, relative poverty, unorganized sector

Procedia PDF Downloads 61

Authors: Misagh Ghobadi, Rich Crane, Karen Hudson-Edwards, Clemens Vinzenz Ullmann

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Lithium is recognized as the critical energy metal of the 21st century, comparable in importance to coal in the 19th century and oil in the 20th century, often termed 'white gold'. Current global demand for lithium, estimated at 0.95-0.98 million metric tons (Mt) of lithium carbonate equivalent (LCE) annually in 2024, is projected to rise to 1.87 Mt by 2027 and 3.06 Mt by 2030. Despite anticipated short-term stability in supply and demand, meeting the forecasted 2030 demand will require the lithium industry to develop an additional capacity of 1.42 Mt of LCE annually, exceeding current planned and ongoing efforts. Brine resources constitute nearly 65% of global lithium reserves, underscoring the importance of exploring lithium recovery from underutilized sources, especially geothermal brines. However, conventional lithium extraction from brine deposits faces challenges due to its time-intensive process, low efficiency (30-50% lithium recovery), unsuitability for low lithium concentrations (<300 mg/l), and notable environmental impacts. Addressing these challenges, direct lithium extraction (DLE) methods have emerged as promising technologies capable of economically extracting lithium even from low-concentration brines (>50 mg/l) with high recovery rates (75-98%). However, most studies (70%) have predominantly focused on synthetic brines instead of native (natural/real), with limited application of these approaches in real-world case studies or industrial settings. This study aims to bridge this gap by investigating a geothermal brine sample collected from a real case study site in the UK. A Mn-based lithium-ion sieve (LIS) adsorbent was synthesized and employed to selectively extract lithium from the sample brine. Adsorbents with a Li:Mn molar ratio of 1:1 demonstrated superior lithium selectivity and adsorption capacity. Furthermore, the pristine Mn-based adsorbent was modified through transition metals doping, resulting in enhanced lithium selectivity and adsorption capacity. The modified adsorbent exhibited a higher separation factor for lithium over major co-existing cations such as Ca, Mg, Na, and K, with separation factors exceeding 200. The adsorption behaviour was well-described by the Langmuir model, indicating monolayer adsorption, and the kinetics followed a pseudo-second-order mechanism, suggesting chemisorption at the solid surface. Thermodynamically, negative ΔG° values and positive ΔH° and ΔS° values were observed, indicating the spontaneity and endothermic nature of the adsorption process.

Keywords: adsorption, critical minerals, DLE, geothermal brines, geochemistry, lithium, lithium-ion sieves

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Authors: Linlong Mu, Maosong Huang

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Considering excavations in urban areas, the soil deformation induced by the excavations usually causes damage to the surrounding structures. Displacement control becomes a critical indicator of foundation design in order to protect the surrounding structures. Evaluation, the damage potential of the surrounding structures induced by the excavations, usually depends on the finite element method (FEM) because of the complexity of the excavation and the variety of the surrounding structures. Besides, evaluation the influence of the excavation on surrounding structures is a three-dimensional problem. And it is now well recognized that small strain behaviour of the soil influences the responses of the excavation significantly. Three-dimensional FEM considering small strain behaviour of the soil is a very complex method, which is hard for engineers to use. Thus, it is important to obtain a simplified method for engineers to predict the influence of the excavations on the surrounding structures. Based on large-scale finite element calculation with small-strain based soil model coupling with inverse analysis, an empirical method is proposed to calculate the three-dimensional soil movement induced by braced excavation. The empirical method is able to capture the small-strain behaviour of the soil. And it is suitable to be used in layered soil. Then the free-field soil movement is applied to the pile to calculate the responses of the pile in both vertical and horizontal directions. The asymmetric solutions for problems in layered elastic half-space are employed to solve the interactions between soil points. Both vertical and horizontal pile responses are solved through finite difference method based on elastic theory. Interactions among the nodes along a single pile, pile-pile interactions, pile-soil-pile interaction action and soil-soil interactions are counted to improve the calculation accuracy of the method. For passive piles, the shadow effects are also calculated in the method. Finally, the restrictions of the raft on the piles and the soils are summarized as: (1) the summations of the internal forces between the elements of the raft and the elements of the foundation, including piles and soil surface elements, is equal to 0; (2) the deformations of pile heads or of the soil surface elements are the same as the deformations of the corresponding elements of the raft. Validations are carried out by comparing the results from the proposed method with the results from the model tests, FEM and other existing literatures. From the comparisons, it can be seen that the results from the proposed method fit with the results from other methods very well. The method proposed herein is suitable to predict the responses of the pile-raft foundation induced by braced excavation in layered soil in both vertical and horizontal directions when the deformation is small. However, more data is needed to verify the method before it can be used in practice.

Keywords: excavation, pile-raft foundation, passive piles, deformation control, soil movement

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Authors: Charles Davidson

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This paper presents the Stoplight Analysis System of Partnering Organizations Readiness, offering a structured framework to evaluate conflict resolution collaboration feasibility, especially crucial in conflict areas, employing a colour-coded approach and specific assessment points, with implications for more informed decision-making and improved outcomes in peacebuilding initiatives. Derived from at total of 40 years of practical peacebuilding experience from the project’s two researchers as well as interviews of various other peacebuilding actors, this paper introduces the Stoplight Analysis System of Partnering Organizations Readiness, a comprehensive framework designed to facilitate effective collaboration in international/local peacebuilding partnerships by evaluating the readiness of both potential partner organisations and the location of the proposed project. ^The system employs a colour-coded approach, categorising potential partnerships into three distinct indicators: Red (no-go), Yellow (requires further research), and Green (promising, go ahead). Within each category, specific points are identified for assessment, guiding decision-makers in evaluating the feasibility and potential success of collaboration. The Red category signals significant barriers, prompting an immediate stoppage in the consideration of partnership. The Yellow category encourages deeper investigation to determine whether potential issues can be mitigated, while the Green category signifies organisations deemed ready for collaboration. This systematic and structured approach empowers decision-makers to make informed choices, enhancing the likelihood of successful and mutually beneficial partnerships. Methodologically, this paper utilised interviews from peacebuilders from around the globe, scholarly research of extant strategies, and a collaborative review of programming from the project’s two authors from their own time in the field. This method as a formalised model has been employed for the past two years across a litany of partnership considerations, and has been adjusted according to its field experimentation. This research holds significant importance in the field of conflict resolution as it provides a systematic and structured approach to peacebuilding partnership evaluation. In conflict-affected regions, where the dynamics are complex and challenging, the Stoplight Analysis System offers decision-makers a practical tool to assess the readiness of partnering organisations. This approach can enhance the efficiency of conflict resolution efforts by ensuring that resources are directed towards partnerships with a higher likelihood of success, ultimately contributing to more effective and sustainable peacebuilding outcomes.

Keywords: collaboration, conflict resolution, partnerships, peacebuilding

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Authors: Natnael Debalklie Teshome

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The purpose of the study was to empirically investigate the impacts of export performance and its volatility on economic growth in the Ethiopian economy. To do so, time-series data of the sample period from 1974/75 – 2017/18 were collected from databases and annual reports of IMF, WB, NBE, MoFED, UNCTD, and EEA. The extended Cobb-Douglas production function of the neoclassical growth model framed under the endogenous growth theory was used to consider both the performance and instability aspects of export. First, the unit root test was conducted using ADF and PP tests, and data were found in stationery with a mix of I(0) and I(1). Then, the bound test and Wald test were employed, and results showed that there exists long-run co-integration among study variables. All the diagnostic test results also reveal that the model fulfills the criteria of the best-fitted model. Therefore, the ARDL model and VECM were applied to estimate the long-run and short-run parameters, while the Granger causality test was used to test the causality between study variables. The empirical findings of the study reveal that only export and coefficient of variation had significant positive and negative impacts on RGDP in the long run, respectively, while other variables were found to have an insignificant impact on the economic growth of Ethiopia. In the short run, except for gross capital formation and coefficients of variation, which have a highly significant positive impact, all other variables have a strongly significant negative impact on RGDP. This shows exports had a strong, significant impact in both the short-run and long-run periods. However, its positive and statistically significant impact is observed only in the long run. Similarly, there was a highly significant export fluctuation in both periods, while significant commodity concentration (CCI) was observed only in the short run. Moreover, the Granger causality test reveals that unidirectional causality running from export performance to RGDP exists in the long run and from both export and RGDP to CCI in the short run. Therefore, the export-led growth strategy should be sustained and strengthened. In addition, boosting the industrial sector is vital to bring structural transformation. Hence, the government has to give different incentive schemes and supportive measures to exporters to extract the spillover effects of exports. Greater emphasis on price-oriented diversification and specialization on major primary products that the country has a comparative advantage should also be given to reduce value-based instability in the export earnings of the country. The government should also strive to increase capital formation and human capital development via enhancing investments in technology and quality of education to accelerate the economic growth of the country.

Keywords: export, economic growth, export diversification, instability, co-integration, granger causality, Ethiopian economy

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Authors: Debabrata Adhikari, Mikhail Matveev, Louise Brown, Andy Long, Jan Kočí

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A good understanding of mesoscale permeability of complex architectures in fibrous porous preforms is of particular interest in order to achieve efficient and cost-effective resin impregnation of liquid composite molding (LCM). Fabrics used in structural reinforcements are typically woven or stitched. However, 3D fabric reinforcement is of particular interest because of the versatility in the weaving pattern with the binder yarn and in-plain yarn arrangements to manufacture thick composite parts, overcome the limitation in delamination, improve toughness etc. To predict the permeability based on the available pore spaces between the inter yarn spaces, unit cell-based computational fluid dynamics models have been using the Stokes Darcy model. Typically, the preform consists of an arrangement of yarns with spacing in the order of mm, wherein each yarn consists of thousands of filaments with spacing in the order of μm. The fluid flow during infusion exchanges the mass between the intra and inter yarn channels, meaning there is no dead-end of flow between the mesopore in the inter yarn space and the micropore in the yarn. Several studies have employed the Brinkman equation to take into account the flow through dual-scale porosity reinforcement to estimate their permeability. Furthermore, to reduce the computational effort of dual scale flow, scale separation criteria based on the ratio between yarn permeability to the yarn spacing was also proposed to quantify the dual scale and negligible micro-scale flow regime for the prediction of mesoscale permeability. In the present work, the key parameter to identify the influence of intra yarn permeability on the mesoscale permeability has been investigated with the systematic study of weft and warp yarn spacing on the plane weave as well as the position of binder yarn and number of in-plane yarn layers on 3D weave fabric. The permeability tensor has been estimated using an OpenFOAM-based model for the various weave pattern with idealized geometry of yarn implemented using open-source software TexGen. Additionally, scale separation criterion has been established based on the various configuration of yarn permeability for the 3D fabric with both the isotropic and anisotropic yarn from Gebart’s model. It was observed that the variation of mesoscale permeability Kxx within 30% when the isotropic porous yarn is considered for a 3D fabric with binder yarn. Furthermore, the permeability model developed in this study will be used for multi-objective optimizations of the preform mesoscale geometry in terms of yarn spacing, binder pattern, and a number of layers with an aim to obtain improved permeability and reduced void content during the LCM process.

Keywords: permeability, 3D fabric, dual-scale flow, liquid composite molding

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Authors: Elizabeth O. Odewale, Sachithra T. Wanasinghe, Aaron S. Rury

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Cavity polaritons form when molecular excitons strongly couple to photons in carefully constructed optical cavities. These polaritons, which are hybrid light-matter states possessing a unique combination of photonic and excitonic properties, present the opportunity to manipulate the properties of various semiconductor materials. The systematic manipulation of materials through polariton formation could potentially improve the functionalities of many optoelectronic devices such as lasers, light-emitting diodes, photon-based quantum computers, and solar cells. However, the prospects of leveraging polariton formation for novel devices and device operation depend on more complete connections between the properties of molecular chromophores, and the hybrid light-matter states they form, which remains an outstanding scientific goal. Specifically, for most optoelectronic applications, it is paramount to understand how polariton formation affects the spectra of light absorbed by molecules coupled strongly to cavity photons. An essential feature of a polariton state is its dispersive energy, which occurs due to the enhanced spatial delocalization of the polaritons relative to bare molecules. To leverage the spatial delocalization of cavity polaritons, angle-resolved photoluminescence excitation spectroscopy was employed in characterizing light emission from the polaritonic states. Using lasers of appropriate energies, the polariton branches were resonantly excited to understand how molecular light absorption changes under different strong light-matter coupling conditions. Since an excited state has a finite lifetime, the photon absorbed by the polariton decays non-radiatively into lower-lying molecular states, from which radiative relaxation to the ground state occurs. The resulting fluorescence is collected across several angles of excitation incidence. By modeling the behavior of the light emission observed from the lower-lying molecular state and combining this result with the output of angle-resolved transmission measurements, inferences are drawn about how the behavior of molecules changes when they form polaritons. These results show how the intrinsic properties of molecules, such as the excitonic lifetime, affect the rate at which the polaritonic states relax. While it is true that the lifetime of the photon mediates the rate of relaxation in a cavity, the results from this study provide evidence that the lifetime of the molecular exciton also limits the rate of polariton relaxation.

Keywords: flourescece, molecules in cavityies, optical cavity, photoluminescence excitation, spectroscopy, strong coupling

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Authors: Shabnam Najafi, Metin Turkay

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Network design problem (NDP) is used to determine the set of optimal values for certain pre-specified decision variables such as capacity expansion of nodes and links by optimizing various system performance measures including safety, congestion, and accessibility. The designed transportation network should improve objective functions defined for the system by considering the route choice behaviors of network users at the same time. The NDP studies mostly investigated the random demand and route selection constraints separately due to computational challenges. In this work, we consider both random demand and route selection constraints simultaneously. This work presents a nonlinear stochastic model for land use and road network design problem to address the development of different functional zones in urban areas by considering both cost function and air pollution. This model minimizes cost function and air pollution simultaneously with random demand and stochastic route selection constraint that aims to optimize network performance via road capacity expansion. The Bureau of Public Roads (BPR) link impedance function is used to determine the travel time function in each link. We consider a city with origin and destination nodes which can be residential or employment or both. There are set of existing paths between origin-destination (O-D) pairs. Case of increasing employed population is analyzed to determine amount of roads and origin zones simultaneously. Minimizing travel and expansion cost of routes and origin zones in one side and minimizing CO emission in the other side is considered in this analysis at the same time. In this work demand between O-D pairs is random and also the network flow pattern is subject to stochastic user equilibrium, specifically logit route choice model. Considering both demand and route choice, random is more applicable to design urban network programs. Epsilon-constraint is one of the methods to solve both linear and nonlinear multi-objective problems. In this work epsilon-constraint method is used to solve the problem. The problem was solved by keeping first objective (cost function) as the objective function of the problem and second objective as a constraint that should be less than an epsilon, where epsilon is an upper bound of the emission function. The value of epsilon should change from the worst to the best value of the emission function to generate the family of solutions representing Pareto set. A numerical example with 2 origin zones and 2 destination zones and 7 links is solved by GAMS and the set of Pareto points is obtained. There are 15 efficient solutions. According to these solutions as cost function value increases, emission function value decreases and vice versa.

Keywords: epsilon-constraint, multi-objective, network design, stochastic

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Authors: Anna Ghosh, Dominic Shields, Ceri McIntosh, Stephen Crank

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A 29-year-old male was a referral to the maxillofacial unit following a referral from his general dental practitioner via a routine pathway regarding a large periapical lesion on the LR4 with root resorption. The patient was asymptomatic, the LR4 vital and unrestored, and this was an incidental finding at a routine check-up. The patient's past medical history was unremarkable. Examination revealed no extra or intra-oral pathology and non-mobile teeth. No focal neurology was detected. An orthopantogram demonstrated a well-defined unilocular corticated radiolucency associated with the LR4. The root appeared shortened with the radiolucency between the root and a radio-opacity, possibly representing the displacement of the apical tip of the tooth. It was recommended that the referring general practitioner should proceed with orthograde root canal therapy, after which time exploration, enucleation, and retrograde root filling of the LR4 would be carried out by a maxillofacial unit. The patient was reviewed six months later where, due to the COVID-19 pandemic, the patient had been unable to access general dental services for the root canal treatment. He was still entirely asymptomatic. A one-year review was planned in the hope this would allow time for the orthograde root canal therapy to be completed. At this review, the orthograde root canal therapy had still not been completed. Interestingly, a repeat orthopantogram revealed a significant reduction in size with good bony infill and a significant reduction in the size of the lesion. Due to the ongoing delays with primary care dental therapy, the patient was subsequently internally referred to the restorative dentistry department for care. The patient was seen again by oral and maxillo-facial surgery in mid-2022 where he still reports this tooth as asymptomatic with no focal neurology. The patient's history was fully reviewed, and noted that 15 years previously, the patient underwent open reduction and internal fixation of a left angle of mandible fracture. Temporary IMF involving IMF screws and fixation wires were employed to maintain occlusion during plating and subsequently removed post-operatively. It is proposed that the radiolucency was, as a result of the IMF screw placement, penetrating the LR4 root resulting in resorption of the tooth root and development of a radiolucency. This case highlights the importance of careful screw size and physical site location, and placement of IMF screws, as there can be permeant damage to a patient’s dentition.

Keywords: facial trauma, inter-maxillary fixation, mandibular radiolucency, oral and maxillo-facial surgery

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Authors: Gebreselassie Sebhatleab

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According to the Global Peace Index report (GPI, 2023), global peacefulness has deteriorated by more than 0.42%. Old and new conflicts, COVID-19, and political and cultural polarization are the main drivers of conflicts in the world. The 2022 was the deadliest year for armed conflict in the history of the GPI. In Ethiopia, over half a million people died in the Tigray war, which was the largest conflict death event since the 1994 Rwandan genocide. In total, 84 countries recorded an improvement, while 79 countries recorded a deterioration in peacefulness across the globe. The Russia-Ukraine war and its consequences were the main drivers of the deterioration in peacefulness globally. Both Russia and Ukraine are now ranked amongst the ten least peaceful countries, and Ukraine had the largest deterioration of any country in the 2023 GPI. In the same year, the global impact of violence on the economy was 17 percent, which was equivalent to 10.9% of global GDP. Besides, the brutal conflict in Tigray started in November. 2020 claimed more than half a million lives lost and displaced nearly 3 million people, along with widespread human rights violations and sexual violence has left deep damage on the population. The displaced people are still unable to return home because the western, southern and Eastern parts of Tigray are occupied by Eritrean and Amhara forces, despite the Pretoria Agreement. Currently, armed conflicts in Amhara in the Oromya regions are intensified, and human rights violations are being reported in both regions. Meanwhile, protests have been held by war-injured TDF members, IDPs and teachers in the Tigray region. Hence, the general objective of this project is to explore the challenges of peace-building processes in the border woredas of the Eastern Zone of the Tigray Region. Methodologically, the project will employ exploratory qualitative research designs to gather and analyze qualitative data. A purposive sampling technique will be applied to gather pertinent information from the key stakeholders. Open-ended interview questions will be prepared to gather relevant information about the challenges and perceptions of peacebuilding in the study area. Data will be analyzed using qualitative methods such as content analysis, narrative analysis and phenomenological analysis to deeply investigate the challenges of peace-building in the study woredas. Findings of this research project will be employed for program intervention to promote sustainable peace in the study area.

Keywords: peace building, conflcit and violence, political instability, insecurity

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Authors: Pinkey Yaqub

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The aim of this study was to investigate secondary (grades IX and X) students’ attitudes towards learning the English language based on the medium of instruction of the school, the gender of the students and the grade level in which they studied. A further aim was to determine students’ proficiency in the English language according to their gender, the grade level and the medium of instruction of the school. A survey was used to investigate the attitudes of secondary students towards English language learning. Simple random sampling was employed to obtain a representative sample of the target population for the research study as a comprehensive list of established English medium schools, and newly established English medium schools were available. A questionnaire ‘Attitude towards English Language Learning’ (AtELL) was adapted from a research study on Libyan secondary school students’ attitudes towards learning English language. AtELL was reviewed by experts (n=6) and later piloted on a representative sample of secondary students (n= 160). Subsequently, the questionnaire was modified - based on the reviewers’ feedback and lessons learnt during the piloting phase - and directly administered to students of grades 9 and 10 to gather information regarding their attitudes towards learning the English language. Data collection spanned a month and a half. As the data were not normally distributed, the researcher used Mann-Whitney tests to test the hypotheses formulated to investigate students’ attitudes towards learning English as well as proficiency in the language across the medium of instruction of the school, the gender of the students and the grade level of the respondents. Statistical analyses of the data showed that the students of established English medium schools exhibited a positive outlook towards English language learning in terms of the behavioural, cognitive and emotional aspects of attitude. A significant difference was observed in the attitudes of male and female students towards learning English where females showed a more positive attitude in terms of behavioural, cognitive and emotional aspects as compared to their male counterparts. Moreover, grade 10 students had a more positive attitude towards learning English language in terms of behavioural, cognitive and emotional aspects as compared to grade 9 students. Nonetheless, students of newly established English medium schools were more proficient in English as gauged by their examination scores in this subject as compared to their counterparts studying in established English medium schools. Moreover, female students were more proficient in English while students studying in grade 9 were less proficient in English than their seniors studying in grade 10. The findings of this research provide empirical evidence to future researchers wishing to explore the relationship between attitudes towards learning language and variables such as the medium of instruction of the school, gender and the grade level of the students. Furthermore, policymakers might revisit the English curriculum to formulate specific guidelines that promote a positive and gender-balanced outlook towards learning English for male and female students.

Keywords: attitude, behavioral aspect of attitude, cognitive aspect of attitude, emotional aspect of attitude

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Authors: Wisam Ismail, Chole Wright, Elizabeth Baker, Cathy Tait, Mohamed Salhab, Richard Linforth

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Background: Post-mastectomy breast reconstruction is an important treatment option for women with breast cancer with psychosocial, emotional and quality of life benefits. Despite this, Asian patients are one-fifth as likely as Caucasian patients to undergo reconstruction after mastectomy. Aim: This study aimed to assess the difference in breast reconstruction rates between Asian and Caucasian patients treated at Bradford Teaching Hospitals between May 2011 – December 2015.The long-term goal is to equip healthcare professionals to improve breast cancer treatment outcome by increasing breast reconstruction rates in this sub-population. Methods: All patients undergoing mastectomy were identified using a prospectively collected departmental database. Further data was obtained via retrospective electronic case note review. Bradford city population is about 530.000 by the end of 2015, with 67.44% of the city's population was White ethnic groups and 26.83% Asian Ethnic Groups (UK population consensus). The majority of Asian population speaks Urdu, hence an Urdu speaking breast care nurse was appointed to facilitate communications and deliver a better understanding of the reconstruction options and pathways. Statistical analysis was undertaken using the SAS program. Patients were stratified by age, self-reported ethnicity, axillary surgery and reconstruction. Relative odds were calculated using univariate and multivariate logistic regression analyses with adjustment for known confounders. An Urdu speaking breast care nurse was employed throughout this period to facilitate communication and patient decision making. Results: 506 patients underwent Mastectomy over 5 years. 72 (14%) Asian v. 434 (85%) Caucasian. Overall median age is 64 years (SD1.1). Asian median age is 62 (SD0.9), versus Caucasian 65 (SD1.2). Total axillary clearance rate was 30% (42% Asian v.30% Caucasian). Overall reconstruction rate was 126 patients (28.9%).Only 6 of 72 Asian patients (<1%) underwent breast reconstruction versus 121of 434 Caucasian (28%) (p < 0.04), Odds ratio 0.68, (95% confidence interval 0.57-0.79). Conclusions: There is a significant difference in post-mastectomy reconstruction rates between Asian and Caucasian patients. This difference is likely to be multi-factorial. Higher rates of axillary clearance in Asian patients might suggest later disease presentation and/or higher rates of subsequent adjuvant therapy, both of which, can impact on the suitability of breast reconstruction. Strategies aimed at reducing racial disparities in breast reconstruction should include symptom awareness to enable earlier presentation and facilitated communication to ensure informed decision-making.

Keywords: aesthetic, Asian, breast, reconstruction

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Authors: Lennart Dimberg, Lala Joulha Ian

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Introduction: Overweight (BMI 25-30) and obesity (BMI 30+) have consistently been associated with cardiovascular (CV) risk and death since the Framingham heart study in 1948, and BMI was included in the original Framingham risk score (FRS). Background: Myocardial infarction (MI) poses a serious threat to the patient's life. In addition to BMI, several other indices of overweight have been presented and argued to replace FRS as more relevant measures of CV risk. These indices include waist circumference (WC), waist/hip ratio (WHR), sagittal abdominal diameter (SAD), and sagittal abdominal diameter to height (SADHtR). Specific research question: The research question of this study is to evaluate the interrelationship between the various body measurements, BMI, WC, WHR, SAD, and SADHtR, and which measurement is strongly associated with MI and death. Methods: In 1993, 1,000 middle-aged Caucasian, randomly selected working men of the Swedish Volvo-Renault cohort were surveyed at a nurse-led health examination with a questionnaire, EKG, laboratory tests, blood pressure, height, weight, waist, and sagittal abdominal diameter measurements. Outcome data of myocardial infarction over 28 years come from Swedeheart (the Swedish national myocardial infarction registry) and the Swedish death registry. The Aalen-Johansen and Kaplan–Meier methods were used to estimate the cumulative incidences of MI and death. Multiple logistic regression analyses were conducted to compare BMI with the other four body measurements. The risk for the various measures of obesity was calculated with outcomes of accumulated first-time myocardial infarction and death as odds ratios (OR) in quartiles. The ORs between the 4th and the 1st quartile of each measure were calculated to estimate the association between the body measurement variables and the probability of cumulative incidences of myocardial infarction (MI) over time. Double-sided P values below 0.05 will be considered statistically significant. Unadjusted odds ratios were calculated for obesity indicators, MI, and death. Adjustments for age, diabetes, SBP, and the ratio of total cholesterol/HDL-C and blue/white collar status were performed. Results: Out of 1000 people, 959 subjects had full information about the five different body measurements. Of those, 90 participants had a first MI, and 194 persons died. The study showed that there was a high and significant correlation between the five different body measurements, and they were all associated with CVD risk factors. All body measurements were significantly associated with MI, with the highest (OR=3.6) seen for SADHtR and WC. After adjustment, all but SADHtR remained significant with weaker ORs. As for all-cause mortality, WHR (OR=1.7), SAD (OR=1.9), and SADHtR (OR=1.6) were significantly associated, but not WC and BMI. However, after adjustment, only WHR and SAD were significantly associated with death, but with attenuated ORs.

Keywords: BMI, death, epidemiology, myocardial infarction, risk factor, sagittal abdominal diameter, sagittal abdominal diameter to height, waist circumference, waist-hip ratio

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Authors: Shyamani Hettiarachchi, Gopi Kitnasamy

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Background: The potentially high level of physical need and dependency experienced by children with cerebral palsy could affect the quality of life (QOL) of the child, the caregiver and his/her family. Poor QOL in children with cerebral palsy is associated with the parent-child relationship, limited opportunities for social participation, limited access to healthcare services, psychological well-being and the child's physical functioning. Given that children experiencing disabilities have little access to remedial support with an inequitable service across districts in Sri Lanka, and given the impact of culture and societal stigma, there may be differing viewpoints across respondents. Objectives: The aim of this study was to evaluate the psychometric properties of the Tamil version of the Cerebral Palsy Quality of Life for Children (CPQOL-Child) Questionnaire. Design: An instrument development and validation study. Methods: Forward and backward translations of the CPQOL-Child were undertaken by a team comprised of a physiotherapist, speech and language therapist and two linguists for the primary caregiver form and the child self-report form. As part of a pilot phase, the Tamil version of the CPQOL was completed by 45 primary caregivers with children with cerebral palsy and 15 children with cerebral palsy (GMFCS level 3-4). In addition, the primary caregivers commented on the process of filling in the questionnaire. The psychometric properties of test-retest reliability, internal consistency and construct validity were undertaken. Results: The test-retest reliability and internal consistency were high. A significant association (p < 0.001) was found between limited motor skills and poor QOL. The Cronbach's alpha for the whole questionnaire was at 0.95.Similarities and divergences were found between the two groups of respondents. The child respondents identified limited motor skills as associated with physical well-being and autonomy. Akin to this, the primary caregivers associated the severity of motor function with limitations of physical well-being and autonomy. The trend observed was that QOL was not related to the level of impairment but connected to environmental factors by the child respondents. In addition to this, the main concern among primary caregivers about the child's future and on the child's lack of independence was not fully captured by the QOL questionnaire employed. Conclusions: Although the initial results of the CPQOL questionnaire show high test-retest reliability and internal consistency of the instrument, it does not fully reflect the socio-cultural realities and primary concerns of the caregivers. The current findings highlight the need to take child and caregiver perceptions of QOL into account in clinical practice and research. It strongly indicates the need for culture-specific measures of QOL.

Keywords: cerebral palsy, CPQOL, culture, quality of life

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Authors: Patcharaporn Sakulpong, Wiriya Phokhwang

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Background: Banpunrug (Love Sharing House) established in 2013 provides a community-based palliative care for patients with cancer from 7 provinces in southern Thailand. These patients come to receive outpatient chemotherapy and radiotherapy at Suratthani Cancer Hospital. They are poor and uneducated; they need an accommodation during their 30-45 day course of therapy. Methods: A community-participatory action research (PAR) was employed to establish a model of palliative care for patients with cancer. The participants included health care providers, community, and patients and families. The PAR process includes problem identification and need assessment, community and team establishment, field survey, organization founding, model of care planning, action and inquiry (PDCA), outcome evaluation, and model distribution. Results: The model of care at Banpunrug involves the concepts of HHHS model, in that Banpunrug is a Home for patients; patients live in a house comfortable like in a Hotel resource; the patients are given care and living facilities similarly to those in a Hospital; the house is a School for patients to learn how to take care themselves, how to live well with cancer, and most importantly how to prepare themselves for a good death. The house is also a humanized care school for health care providers. Banpunrug’s philosophy of care is based on friendship therapy, social and spiritual support, community partnership, patient-family centeredness, Live & Love sharing house, and holistic and humanized care. With this philosophy, the house is managed as a home of the patients and everyone involved; everything is costless for all eligible patients and their family members; all facilities and living expense are donated from benevolent people, friends, and community. Everyone, including patients and family, has a sense of belonging to the house and there is no authority between health care providers and the patients in the house. The house is situated in a temple and a community and supported by many local nonprofit organizations and healthcare facilities such as a health promotion hospital at sub-disctrict level and Suratthani Cancer Hospital. Village health volunteers and multi-professional health care volunteers have contributed not only appropriate care, but also knowledge and experience to develop a distinguishing HHHS community-based palliative care model for patients with cancer. Since its opening the house has been a home for more than 400 patients and 300 family members. It is also a model for many national and international healthcare organizations and providers, who come to visit and learn about palliative care in and by community. Conclusions: The success of this palliative care model comes from community involvement, multi-professional volunteers and distributions, and concepts of HHHS model. Banpunrug promotes a consistent care across the cancer trajectory independent of prognosis in order to strengthen a full integration of palliative

Keywords: community-based palliative care, model, participatory action research, patients with cancer

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Authors: Qing Wu, Xuchun Ye, Kirsten Corazzini

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Objective: It is increasingly recognized that patients’ rational and meaningful engagement in healthcare could make important contributions to their health care and safety management. However, recent evidence indicated that patients' actual roles in healthcare didn’t match their desired roles, and many patients reported a less active role than desired, which suggested that patient engagement in healthcare may be influenced by various factors. This study aimed to analyze influencing factors on patient engagement and explore the influence mechanism, which will be expected to contribute to the strategy development of patient engagement in healthcare. Methods: On the basis of analyzing the literature and theory study, the research framework was developed. According to the research framework, a cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale, Facilitation of Patient Involvement Scale and Wake Forest Physician Trust Scale, and other influencing factor related scales. A convenience sample of 580 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province, and Zhejiang Province. Results: The results of the cross-sectional survey indicated that the mean score for the patient engagement behavior was (4.146 ± 0.496), and the mean score for the willingness was (4.387 ± 0.459). The level of patient engagement behavior was inferior to their willingness to be involved in healthcare (t = 14.928, P ＜ 0.01). The influencing mechanism model of patient engagement in healthcare was constructed by the path analysis. The path analysis revealed that patient attitude toward engagement, patients’ perception of facilitation of patient engagement and health literacy played direct prediction on the patients’ willingness of engagement, and standard estimated values of path coefficient were 0.341, 0.199, 0.291, respectively. Patients’ trust in physician and the willingness of engagement played direct prediction on the patient engagement, and standard estimated values of path coefficient were 0.211, 0.641, respectively. Patient attitude toward engagement, patients’ perception of facilitation and health literacy played indirect prediction on patient engagement, and standard estimated values of path coefficient were 0.219, 0.128, 0.187, respectively. Conclusions: Patients engagement behavior did not match their willingness to be involved in healthcare. The influencing mechanism model of patient engagement in healthcare was constructed. Patient attitude toward engagement, patients’ perception of facilitation of engagement and health literacy posed indirect positive influence on patient engagement through the patients’ willingness of engagement. Patients’ trust in physician and the willingness of engagement had direct positive influence on the patient engagement. Patient attitude toward engagement, patients’ perception of physician facilitation of engagement and health literacy were the factors influencing the patients’ willingness of engagement. The results of this study provided valuable evidence on guiding the development of strategies for promoting patient rational and meaningful engagement in healthcare.

Keywords: healthcare, patient engagement, influencing factor, the mechanism

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Authors: Bill Wang, Paul Childerhouse, Yuanfei Kang

Abstract:

Purpose: The research is to extend resource orchestration theory (ROT) into supply chain management (SCM) area to investigate the dyadic relationships at both individual and organizational levels in supply chain integration (SCI). Also, we try to explore the interaction mechanism between inter-personal relationships (IPRs) and inter-organizational (IORs) during the whole SCI process. Methodology/approach: The research employed an exploratory multiple case study approach of four New Zealand companies. The data was collected via semi-structured interviews with top, middle, and lower level managers and operators from different departments of both suppliers and customers triangulated with company archival data. Findings: The research highlights the important role of both IPRs and IORs in the whole SCI process. Both IPRs and IORs are valuable, inimitable resources but IORs are formal and exterior while IPRs are informal and subordinated. In the initial stage of SCI process, IPRs are seen as key resources antecedents to IOR building while three IPRs dimensions work differently: personal credibility acts as an icebreaker to strengthen the confidence forming IORs, and personal affection acts as a gatekeeper, whilst personal communication expedites the IORs process. In the maintenance and development stage, IORs and IPRs interact each other continuously: good interaction between IPRs and IORs can facilitate SCI process while the bad interaction between IPRs can damage the SCI process. On the other hand, during the life-cycle of SCI process, IPRs can facilitate the formation, development of IORs while IORs development can cultivate the ties of IPRs. Out of the three dimensions of IPRs, Personal communication plays a more important role to develop IORs than personal credibility and personal affection. Originality/value: This research contributes to ROT in supply chain management literature by highlighting the interaction of IPRs and IORs in SCI. The intangible resources and capabilities of three dimensions of IPRs need to be orchestrated and nurtured to achieve efficient and effective IORs in SCI. Also, IPRs and IORs need to be orchestrated in terms of breadth, depth, and life-cycle of whole SCI process. Our study provides further insight into the rarely explored inter-personal level of SCI. Managerial implications: Our research provides top management with further evidence of the significance roles of IPRs at different levels when working with trading partners. This highlights the need to actively manage and develop these soft IPRs skills as an intangible competitive resource. Further, the research identifies when staff with specific skills and connections should be utilized during the different stages of building and maintaining inter-organizational ties. More importantly, top management needs to orchestrate and balance the resources of IPRs and IORs.

Keywords: case study, inter-organizational relationships, inter-personal relationships, resource orchestration, supply chain integration

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Authors: Yongrong Liu, Xin Tang

Abstract:

Background: Persistent atrial fibrillation is a common arrhythmia closely related to heart failure. Heart rate control is an essential strategy for treating persistent atrial fibrillation. Still, the understanding of the relationship between different heart rate control levels and the risk of heart failure rehospitalization is limited. Objective: The objective of the study is to determine the relationship between different levels of heart rate control in patients with persistent atrial fibrillation and the risk of readmission for heart failure. Methods: We conducted a retrospective dual-centre cohort study, collecting data from patients with persistent atrial fibrillation who received outpatient treatment at two tertiary hospitals in central and western China from March 2019 to March 2020. The collected data included age, gender, body mass index (BMI), medical history, and hospitalization frequency due to heart failure. Patients were divided into three groups based on their heart rate control levels: Group I with a resting heart rate of less than 80 beats per minute, Group II with a resting heart rate between 80 and 100 beats per minute, and Group III with a resting heart rate greater than 100 beats per minute. The readmission rates due to heart failure within one year after discharge were statistically analyzed using propensity score matching in a 1:1 ratio. Differences in readmission rates among the different groups were compared using one-way ANOVA. The impact of varying levels of heart rate control on the risk of readmission for heart failure was assessed using the Cox proportional hazards model. Binary logistic regression analysis was employed to control for potential confounding factors. Results: We enrolled a total of 1136 patients with persistent atrial fibrillation. The results of the one-way ANOVA showed that there were differences in readmission rates among groups exposed to different levels of heart rate control. The readmission rates due to heart failure for each group were as follows: Group I (n=432): 31 (7.17%); Group II (n=387): 11.11%; Group III (n=317): 90 (28.50%) (F=54.3, P<0.001). After performing 1:1 propensity score matching for the different groups, 223 pairs were obtained. Analysis using the Cox proportional hazards model showed that compared to Group I, the risk of readmission for Group II was 1.372 (95% CI: 1.125-1.682, P<0.001), and for Group III was 2.053 (95% CI: 1.006-5.437, P<0.001). Furthermore, binary logistic regression analysis, including variables such as digoxin, hypertension, smoking, coronary heart disease, and chronic obstructive pulmonary disease as independent variables, revealed that coronary heart disease and COPD also had a significant impact on readmission due to heart failure (p<0.001). Conclusion: The correlation between the heart rate control level of patients with persistent atrial fibrillation and the risk of heart failure rehospitalization is positive. Reasonable heart rate control may significantly reduce the risk of heart failure rehospitalization.

Keywords: heart rate control levels, heart failure rehospitalization, persistent atrial fibrillation, retrospective cohort study

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Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

Abstract:

In a disaster event, sharing patient information between the pre-hospitals Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre-EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors which are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality and the data were analysed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system which can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analysed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospitals staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: communication, emergency communication services, emergency medical teams, emergency physicians, emergency nursing, paramedics, information and communication technology, communication systems

Procedia PDF Downloads 85